THERAPEUTIC

MODALITIES
Prepared by: John Patrick B. De Jesus
 Overview of Therapeutic Community
Concept
 Rehabilitation
 History of Therapeutic Community
 Therapeutic Community
 Concept of Therapeutic Community
 Hierarchical format of Therapeutic Community
 Phases of Therapeutic Community
 What is Rehabilitation?
It is the process of re-educating and retraining
those who commit crime.
It generally involves psychological approaches
which target the cognitive distortions associated
with specific kinds of crime committed by particular
offenders - but may also involve more general
education such as literacy skills and work training.
The goal is to re-integrate offenders back into
society.
 Rehabilitation Vs Reformation
Rehabilitation
 A program of activity directed to restore an
inmate’s self-respect thereby making him a
low abiding citizen after serving his sentence.
Reformation
 Change of behavior from unaccepted norm of
behavior.
 HISTORY OF
THERAPEUTIC
COMMUNITY
 HISTORY OF THERAPEUTIC COMMUNITY
 Historically, the term "therapeutic community" (TC) has been used for several different
forms of treatment - sanctuaries, residential group homes and even special schools - and
for several different conditions, including mental illness, drug abuse and alcoholism.
 For example, the British TC emerged primarily as a process for treating military veterans as they returned from
World War II with serious neurotic conditions from their experiences in combat and as prisoners of war.

 The term was coined when Thomas Main pioneered a therapeutic model combining
community therapy with ongoing psychoanalytic psychotherapy in 1946. This was a
modification of therapeutic work developed about the same time by Maxwell Jones and
several others.
 As defined by the Bureau of Correction, the Therapeutic Community (TC) Program
represents an effective, highly structured environment with defined boundaries, both
moral and ethical.
 The primary goal is to foster personal growth. This is accomplished by reshaping an
individual’s behavior and attitudes through the inmates’ community working together to
help themselves and each other, restoring self confidence, and preparing them for their
re-integration into their families and friends as productive members of the community.
 What is a therapeutic community?
A therapeutic community
treatment model is one in which
participants are taught to work
with one another.
 Community members promote
self-change by becoming positive
role models for one another
under the guidance of the staff.
 Making a therapeutic community
 The therapeutic community program is a positive environment for learning how to be
accountable for one’s choices in a caring community where members can help
themselves and each other make positive changes.
 Staff and residents work together to establish and maintain a positive, growth-filled
environment.
 Community members focus on behavioral change, accountability and confronting
attitudes, behaviors and criminal thinking patterns, which are destructive to
individuals and the life of the program.
 It is a place to set goals, develop discipline and practice behaviors that lead to
successful living. It is a place where you learn to let go of a “victim mentality” and
incorporate an “accountability mentality” into all of your relationships. The program
allows you a chance to change, to confront mistakes and accept responsibility for
your life.
 Cardinal rules of the therapeutic
community
 No escape or attempts to escape.
 No violence or imminent threats of bodily harm.
 No possession or use of weapons.
 No possession or use of alcohol or other drugs nor refusal to submit to
urinalysis testing.
 No gang-related or racially motivated activities, specifically violence,
intimidation and/or recruiting.
 No sexual misconduct.
Notes: Violation of a cardinal rule may result in expulsion from the program.
 Important concepts
The therapeutic community program helps
participants learn how to be accountable
for their choices and behavior in a
positive, caring environment.
Important concepts to know and
practice

