Treatment for Addiction

This book offers a framework for the treatment of addicts and the problems associated with addiction based upon the therapeutic community or TC model. The emphasis in this treatment modality is on peer influence helping the addict learn and assimilate social norms and through the dynamics created in group settings to encourage the development of more effective social skills. "Individuals are taught to use the peer community to learn about themselves." (1)

I found this approach refreshing in that it is based upon the principle that the individuals in treatment are the main contributors to the change process when they take a measure of responsibility for the recovery of their fellow residents. In my opinion this contributes positively to the individual's own recovery and lends itself well to the proven recovery maxim that "I alone can do it but I can't do it alone." The image of an established resident in the TC offering advice and encouragement to the newcomer is striking to me because it imparts a feeling of coming home and a sense of family.

The words "family", "big brother", and "big sister" are frequently used within the TC as a reminder of the care and concern each resident should have for one another. This type of atmosphere appeals to many addicts, including myself, who were raised in predominantly dysfunctional families or who have had their family relationships erode because of substance abuse.

By becoming the resident's family surrogate the TC is able to provide features inherent to a "good" family: order in daily living through a structured environment; psychological and physical safety through an atmosphere of nurturance; and a sense of belonging through acceptance and encouragement. "Thus, the terms family and community become interchangeable in the TC." (2)

This underscores the TC philosophy of every resident being an integral part of the whole. Just as within a healthy family structure members are expected to contribute to the family's shared goals. Central to the goals of the TC family is the creation of an environment that teaches, heals, supports, and guides through community.

Within this framework the TC approaches substance abuse as a disorder of the whole person. The problem is not the drug but the person. I think this approach is conducive to lasting change because it focuses on behavior, attitude, values, and lifestyle rather than on the choice of drugs or patterns of use. Close attention is given to the uniqueness of each person's life journey and the particulars of the path that led them to the TC.