What is the Therapeutic Community model?
The TC model is a method of treating substance abuse. It’s unique because it incorporates the 12 Steps of AA/NA with social learning, teaching participants how to work through their substance abuse issues, in conjunction with inner and social difficulties which can contribute to their addiction. Many times, the TC model is carried out within a residential treatment facility where residents participate in group therapy and regular daily activities together. A strong and tightly-knit community and social support system is intrinsic to the Therapeutic Community model.
What does the TC model consist of?
Therapeutic Community incorporates many crucial tools into its model in order to be as effective as possible in helping people to recover from addiction.
- The 14 Competencies.
The Therapeutic Community includes 14 competencies, which all residents are expected to learn before the completion of their treatment. These competencies cover 4 significant areas: community membership, socialization, personal psychology, and personal development. Each category contains specific attitudes, behaviors and skills that are expected to evolve over the course of their treatment. Through hard work, all members of the community will grasp these concepts and begin to work on areas in need of growth. The overall goal of the 14 Competencies of the TC is to strengthen our residents’ skills in each of the competency fields. Once an individual reaches stability within each of these areas, they’re often ready to move on to the next stage in their treatment – aftercare, or outpatient treatment – which is the last step before becoming completely autonomous in their recovery. With these new skills and strengths in hand, they are very much more likely to have success in reaching long-term sobriety.
Besides the 14 competencies, which describe the overall goal of treatment and outline the work that should be accomplished through their treatment, Therapeutic Community relies heavily on the community, which supports each individual through their recovery. The TC model believes that there is therapeutic value in community itself, and that a strong community bond is essential to recovering from addiction. Not only does the community provide support to each other, but individuals also help each other to identify problem areas, or areas in need of growth, which can be presented to a peer member in the form of constructive criticism, commonly known as “pull-ups.” Individuals also work to mentor one another through role-modeling and peer mentoring as they successfully move through their treatment. Each individual plays a crucial role in the recovery of the community as a whole, and therefore each individual faces much pressure to succeed and work hard on their own, as well as with each other. As a result of the common residential-style setting in therapeutic communities, the Therapeutic Community also provides a safe environment for individuals to partake in social learning, which teaches them crucial skills regarding relationships with others. These skills will undoubtedly benefit them in and outside of the community, and will contribute greatly to their ability to remain sober outside of treatment.
Each individual in the community is expected to take accountability for their actions. When confronted by a peer member about an inappropriate behavior, individuals are expected to accept the constructive criticism and thank the peer member for bringing it to their attention. The individual is then expected to put a sincere effort into changing those negative behaviors. One of the main goals of treatment is to put an end to negative behaviors which feed into individuals’ addictions. If all measures have been exhausted to get an individual on track in their recovery, and the individual continually slips up, doesn’t take accountability, and doesn’t take measures to change their behavior, the community may decide it’s best for the individual to leave until they’re truly ready to recover. Recovery means positive change, and change can only come through recognizing problems – not just in the addiction, but also in the behaviors that fuel it. Trying to avoid accountability can be normal in the beginning, but as it’s an integral part of the recovery process, individuals are expected to move past this barrier as they settle into treatment and come to understand what’s expected of them. The TC can help people to move past barriers like these as long as they are willing.
Using the TC model, it’s important to consider that each individual contributes to others’ recovery, and if an individual is not ready or committed to recovering, it can be toxic for others, hindering the entire community’s growth and recovery. The TC provides a safe space to make mistakes, which will inevitably happen in early recovery, and also teaches individuals how to work through and learn from them. At the same time, it provides a space for individuals to learn the importance of taking accountability for their actions, and how to do it in the first place. It’s okay for residents to slip up and have rough patches, but the Therapeutic Community can only consist of individuals who are willing and ready to put work into getting better.
Often within TCs, something called “organizational structure” is put into place, which assigns duties/responsibilities to individuals in treatment. Duties are divided into departments and individuals can be given leadership roles based on what would be most beneficial to their treatment. Sometimes individuals are given these leadership roles to reward progress made in their recovery; other times they can be given to push an individual to take responsibility in their given role, and in turn, in their treatment. Many therapists, including ours at Liberty Bay, are great at gauging what would be most beneficial to individuals’ treatment, and the organizational structure is an amazing, versatile tool which can be incredibly useful in recovery. If individuals excel in their given role and show a true display of responsibility and drive, it may be rewarded by privileges that the therapists approve (e.g., extra money for shopping, a trip to the gym). Of course, these privileges are given on an individual basis and are processed by the therapists.
There are many benefits to this practice. First, having the chance to move up the ladder can spark a sense of purpose and motivation in individuals, which may not have been reachable for them before. Second, individuals are able to observe others and learn from their peers – before deciding on their behavior, they’re able to observe what the outcomes could be, helping them to make the best choice. Third, the reward system encourages individuals to work and do the right thing – positive reinforcement often leaves individuals feeling fulfilled with their decision making, as it’s been rewarded and recognized, and they’ve been able to reap the benefits of their work, both personally and through their reward. Finally, the responsibilities often hold inherent value in the skills associated with them, such as cooking from the kitchen department, or job skills through the procurement department or household maintenance through the household operations department. All aspects of this practice hold value for all individuals involved in the Therapeutic Community, and it’s a crucial aspect of the TC model.
Why use the Therapeutic Community model?
The Therapeutic Community model has proven to be effective in treating addiction and persistent mental health issues. Its core values center around the value of community, the correction of negative behaviors/thought processes, skill building, responsibility, and personal growth, which all contribute to the success of the clients who complete the program. Our goal at Liberty Bay Recovery isn’t just to stop our clients from using drugs and then send them out into the world – we truly want to help them begin the life-changing process of troubleshooting within themselves to find the root causes for their addictions and mend them, so they can leave not only drug-free, but secure in being that way, and hopeful of their future and success.
Our ultimate goal at Liberty Bay Recovery is to equip our residents as best we can to be successful in the sober adult world. The Therapeutic Community model reflects our values and is incredible effective, and we are proud to utilize it in our facility.