Paper
Saturday, November 3, 2007
66
A Conceptual Framework for Understanding Therapeutic Community
Susan M. Bankston, BS, BSN, Psychiatric/Mental Health Nursing, The University of Texas Health Science Center at Houston School of Nursing, Houston, TX, USA
| Learning Objective #1: understand how therapeutic community facilitates change in substance abuse. |
| Learning Objective #2: apply therapeutic community concepts to substance abuse treatment and research. |
Therapeutic community (TC) for substance abuse is a unique psychosocial approach to healing, by nurturing self-responsibility and growth through the use of community to teach, support and guide behavioral change. Ideally the TC environment supports motivation and behavioral change by facilitating social learning, agency, and spirituality within a structured environment. In the United States, TC is an established, influential and widespread approach and is considered to be an effective treatment for chemical dependency. This model addresses explicit conceptual issues associated with TC, and underlying behavioral change, by proposing a framework that can guide research and improve the effectiveness of substance abuse treatment. This framework builds on De Leon’s (2000) model by providing conceptual definitions and a clearer understanding of the interrelationships that exist between concepts. The goal is to suggest that the concept of TC may be understood in terms of social processes. Specifically, that recovery from chemical dependency, while necessitating reformation at the individual level, relies upon agency, spirituality and structure in the context of self-efficacy, self-esteem and relationship influences. This model is consistent with nursing practice as it encompasses essential nursing concepts – person, environment, and health. The model is graphically presented to facilitate the understanding of substance abuse treatment within the context of TC.