Is there a European approach to drug-free therapeutic communities? A narrative review

Esiste un approccio europeo alle comunità terapeutiche per i disturbi correlati a sostanze? Una revisione narrativa

E. Cortini[1] [2], M. Clerici[1], G. Carrà[3]

1 Dipartimento di Neuroscienze e Tecnologie Biomediche, Università di Milano Bicocca; 2 ASL Monza e Brianza; 3 AO San Gerardo, Monza


Since early 1960s, the American Therapeutic Communities (TC) movement has strongly influenced the addiction treatment field. However, in Europe the knowledge base of TCs is still fragmented.


There is the need to describe differences and similarities between American and European TCs, in terms of approaches, roles and positions for organizational, treatment and preventive policies issues in substance abuse.


An electronic literature search was conducted (1966-2010) using the Medline, Psych Info and CINAHL databases.


Social and ideological characteristics supporting TCs significantly influence the relative weight given to different therapeutic contents such as behaviourism, milieu therapy, social learning, professional team role, networking and evidence based assessment of outcomes. Across Europe, different trends in different countries coexist.


Although the American TC movement undoubtedly influenced treatment of addiction throughout Europe, an original European model has emerged in terms of theoretical models, treatment implementation strategies and staff training. An ongoing crosscultural comparison between different settings would allow a better understanding of the strengths and weaknesses of rehabilitation programmes in TCs.

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