Treating the Most Seriously Addicted Using Elements of Therapeutic Community: The Importance of Treatment Vocabulary

The inadequacy of individual psychotherapy and pharmacotherapy for treating the severely addicted (those addicted to many substances, or if one, opioids) was addressed by the development of the therapeutic community (TC) treatment model. TC treatment was residential and lengthy, but effective: it enabled the most pernicious of addictions to be managed, relapses to be reduced, and the patients enabled to lead enjoyable lives with rewarding relationships, families, education, and employment. Years of budget difficulties have reduced the cost of TC treatment by reducing or eliminating elements of TC treatment, with commensurate loss of treatment gains for the patients. This paper highlights the TC elements that should be eliminated last and restored first to improve patient success.

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