Drug addiction is a complex disease that affects every aspect of a person’s life, and continuous, life-long care is needed in order for that person to be able to maintain success in sobriety. Thankfully, a wide range of treatment options and support services are available to those struggling with addiction, with Therapeutic Communities (TC) being one of those options.
But are TC’s effective in helping a person treat addiction and, ultimately, stay sober? Let’s talk about it.
Been There, Done That
I actually have first-hand knowledge on the subject of therapeutic communities. While I was serving my four-year prison sentence for a DUI Serious Bodily Injury conviction in the Florida state prison system, I became eligible (due to good behavior and the nature of my crime) to serve the remainder of my sentence in a substance abuse program.
With 19 months left to go, I was shipped to an unfenced work-release facility located in the center of a busy community – an environment that was completely opposite of what I’d become accustomed to as an inmate living in general population.
My new home was one that embraced a therapeutic community-based lifestyle. Instead of spending most of my time at the rec yard with thousands of other women, my days were spent in classrooms with hours of addiction counseling, self-betterment classes, and AA meetings – all on very little sleep.
Needless to say, it was grueling at times, but life in a TC yielded benefits not only for me, but for those around me.
What Are Therapeutic Communities Exactly?
Therapeutic communities are a common form of long-term residential treatment, and they have been defined by The Scientific World Journal as “drug-free environments in which people with addictive problems live together in an organized and structured way to promote change toward recovery and reinsertion in society.”
TC’s take a holistic approach towards the treatment of addiction, as they view addiction as a disorder of the entire person. Not only does it affect cognition and behavior, but they believe it affects interpersonal relations and values, as well.
Therapeutic communities stress the importance of responsibility, accountability, structure, participation, and education – all by focusing on the community as the main method of treatment. When I lived in a TC, there were about 100 women living together in our “community.” Everyone in the program was required to be an active participant, and that meant that we all took responsibility for our own recovery, as well as for the recovery of others. This taught us to stay accountable for our choices. The community aspect also forced those out of isolation who had the tendency to do so, and it enabled everyone in the program to form solid connections with one another.
Therapeutic communities are highly structured, and everyone’s daily regimen is strictly regulated with clearly stated expectations for behavior. Rewards (such as praise and increased leadership status within the community) are given to those who consistently follow the rules and meet expectations, while disciplinary sanctions (such as loss of amenities, like phone calls or visitation hours) are issued when rules are violated. This helps to maintain structure for everyone in the community and ensure that daily lives are kept orderly and productive.
When I was living in a TC, my daily life was scheduled down to the minute. My routine included morning and evening house meetings, group therapy, and individual counseling sessions. We also were required to attend a variety of group classes, such as Budgeting, Criminal Thinking, and Anger Management, which helped with educational and coping skills that we could apply when re-entering society.
Another important aspect of the TC was being assigned a job to perform each day. This could be anything from teaching GED classes to those women in the program who hadn’t yet completed high school to working in the kitchen and preparing the community’s meals. Having a job that we had to regularly show up for taught responsibility, as well as the importance of hard work and self-reliance.
Experts Ask: Are Therapeutic Communities Effective?
A 2013 article published in The Scientific World Journal tackled this very subject. It undertook a comprehensive systematic review of a variety of past controlled studies that had evaluated the effectiveness of TC’s as compared with other viable recovery methods. In addition, it specifically focused on various indicators related with recovery, such as substance use, criminal involvement, employment, psychological well-being, and family and social relations.
Based on their findings, the authors concluded that TC treatment has generated beneficial outcomes in diverse treatment settings. They also have particularly strong effects among “severely addicted” individuals, including those who are incarcerated, homeless, or mentally ill.
The article also acknowledges the importance of the length of treatment, as those who participate in treatment programs for a longer duration generally have better outcomes than those in treatment for shorter periods. Treatment in TC’s usually lasts up to 12 months, but due to the longer treatment duration, there is a higher possibility that participants leave the program prematurely.
Ultimately, the article concluded that TC’s can be regarded as a valuable alternative for those who are severely addicted and those who don’t respond well to outpatient treatment. They also recognized TC’s as supportive places for addicted individuals to learn the behavioral skills, attitudes, and values associated with being a healthy and functioning adult.
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How Do I Feel About TC’s?
Based on my personal experience, the time I spent in a TC was well-spent. Even though I didn’t love the highly structured and regulated aspect of it, I learned a lot about myself while I was in the program and I took the time to really focus on self-betterment.
Most importantly, though, the greatest impact of living in a TC was the women I met in the program. Despite coming from completely different backgrounds, we ended up having much more in common that I initially thought. We bonded through the incarceration struggles we’d all endured, and we formed strong connections through the rigorous substance abuse program we completed – one that required us all to be completely open, honest, and vulnerable.
As a result, the nature of this treatment program led me to create long-lasting friendships that I still have to this day, almost 10 years later.
If you or someone you love is experiencing a substance use disorder, help is available. Call 800-661-1690 (Who Answers?) today to speak with a treatment specialist.