 Help yourself/help each  Maintain accurate records

other
 Earn your privileges
 Acting as if
 Make a connection with
 No we/they dichotomy
the community
 Learn and model pro-social
values  Role modeling
 Establish a common belief  Respect staff as rational
system authorities
 Important concepts
Help yourself/help each other
 In the therapeutic community, members work
together to help each other and themselves.
 “I am my brother’s keeper” is a given.
 There is great therapeutic value in one addict
helping another
 Important concepts
Acting as if
 If a person acts a certain way long enough, he
will begin to feel that way and change his
attitude in that direction.
 For example, if you act like a positive person
you will soon feel like a positive person and be
comfortable doing it.
 Important concepts
No we/they dichotomy
 In the therapeutic community the differences are
minimized.
 While there is value in the differences among
cultural and ethnic backgrounds, all participants
suffer from the common problems of addiction.
 All members are given equal opportunity to succeed
 Important concepts
Learn and model pro-social values
 The learning process in the therapeutic
community comes from the community itself.
 The community is the agent of change.
 In a healthy therapeutic community, one learns
positive pro-social values and models them in
the community
 Important concepts
Establish a common belief system
 In the therapeutic community there is a common belief that
people can and do change for the better if they so choose
Earn your privileges
 One of the most basic beliefs in the therapeutic community is
that you earn what you get.
 Members of the community are expected to work and grow.
“Doing time” is not what the community is all about. All
privileges are earned
 Important concepts
Make a connection with the community
 When residents first enter treatment, their connection is with the community of
the “street.”
 The therapeutic community is a new environment and is quite different in terms
of beliefs, values, behaviors and expectations.
 In the beginning the therapeutic community challenges old beliefs and attitudes.
 The community, over time, believes and expects that what it has to offer is
valuable and beneficial.
 Residents are asked and are expected to join other community members around
the common bond of a substance-free and crime-free lifestyle
 Important concepts
Role modeling
 Throughout your life, you have learned from others.
 Much of this learning came from watching their behaviors.
 Sometimes you watched on purpose and other times you may have
been unaware that you were learning from what you observed.
 In the therapeutic community it is often said: “If you’re going to
talk the talk, walk the walk.”
 When you learn by watching others, you are learning from what
they model
 Important concepts
Respect staff as rational authorities
 In the past therapeutic community members have not
seen or trusted authority figures as guides and teachers.
 Staff in the therapeutic community serve as positive role
models and are considered Rational Authorities.
 They provide reasons for their decisions and the meaning
of consequences. Staff facilitate and correct, rather than
punish, behaviors
 Tools and structure
Therapeutic Community Tools

 Pull up  Ban contract

 Talking to  Glue contract
 Learning experience  Encounter slip
 Ticket  Encounter groups
 Therapeutic peer  Act As If
reprimand
 Therapeutic Community Tools
Pull up
 This is a verbal comment to someone to make
him aware of a negative action or behavior.
 The proper response to a pull up is to say,
“Thank you,” and then correct the behavior
 Therapeutic Community Tools
Talking to
 When someone has been pulled up for negative
behavior and failed
 to correct it, the next step would be a “talking
to.” The “talking
 to” tool is used by upper structure members or
staff.
 Therapeutic Community Tools
Learning experience
 Dr. George DeLeon teaches that therapeutic communities are
“environments engineered for social learning.” Learning experiences are
given to help residents focus on problems that are caused by their
behaviors and look at solutions to correct them. Learning experiences
typically consist of three areas: Behavioral, Cognitive and Social.

• Behavioral learning experiences consist of actions to focus one’s attention on

what is causing problems;
• Cognitive learning experiences consist of looking at one’s thinking;
• Social learning experiences consist of how one’s actions affect the community.
 Therapeutic Community Tools
Ticket
 A ticket is a written pull up given by expeditors,
department heads or senior residents. There is usually
a learning experience given with a ticket to help the
person correct the behavior that is causing problems.
 All tickets and learning experiences are approved
after investigation and agreement by treatment staff
 Therapeutic Community Tools
Therapeutic peer reprimand
 A therapeutic peer reprimand is used to raise an individual’s
 awareness of negative or destructive behavior. This creates an
 opportunity to teach appropriate behavior that is acceptable.
 Therapeutic peer reprimands can be conducted in front of the
 community or in a room with a panel and counselor.
 Therapeutic Community Tools
Ban contract
 Two people who feed into each other’s negativity might be banned
 from hanging out together for a period of time.
Glue contract
 This is a contract used when two clients would benefit from knowing
 each other at a deeper level. This contract is used to help clients
gain
 insight into each other’s culture or belief systems.
 Therapeutic Community Tools
Encounter slip
 Used to get someone in your Encounter Group to
encounter another
 member about his behavior or to determine how another
member is
 doing in the program. Encountering is done out of care
and concern
 to help the community member and the community
 Therapeutic Community Tools
Encounter groups
 This includes both “encounter process” and “special
groups.” This
 group is considered the “heartbeat” of a therapeutic
community.
 Many of the residents’ behavioral changes are the direct
result of the
 interactions experienced in these groups
 Therapeutic Community Tools
Act As If
 If a person acts a certain way long enough, he
will begin to feel that
 way and will change his attitude or behavior in
that direction
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 Structure and function
Structure board (job functions).
 clearly marked and must be followed.
Participants will be taught the different job
functions
Having a well-run structure is critical to a
successful treatment community.
TC structure board