australasian alcohol and other drug therapeutic ... · the realisation of the australasian alcohol...

Australasian Alcohol and other Drug

Therapeutic Communities Standards

(TC Standards)

Pilot Edition

Project funded by the

Australian Government Department

of Health and Ageing

Australasian AOD TC Standards of 39

© Australasian Therapeutic Communities Association (ATCA) 2009 Except as provided herein, the text in this document and corresponding electronic files available on the ATCA website are not to be reproduced or copied without prior consent of ATCA. The material in this document and corresponding electronic files available on the ATCA website can be reproduced for the purpose of supporting quality processes by ATCA’s member organisations. Enquiries should be addressed to:

Australasian Therapeutic Communities Association

PO Box 42

Bangalow NSW 2479

Email: [email protected]

Author: Jill Rundle on behalf of the Australasian Therapeutic Communities

Association (ATCA) Funder: Australian Government Department of Health and Ageing

The ATCA acknowledges the funding contribution made by the Australian Government Department of Health and Ageing for the National Standards project which saw the development of the TC Standards and the TC Standards Support Package.


Contents

Forward ........................................................................................................................................................ 4

About ATCA ................................................................................................................................................ 7

Acknowledgements .................................................................................................................................... 8

The Development of the TC Standards .................................................................................................. 9

Why have TC Standards? ......................................................................................................................... 9

Piloting the TC Standards ....................................................................................................................... 10

Using the TC Standards and available support ................................................................................... 10

Which TCs can be involved in the pilot? ............................................................................................... 11

Self-Review ............................................................................................................................................... 11

Peer-Review .............................................................................................................................................. 11

The indicator categories – what do they mean? .................................................................................. 13

Desired Timeline....................................................................................................................................... 13

The TC Standards .................................................................................................................................... 14

STANDARD 1 ........................................................................................................................................... 15

STANDARD 2 ........................................................................................................................................... 16

STANDARD 3 ........................................................................................................................................... 17

STANDARD 4 ........................................................................................................................................... 18

STANDARD 5 ........................................................................................................................................... 19

STANDARD 6 ........................................................................................................................................... 20

STANDARD 7 ........................................................................................................................................... 21

STANDARD 8 ........................................................................................................................................... 22

Appendix 1: History of the TC sector in Australia and New Zealand .......................................... 23

Appendix 2: Glossary of terms and definitions ............................................................................... 26

Appendix 3: TC Standards Feedback Form ................................................................................... 33

Appendix 4: TC Standards Self-Review Worksheet Feedback Form ......................................... 34

Appendix 5: Peer-Review Feedback Form ..................................................................................... 35

Appendix 6: APPLICATION FOR MEMBERSHIP OF AUSTRALASIAN THERAPEUTIC

COMMUNITIES ASSOCIATION INC ........................................................................ 36


Forward

Australasian Alcohol and Other Drug Therapeutic Communities Standards

Therapeutic communities (TCs) have operated in Australia for 35 years. Originating in

Britain during the 1940s they proliferated in the United States in the 1960s and in Australia in

the early 1970s when they emerged in response to growing evidence of an increase in illicit

drug use.

Quality assurance in the community health sector had its origins in the early 1990s with the

Community Health Accreditation and Standards Program.

The realisation of the Australasian Alcohol and Other Drug Therapeutic Communities

Standards (TC Standards) is the culmination of efforts by the Australasian Therapeutic

Communities Association Board and member agencies since the Association was first

formed in 1986 to bring the disciplines of quality assurance to the sector to ensure the

integrity of the therapeutic community model in Australia.

By way of an introduction to the TC Standards an abbreviated history is important to place

them in context.

The formation of the Commonwealth National Campaign Against Drug Abuse in 1985

allowed for the first time a nationwide effort to address drug abuse. As part of this effort a

National Conference was convened to discuss the issues, however the TCs which were

represented at the Conference were not recognised as a stakeholder by the organisers.

In reaction to this lack of recognition the previously disparate TCs were galvanised into the

search for a collective voice and identity. A working party was convened at the Conference

to discuss the issues and the lack of advocacy for the TC movement. This group scheduled

a follow-up meeting at Odyssey House Melbourne in December 1986. At that meeting a

commitment was made by the leaders of the TCs representing all states and territories to

continue to develop the TC movement in Australia. A working party was formed and a

Statement of Purpose and Rules of the Association including a Staff Code of Ethics and a

Resident Bill of Rights was developed and the association became known as the Australian

Therapeutic Communities Association (ATCA).

