Peter and David (and other Listmates)
I’ve been thinking about your recent contributions and it’s sparked me into making my own.
I think Peter raises a very valid point in his assertion that heavy drinking (particularly amongst senior staff) was a significant factor in many UK TCs. How much that was the case in other European (or even American) TCs, I would not really know. My view is that this exposes one of the weaknesses of the then system. I think there was a failure to understand and respond to the pressures that the system put senior staff under with its reliance on them as role models. David Warren-Holland, in a recent issue of the TC journal talked very openly and movingly about the difficulties he faced when he left the “TC world” and had to function in the other reality.
But I don’t know where Peter gets the idea that the problems of the early TC are glossed over. I’m a member of a number of on-line discussion groups around drugs and alcohol and I can say with some certainty that this is not the case. In UK/European lists, TCs are rarely mentioned – in fact, I suspect many list members will never have heard of them. Not surprising since (as an example) until fairly recently, only the Ley Community (amongst the remaining UK TCs) actually used the phrase on its website! On American lists, TCs are often attacked and vilified. Usually on the basis of stories or rumours about early TC practices although there seems strong evidence that some graduates of Synanon, Daytop, Phoenix etc. have gone on to make a healthy living through using that early methodology particularly with young people in teen challenge type boot-camps where vulnerable teenagers are dumped by their parents (often against their will – kidnap style) and face what can only be described as bullying and abuse:
http://www.alternet.org/story/11228/
So I really don’t think the early failures of TCs are hidden at all. The story of Synanon is retold (generally without acknowledging the ground-breaking work achieved in the early years) on numerous cult-watcher sites. If anything, we need to be redressing the balance.
My view is that there were some things that TCs got very badly wrong and that one of those things was often a self-destructive reluctance to recognise those problems and change. But that is not to deny that they were one of the most powerful influences for good in a drug treatment field that was really learning good practice as it went along.
I’m struck though by an interesting piece of symmetry. As some of you know, I and others, have been spending some time tracking down the early pioneers of the TC movement and interviewing them. One of the things that has struck me was the powerful feelings of epiphany many of them felt. In a time when no-one believed in recovery, here was a system that appeared to achieve the impossible. Now it seems to me that the wheel has turned full circle. Two decades of substitute prescribing has left us with a generation of addiction workers who have never heard of recovery and generally do not believe it exists. We have seen the return of the disease model to centre stage. Worse! It has return in cunning disguise and sucked in many of the more progressing developments of the late 20th Century and twisted them to its own ends (the use of Motivational Interviewing is an interesting case in point here).
So perhaps now is a good time to use a list like this to develop our arguments and examine the possibility of an enhanced role for TCs in the new millennium. In Scotland at least, there is a growing dissatisfaction with the current methadone-dominated response. What is holding back the consideration of TC methodology (apart from a lack of knowledge of its very existence) is the myth that it is prohibitively expensive. Here is an area that we can think about. I’m pretty sure that the EFTC with its connections to EWODOR can develop the evidence base to show that it is, if anything, cheaper. So I do think that there is a value in raking over the embers and visualising what a TC for the 21st Century would ideally look like and where it would fit within - and interact with – the rest of the drug treatment network. It certainly wouldn’t look like early Synanon, those days are gone – but it would, without doubt contain many of the early elements.
I’d really like to hear the views of other list members on this. What do people think will be the role of therapeutic communities for addiction in the coming years. Am I being fanciful or is this really a good time for a come-back tour?
Rowdy Yates
Senior Research Fellow
Scottish Addiction Studies
Department of Applied Social Science
University of Stirling
E: [log in to unmask]
T: 01786 - 467737
W: http://www.dass.stir.ac.uk/sections/scot-ad/
NOTE: EFTC Conference, 6 - 9 June 2007, Ljubljana, Slovenia
W: http://www.eftc-europe.com/conferentie/--The University of Stirling is a university established in Scotland by charter at Stirling, FK9 4LA. Privileged/Confidential Information may be contained in this message. If you are not the addressee indicated in this message (or responsible for delivery of the message to such person), you may not disclose, copy or deliver this message to anyone and any action taken or omitted to be taken in reliance on it, is prohibited and may be unlawful. In such case, you should destroy this message and kindly notify the sender by reply email. Please advise immediately if you or your employer do not consent to Internet email for messages of this kind.