What are the fundamental components of therapeutic communities?

Research spanning more than 30 years has identified key concepts, beliefs, clinical and educational practices, and program components common to most TC programs. These elements reflect the two principles that drive TC operations: the community as change agent and the efficacy of self-help.

Typically, TCs are residential facilities separate from other programs and located away from the drug-related environment. As a participant in the community, the resident in treatment is expected to adhere to strict and explicit behavioral norms. These norms are reinforced with specific contingencies (rewards and punishments) directed toward developing self-control and responsibility. The resident will progress through a hierarchy of increasingly important roles, with greater privileges and responsibilities. Other aspects of the TC's "community as method" therapeutic approach focus on changing negative patterns of thinking and behavior through individual and group therapy, group sessions with peers, community-based learning, confrontation, games, and role-playing.

TC members are expected to become role models who actively reflect the values and teachings of the community. Ordered routine activities are intended to counter the characteristically disordered lives of these residents and teach them how to plan, set, and achieve goals and be accountable.

Ultimately, participation in a TC is designed to help people appropriately and constructively identify, express, and manage their feelings. The concepts of "right living" (learning personal and social responsibility and ethics) and "acting as if" (behaving as the person should be rather than has been) are integrated into the TC groups, meetings, and seminars. These activities are intended to heighten awareness of specific attitudes or behaviors and their impact on oneself and the social environment.