The Nine Competencies of a Traditional Therapeutic Community
First published in 1981, Revised in November 2014
by David H. Kerr
I have met with the “father” of the therapeutic community, Dr. Maxwell Jones[1]. Jones started the first therapeutic community in England in the 1940s, designed for returning veterans from the Second World War. Jones explained to me that the best way to help people was to engage them in helping themselves and others in a communal setting. This was the same design used at the Yale Psychiatric Institute and was later to be used by many TC’s around the world.
The therapeutic community emphasizes a person’s relationship with the surrounding community as a prime indicator of health and well-being. The tenants of AA and NA are important, and meetings organized under the twelve steps are common in many TCs even today. Positive behavior and attitudinal change are promoted and practiced and expected in the long-term TC and this encourages a positive demonstrated lifestyle change by program completion. This is in contrast with today’s focus on the “patient” or “client” as the recipient of help rather than as the key to providing help. With that in mind, there are nine competencies listed below that should be understood and practiced by a counselor/coach working in a therapeutic community or TC:
Competence 1: Understanding and promoting upward mobility and the privilege system
Definition of Competence: Nothing in a therapeutic community except basic human rights is awarded without being earned by the member i.e. there is no “free-lunch” in the TC. The system of advancement and rewards, as well as imposed sanctions is clearly spelled out and understood by each new TC member. Examples of some privileges that must be earned in a therapeutic community include passes or furloughs, letter writing, dating, advancement in the community structure, visits, eligibility for work, school, etc. It is the belief in the therapeutic community that when status and recognition are earned and owned, the positive effects are much more permanent. Privileges that are unearned are soon taken for granted, promoting an attitude of selfishness in community members that doesn’t bode well for recovery.
Competence 2: Understanding and promoting self-help and mutual-Help
Definition of Competence: Members of a community working together to help themselves and each other; a self-help environment is a supportive environment with loving concern rather than selfishness; an environment emphasizing human understanding; an environment that emphasizes self-responsibility and deemphasizes people being serviced or the traditional service model.
Competence 3: Understanding and promoting the concept of “no we-they dichotomy.”
Definition of Competence: Attempts should be made to create a structure that reduces the barriers between “helper” and “helpee.” The “helpee,” or student member, should be looked at as possessing equal capabilities and potential as the “helper,” or staff facilitator or coordinator or coach. In a therapeutic community, members help themselves and each other; while staff, facilitate this process. The fact that the staff is usually paid and members are not makes it impossible to eliminate this dichotomy completely. However, fostering this dichotomy encourages the traditional service model. Here the student members are seen more as helpless patients. The staff assumes the role of providing advice and counsel rather than coaching and support. To the extent that this dichotomy between staff and student member exists, the TC effectiveness is diminished.
Definition of Competence: If a person acts a certain way long enough, that individual soon will feel that way and, in fact, reorient his lifestyle in that direction. The therapeutic community emphasizes acting pleasant or happy, even though members (or staff) may have problems or feel bad. This “act-as-if” philosophy supports a positive therapeutic community environment that, in turn, supports other members acting and thinking positively. Despondent and depressing attitudes or clownish or negative behaviors are often infectious and counterproductive in a small community. One individual’s problems or issues can easily become a major crisis for the entire therapeutic community family.
Competence 5: Understanding the relationship between belonging and individuality
Definition of Competence: “Without something to belong to, we have no stable self, and yet total commitment and attachment to any social unit implies a kind of selflessness. Our sense of being a person can come from being drawn into a wider social unit; our sense of selfhood can arise from little ways in which we resist the pull. Our status is backed by the social buildings of the world, while our sense of personal identity often resides in the cracks.[3]” Generally, the priority of the initial phase of the therapeutic community is on ownership and belonging, while individuality and self-realization are stressed in the latter phase of the therapeutic community. The term “belonging” connotes a sense of ownership and identification with the community and the people therein. Fostering belonging encourages members’ belief that the therapeutic community will help them. Belonging also encourages team activities and group spirit, which enhances self-esteem. It also encourages a search for personal identity, which requires support and nurturing, as does encouraging a sense of ownership in the program; belonging and individuality maintain a dialectic relationship throughout the therapeutic community program. Emphasis is placed initially on “belonging,”while “individuality” is stressed at a later stage in the recovery process. Too much weight placed on the area of belonging, however, encourages cultist and unchecked devotion to a cause; while overemphasis on individuality may support selfishness, causing members to lose sight of the need for support for and help from others.
