The Therapeutic Community for Addictions: An Evolving Knowledge Base

• Author: Harry Wexler,George De Leon
• DOI: 10.1177/002204260903900113
• Date: 01 January 2009
• Published date: 01 January 2009
• Subject Matter: Article

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 167-178

__________

George De Leon, Ph.D., is an internationally recognized expert in the treatment of substance abuse

and is acknowledged as the leading authority on treatment and research in therapeutic communities.

His numerous publications include The Therapeutic Community: Theory, Model and Method, considered

a primary text in the f‌i eld of addictions. During the last 40 years, Dr. Harry Wexler achieved a national

reputation in the areas of substance abuse policy, treatment, and research. His research has been

inf‌l uential in efforts to expand prison drug treatment. He has also done signif‌i cant work in the areas of HIV/

AIDS prevention, gender treatment issues, stigma reduction and co-occurring disorders among offenders.

THE THERAPEUTIC COMMUNITY FOR ADDICTIONS: AN

EVOLVING KNOWLEDGE BASE

GEORGE DE LEON, HARRY WEXLER

The therapeutic community (TC) has become an established treatment approach

serving thousands of substance abusers in community, institutional, and other

settings. This article summarizes the research that contributed to the acceptance and

growth of TCs and laid the groundwork for the establishment of TCs for substance

abusers in correctional settings. The TC knowledge base has contributed to the

revival of a rehabilitation philosophy in correctional policy, which is described in the

second section. The ref‌l ections of the authors who have collaborated for about 40

years are provided at the end of the paper.

INTRODUCTION

The evolution of theraputic community (TC) research can be framed in terms of

two broad eras, early (roughly 1970-1989) and recent (1990-present). The emphasis

of research shifted over these time periods, ref‌l ecting the social and political context

as well as scientif‌i c issues. There are several major lines of inquiry and each consists

of main questions, f‌i ndings, and conclusions.

EARLIER RESEARCH

WHO COMES FOR TREATMENT?

TCs view substance abuse as a disorder of the whole person, which requires

long-term residential treatment to foster changes in lifestyle and identity. Numerous

studies that describe the social and psychological characteristics of admissions to

TC programs support this perspective (e.g., De Leon, 1984, 1999). In addition