In the years following, the ATCA Board provided a focal point for sector development and

through its annual conference and the ATCA Magazine it facilitated information exchange on

TC program innovations, updates on issues affecting the sector and the opportunity for

networks to grow. All of these initiatives helped to break down the isolation that many TCs

had experienced in the decade or so before.

Since the late 80’s a major concern for ATCA has been the implementation of a program of

ongoing quality assurance for member agencies and agencies aspiring to be TCs as well as

members of ATCA. At the time it was felt that evaluation processes would eventually be

required by both funding agencies and management committees, and the ATCA Board was

keen to take the initiative. In addition to individual program evaluations, ATCA recognised

the need to assist member agencies to continually improve service delivery in a non-

threatening way, the mechanism selected to do this was a quality assurance process

conducted as a Peer Review.

In 1996 New Zealand TCs joined ATCA and in 1997 ATCA became the Australasian


Therapeutic Communities Association formally recognising the collegial relationship that had

existed over a number of years.

In 2001-2 with financial assistance from the Commonwealth Government, ATCA completed

the research project ‘Towards Better Practice’ which reviewed the Essential Elements of

Therapeutic Communities developed in the USA, in the Australian context.

Amongst the recommendations, Dr Linda Gowing, researcher and author of the report

concluded,

Recommendation 2: Consideration needs to be given to which components of the MEEQ1 are most relevant to routine monitoring and quality assurance aspects. Extraction of these components into much shorter instruments is desirable for efficient application.

In 2005 ATCA commissioned the Future Directions document which canvassed member

agencies for their views on the future of the Association, the second highest key objective

identified by membership was;

‘To provide leadership, advocacy and representation of the therapeutic community

model to the broader community’

In 2007 at the Melbourne ATCA Conference the guest speaker Rex Haig spoke about the

Community of Communities Service Standards for Addiction Therapeutic Communities and

provided training to some member agencies after the Conference.

In 2008 at the Byron Bay ATCA Conference the guest speaker Dr George De Leon spoke

about the qualities of TCs and integrated treatment, he also spoke about a training

curriculum and the value of training in the implementation of the model.

On 30 June 2008, the Department of Health and Ageing provided funding to ATCA to

develop National Standards for Therapeutic Communities (AOD) in Australia. The project

vision was seen as part of an overall development of national standards for alcohol and

other drug agencies, and as such was intended to fit within a National Framework. In its

submission to the Commonwealth ATCA had outlined its intent to assist members to achieve

best practice in TCs.

“The Australasian Therapeutic Communities Association’s objective is to ensure the

integrity of the “Therapeutic Community” principle is maintained and will continue to

stand as a model of best practice in the treatment of substance misuse and co-

occurring disorders.

To support this contention the ATCA aims to develop a set of service standards

which identify and describe good practice and will facilitate service evaluation within

a quality framework. In concert with this project the ATCA intends to produce a

training package for the professional development of management and staff working

within the Therapeutic Community (TC) sector. This package will also include an

1 MEEQ is the Modified Essential Elements Questionnaire, which as per the Glossary of terms and definitions

have been renamed the Australasian Therapeutic Communities Essential Elements (ATCEEs) for the purposes

of the TC Standards and the Support Package.


induction kit for staff entering the TC field. “ (Lynne Magor-Blatch ATCA

Chairperson 2008)

The anticipated outcomes for the project included a set of service standards which would

identify and describe good TC practice and fit within a national quality framework.

� A process for conducting service reviews which will define best practice and enhance service provision in the AOD & Co-morbidity sector.

� An assurance that the integrity of the “Therapeutic Community” principle is maintained.

� A comprehensive training package that supports the Therapeutic Community approach to good practice and professional service provision.

� A workforce development process that enhances the sustainability of the NGO AOD sector.

� A professional framework for the Therapeutic Community model owned and supported by the members of the Australasian Therapeutic Communities Association which fits within a National Quality Framework.

The design of the TC Standards and accompanying Support Package is the work of Jill

Rundle who in a process of extensive consultation with ATCA members, the ATCA Board

and its Secretariat, has produced an excellent quality ‘map’ for TCs. These documents

provide instruction, direction and a toolkit for TCs just setting out as well as for those well

along the journey to self realisation of the model. The TC Standards are designed to

integrate readily into existing national frameworks, to minimise the administrative burden and

the workload inherited by organisations when they proceed down the accreditation road. I

would like to congratulate Jill for the outstanding work that she has done in a relatively small

period of time. I would also like to thank the members of ATCA who contributed to the TC

Standards in the consultation phase and who trialed both the TC Standards and the Support

Package modules in the review stage. I would also like to thank the ATCA Board, the

Steering Committee and the Secretariat for their involvement in the project.

