Book Review

Citation

Warren, K.L. (2021), "Book Review", Therapeutic Communities: The International Journal of Therapeutic Communities, Vol. 42 No. 2, pp. 109-110. https://doi.org/10.1108/TC-06-2021-049

Therapeutic communities are complex interventions, incorporating work, peer and staff feedback, role modeling on the part of staff and residents, discussion groups, didactic groups run by residents and movement through a peer hierarchy, among other aspects of the programs. Each piece of the TC interacts with other pieces; for instance, work positions serve as an arena for peer feedback, and residents are expected to become better role models as they rise through the hierarchy.

The complex nature of TCs makes them challenging to describe and manualize. The authors of this handbook, who between them have well over a century’s worth of experience in TC clinical practice and research, address this problem in two ways. In developing the book, they interviewed a broad group of TC professionals and researchers about TC clinical practice in a prison setting. In writing it, they use a structure that moves from general principles such as community as method to gritty specifics such as problems that individual residents are likely to have in adjusting to the work program. This structure allows the reader to deepen her or his understanding of TCs while repeatedly encountering key clinical ideas in different contexts.

The resulting handbook begins with a history of TCs for substance abuse treatment. The second section of the book discusses the general principles that distinguish TCs from other forms of treatment, such as community as method, the vital balance between work time and group time, the asset-based nature of the TC and the role of staff as senior members of the community. Material on planning and implementing TCs in a prison environment follows, with a strong emphasis on maintaining community identity in the face of a prison subculture. A case study chronicles the actual implementation of a prison TC. (A striking aspect of this chapter is the amount of contact between TC clinicians from other programs and those from the new program. Despite the use of manuals such as this one, TC practice, similar to other forms of mental health and addiction treatment, remains to a considerable extent an oral tradition.) The handbook concludes with material for an entire workshop on prison TCs, including a set of workshop student roles such as time keeping and cleanup that mimic the work structure of TCs and links to presentation slides, exercises, student handouts and further readings.

The assumption throughout is that staff will need a thorough grounding in TC principle and practice before considering how to adapt the program to correctional settings, and so the bulk of the material in the book addresses TCs in general rather than specific adaptations to prison settings. It therefore goes well beyond its title, serving as a well-organized and thoughtful introduction to TC practice as well as a handbook for implementing TCs in prisons. This means that almost anyone with an interest in these programs will find material of value. An academic researcher or student writing a term paper who is interested in the reason for the TC emphasis on work will find an explanation in the discussion of community as method in the second section of the book. A clinician who wants more detail can refer to the workshop material on work in TCs and may wish to read some of the associated readings. Prison administrators who are implementing a TC will want to run the workshop for all staff.

In some cases, this book could have devoted more detail to the issues it raises. More material on aftercare and the general issue of community reentry would have been useful, potentially including some discussion of systems such as alumni clubs and peer outreach counselors, which could be based at the TC. A discussion of ways to encourage staff who have been trained in more professionally centered clinical techniques to transition into the role of senior members facilitating the interaction of TC residents might also be useful. But any introduction to TCs is bound to be incomplete in some way, given the complex nature of the programs. Overall, this handbook and its associated workshop and reading materials are the most approachable introduction to TCs currently in circulation. They should be widely read by current and future TC clinicians and researchers.

All materials can be found at the Council of Europe Pompidou website: www.coe.int/en/web/pompidou/tctraining