Modified therapeutic communities and adherence to traditional elements

Meredith Huey Dye, Lori J. Ducharme, J. Aaron Johnson, Hannah K. Knudsen, Paul M. Roman

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Traditional therapeutic communities (TCs) are characterized by confrontational group therapy, treatment phases, a tenure-based resident hierarchy, and long-term residential care. Many TCs have modified the structure and intensity of the traditional model, tailored services for specific client populations, and hired more professionally trained staff. This study examines the extent to which modified TCs are able to retain the underlying core technology of the TC. Using data from a nationally representative sample of 380 self-identified TCs, six traditional TC elements are identified. Results from a structural equation model indicate that offering services for specific populations and professionalization of staff has limited impact on the six TC elements. Modifications to structure and intensity of TC programming evidenced the strongest effect. Specifically, outpatient-only TCs showed significantly lower adherence to five of the six elements. Short-term residential programs showed a similar negative trend. Findings suggest selected modifications are possible without significantly impacting the TC model's core technology.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalJournal of Psychoactive Drugs
Issue number3
StatePublished - Sep 2009


  • Substance abuse treatment
  • Therapeutic community

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychology (all)


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