Rowdy Yates

The Third Generation of Therapeutic Communities: The Early Development of the TC for Addictions in Europe

Aims: It is the goal of this study to investigate the first development of the drug-free therapeutic community (TC) in Europe. The paper aims at systemizing information, scattered all over Europe and is the first stage in an ongoing study to record the development of the European TC movement and its influences. Design: After a study of the grey (hidden) literature, TC pioneers and experts per country were contacted to further elaborate the first findings. Subsequently, a preliminary summary of our findings was published in the Newsletter of the European Federation of Therapeutic Communities (EFTC), inviting additional information and corrections. The authors completed the results for this article with relevant first-hand information, obtained through interviews with European pioneers. Findings: The findings are summarized under three topics: chronology, interconnections and European identity. It was found that from 1968 until 1989, a new therapeutic approach arose all over Europe, modeled after Synanon, Daytop and Phoenix House, New York, through Phoenix House, London and Emiliehoeve in the Netherlands. Therapeutic communities were established in Belgium, Finland, Germany, Greece, Ireland, Italy, Norway, Spain, Sweden and Switzerland as well. These communities were closely-knit and interconnected in their reaction against psychiatric and methadone treatment. The European TCs developed an own identity compared to the American ones. Conclusions: The European TCs adapted the model of their American predecessors to their own culture, influenced more by milieu-therapy and social learning. Instead of harsh behaviorism, more emphasis was placed on dialogue and understanding. Professionals occupied a more pivotal role and took over the dominant position of ex-addicts. Research, executed by TC professionals gradually entered the TC. A generic network of TC connections, through which the development evolved, was uncovered, and clear regional trends can be observed.

The development of the therapeutic community in correctional establishments: a comparative retrospective account of the 'democratic' Maxwell Jones TC and the hierarchical concept-based TC in prison.

Background: The correction-based therapeutic community (TC) is one of the most described treatment modalities for (substance abusing) incarcerated offenders. The origins and development of the therapeutic community have been traced back to two independent traditions: the American hierarchical conceptbased TC and the British democratic Maxwell Jones-type TC. Both branches have developed independently, targeting different people and tackling diverse problems. Aims: To demonstrate that there are clear and undeniable similarities between the ‘two’ prison-based therapeutic communities. Method: A comparative historical review of the literature and a critical discussion and comparison. Results: The links between the democratic and hierarchical therapeutic communities are summarised under five headings: social learning and behavioural modification; permissiveness and modelling; democracy and hierarchy; communalism and community as method; reality testing and ‘acting as if ’. Conclusions: The ‘two’ correction-based therapeutic communities are on converging pathways. Far from being oppositional models, they can be regarded as being complementary.

A brief moment of glory: the impact of the therapeutic community movement on the drug treatment systems in the UK

The introduction of concept-based therapeutic communities, based upon the model pioneered by Charles Dederich with the Synanon community in California, was a significant development in the evolution of drug treatment provision in the UK. For a short period in the 1970s, these communities enjoyed unparalleled influence in the development and direction of treatment approaches across the whole spectrum of services. This article considers the developments in psychiatry and social care that prepared the ground for that phenomenon. In addition, the article considers the subsequent demise in the importance of therapeutic communities to the direction of drug policy and the implications that this might have for future development of residential treatment services.

Bad mouthing, bad habits and bad, bad, boys: an exploration of the relationship between dyslexia and drug dependence

This was a largely exploratory attempt to consider the relationship, if such a relationship exists, between dyslexia and drug dependence. Dyslexia is popularly considered to be a disability which affects the individuals ability to read and write. However, there is a considerable body of evidence indicating that dyslexia is far more than a literacy problem. Dyslexics, particularly in adulthood, are more likely to exhibit poor capacity for memory-span tasks, issues of organisational incapacity and physical awkwardness (dyspraxia) with various coping strategies having been developed over the years, to neutralise difficulties with reading and writing. As a first step, this study sought to establish whether dyslexia is more prevalent amongst a drug treatment population than within the wider community. In addition, this study sought to examine any correlation between levels of severity in dyslexia and dependence. Finally, this study offered an opportunity for a small sample of drug users to offer their thought...

Therapeutic Communities: Can-Do Attitudes for Must-Have Recovery

The therapeutic community (TC) in the United Kingdom was built out of a merging of the democratic TC tradition pioneered by Maxwell Jones and others immediately after the Second World War and after the American drug-free TC originating in the Synanon experiment in the late 1950s. This latter tradition traces its roots back through the mutual-aid fellowship Alcoholics Anonymous (AA). This article examines how AA principles were adapted for the TC and how this new approach impacted upon the early drug treatment network in the United Kingdom. The evidence base for TC methodology is briefly described along with a short analysis of the marginalization of the approach in the past two decades and the future possibilities for modified TCs for special populations.

North West Recovery Forum: Recovery and Harm Reduction, the Odd Couple of Drug Treatment?