Competence 6: Understanding of social learning versus didactic learning
Definition of Competence: Social learning or experiential learning in a TC is best described as the natural process of “growing up” or maturing. Didactic learning occurs with cognitive or intellectual communication of ideas or thoughts from one individual to another. In the therapeutic community, didactic learning takes place in the form of seminars, schooling, or lectures; while social learning embraces TC concepts, including, but not limited to, role modeling, peer pressure, learning by experience, and the “family concept” and social order. Didactically offering advice, or providing a service to a student member, by advising him/her what to do is not considered in a TC the most effective way to enhance personal growth, although it might be necessary from time to time. Social learning, however, as in osmosis, is a process by which TC members absorb information, suggestions, and TC concepts to improve their behavior and attitude. While this process supports didactic learning, the TC is most effective when there is practice of new behaviors and continuing feedback from other student members and staff during the normal functioning in the residential community.
Competence 7: Understanding the need for a belief system within the community
Definition of Competence: Most cultures or societies are guided by a written or unwritten set of beliefs, values, mores, spiritual guidelines, rules and regulations, or laws. Most therapeutic community proponents agree with the definition mentioned above, that in the TC, something greater than the individual member is at work in their lives, facilitating and enhancing the positive social learning process. Each therapeutic community, however, has a slightly different set of beliefs; and, in fact, some belief systems may be radically different than others. As long as the therapeutic community belief system is reflective of the larger society’s system of values, mores, and beliefs, and is ethical, there is no need to question or criticize a programs particular set of beliefs. This concept is designed to separate a cult of radical beliefs from a TC that reflects the positive norms of the larger society.
Competence 8: Understanding and practicing positive role modeling
Definition of Competence: The behavior and attitude of a staff coach must exert a positive influence over the community members. Since much learning and growth occurs through the process of modeling behavior or imitating others, it is important that the coach understands the need to set a positive example. A positive example does not mean inflicting the coach’s personal values and mores on the student member. Both staff and student members must be encouraged to be positive models. For example, if there are primarily black members in a community, it is more natural to hire black staff members to facilitate more effective identification and role modeling. If most TC student members are recovering people with mental health issues, then there should be some long term clean and sober certified recovering addicts who have overcome their mental health issues employed as staff members.
Competence 9: High Expectations
Definition of Competence: This is another essential process that must function at a high level in the TC. The TC expects much of its student members and its staff, and although incoming student members bring with them a long and troubling past, they should not be seen as helpless. These student members are not to be referred to as “patients,” The concept of “high expectations” demonstrates why it is not appropriate for TCs to use the word “patient,” a word that describes a helpless person. Once the “patient” label is tacked on, the concept of “high expectations” becomes questionable since we then have a “we-they” or counselor-patient environment possibly limited by a counselor’s expectations. That said, the TC must recognize the different levels of functioning of student members needing support and coaching, so as to guide the process of self-help and mutual-help based on individual needs.
[1] The therapeutic community: A new treatment method in psychiatry” Maxwell Jones http://www.amazon.com/The-
[2] “Success or failure depends more upon attitude than upon capacity; successful men act as though they have accomplished or are enjoying something. Soon it becomes a reality. Act, look, feel successful, conduct yourself accordingly, and you will be amazed at the positive results.” From William James. http://www.brainyquote.com/
[3] Erwin Goffman, Asylums, Garden City: Doubleday and Company Inc., 1961
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