The Importance of a Supportive Environment
People will usually find it easier to deal with their problems if they are in a supportive environment. A therapeutic community program aims to create the right conditions for people to change undesirable behaviors and learn new ways of doing things. It can be very useful for helping the individual deal with problems such as addiction. The focus is on the life of the individual and not just on their specific symptoms. This type of environment is artificially created, but the individual will be able to take what they learn and use this in the outside world.
Therapeutic Community Defined
This is a type of community where people live together as a form of therapy. Such environments are drug free and highly structured. Within such a community the individual can feel safe to explore new coping mechanisms and learn to cooperate with other people. It is like a miniature society in which members can grow and develop.
The therapeutic community is closely associated with Milieu therapy. This is a form of psychotherapy where the emphasis is on using the environment as a therapeutic tool. The word milieu is French and means middle place or middle ground. The idea of a middle ground tends to conjure up images of a safe place, and this is exactly what such a therapeutic setting is meant to be. Here the individual is viewed as possessing the inner strengths to change their own behavior. Their surroundings will encourage them to take advantage of these inner strengths and put them to work. The lofty goal of milieu therapy is that every element of the individual’s environment should be therapeutic in nature.
Most therapeutic programs involve participants living together with therapists. In some communities a therapist will be there all the time, but this is not always the case. This community is run by consensus, and the role of the therapist is just to facilitate. The individuals within the program are put into a position where they have to fit in with the rest of the group. Peer pressure can work as a powerful force in ensuring that people adapt. If they fail to do this then life will become difficult.
It is usual for this type of program to include:
* Regular community meetings and discussions. This gives the members the opportunity to discuss problems and evaluate the behavior of each other.
* Coping skills workshops and other types of learning. The individual will not only learn new strategies but will also be able to experiment by using these within the community.
* Community government. This is where all the members of the community make collective decisions.
* Care plans based on the individual needs of each client.
This type of environment works to help the individual in a number of ways including:
* People within such a community have a much better idea of how their behavior impacts other people
* Members can develop leadership skills
* The individual will develop a better understanding of other people
* Life is highly structured and this means that members can feel safe
* The individual is empowered and so able to take responsibility for their own behavior
* Members are motivated to solve problems due to challenges faced in the community
* There is a focus on living rather than dealing with symptoms
* The confidence of the individual increases as they see their importance within the community
* Members learn how to corporate with others
* The individual feels that they have some control over the rules that govern their life in the program
* Membership of such a community is often a joyful experience
In order for this type of community to be truly therapeutic it needs to involve certain elements including:
* A complete ban on all intoxicants
* A focus on shared responsibility
* Members should be protected as much as possible from potential stressors
* Each individual takes responsibility for their own behavior and be willing to follow the rules
* The group is encouraged to solve problems together
* Participation by all members in decision making
* A clear understanding of roles within the community; including the role of the therapist
* Agreed upon rules which are enforced by the group
* Open communication
* Regular feedback on the behavior of participants
* Individuals are encouraged to confront anyone who is behaving poorly within the community
In order for the individual to change they will need to feel safe to do so. In the outside world there can be many pressures that keep people locked in undesirable behavior. The stress of just trying to make it though the day may be all they can manage. Trying to change in such an environment can be a challenge. The therapeutic community is created in such a way that people are protected from many stressors. There is comfort in routine and predictability—something that is often missing in the outside world. They will have fewer temptations and while they are a member of the community there are usually no pressing work worries or bills to pay. The community is completely focused on therapy and growth. This gives the individual a lot more freedom to try new ways of dealing with life.
It is generally accepted that the setting in which addition treatment takes place is important. This is why rehabs will put a lot of effort into creating a therapeutic environment. These programs are not always spoken of as milieu therapy but they are based on the same principles. The benefit of such an approach is that it moves the focus away from merely treating the symptoms of addiction to building a life in recovery.
Some people who leave rehab go on to spend some time in a halfway house. These are sometimes referred to as dry houses because intoxicants will not be allowed. Residents can stay in a halfway house for periods of a year or more. In many instances such facilities provide a therapeutic community where residents can further develop coping mechanisms. Such places also provide a safe environment from which he individual can build a successful recovery.