Incarcerated clients' perceptions of therapeutic change in substance abuse treatment: a 4-year case study.

Therapeutic communities (TCs) are a primary approach for treating substance abusers in the criminal justice system. The transformation from residential treatment to a TC marked a significant change in the service delivery and organizational culture for one in-prison substance abuse treatment program. This longitudinal case study examines how clients perceived their treatment as a result of treatment and organizational changes. This is important because the scientific literature shows that client perceptions of their treatment impacts treatment retention and the benefit they gain from treatment. Data that were collected over 5 years are presented. Implications, including how the program's interim therapeutic milieu eased the transition to a therapeutic community, are discussed.