Core characteristics, treatment process and retention in therapeutic communities for addictions: a summary of four studies

Abstract

Purpose – The purpose of this paper is to summarize the main findings and conclusions of four separate studies on treatment in therapeutic communities (TCs) for addictions. Design/methodology/approach – The first two studies address the core characteristics of the TC approach: a study on the workable and destructive elements of the Synanon model; and a comparative study on the essential elements of TCs for addictions in Europe and in the USA. The final two studies highlight clients’ perceptions of the TC treatment process in relation to retention: a study on clients’ first month perceptions of the TC treatment process and the influence of fixed and dynamic client factors; and a longitudinal study on changes in clients’ perception of the TC treatment process and the impact of motivation, psychological distress and cluster B personality traits. Findings – The first study showed that Synanon’s therapeutic and pedagogical methods are still highly valued despite its negative reputation. The results of the second study suggest that while traditional TCs operate as concept-based TCs in Europe, modified TCs might differ in the extent to which they apply the core principles and elements of the TC approach. The third study provides evidence that suitability for treatment is a very important predictor for clients’ first month perceptions of the community environment. The fourth study shows that with time in treatment clients develop more profound perceptions regarding the essence of TC treatment. Research limitations/implications – Finally, implications for clinical practice, general limitations and some concrete recommendations for future research are presented in this paper. Originality/value – The PhD summary study contributes to the existing literature on TC treatment.