Finally I would like to thank the Commonwealth Government Department of Health and

Ageing for its ongoing support of TCs in Australia and for its commitment to ensuring that the

work of Australian TCs remains of a high standard comparable to the best in the world.

Barry Evans

Chairperson

Australasian Therapeutic Communities Association 2009


About ATCA

The Australasian Therapeutic Communities Association (ATCA) was established in 1986 as

a membership association whose purpose was to bring together Therapeutic Communities

(TC) across Australia & New Zealand and to support and promote the TC as the method of

treatment for substance dependency.

In 2006 the Association received a grant from the Australian Government Department of

Health & Ageing which provided funding to operate a secretariat to; “provide information

aimed at improving the quality of TC services in the areas of treatment, research, education

and support”. This grant facilitated the employment of an Executive Officer to take

responsibility for fulfilling these goals.

The ATCA’s key functions are professional development and maintaining the fidelity of the

TC model. The Association is cognisant of the need to foster evidence-based practices as

the foundation for treatment.

The Association’s membership currently consists of 26 agencies providing 38 TC programs

across Australia & New Zealand.

TCs play a unique role in the treatment of dependency and co-morbidity. The TC model

focuses on the bio-psychosocial, emotional and spiritual dimensions of substance use, with

the use of the “community” to heal individuals and support the development of behaviours,

attitudes and values of healthy living. The holistic approach offered by TCs leads to

significant improvement in many areas of individual functioning. A shift from problematic

substance use, adoption of safe usage practices, improved work performance, reduced

criminal activity, improved interpersonal relationships and increased self-esteem are all

legitimate areas of success and all areas targeted by most TC programs.

Vision: To advance the TC model in Australasia through advocacy, research, capacity

building and networking.

Mission: Through community as method of treatment, we restore a sense of self, hope

and belonging to people who enter our Therapeutic Communities.

Purpose:

• Advance the TC Model in Australasia

• Advocate for recognition and funding for TCs in Australasia

• Encourage and support research into the TC Model

• Encourage capacity building in TCs by organising and disseminating information about development and funding opportunities.

• Networking organisations and individuals interested in therapeutic communities.


Acknowledgements

Funding for the project that saw the Australasian AOD TC Standards and the Support

Package developed was provided by The Australian Department of Health and Ageing.

Jill Rundle was contracted by ATCA in 2009 to undertake the project to develop the TC

Standards and the Support Package. The project was overseen by a sub-committee of the

ATCA Board, and included:

• Barry Evans (Chairperson ATCA; Executive Director The Buttery in NSW)

• Stuart Anderson (Vice Chairperson ATCA; Director Higher Ground in Auckland NZ)

• Lynne Magor-Blatch (ATCA Board Member; TC Sector Consultant)

The ATCA Board provided feedback and guidance to the progress of the project.

Additional ATCA Board members include:

• Eric Allan (ATCA Board Member; Managing Director Odyssey House, Vic)

• Gerard Byrne (Treasurer ATCA; Program Consultant, Recovery Services, Salvation

Army Australian Eastern Territory)

• Carol Daws (ATCA Board member; CEO Cyrenian House in WA)

• Mitchell Giles (ATCA Board Member; CEO Alcohol and Drug Foundation

Queensland)

• Garth Popple (ATCA Board Member; Executive Director We Help Ourselves, NSW

and Qld)

Janice Jones, ATCA’s Executive Officer, provided feedback, contribution and

administrative support to the project.

The Australasian TC sector contributed significantly to the development of the TC

Standards and the Support package, including a number of TC service board members,

123 TC staff and 350 service consumers contributing primarily through completing

questionnaires. The majority of the CEOs and/or TC service managers also contributed

through individual face-to-face, telephone or collective consultations.

ATCA would like to take this opportunity of thanking all who contributed to this project for

their input and support.


The Development of the TC Standards

ATCA’s objective in developing a set of service standards was to ensure the integrity of the

TC principle would be maintained and continue to stand as a model of best practice in the

treatment of substance misuse and co-occurring disorders. The set of standards aims to:

• Identify and describe good TC practice which can be incorporated into a national

quality framework

• Enable TCs to engage in service evaluation and quality improvement, using

methods and values that reflect the TC philosophy

• Develop a common language which will facilitate effective relationships with all

jurisdictions (national, state and territory)

• Provide a strong network of supportive relationships

• Promote best practice through shared learning and developing external links.

