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Therapeutic Communities

What are Therapeutic Communities?

1. Therapeutic communities (TCs) are a common form of long-term residential treatment for substance use disorders, and to date the TC approach has been adopted in more than 65 countries around the world.

A. True

B. False


2. Each of the following is an accurate statement about the evolution of therapeutic communities EXCEPT:

A. Historically, TCs have seen themselves as a mutual self-help alternative to medically orientated strategies to address addiction, and most have only allowed program participants to use medications such as methadone and naltrexone

B. Over the past 30 years, TC's attitudes toward medications have gradually evolved, reflecting changing social attitudes toward addiction treatment and the scientific recognition of addiction as a medical disorder

C. A growing number of TCs now take a comprehensive approach to recovery by addressing participants' other health issues in addition to their SUDs, incorporating comprehensive medical treatment

D. Many of today’s TCs are offering shorter-term residential or outpatient day in addition to long-term residential treatment


What is a Therapeutic Community’s Approach?

3. Therapeutic communities have a recovery orientation thats focuses on abstinence from drug use as well as:

A. Acute-care, including improvements in overall health

B. Development of healthy stress-management and coping skills

C. The whole person and overall lifestyle choices

D. Simultaneously addressing mental health issues that may impact substance use


4. While adhering to the concept of “alliance by design,” therapeutic communities use active participantion in group living and activities to drive individual change and the attainment of therapeutic goals.

A. True

B. False


5. TC activities are a central part of the mutual help process, and include group discussions with peers, individual counseling, community-based learning through meetings and seminars, confrontation, games, and role playing.

A. True

B. False


How is Treatment Provided in a Therapeutic Community?

6. Which of the following is NOT one of the characteristics of the treatment stages of therapeutic communities?

A. In the first stage, the individual assimilates into the TC in order to disrupt the identification with and ties to his or her previous drug-using life and replace these affiliations with new pro-social attitudes

B. The second treatment stage often incorporates evidence-based behavioral treatments including cognitive-behavioral therapy (CBT) and motivational interviewing, to facilitate to process of change

C. In the third treatment stage, the participant prepares for separation from the TC and successful re-entry into the larger community by seeking employment or making educational or training arrangements with the TC’s help

D. Typically, patients move through the stages of treatment in 12 to 18 months, which is the amount of time covered by most insurance policies


How do Therapeutic Communities Treat Populations with Special Needs?

7. TCs for individuals with co-occurring substance use and mental disorders are designed for participants with moderate mental illnesses such as mood disorders, personality disorders, and adjustment disorders.

A. True

B. False


Women

8. Women-only mixed gender TCs offer integrated mental health, substance abuse, educational, vocational, legal, and housing placement services that seek to address women’s complex needs.

A. True

B. False


Adolescents

9. The adolescent TC addresses the specific needs of the adolescent participant, providing a ____________________________ treatment approach that recognizes and attends to the development issues that adolescents face.

A. Supportive and individualized

B. Complementary and cooperative

C. Comprehensive and holistic

D. Compassionate and constructive


How are Therapeutic Communities Integrated into the Criminal Justice System?

10. Some prisons have incorporated TCs modified for the special needs of offenders, with an emphasis on treatment that focuses on living honestly, developing self-reliance, learning to manage their strong emotions and accepting responsibility for their actions.

A. True

B. False


How are Therapeutic Communities Adapting to the Current Environment?

11. While some therapeutic communities now accept patients receiving maintenance therapy with addiction medications, most continue to educate staff and participants about how such medications are often used as a “crutch” for those with addictive behaviors.

A. True

B. False


Responding to Health Care Reform

12. Recent health care reforms that expand access to and coverage for substance abuse treatment for greater numbers of people are providing incentives for addiction treatment to:

A. Integrate more with general medical care

B. Provide more evidence-based treatments

C. Improve tracking of patient outcomes

D. All of the above


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