Therapeutic communities for addictions: a theoretical framework.

Adaptation of therapeutic communities (TCs) for new clients and in different settings has resulted in a diversity of programs with unique treatment protocols and different planned duration of stays. The extent to which the various adaptations retain the essential elements of the TC model is not known, and moreover, casts questions about the general effectiveness of the therapeutic community modality. This paper outlines a theoretical framework of the addiction TC to advance research and guide training, practice, and program development. The essential elements of the TC are organized into four areas: its perspective, treatment approach, program model, and the treatment process. Some implications of a TC theory, model, and method are discussed in terms of research, treatment, and policy issues.