The development of the TC Standards and the accompanying Support Package for

implementing the TC Standards was informed by a literature review and consultation with

the Australasian TC sector. The literature review focused on the expectations of a set of

standards within the health sector. The set of standards has also been informed by previous

research undertaken by ATCA which resulted in the Towards Better Practice in Therapeutic

Communities report (Linda Gowing, Richard Cooke, Andrew Biven, and David Watts on

behalf of ATCA, 2002). The literature review report can be found on the ATCA website.

Consultation to inform the TC Standards was undertaken in two phases. The first was with

approximately 60% of the Australasian TC sector, including CEOs and managers, staff,

resident members and board members. This first phase consultation resulted in a draft set of

service standards and an outline for the Support Package. The second phase consultation

involved, wherever possible, the rest of the Australasian TC sector, and was used to refine

the TC Standards and Support Package. A summary report of the consultation can be found

on the ATCA website.

The significant participation by ATCA members (CEOs, managers, staff, consumers and

board members) in the process is a demonstration of the solidarity and goodwill within the

TC sector. The TC Standards, as such, have been developed by the sector for the sector.

Why have TC Standards?

Most TCs in Australia and New Zealand already apply a quality process, such as QIC,

EQuIP, ISO, TELAC, or QF. Some TCs have standards also set by different funding bodies.

The overwhelming feedback from TC representatives has been to ensure minimal

duplication and maximum links.

• The literature review that was completed as a part of the TC Standards

development determined consistent standard areas for quality processes relevant


to health services. The TC Standards were developed to fit into these areas in

order to maximise the links.

• The mandate for the development of the TC Standards was to support the fidelity of

the TC model and approach. As such, within the TC Standards, all but two key

indicators (on occupational health and safety and governance) are primarily

focused on supporting the fidelity of the TC model and approach – minimising

duplication.

Feedback from the TC sector also indicated that the application of general/non-sector

specific standards did not necessarily support the strengthening of the TC model, and the

fidelity of the approach was left up to the vigilance of the individual service. If your

organisation has an existing quality process that it applies, then undertaking the TC

standards will support the focus on the TC model. Linking the TC Standards with any

existing quality process in place will see both processes progressed as you work through the

TC Standards via the Support Package.

Piloting the TC Standards

The ideal, from ATCA’s perspective, is that the TC Standards can develop into a recognised

stand-alone quality process, recognised by the TC sector as well as all relevant regulatory

and funding bodies. The piloting of the TC Standards, the Support Package, the self-review

and the future peer-review processes will provide invaluable support to ATCA in its bid to

see the TC Standards registered as a recognised auditing tool.

ATCA needs support from its members, through participation and providing

considered feedback, if this is to eventuate.

Using the TC Standards and available support

In concert with the development of the set of TC Standards a Support Package for

organisation leaders and staff working within the TC sector has been developed. This

package supports:

• Organisation leaders and staff currently working at a TC

• The induction of new organisation leaders and staff working at a TC

• Organisation leaders and staff of services that intend to become or evolve into a

TC.

The Support Package aims to support the implementation of the AOD TC Standards.

In so doing it is intended that it will support the workforce capacity within the AOD and co-

occurring mental health sector and create an environment for sustaining the “career paths”

of trained AOD workers within the NGO sector, including the valued practice of workers with

“lived” experience of the field. Therapeutic communities particularly value the experience of


staff who are graduates of programs, and seek to incorporate learned knowledge and

experience into their professional practice.

The Support Package guides participants through the standards, providing relevant

information, suggestions for “measuring” quality approaches, and a link to the Self-Review

Worksheet. Working through the Support Package will simultaneously support your TC to

complete the Self-Review Worksheet, develop a list of opportunities for improvement, and

prepare you for a peer-review at a later date.

Which TCs can be involved in the pilot?

It is hoped that all ATCA members will participate in the pilot, that is:

• Implement the TC Standards using the Support Package resource

• Complete the Self-Review Worksheet; and once completed

• Organise for a peer-review at your TC.

Self-Review

The purpose of self-review is to determine:

• How effective the relevant approaches currently being applied at your TC are

• If there is a common understanding of what is needed in practice, for example, if

any “guidelines” in place are being adhered to

• Whether or not any opportunities for improvement can be identified.

The first two of these are effectively “measurements”, which can be quantitative or

qualitative. Measuring effectiveness or common values/adherence does not have to be

arduous, can be fun as well as enlightening, and can be incorporated into existing regular

meetings – for example in staff or board meetings. Keeping a record of any discussion that

occurs around such processes is useful so that the relevance of any issues raised are not

lost when you work through this aspect or approach in future reviews. As such the

“measurements” you record in this process become the “benchmarks” for the future.

