What is the role of violence in the therapeutic community?

The violence inherent in the world of substance abuse is conspicuously absent as a research issue in published studies in this area. Computer searches surfaced articles dealing with mental health/mental retardation. A synthesis of these articles indicates that the setting, therapy, and staff identified as most effective in the treatment of violent patients coincide with those found in drug and alcohol therapeutic communities. (The use by some drug and alcohol clinicians of radical confrontation therapy was the only practice seemingly counterindicated on treatment effectiveness and ethical and legal grounds). We emphasize the need for a drug and alcohol research focus on violence.