A Therapeutic Community is a positive group environment where people who have similar problems live and work together to better their lives. Therapeutic Communities, commonly called TCs, are distinguished from other treatment approaches in that the purposeful use of the treatment community is the primary method for bringing about needed changes in the individual client.
TCs were introduced in the United Kingdom for the treatment of mental illness and drug addiction in the 1940s. TCs have been in existence in the United States since the late 1960s and are commonly located within correctional institutions.
The Treatment Team in the Men’s Residential Treatment program is comprised of staff, interns and volunteers who serve in a variety of roles, described below.
Master’s-level interns provide individual, group and family therapy to clients. In the course of a day, members of the Treatment Team routinely talk with clients about their issues, progress and plans. Individual and family therapy take place in longer, scheduled and private therapy sessions. A Motivational Interviewing style brings out in the client the desire and skills needed to make and sustain changes.
Members of the Treatment Team guide clients through self-discovery and change. Treatment Team members insure that clients receive the experiences necessary to understand and incorporate the principles and values of “Right Living” into their everyday lives.
Members of the Treatment Team assure the physical and psychological safety of the Therapeutic Community by empowering each client to sustain the self-help process. The Team elicits client input in the disciplinary process but is ultimately responsible for implementing all disciplinary actions (sanctions, loss of privileges, bans, etc.).
The Treatment Team demonstrates for clients rationality and appropriate use of authority. Team members provide explicit reasons for clinical and disciplinary actions. Decision-making must be grounded and explained in terms of the Therapeutic Community perspective (the disorder, the person, recovery and Right Living). How staff delivers the decision is as important as the decision itself.
Treatment Team members are not friends with clients but skilled professionals who model appropriate boundaries and behaviors.
Clients are viewed as experts on their addiction. They are capable of changing and of helping others to change. Clients accomplish this by serving in a variety of roles, described below.
Clients continually reverse roles as counselor and counselee. In this way, they benefit from the mutual helping process. Clients with more time or experience in recovery or those who have overcome difficult situations offer their strength and hope to others.
Clients serve as coordinators, expeditors and crew leaders. They are expected to supervise and manage the work of fellow clients, to confront negative behaviors and attitudes, and to report breaches to the Treatment Team.
Clients may tutor each other in reading and writing, math, computers and cooking. All clients are alternately students and tutors and are continually engaged in learning.
Seasoned clients have the opportunity to serve as Big Brothers to new clients. The Big Brother helps his Little Brother to settle into the Therapeutic Community and work toward growth. As in healthy families, the Big Brother watches out for the Little Brother and teaches care and concern for one another and their other Brothers in the community.
Clients act as role models when they demonstrate the principles of recovery and Right Living. Those earning an honest living, attending school or supporting a family show fellow clients that success is possible despite frustrations and setbacks.