CULTURE AND COMMUNITY IN THE THERAPEUTIC-COMMUNITY - IMPLICATIONS FORTHE TREATMENT OF RECOVERING SUBSTANCE MISUSERS

This paper critically discusses the conceptualization and structure of the therapeutic community employed for the treatment of substance mis use in America. The predominant American model, the concept-house mode l, is criticized on the grounds that the therapeutic milieu of these t reatment agencies is contaminated by their subordinance to the influen ces of the larger American society. These influences include: the pred ominance of the medical model, the agency as an agent of service deliv ery, capitalism and inequity, implicit views of human nature, and stra tification of social structure. The thesis of this paper is that treat ment personnel in therapeutic communities must develop increased sensi tivity to the larger cultural factors which influence the construction of the therapeutic community. It is argued that problems within the A merican culture play a significant role in the etiology of substance m isuse. Therefore, treatment personnel must be careful to avoid constru cting therapeutic communities which too closely mirror the larger cult ure. This cultural influence in therapeutic communities functions to m aintain long-term substance misuse problems within the individual and the nation.