Peer-Review

The intention of peer-reviews is to support the strengthening of the TC model at individual

services and across the TC sector.

Once an initial self-review is completed, your TC is ready for a peer-review against the

Australasian AOD TC Service Standards. Services do not need to feel that they have


achieved any ideal against the indicators – the process is as significant as the achievement

against the indicators, and the support that can be obtained through a peer-review will be

invaluable in future achievements.

Who will be the peers reviewing the TCs?

“Peers” participating in the review will be trained in supportive and objective review

processes. Your organisation is invited to have a manager participate in this training. The

training will facilitate improved understanding of the process at your TC and, through having

a trained representative peer-reviewer support other TCs, it will facilitate increased

networking throughout the sector and exchange of information.

It is expected that each ATCA member will host a peer-review visit during a pilot phase,

negotiating the peer-review dates and peer-reviewers through ATCA.

What will be the result of a peer-review?

The peer-reviewers will produce a report summarising the review process and the

demonstration of indicators at the TC. The level of expected demonstration of each indicator

(provided in each module component of the Support Package) provides a guide to this

process with rules for compliance yet to be established. The rationale for the level of

expected demonstration is based on feedback from the TC sector.

The peer-review report is also likely to include recommendations for future considerations in

your TC’s continuous quality improvement process.

The review process will be transparent, and as such it is anticipated that a report on a TC

will not present anything that is unexpected. A feedback form will specifically ask for your

view on the process, the report, and the effectiveness in supporting your TC.

The peer-review report will be the property of the TC that has been reviewed and as such

will be confidential. The distribution of that report, or dissemination of any information from

the report, will be at the discretion of the TC.

Feedback from the TCs about the peer-reviews will assist ATCA to review the TC Standards

and to take them to the next level as an auditing tool. The primary aim of the peer-reviews is

to support the fidelity of the TC model.

How might your TC demonstrate the indicators in a peer-review process?

The demonstration of each indicator is likely to be different, and may include one or more of

the following approaches:

• An audit of a sample of resident member records

• Resident feedback

• Documents and guidelines

• Observation of practice

• Staff consultation

• A community discussion


• A discussion with board members/organisation leaders

• Feedback from stakeholders

• Documented continuous quality improvement process which may include

demonstration of planning, implementing and reviewing.

There is likely to be a variety of ways that different services demonstrate the indicators,

some of those variances will be as a result of the specific approaches taken by TCs that

meet the needs of different population groups.

The indicator categories – what do they mean?

Each indicator has been categorised as one of the following:

• Essential: Indicators that demonstrate the service is a TC

• Expected: Indicators that are expected to be demonstrated by the TC sector

• Desirable: Indicators that demonstrate further best practice

It is important to note that each indicator may be achieved differently by different TCs,

significantly for those that are modified to meet the needs of different population groups.

The rationale for the categorisation of each indicator is based on feedback from the TC

sector and is presented in the Support Package.

Consideration of the level of expectation to demonstrate each indicator will inform the peer-

review. Feedback on how achievable and the appropriate the categories are will be good

feedback to receive from your TC as part of the piloting process.

Desired Timeline

The overall stages and the desired timeline for the development and piloting the TC

Standards are as follows:

1. Develop of the TC Standards and Support Package By July 2009

2. Pilot the TC Standards implementation and self-review

- Each ATCA member undertaking a self-review against the

TC Standards using the Support Package and the Self-

Review Worksheet

Annually with first

round completed

by July 2010

3. Pilot the peer-review of the TC Standards

- ATCA coordinating training of peer reviewers, encouraging

participation from managers of as many member agencies as

possible

Completed by July

2011


- Each ATCA member hosting a peer-review irrespective of

the level of perceived achievement determined through the

self-review

4. Reviewing the TC Standards, support and self and peer review

processes, and progress the TC Standards as a recognised auditing

tool

- Each ATCA member providing feedback on the Standards,

the self-review and the peer-review process, with any issues

addressed

- ATCA obtain support from significant funding/ regulatory

bodies for the Standards and the process

- ATCA refine the standards, support, review processes and

rules for compliance through sector feedback, and feedback

from regulatory bodies

- ATCA negotiate to secure auditable status of the standards

Completed by

January 2012

The TC Standards

The set of Australasian AOD TC Standards developed covers eight areas, identified in the

literature as being significant to the health care sector. These eight areas are also replicated

in most of the sets of standards that the AOD TC sector is currently applying. As such the

TC Standards can be well linked with and complement any existing quality process. The

inclusion of these eight areas was confirmed as important for the sector in the consultation

process that informed the development of the TC Standards. The areas covered include:

1. Appropriate and timely service provision;

2. Leadership and management principles;

3. Consumer participation;

4. Strategic human resource management;

5. Information management and appropriate use/evaluation of data;

6. Occupational health and safety;

7. Health and safety risk management; and

8. Continuous improvement.

The standard statements are broad, asserting the overall desired statement that a TC aims

to make in each of the areas. Each standard has a set of indicators which, when

demonstrated, support the assertion of the standard.


