The therapeutic community: exploring the boundaries.

The past 20 years have demonstrated the effectiveness of therapeutic community (TC) treatment for drug abuse as it evolved in the United States. We now better understand the influence that psychodynamic features of TC treatment have on character disorder. Best perceived as a setting designed--as society is not--to encourage and support social learning, the TC has succeeded in modifying its programs and adapting self-help methods to serve drug abusers of all kinds and abusers of all drugs. Continued evolution of the TC depends upon development of its already-demonstrated capacity to affect disordered behaviour other than drug abuse. The growth of disordered populations in the United States and increasingly in Great Britain gives urgency to such future employment. Therapeutic communities and TC-like programs for non-drug abusers already exist. But widespread use depends upon strengthening the theoretical underpinnings of TC treatment and establishing closer working relationships between TC's and mainstream medical, mental health and social service institutions.