How are therapeutic communities structured?

TCs are physically and programatically designed to emphasize the experience of community within the residence. Newcomers are immersed in the community and must fully participate in it. It is expected that in doing so, their identification with and ties to their previous drug-using life will lessen and they will learn and assimilate new prosocial attitudes, behaviors, and responsibilities.

Although the residential capacity of TCs can vary widely, a typical program in a community-based setting accommodates 40 to 80 people. TCs are located in various settings, often determined by need, funding sources, and community tolerance. Some, for example, are situated on the grounds of former camps and ranches or in suburban houses. Others have been established in jails, prisons, and shelters. Larger agencies may support several facilities in different settings to meet various clinical and administrative needs.

In DATOS, there was an average of one counselor reported for every 11 residents in treatment. About two-thirds of the counseling staff had themselves successfully completed drug abuse treatment programs. Increasingly, TCs rely on degreed staff (e.g., social workers, nurses, and psychologists) for some aspects of treatment.