From a social and psychological perspective the therapeutic community (TC) can be distinguished from other institutional or treatment settings in that its social environment is the treatment model. The main elements of this model, its social organization, and social relationships are utilized for a single purpose the reintegration of the individual into the larger macrosociety. The social organization of the TC model may be described in terms of four major components: program structure, systems, communication, and the daily regimen of schedule activities. In the TC, however, each component is utilized to facilitate the socialization and psychological growth of the individual members. This chapter provides an overview of these components and how they contribute to the TC treatment approach. Each of these components of the social organization reflects an understanding of the TC perspective and each is used to convey community teachings and promote self-examination and self-change.
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Work is one of the most distinctive components of the therapeutic community (TC) treatment model. Indeed, the telling mark of the TC social environment is the vibrancy of its work activities. Work in the TC is a fundamental activity used to mediate socialization, self-help recovery, and right living. This chapter describes how work mediates essential educational, therapeutic, and community goals. For disadvantaged, antisocial, or nonhabilitated substance abusers, many of whom have few work skills, social identity and self-esteem are first acquired through participation in the work structure of the TC. Work in the TC addresses characteristics of the person and the disorder. These characteristics can be classified into related categories: personal habits, work habits, work relations, self-management, and work value. Job functions are utilized in three main ways: for skills training and education, for therapeutic change, and to enhance the peer community.
In the therapeutic community (TC), surveillance means supervision and management of the orderliness and safety of the physical environment, as well as the health and conduct of the social environment. This chapter describes the main facility-wide surveillance activities of the general inspections (GI), the house run, and urine testing, actions implemented in the management of the community. The GI is a useful community and clinical management activity. The house run is the main system of surveillance in the TC. In terms of management goals, house runs permit early detection of potentially larger problems such as those related to fire, sanitation, and security. However, its fundamental clinical purpose is to assess the status of individuals in terms of self-care, self-management, and their relationship to the community. The main urine test procedures used by most TCs are unannounced random urine screens and incident-related testing procedures.