APPROPRIATE AND TIMELY SERVICE PROVISION

STANDARD 1

Service provision at the TC is informed by evidence based practice and sector

literature, including the Australasian TC Essential Elements

1.1 The TC program applies the Community as Method approach ESSENTIAL Module 1

Component 1.1:

Community as

Method

1.2 The TC program has distinct stages generally covering

assessment/orientation, treatment, transition and re-entry

ESSENTIAL Module 1

Component 1.2:

Staged Approach

1.3 The TC approach is multidimensional, involving therapy,

education, values and skills development, and flexibly meets the

needs of individuals accessing the service

ESSENTIAL Module 1

Component 1.3:

Holistic &

Multidimensional

Approach

1.4 Community resident members are informed of the TC’s

underlying values and principal rules at assessment and/or prior

to admission, and are supported throughout the program to

understand the underlying values informing the TC’s service and

the rationale of consequences for any breaches of the rules

DESIRABLE Module 1

Component :

Residents & TC

Values

1.5 Staff induction and in-house training incorporates the

Australasian TC Essential Elements

EXPECTED Module 4

Component :

Staff Induction

1.6 During recruitment potential staff are informed of the TC’s

underlying values to ensure best fit between the individual staff

and the TC

EXPECTED Module 4

Component :

Recruitment of

Staff using TC

Values

1.7 Assessment takes into consideration the resident member’s

health and safety risk factors, staff skills, and the capacity of the

service to inform appropriate treatment matching either at the

TC and/or via referral to another service

EXPECTED Module 1

Component :

Treatment

Matching

1.8 The Australasian TC Essential Elements are used to review the

practices and the continuous quality improvement of the TC

DESIRABLE Module 3

Component :

Review using

ATCEEs


LEADERSHIP AND MANAGEMENT PRINCIPLES

STANDARD 2

Clear principles, that are complementary to the TC model inform and guide the work

of the leaders and managers of the TC

2.1 Where an independent board oversees the governance of the

organisation and sanctions the activities of the TC the board

consists of, or draws on the expertise of, relevant professionals

to ensure fiduciary, legal and ethical clinical practices

EXPECTED Module 8

Component :

Governance

Planning

2.2 TC leaders and managers inform themselves of the TC

approach through relevant evidence based practice material in

order to support their roles

ESSENTIAL Module 2

Component :

The Model &

Principles for

TC Leaders

2.3 Managers and leaders are committed to and promote their

services as being based on the TC model, promoting the

efficacy of the TC approach and the consequent outcomes

DESIRABLE Module 2

Component :

TC Promotion

2.4 Career development and succession planning, with the view to

retaining and building on the TC knowledge base of the

organisation, is undertaken, supported and promoted by TC

leaders and managers

DESIRABLE Module 4

Component :

Career

Development &

Succession

Planning

2.5 Managers and leaders undertake regular review of their

practices, ensuring processes are in line with the TC principles

DESIRABLE Module 3

Component:

Reviewing

Management/

Leadership

Practices


CONSUMER PARTICIPATION

STANDARD 3

Resident member participation is supported and acknowledged as a key component

of the TC

3.1 The roles and expectations for resident members participating in

service provision are clearly articulated prior to admission and

reinforced throughout their engagement at the TC

EXPECTED Module 5

Component :

Resident Roles

3.2 Clear principles of resident member participation are developed

and ratified by management of the TC

EXPECTED Module 5

Component :

Principles of

Resident

Participation

3.3 A Bill of Rights for resident members at the TC is understood by

all community members

ESSENTIAL Module 5

Component :

Bill of Rights

for Resident

Members

3.4 Staff demonstrate an understanding of resident members’

participation processes and principles, and have clear guidelines

to maintain objective facilitation as final decision makers only

where necessary and for the purposes of ensuring best

outcomes

EXPECTED Module 5

Component :

Objective

Facilitation

3.5 Feedback, including information gained through consultations

with resident members, is used to evaluate the gains that they

have made through different levels of participation and their

sense of safety in that participation

EXPECTED Module 5

Component :

