A structured environment for heroin addicts: the experiences of a community-based American methadone clinic and a residential Dutch therapeutic community.

The experiences of a community-based American methadone clinic and a Dutch residential Therapeutic Community are described. Both programs, which provided comprehensive psychotherapeutic services for a diverse subpopulation of heroin addicts who lived in different cultures independently, discovered that character disordered individuals respond positively to the structured environment and confrontation group psychotherapy orientation which are characteristic of the Therapeutic Community. Both programs modified the initial non-directive model into a structured one adopting the treatment technology of the American Self-Help Therapeutic Communities.