Privileges and sanctions constitute an interrelated system of community and clinical management through behavioral training. The management of the community is the responsibility of peers and staff. This chapter details the formal system of community privileges and sanctions prescribed by staff and the informal system of verbal affirmations and correctives implemented primarily by peers. Privileges are used to promote individual socialization and personal growth. It confirms the resident’s overall personal autonomy and ability for self-management. Money is a major problem in the lives of substance abusers. However, money difficulties also reflect social and psychological problems among substance abusers in therapeutic communities (TCs). Sanctions may be grouped into verbal correctives and disciplinary actions. Sanctions promote community awareness and peer self-management and maintain social order through addressing individual and collective infractions. Sexuality is approached differently from the other rule-governed behaviors in the TC.
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Residents in the therapeutic community (TC) engage in a variety of interpersonal roles and relationships both within and outside of the program. Friendships and attachments, romantic or sexual, “naturally” emerge within the peer community and are profoundly affected by the insistent intimacy of the TC community life. This chapter examines how these interpersonal relationships are utilized to transmit community teachings on right living and recovery. The poor quality of past friendships and romantic attachments has been implicated in the drug problems of substance abusers in general. Among residents in TCs, the relationship problems that most commonly surface are related to sexuality, interpersonal fears, and lack of relationship skills and values. Of special importance to the individual and the community, however, are three main types of relationships: sexual relationships, romantic relationships, and friendships. Contemporary TCs have changed their tolerance levels toward greater acceptance of homosexuality.