Our 44 member agencies provide more than 72 Therapeutic Communities (TCs) and associated services across Australia and New Zealand. These TCs vary in size from 10 to 150 beds, with their residential program length from short to medium to long term. Therapeutic Communities also vary in their program structure and content, some based on a 12 Step Model philosophy, others on a family therapy model or cognitive behavioural interventions, and others with a combination of some or all of the above.
However, all TCs have one important factor in common – they are underpinned by the concept of ‘Community-as-Method’ in which the community itself is seen as the main vehicle for treatment and change. The TC model has proven to be a powerful treatment approach for substance use and its related problems in living (DeLeon, 2000; Magor-Blatch, Bhullar, Thomson & Thorsteinsson, 2014; Vanderplasschen, 2012). All TCs take an approach that treats the whole person through the use of peer community, supported by a variety of evidence based services and interventions related to family, education, vocational training, physical and mental health.
Members of ATCA are diverse in terms of the range of programs offered, to meet the particular needs of the client group. In general, programs aim to have enough structure to ensure a degree of order, security and clarity, while allowing room for residents to learn, make mistakes and learn from experience.
The desire to continually improve the service offered has led members to consult the research literature, to seek forums for exchange and to encourage client involvement and feedback on all aspects of service delivery. It has also led services to consider means of matching clients to services and to developing new initiatives. For example, brief intervention programs of 4 – 6 weeks are available, some programs offer services to clients on opioid substitution therapies, some offer residential withdrawal management services and groups requiring specialist approaches, such as women and families with children, people with co-morbid mental health conditions, young people and victims of physical/sexual abuse.
It must be emphasised that whilst TCs maintain an environment free from illicit drugs and alcohol, this does not mean a rejection of medically prescribed substances. Residents may require psychotropic medication and all agencies have appropriate medical, psychological and psychiatric support. The use of methadone and other pharmacotherapies is supported by a number of TCs, either as a reduction and withdrawal regime, or as stabilisation and maintenance. Other programs offer a range of naturopathic therapies.
Our member agencies are cognisant of the public health risks of transmission of HIV and in particular of Hepatitis C (HCV) and the need to include safe sex, safe needle use and health education messages to clients.
Therapeutic Communities provide treatment which fit within the harm minimisation continuum, providing an opportunity for each person to make an individual treatment choice, based on their previous experience and attempts at treatment.
De Leon G. (2000). The Therapeutic Community: Theory, Model, and Method. New York, Springer Publishing Company.
Magor-Blatch, L., Bhullar, N., Thomson, B. & Thorsteinsson, E. (2014). A systematic review of studies examining effectiveness of therapeutic communities. Therapeutic Communities: The International Journal for Therapeutic Communities, 35 (4), 168-184.
Vanderplasschen, W., Colpaert, K., Autrique, M., Rapp, R.C., Pearce, S., Broekaert, E., & Vandevelde, S. (2012). Therapeutic Communities for Addictions: A Review of Their Effectiveness from a Recovery-Oriented Perspective. The Scientific World Journal, http://dx.doi.org/10.1155/2013/427817.