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RSAT Forum > Monthly Discussion > September 2023: Modified Therapeutic Communities View modes: 
skossow - 9/12/2023 9:54:52 AM
September 2023: Modified Therapeutic Communities
What's the difference between a regular therapeutic community (TC) and a modified therapeutic community? We have, I think, a traditional TC, but have trouble getting the correctional officers on board. Have other RSAT programs with TCs or MTCs been able to get correctional officers to be active TC or MTC members?

skossow - 9/12/2023 12:58:35 PM
RE:September 2023: Modified Therapeutic Communities

First question: There are a number of differences between a TC and a MTC, although the core elements are much the same. MTCs address participants with mental health disorders, histories of trauma, and sometimes even medical issues, as well as substance use disorders. TCs usually address substance use disorders only. Within correctional settings, both TCs and MTCs should also address more broadly criminogenic needs. Given the differences in participants, MTCs should employ less confrontational methods than those is traditional TCs, asking participants to use reflection as a way to process unhealthy and risky ways of thinking and behaving. MTCs emphasize helping participants to understand their mental health issues, including trauma, so participants can anticipate and avoid triggers when possible, and learn coping strategies to better respond to emotional triggers.

Second question:  One of the most important components of both TCs and MTCs is the role of the correctional officers (CO) assigned to the units that house the programs. COs need to serve as consistent, trustworthy, compassionate, and transparent role models for participants. To do this, along with the rest of the staff involved, they must be trained in the philosophy and practice of TCs or MTCs to ensure fidelity to the TC or MTC model. The research is clear that TCs and MTCs that stray from evidence-based practices and philosophies compromise their effectiveness.

RSAT MTC programs that have successfully incorporated COs into their units have employed several strategies.  First, they have included COs assigned to their units in the same trainings provided to RSAT treatment providers, case managers and management about what a MTC is. It is vital that COs are on the same page on how to interact with RSAT participants with both SUD and mental health disorders.  However, if there is high turnover in COs assigned to the MTC unit, it is generally impossible to maintain trained COs in the unit. For this reason, RSAT programs have found it is also important that education on MTCs be provided to all COs, whether they are specifically assigned to the RSAT units. Every CO, whether in the unit or not, should have some basic idea of what a MTC is doing.  Also, every CO needs to understand the basics about SUD and mental health disorders in order to carry out any assigned position effectively in today’s prison or jail.

This leads to the second successful strategy RSAT MTC programs have employed.  Convincing facility administrators to maintain the same COs in the MTC units as much as possible so that there is always a consistent core of trained COs present, including the senior ranking or most experienced CO in the unit. 

Third, RSAT MTC programs have found it helpful to ask administrators to prioritize MTC assignments for COs who volunteer.  Many COs are not comfortable being so personally involved with individuals in these units. Some find it too difficult to break away from a prison/jail culture that maintains a strict “us vs them” dichotomy.   In many prison/jail cultures, both officers and those incarcerated regard their peers with suspicion if they appear to be too willing to interact with the other.  Obviously, to be effective in MTCs, COs must be willing and able to talk to, listen to, and work with people who are incarcerated so that the participants are able and willing to talk to, listen to and work with COs.

Fourth, the rest of the MTC staff must be encouraged to treat the COs in the unit as colleagues and seek their input and advice.  COs will feel more a part of a program if they have a say in its operation. Issues of security and discipline are generally greatly reduced in RSAT units that are also TCs or MTCs.  The role of COs in providing security and securing everyone’s safety must be appreciated by the MTC staff as well as participants. 

MTC staff must realize that to be successful, the “community” of a successful MTC program must be maintained and nurtured 24/7, 365 days a year. During most of these hours, this depends upon the COs alone. Their collaboration, cooperation, and willingness to act as role models for RSAT MTC participants are essential for a successful treatment environment.