What is a Therapeutic Community

When healthcare professionals hear about a “therapeutic community” they might think about an institution for long-term drug users where staff and patients live, work and eat together.

At Castle Craig, the therapeutic community is a powerful part of the addiction treatment programme. The idea is that patients become participants in their own, and each other’s treatment.

In a new video on the subject Dr. McCann, Managing Director at Castle Craig, explains: “The therapeutic community is an essential part of what Castle Craig provides. It is a supportive fellowship in which people can feel safe, can expose themselves, can allow themselves to become vulnerable by opening up in therapy, by opening up to individuals within the community, by disclosing aspects of themselves they wouldn’t normally discuss.”


How does the therapeutic community at Castle Craig work?

Patients undergoing addiction treatment guide new patients through the daily programme, offer mutual support and talk with each other in one of the large sitting rooms. The community adapts naturally as patients come and go and it complements the medical and therapy services that are offered to all patients.

Addiction is a very complex illness and needs to be treated holistically. It’s important to not forget the social, or human, angle in its treatment. Professor Jonathan Chick explains: “Addictions are probably best thought of as mental, emotional or psychological illnesses — with a very important social aspect. The cultural pressures and group dynamics that take place are very important not only in the starting of addiction but also in the perpetuation of addiction.”

Mark Abrami, a therapist at Castle Craig, sees the Therapeutic Community as “the most important and valuable tool that we have — where new patients spend their time with other patients in the community. They really get to know about each other. That acts as a mirror, a mirroring process, back to the individual patient.”

“It’s like a laboratory”, says Professor Chick, “where people practice living a different way of life; living their ups and downs, their little skirmishes with other folk, those little annoyances in their daily life — learning to handle all that on their own and gaining a confidence, regaining that self-confidence that they’ve lost.”

Professor Chick points out that the patients who have left Castle Craig often say that it was the groups, the group experience, and the people they had met, that was the most valuable aspect of what they learned at Castle Craig. “Seeing that they could also help others” continued Professor Chick, “[has an] amazing effect on building self-confidence.”

“I like the atmosphere as you come in the door,” says Dr Maria Kelly in the new video, “the patients all have their own jobs to support the community. It seems very peaceful and supportive.” Dr Kelly, who is Castle Craig’s Associate Medical Director, believes that the patients can give each other support that is “really unique” and she talks of the “power of the group.”