“The structure of a therapeutic community, with its community meetings, diverse
network of relationships, supportive peer group, strong sense of belonging, means
that a strong therapeutic attachment can be forged – an attachment that can
withstand high levels of aggression and risk.”13
But the basic complication of such a residential community method whereby a more
specialist architectural design is needed, with facilities to accommodate usually 40-
80 individuals, has been the cost. Financial limitations have meant, in cases, that an
ideal period of up to 2 years rehabilitation often had to be sliced in half or at worst,
the residential model of community design treatment, abandoned altogether for
cheaper alternatives. The drop-out rate or lack of motivation to join can also become
a problem and to this end, more recently, those involved in therapeutic communities
have conducted extensive research in order to establish why many addicts often lack
the determination to carry on with the programme. What has been established is
that stronger family connections are, the more likely an individual is to make a
positive decision and remain with the programme in the longer-term. What might
also influence addicts to become members of a therapeutic community and stay for
the duration or at least a long period of time, are improved job opportunities
through skills attainment, as well as fear of getting entangled with the law once
again. According to many documented responses by addicts themselves even a
limited time at a residential drug-free community, can go a long way.
“…I left early (but) what happened to me was I felt the power gained from having
peers who were all experiencing the same issues with addiction as me… I am taking
baby steps in life. But baby steps or not they are still steps”.14
Ultimately, the level of self-esteem stemming both from the addicts support system
as well as his own vocational and educational past, determines to a great extent
whether he decides to go ahead and fully join the programme and more so, whether
he has the psychological strength to continue with it. It can be said, in addition, that
effectiveness, does also depend from the way professionals structure the community
programme and whether they can retain trust.
1.3 (i) The fundamental components and basic structure of Therapeutic
Communities
Therapeutic communities, drug-free residential settings are primarily of a humanistic
philosophy in which the member gradually develops social group responsibility and a
sense of personal growth through structured activities but also the opportunity of
more creative expression such as theatre therapy, art, photography and prose
writing that bring out untold emotions and help the resident through this active self-help process, become aware of their problems and finally come to terms with what
brought them to that situation. The member is forced to become part of their future,
by developing on a daily basis individually and with the group, having a daily routine,
starting at seven in the morning, sharing and having a common target, feeling
responsible also through the choice of employment that can be provided at the
facility. For example many communities make their own furniture. Work is a means
of strengthening the sense of community and developing the communication and
interpersonal tools needed.
“…the therapeutic community movement holds a multidisciplinary view of health
which is based on ideas of collective responsibility, citizenship and empowerment”.15
The therapeutic community is usually at a distance from city centers where drugs are
much more accessible, (but not too far from the reminder of daily life-the sports
facilities of the Groot Klimmendaal rehabilitation centre in the Netherlands are also
used by the general public as a means for residents to feel social proximity) and close
to the positive influence of nature. Funding also determines the location of
therapeutic communities. The ultimate aim is for these residences to become a
microcosm of real life, a placebo of a social situation, whereby conditions proceed
pretty similarly to a societal motif-providing solutions to situations that might come
up through activities or assigned work, planning a schedule, following necessary
rules, having control over your life as well as realizing that the way one conducts
themselves must be respectful to the group. Individual and group therapy sessions
are conducted daily, lasting more than an hour and offering the opportunity of
openly expressing emotions.
“Problems and their solutions are discussed in the community before action is taken.
The discussion is regarded as a learning opportunity