Harm reduction and recovery are not mutually exclusive concepts, and it is perfectly possible to build a recovery orientation into or onto an existing harm-reduction-oriented treatment structure. This short article chronicles the work of the North West Recovery Forum in England in bringing together treatment providers and purchasers, community activists, international recovery experts, and people in recovery to move treatment services toward a recovery vision and grow recovery-friendly communities.

Bridging the Gap Between Research and Practice in Therapeutic Communities (TCs) for Addictions

Therapeutic communities (TCs) are well-known as a treatment modality and can be found in a variety of populations and settings, including addicts, as well as children and young people, individuals with personality disorders and learning disabilities, prisons and hospitals (see Boyling, 2009; De Leon, 2000; Kennard, 1998; Vanderplasschen, Vandevelde, & Broekaert, 2014). The term therapeutic community was first used by the British psychiatrist TomMain (1946), who was involved in the so-called Northfield Experiments (see Vanderplasschen, Vandevelde, De Ruysscher, Vandevelde, & Broekaert, 2017), where soldiers suffering from shell shock and war neuroses after the Second World War were treated by using group processes therapeutically (Harrison & Clarck, 1992). From that time forwards, the term therapeutic community has been linked to a range of treatment traditions and approaches that essentially share the “idea of using all the relationships and activities of a residential psychiatric centre to aid the therapeutic task” (Bridger, 1985, p. 60). One of these traditions is commonly referred to as drug-free or hierarchical TCs, also called concept(-based) TCs or TCs for addictions (Vanderplasschen et al., 2014). These TCs were developed in the 1960s as intensive inpatient-type programs to get people off drugs and to provide a complete break from their past lifestyle. Numerous residential programs for addicts have been modelled after this original concept and also drug-free TCs themselves have evolved and beenmodified to address the needs of specific groups, such as adolescents, mothers with young children, incarcerated substance abusers, or persons with co-occurring mental disorders. Community as method has been identified as the core and common mechanism across TCs (De Leon, 1997). It has been described as “teaching individuals to use the context of community life to learn about themselves” (De Leon, 2000, p. 93) and refers to peer and staff relationships, social roles, the social structure, group process and daily activities. Two years ago we agreed to prepare a special issue of the Journal of Groups in Addiction and Recovery (JGAR) on TCs. This decision was inspired by a series of

A religion too far: a historical and qualitative study on how ex-Synanon members value critical incidents that might have led to the downfall of their Utopia

Although Synanon has been extensively studied, attention has seldom been paid to the question of how the many ex-members who left Synanon before or at its dissolution ‘survived’ their community and indoctrination, and how they now evaluate their involvement. This article explores how ex-members react to their previous affiliation to Synanon, the cradle of the therapeutic community (TC) for addiction. A series of critical incidents, following Synanons public proclamation restyling itself as a religion, which led to the dismantlement of Synanon, are highlighted and contrasted with the achievements of the movement. For this research study, we used a social constructivist methodology. Following qualitative snowball targeted sampling, open interviews and text analysis, 14 statements, representing the main reactions, were retained. These served as the basis for a web-based survey. It was found that ex-Synanon members still believe in the positive realizations of their experience. On the other hand, they are no...

The rise and fall and rise again of the therapeutic community

Purpose Therapeutic communities (and many other residential services) have been effectively marginalised in recent years with the increasing popularity of community-based outpatient responses to a variety of social issues including addiction, learning difficulties, mental health issues, etc. The paper aims to discuss this issue. Design/methodology/approach This has inevitably led to a low profile and has resulted in a lack of knowledge about therapeutic communities and how the methodology differs significantly from other approaches. Findings This situation is beginning to change in a number of fields and it is important that the therapeutic community movement adapts its methodology to the needs of their respective client groups and clarifies its approach (and the efficacy of that approach) to funders and service commissioners. Originality/value This paper is a personal contribution.

Eric Broekaert (1951-2016): the life and legacy of a TC pioneer and integrative thinker

Purpose Eric Broekaert passed away shortly after the XVIth European Working group on Drug-Oriented Research (EWODOR)-conference in Rome on 28 September 2016. He was one of the great TC pioneers in Europe, who founded the first TC for addictions in Belgium (De Kiem) and co-founded the European Federation of Therapeutic Communities and EWODOR. He was a respected Professor of “Orthopedagogics” at Ghent University and a Member of the Editorial Collective of Therapeutic Communities: the International Journal of Therapeutic Communities. The paper aims to discuss the overview of the career of Eric Broekaert. Design/methodology/approach In this obituary, the authors provide an overview of his career, major achievements and theoretical, methodological and integrative ideas, clustered around four typologies: university professor and scholar; manager and source of inspiration; TC pioneer and believer, and integrative thinker. Findings Besides his obvious merits as a TC researcher and advocate, one of his major theoretical contributions has been the introduction of the holistic, integrative approach and the idea that diverse types of interventions, as well as methodological approaches can alternatively go together. Originality/value He regarded TCs as the ultimate integration of various educational and therapeutic approaches to promote growth and quality of life among severely disadvantaged populations, such as drug addicts and children and adults with emotional and behavioural disorders.