Resident

Feedback used

in Evaluation

3.6 Where resident members contribute to the functioning of the TC

their capacity and suitability to undertake tasks, occupational

health and safety considerations, and the potential benefits for

the individual, are assessed by staff, and consumers are

provided with adequate training, support and information

EXPECTED Module 5

Component :

Assessing the

Resident’s

Capacity


STRATEGIC HUMAN RESOURCE MANAGEMENT

STANDARD 4

The human resource management at the TC emphasises open and transparent

communication that enhances, maintains and sustains the development of knowledge

and skills in line with the TC principles and model

4.1 Clear roles for staff and volunteers are developed, maintained

and regularly reviewed to support defined task boundaries for

best effect and outcomes for the TC community

ESSENTIAL Module 4

Component :

Defined Roles

4.2 Leaders and managers invest in human resource management

to ensure appropriate recruitment and development of TC staff in

order to support the maintenance of the functioning of the TC

DESIRABLE Module 4

Component :

Investment in

Human

Resources

4.3 The TC has a policy on the recruitment of staff with a “recovery”

experience and where appropriate strategies that best meet the

needs of any specific population groups including Indigenous,

women and youth/adolescents resident members

DESIRABLE Module 4

Component :

Mix of Staff at

the TC

4.4 Clinical supervision, workplace appraisals and formal feedback

from consultation with resident members is used to review staff

practices

EXPECTED Module 3

Component :

Reviewing Staff

Practices

4.5 The TC has, and regularly reviews, a Code of Practice that

includes: issues of confidentiality; respect for the resident

members; limits of the service/staff and resident member

relationship including potential exploitation of resident members;

legal obligations; working with family members; and any conflict

of interest

EXPECTED Module 4

Component :

Code of

Practice

4.6 Staff skills and knowledge gaps are regularly assessed in terms

of meeting the needs of the current resident member group, and

this informs strategic workforce development

DESIRABLE Module 3

Component :

Reviewing Staff

Capacity


INFORMATION MANAGEMENT AND APPROPRIATE USE / EVALUATION OF DATA

STANDARD 5

Information management ensures the rights of the resident members are maintained

and the use of data supports continuous quality improvement and improved

outcomes

5.1 Service outcome measures are based on the range of factors

impacting on the resident member, such as: self-determined

goals; securing accommodation; improved relationships;

reduced criminal activity/improved post-prison integration;

improved health and well-being; education and vocational

development; improved living skills; and reduced drug use

harm

DESIRABLE Module 6

Component :

Outcome

Measures

5.2 Leaders and managers actively participate in and support

research contributing to evidence based practice and

collective TC sector information sharing

DESIRABLE Module 2

Component :

Contribution to

Sector

Research

5.3 Resident members are supported with guidelines to

understand their responsibilities in relation to sharing

information, confidentiality and maintaining respectful

communication

ESSENTIAL Module 5

Component :

Guidelines of

Responsibilities

for Resident

Members

5.4 Resident members’ records are maintained appropriately EXPECTED Module 6

Component :

Maintaining

Resident

Records

5.5 An appropriate data base is maintained to support service

evaluation, continuous quality improvement and reporting

DESIRABLE Module 6

Component :

Data Base for

Evaluation and

Improvement

5.6 Staff and resident members are trained in and have an

understanding of relevant policies, procedures and review

processes to ensure maximum compliance and relevance

DESIRABLE Module 3

Component :

Reviewing

Policies and

Procedures


OCCUPATIONAL HEALTH AND SAFETY

STANDARD 6

The TC is compliant with Occupational Health and Safety legislation to ensure the well

being of all community members

6.1 The organisation complies with relevant Occupational Health

and Safety requirements and legislation

EXPECTED

(Not a part of

ATCA Review

Process)

Module 7

Component :

OH&S

Compliance

6.2 In line with their governance role, managers and leaders are

aware of any occupational health and safety consideration

relevant to the TC and take appropriate action

EXPECTED Module 7

Component :

OH&S and the

TC

6.3 Staff oversee tasks and activities performed by the resident

members and encourage quality achievements and skills

development

EXPECTED Module 1

Component :

Overseeing

Tasks

6.4 Occupational Health and Safety policies and processes ensure

a safe environment for all community members

EXPECTED Module 7

Component :

Safe

Environment at

the TC


HEALTH AND SAFETY RISK MANAGEMENT

STANDARD 7

The health and safety of individual resident members is a priority for the TC

7.1 Resident members are provided with information on health

and safety factors particularly relevant to drug use, and where

appropriate are provided with opportunities of sharing this

knowledge with peers

EXPECTED Module 1

Component :

