1. Treatment for Substance Abusers in the Therapeutic Community

2. Therapeutic Communities  Highly structured, comprehensive  Designed for addicts with psycho- social deficits, antisocial patterns, criminal behavior  Inpatient or outpatient; 6 months or longer  Problem is multifaceted.  Drug dependence is a symptom, not the essence of the disorder.

3. TC Programs  Focus on:  socialization  positive value formation  education  Appropriate for hard core users involved in anti social activities.  Not specific to particular class of drugs.

4. TC Goals  Rehabilitation of the total individual  Changing behaviour and attitudes  Development of drug-free lifestyle  Strengthen Family Millue Concept  Reduction of Criminal Activities  Strengthen family value system

5. Primary Goals of Treatment in Therapeutic Community l Reduction of substance abuse and related criminal activity. l Reduction of relapse and recidivism. l Promotion of pro-social behaviour. l Reintegration into society

6. TC Elements  Self-contained residential programs  Drug-free supervised abstinence  Trained staff, former addicts, peers who role-model successful personal change  Emphasize peer self-help  Accountability and confrontation  Feedback and confrontation of behaviour and attitudes; self-disclosure  Highly structured; progressively demands more responsibility/provides more freedom

7. More TC Elements  Group encounter sessions  Social and vocational skills  Practice in real life situations  Attention to attitudes and behavior  Individual and group therapy  Recreation  Drug education  Family, legal, medical, and social services

8. T.C. Internal Core Elements l Change or modify behavior l Teach pro-social values and skills l Encourage on-going exploration and growth in inter/intra-personal relationships l Encourage development of active, inquiring attitude toward learning

9. Therapeutic Community looks like  Behavior Management  Emotional / Psychological  Intellectual / Spiritual  Vocational / Survival Skills

10. T.C. Core Element : Emotional Exploration and Growth l Group format has highest long-term positive outcomes l “Here and now” vs. “there and then” l One-to-one counseling/therapy: –develop trusting relationship –work through problems around negotiating treatment –Identify sensitive issues

11. Aftercare and Outpatient Programs l The primary therapeutic relationship is between the person and the group l Achieve and maintain abstinence while living in the community. l Halfway houses, satellite housing, sober living environments. l Allows for longer-term support. l Aftercare and Outpatient programs are considered to be a low intervention approach, appropriate for the low-risk substance abusers.

12. Aftercare and Outpatient Considerations l Motivation for treatment l Everyone gives and receives help. l The individual is responsible for recovery. l Individual responsibility is reinforced by shared decision making. l Ability to discontinue substance abuse l Social support system l Employment situation l Past treatment history

13. Halfway Houses, Independent Living program, Sober Living Environments l A group of people with alcohol and/or drug problems living together in a formal, therapeutic arrangement and abiding by the rule of abstinence. l Transitional living facilities l Provides supportive environment l Rehabilitation services l Small, homelike, informal, l Residents encouraged to work

14. Conclusion Man Helping man to help himself Thank you and Welcome to our world