Wings Trust | Manu Wairua

Explaining the Therapeutic Community

What is a Therapeutic Community?

The Therapeutic Community (TC) is an evidence-based model of treatment which is proven to be a powerful approach to substance abuse and related problems in living.

TC is different from other treatments as it enables individuals to take a “self-help approach” to treatment within the TC community. The primary therapist or teacher is the TC community itself which consists of the social environment, peers, and staff who serve as guides in the recovery process.

It allows individuals the opportunity to experience being in a safe and supportive, structured environment with like-minded individuals in which to explore and share experiences of personal vulnerability that are seen as central to the recovery process.

The daily routine in a TC is set to ensure each member is presented with appropriate and relevant challenges that enable them to move through the treatment stages successfully. This allows them to learn self-reliance and adopt pro-social values within healthy social networks to sustain long-term recovery.

Another significant feature of the TC model is its ability to harness the power and energy of the group with the user of peer-to-peer challenges and feedback. Specifically pointing toward unacceptable behaviour and attitudes that other peers that can work on to enhance their long-term recovery.

Therefore, it is the experience of community - with all its features of safety, consistency, and predictability - that provides the mechanism of change by gradually enabling newcomers to lessen their identification with and ties to the old drug culture and replace them with ties and loyalties to the people, values and lifestyles of the TC.

How effective is the Therapeutic Community model?

Over a 50-year period, there is significant research showing the effectiveness of therapeutic communities positively impacting the lives of individuals worldwide.

Specifically, it has shown positive outcomes for helping those struggling with drug use, criminality, employment and depression.

Individuals who engaged and or remained in their TC programmes for longer periods of time showed positive results.

Each individual's willingness to stay and engage with the TC was a major factor in the outcome and success of the programme. Individuals who successfully completed their TC programme showed lower levels of drug use, criminal behaviour, unemployment and indicators of depression - with improvements being maintained five years after.

What is the purpose of the New Beginnings Treatment?

New Beginnings and or Community Integration (also known as post-treatment) helps to provide continuity of care and support to individuals so they can sustain recovery, as they implement new behaviours and routines while integrating into mainstream society.

The continuity of care model and post-treatment models receive wide support from research, which demonstrates their effectiveness in sustaining progress in recovery after leaving intensive residential treatment facilities.

Why is there a settling in period?

A complete chemical and behavioural detoxification is a necessary initial step in recovery. Residents must not only withdraw from the toxic effects of substance use but must also detach from people, places and things previously associated with their substance use.

The behaviour detox can be undermined if a new resident is constantly exposed to the world outside TC, as they don’t have the skills yet to resist many cues and triggers.

This is why new individuals are asked to hand over their phones (and other electronics) initially to help initiate the behavioural detoxification and detachment process.

Why the space is important

Spaces, rooms and areas are an important feature of the therapeutic community. While these may be “ordinary”, they help reinforce the experience of community, fostering a sense of home and ownership, and the assurance of psychological and physical safety. This includes creating a setting which supports personal interaction.

All of these goals are crucial in the TC perspectives on recovery and right living.