Therapeutic community

The therapeutic community (TC) for the treatment of drug abuse and addiction has existed for about 40 years in the United States. In general, TCs are drug-free residential environments that use a hierarchical model with stages of treatment that reflect increasing levels of personal and social responsibility. Peer influence, mediated through a variety of group processes, is used to help each person learn and assimilate social norms and develop more effective social skills.

TCs differ from other treatment approaches primarily in their use of the community, made up of treatment staff and those in recovery, as key change agents. This approach is often referred to as 'community as method'. TC members interact in structured and unstructured ways to influence attitudes, perceptions, and behaviors associated with drug use.

Many of those admitted to TCs have a history of social functioning, educational/vocational skills, and positive community and family ties that have been weakened by their drug abuse. For them, recovery involves rehabilitation, that is, relearning or restoring healthy functioning, skills and values, as well as rescuing physical and emotional health. Other TC residents never had functional lifestyles. For them, TC is usually the first time they are exposed to an orderly life. In his case, recovery involves empowerment, that is, learning for the first time the behavioral skills, attitudes, and values associated with living in a society.

In addition to the importance of the community as the primary agent of change, a second fundamental principle of TC is "self-help". Self-help implies that the people in treatment are the main contributors to the change process. The "mutual self-help" it means that people also take partial responsibility for the recovery of their partners, an important aspect of the person's own treatment.