The success of therapeutic communities for substance abusers in American prisons

Residential treatment provides opportunities for intensive interventions and support that may not be present in outpatient settings. In the area of substance abuse treatment, the therapeutic community (TC) has become synonymous with residential treatment. A growing body of prison TC outcome research has led to recent acceptance of prison TCs as a major innovation in American correctional institutions. An overview of prison TC outcome research is provided and the emergence of the TC as the primary substance abuse treatment modality in prison is described. The self-help orientation that provides the basis for both residential and 12-Step substance abuse treatment programs is described and contrasted with the relapse recovery model. The theoretical principles of the TC model are discussed and two main variants of the prison TC model are described and contrasted. Finally, recommendations are offered for expanding the TC approach and increasing its effectiveness by treating comorbid problems that are prevalent among prison inmates with substance abuse problems.