Essential Elements of Treatment: A Comparative Study Between European and American Therapeutic Communities for Addiction

Abstract

The purpose of this study was to investigate whether European and American therapeutic communities (TCs) for addiction, both traditional and modified, share a common perspective on what is essential in treatment using the Survey of Essential Elements Questionnaire (SEEQ). TheEuropean sample (N = 19) was gathered in 2009. For the American sample (N = 19) we used previously published research data. Despite comparable perspectives, European traditional TCs (N = 11) scored significantly higher than their American predecessors (N = 11) on 4 SEEQ domains.Cluster differences were more pronounced in Europe than in America.

Before Prison, Instead of Prison, Better Than Prison: Therapeutic Communities as an Abolitionist Real Utopia?

“…It is the alternative models which subsequently evolved in the TC movement that offer a firmer ground for inclusion within an abolitionist real utopia manifesto. (Broekaert, Vandevelde, Schuyten et al 2004;Broekaert, Vandevelde, Soyez et al 2006;Goethals et al 2011;Vanderplasschen, Vandevelde and Broekaert 2014), and thus was more in line with the normative framework of an abolitionist real utopia.…”

Qualitative study of welcome houses: a recent initiative designed to improve retention in therapeutic communities

“…In contemporary TCs, residents still collectively determine codes of acceptable behaviour to guide community members so that they develop 'appropriate' social, educational, and life skills, change their negative behaviours, and remain abstinent (De Leon, 2000). Nonetheless, contemporary TCs are more varied and less restricted than the original American TCs, and the types of punishment used for transgressions of community codes tend to be 'softer' (Broekaert, 2006;De Leon, 2000;Goethals et al, 2011). With these recent modifications, the differences between TCs and other types of residential rehabilitation programmes have become less easy to discern and we might now question whether or not contemporary TCs can really still be regarded as TIs.…”

“…Ogborne & Melotte, 1977;Sansone, 1980). TCs have been an established approach to residential addiction treatment since the late 1950s (De Leon, 2000;Goethals et al, 2011;Toon & Lynch, 1994). In the United States of America (USA), the early 'concept house' approach to TCs was based on the notion of a self-supporting 'community' that operated according to a strict hierarchical structure, punitive regimes and few privileges (Goethals et al, 2011;Toon & Lynch, 1994).…”

“…In the United States of America (USA), the early 'concept house' approach to TCs was based on the notion of a self-supporting 'community' that operated according to a strict hierarchical structure, punitive regimes and few privileges (Goethals et al, 2011;Toon & Lynch, 1994). Residents were publically subjected to harsh and sometimes humiliating confrontation in the name of rehabilitation, the aim being to strip them of their 'destructive' behaviours and 'addict' identities and to promote 'better' drug and alcohol free lives (Goethals et al, 2011).…”

Knowledge displays: Soliciting clients to fill knowledge gaps and to reconcile knowledge discrepancies in therapeutic interaction

“…The term TC designates both a type of residential or semi-residential service that provides psychosocial rehabilitation for persons with diagnoses of mental illness [12][13][14] or drug addiction problems [15,16] and the therapeutic method employed therein [17,18]. The TC method emphasises prolonged interaction between staff and clients (the so-called "living-learning experience" [12] or "community as method" [19,20]), usually over a period of several months [21], in joint work, learning and leisure activities. Staff-led group meetings take place on a weekly basis and are occupied to a significant extent by clients' reports of their recent activities and experiences [22,23].…”