To say "modern TC's have evolved away from these methods" when speaking of confrontational attack therapy methods applied by Synanon derivatives which still operate today is either a whitewashing of the largely unregulated megabucks industry which cheaply often fails to overcome its roots in perpetuating abuses in the name of therapeutic intent or is ignorance or propaganda borne of denial here. Numerous Treatment Centers promote from within the ranks which encourages an under-trained staff to repeat the cycle which they see as having worked for them (as the very program's breakdown tactics foster dependency on the program and a diminished self worth of their identity without the program) despite dismal success rates compared to other models such as those geared toward harm reduction. This makes for slower change. At best you have a participant who attributes their success to the program and internalizes any failures as the result of an inherent flaw within themselves, because the TC doctrine says as much. Such programs often leave the participant with a sense that that place wasn't for them, at worst it results in institutional trauma and profound mishandling of the conditions with which the participant arrived.

"TROSA symbolizes a "gradual shifting" from the more confrontational TC model of Synanon and earlier communities, to methods such as motivational interviewing, according to Paul. Motivational interviewing is a counseling approach that avoids direct confrontation, instead relying on empathetic collaboration to help addicts resolve their ambivalence toward addressing their substance use. Despite these new approaches, Paul is careful not to undermine the core foundations of the therapeutic community."

Of course Paul is careful not to undermine the core differences. This program based on what a success story gleaned from Delancey Street which was started by a Synanon member is basically a dressed up version of the old with less screaming and adjunct medication management thrown in --which in the world of addiction treatment trying to overcome the reputation and sometimes the methods of the harsh hair-cutting humiliations of its origins which still persist today is no small feat, but lets not pretty this up as anything other than a Synanon spin off which is operating as a 2 year work house...

They receive therapy, housing, food, and clothing free during their stay. In exchange, these men and women must stay off drugs and alcohol and work in one of the businesses that TROSA operates

with good copy. Most addicts given the two years time this program runs and if provided wrap around services will have improved immensely, even on an outpatient basis --but that's harder to cash in on and brand --especially those in their young adult years nearing their mid-twenties-- and those won't have had to be taken in by a closed group environment which separates them from the world and their families to achieve this.

Jessie Guy-Ryan has written a really heartfelt article here, and I truly hope that when the brother leaves TROSA he leaves in a better place or eventually finds his way there or that having been sidelined into a netherworld of the environments fostered in such TCs for 2 years hasn't left him too far from getting there