The MICA therapeutic community: challenges for residents and staff

Therapeutic communities (TCs) are residential self-help programs for recovering addicts. Traditional TCs are staffed by recovered addicts. Recently the TC model has been modified for the treatment of chemical abusers with severe mental illness. These programs are to varying degrees staffed by mental health professionals. Furthermore, they are often housed in institutions whose model for care is based on service to patients rather than self-help. There are inherent conflicts in the modified TC which is a hybrid of these two treatment approaches. This paper explores issues related to the roles of patients, mental health professionals, and the parent institution in the TC modified for the treatment of the mentally ill chemical abuser.