Since the beginning of the 20th century, addiction treatment has grown in many ways. The number of treatment centers and therapy options has grown, but we’ve also come a long way in our understanding of addiction and how we treat it. However, there’s one common thread that has remained in diverse treatment approaches throughout the decades: the peer-to-peer communities are of tremendous value in treating addiction.
Bill Wilson, a co-founder of Alcoholics Anonymous, believed that the key to overcoming alcoholism was spiritual growth and for people struggling with alcoholism to help one another. He wrote in the now famous Alcoholics Anonymous manual, often called the Big Book, “We alcoholics see that we must work together and hang together, else most of us will finally die apart.”
That book was originally written in 1939, but the idea of building a community to aid in addiction treatment is still present in modern approaches to treatment.
Therapeutic community drug rehab is a treatment approach that emphasizes peer-to-peer interaction and community building. The idea is to connect a person who is struggling with addiction to a community of people that’s dedicated to pursuing sobriety. Together, these participants will help keep each other accountable for their treatment goals and offer advice.
New studies support the community-driven approach to addiction treatment, where interpersonal connection seems to have profound effects in fighting addiction. The therapeutic model seeks to employ human connection in addressing substance use disorders.
Learn more about the therapeutic community drug rehab approach and how it works.
A therapeutic community is a group or organization formed around the goal of self-improvement, fellowship, and accountability. Therapeutic communities have their roots in the self-help movement that started in the 1930s and grew in popularity through the 20th century.
Therapeutic communities are often made up of peers that help one another toward a common goal, where more experienced members assume leadership positions. Today’s therapeutic communities may be run and facilitated by trained clinicians or therapists, but there is still a significant emphasis placed on peer-to-peer interaction.
At their roots, therapeutic communities were often faith-based programs. One example of an early predecessor to therapeutic communities is the Oxford Group, which was founded in 1931 by a Lutheran minister. The Christian organization was formed to help people grow spiritually and work on personal shortcomings with the help of their peers.
Several organizations influenced what would eventually become therapeutic communities that are specifically intended to help address substance use disorders and addiction including Alcoholics Anonymous and Narcotics Anonymous. However, organizations like AA typically offer meetings and support for people who live on their own or in another residential program. Therapeutic community programs offer this model to people who live in a residential program together.Therapeutic community programs spread throughout the country in the 1950s and 1960s, especially as a way to address alcoholism and drug abuse.
Today, the therapeutic community approach has spread throughout the world and has been widely adopted in 65 countries.
Therapeutic communities are focused on self-help and peer-assisted betterment. However, when it comes to mental and behavioral health, the therapeutic model doesn’t usually employ medical approaches to treatment. While they may not be in opposition to a medical approach, medication would be a supplemental tool that would be received outside of the official theories of the program.
When it comes to addiction treatment, some groups may discourage long-term maintenance programs like methadone maintenance where an addictive medication replaces an addictive drug. Most programs are based on total abstinence from drugs or alcohol.
However, attitudes toward medication-assisted treatment are changing, even in therapeutic communities.
Therapeutic communities approach substance use disorders with a holistic view of facilitating a lifestyle change. Rather than simply zeroing in on abstinence from drug or alcohol use, therapeutic communities focus on the whole person and multiple aspects of a person’s life. Addiction is chronic, and relapse is a serious threat.
According to the National Institute on Drug Abuse (NIDA), substance use disorders are similar to other chronic diseases like hypertension and asthma in that they can all have relapse rates above 50 percent. Addiction may have relapse rates between 40 and 60 percent while hypertension and asthma have rates between 50 and 70 percent. While this doesn’t mean relapse is inevitable; it does mean it’s a threat that needs to be taken seriously.
The therapeutic community model recognizes the threat of relapse and focuses treatment on helping one another to avoid it. Addiction recovery is often treated as a gradual process that requires an ongoing commitment to making lasting behavioral changes. These changes are achieved through clinical interventions and time.
Therapeutic communities are often focused on helping clients address personal behavioral issues that may lead to a destructive lifestyle that includes substance abuse. Isolation, narrow-mindedness and blaming others for your problems are discouraged while honesty, hard work, responsibility, and developing social skills are encouraged.
Progression through a therapeutic community program often means taking on more responsibilities both inside and outside of the program. A participant may start pursuing a career or education after progressing in treatment, but they might also take on staff or leadership roles within the community.
According to NIDA, therapeutic communities have been shown to facilitate significant improvements in the lives of people who go through them. Studies show that participants experienced improvements in their substance abuse, criminal behavior, and mental health symptoms.
NIDA sponsored a study called the Drug Abuse Treatment Outcome Study, which looked at the effectiveness of multiple methods of addiction treatment including therapeutic communities. The study showed that people who had success a year after treatment were likely to have success five years later.
The study also found that the length of time in treatment is an important factor in the success of therapeutic communities. People who spent at least three months in a therapeutic community had better long-term results than people who were in them for shorter amounts of time. Spending more than six months in treatment also produced better results after five years.
One drawback is the fact that most therapeutic communities reject or discourage the use of medication-assisted treatment (MAT). While MAT isn’t for everyone, and many people don’t need it to achieve sobriety, it can be a good option for people who have gone through or attempted treatment multiple times to no success. However, some therapeutic communities are changing their perspective on MAT, especially as better medications become more common.
Addiction is a chronic disease that affects the brain. It can be extremely challenging to overcome, especially when you’re on your own. However, with the right treatment options and professionals helping you in your pursuit of sobriety, you may be able to achieve long-lasting recovery.
To learn more about how you or someone you know might be able to overcome a substance use disorder with the help for addiction treatment, speak to an addiction treatment specialist at Serenity at Summit. Call 844-432-0416 at any time to hear about your treatment options and to take the first steps on your road to recovery today.
Bill Wilson. (2001). The A.A. Tradition. In Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered From Alcoholism (4th Edition ed., pp. 561-566). New York, NY: Alcoholics Anonymous World Services. National Institute on Drug Abuse. (2015, July). What Are Therapeutic Communities? Retrieved from https://www.drugabuse.gov/publications/research-reports/therapeutic-communities/what-are-therapeutic-communities
National Institute on Drug Abuse. (2018, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
SAMHSA. (2015, July 21). Medication-Assisted Treatment (MAT). Retrieved from https://www.samhsa.gov/medication-assisted-treatment