Self-reported learning among residents of a men's prison-based therapeutic community

Background: The prison-based Therapeutic Community (TC) is a widely utilized program for individuals with substance use disorders that has proven effective in reducing recidivism. Yet some recent findings are more equivocal and suggest sources of heterogenous treatment engagement and response.Objectives: Given minimal prior research on the experiences and perspectives of prison-based TC participants, we assessed how men narrate the knowledge or skills they acquired from the TC program. Specifically, we analyzed responses to an open-ended survey item, "What have you learned in the TC?"Methods: Team-based coding of 470 responses to the above question across 177 residents of a prison-based TC resulted in the identification of eight distinct themes. Coding relied on the use of emic codes in open coding and iterative rounds of codebook development, with a final round of coding resulting in a Krippendorff's alpha of .807.Results: Approximately one-third of respondents (33.90%) narrated that they learned nothing in the TC in at least one survey response, demonstrating negative program perceptions. However, other prevalent themes included tangible learned concepts or skills, including specific curriculum or TC "tools" (44.63%), interpersonal skills (25.42%), or self-control (13.56%). Some residents discussed shifts in perspective, like having a self-revelation (37.85%) or recognizing the impact of their prior behaviors on others (27.12%).Conclusion: Variation across self-reported areas of learning indicates heterogeneous experiences in the prison-based TC. The high frequency of negative program perceptions and surface-level discussion of important treatment concepts point to potential interventions to increase treatment engagement and enhance program effectiveness.