NDARC Technical Report No. 18 (1993)
INTRODUCTION
Therapeutic communities had their origins in the late 1940s when Maxwell Jones, a psychiatrist working in London, established a residential community as an alternative to medical treatment for young people with behavioural problems. In 1958, the first drug-free therapeutic community, Synanon, was established in California to rehabilitate drug users.
According to the Therapeutic Communities of America, a therapeutic community, is a non-medical, residential setting that encourages personal growth by changing the lifestyle of individuals with social deficits, including criminal behaviour. People in a therapeutic community are members, not patients, and they play a part in the management of the community. The main emphasis is on the resocialisation of an individual within this community prior to moving back into society.
Some of the common features of therapeutic communities for drug users include a drug free environment, clear rules to govern the behaviour of all members, the development of problem solving skills, encounter groups, and behaviour modification through a hierarchical social system with the goal of re-entry into society (Luger, 1979; Gerstein and Harwood, 1990).
Therapeutic communities have provided drug-free treatment in Australia for approximately twenty years. In 1991, the Australian Therapeutic Communities Association has a membership of 24 organisations, 10 of which are located in New South Wales. According to the much more liberal definition of a "therapeutic community" used in the Australian Directory of Alcohol and Other Drug Services (Mills, 1992), there were a total of 83 therapeutic communities in Australia, 32 of which were in N.S.W.. Since it is doubtful, however, that many of the organisations so classified would meet the narrower definition used by the American Association we prefer the lower estimate of the ATCA.
Currently, therapeutic communities comprise approximately 21% of Australian drug and alcohol treatment agencies that offer a service to individuals who use opioid drugs (Baillie, Webster & Mattick, 1992). A national census of drug and alcohol treatment service agencies undertaken in 1992 (Chen, Mattick, and Baillie, 1993) found that 700 people were residents of therapeutic communities throughout Australia on census day, 317 of whom were in N.S.W..
Surprisingly little is known about the clientele of therapeutic communities. We have only rudimentary information on: the number of persons they assist, their demographic characteristics, drug use, and treatment history, and their length of stay (see Didcott, Flaherty and Muir, 1988 for an exception). This report aims to partly remedy this lack of knowledge by describing the characteristics of clients, and their length of stay, at one such therapeutic community, the Buttery, over the period from 1980 to 1992.