Residents and

Health & Safety

7.2 Staff are provided with regularly reviewed guidelines and

training to: adequately assess health and safety risks; maintain

a register of incidents, including critical incidents and

violations of principal rules; respond to health and safety risks;

and implement consequences for any breaches of TC’s

principal rules

EXPECTED Module 1

Component :

Guidelines for

Staff

7.3 Health and safety risk assessment informs the treatment plan

for each resident member, any case management

requirements with other services, and any safety measures

recommended to support resident members leaving the

program

EXPECTED Module 1

Component :

Treatment

Plans

7.4 An adequate number of clinical staff are supported to maintain

a current first aid certificate, and appropriate first aid training is

also provided to resident members

EXPECTED Module 4

Component :

First Aid

Requirements

7.5 Health and safety risk management processes are continually

monitored and reviewed

EXPECTED Module 3

Component :

Reviewing Risk


CONTINUOUS IMPROVEMENT

STANDARD 8

Monitoring practice and regularly reviewing processes is embedded into the everyday

practice of the TC

8.1 Improving outcomes of resident members, evident through

evaluation wherever possible, is the priority consideration in

decisions to change the service and approach

EXPECTED Module 8

Component :

Prioritising

Outcomes in

Planning

8.2 Improvement initiatives and overall planning processes for

continuous quality improvement takes into consideration

evident need, the principles underlying the Australasian TC

Essential Elements, and the support needs of staff

ESSENTIAL Module 8

Component :

Planning with

TC Principles,

Evidence &

Support

8.3 Processes for continuous improvement and change

management are regularly reviewed

DESIRABLE Module 3

Component :

Reviewing

Change

Processes


Appendix 1: History of the TC sector in Australia and New Zealand

Gowing et al (2002, p 9) in Towards Better Practice in Therapeutic Communities, revealed

that “there is no clearly accepted, simple definition of a therapeutic community”. That

report provided a range of definitions presented in different literature, much of which

focuses on the particular aspects of the TC (this report can be found in ATCA’s website:

www.atca.com.au). De Leon (2000 p: 26) makes mention of the history of resistance to

define the TC on the basis that the “uniqueness of the TC as a personal and communal

experience would be oversimplified, diminished, or simply lost in the process of

codification”.

With this in mind, below is a discussion on the TC aspects presented by the US

Department of Health and Human Services, National Institute on Drug Abuse, August

2002, (p 1- 2), Research Report Series – Therapeutic Communities: What is a

Therapeutic Community?

The therapeutic community (TC) for the treatment of drug abuse and addiction has

existed for about 40 years. In general, TCs are drug-free residential settings that use

a hierarchical model with treatment stages that reflect increased levels of personal

and social responsibility. Peer influence, mediated through a variety of group

processes, is used to help individuals learn and assimilate social norms and develop

more effective social skills.

TCs differ from other treatment approaches principally in their use of the community,

comprising treatment staff and those in recovery, as key agents of change. This

approach is often referred to as “community as method.” TC members interact in

structured and unstructured ways to influence attitudes, perceptions, and behaviors

associated with drug use. Many individuals admitted to TCs have a history of social

functioning, education/vocational skills, and positive community and family ties that

have been eroded by their substance abuse. For them, recovery involves

rehabilitation— relearning or re-establishing healthy functioning, skills, and values as

well as regaining physical and emotional health. Other TC residents have never

acquired functional lifestyles. For these people, the TC is usually their first exposure

to orderly living. Recovery for them involves habilitation—learning for the first time

the behavioral skills, attitudes, and values associated with socialised living. In

addition to the importance of the community as a primary agent of change, a second

fundamental TC principle is “self-help.” Self-help implies that the individuals in

treatment are the main contributors to the change process. “Mutual self-help” means

that individuals also assume partial responsibility for the recovery of their peers—an

important aspect of an individual’s own treatment.

The ATCA Website also offers the following aspects of what makes up a TC:

A Therapeutic Community is a treatment facility in which the community itself,

through self-help and mutual support, is the principal means for promoting personal

change.


In a therapeutic community, residents and staff participate in the management and

operation of the community, contributing to a psychologically and physically safe

learning environment where change can occur.

In a therapeutic community, there is a focus on the bio-psychosocial, emotional and

spiritual dimensions of substance use, with the use of the community to heal

individuals and support the development of behaviours, attitudes and values of

healthy living.

The US Department of Health and Human Services, Therapeutic Community Curriculum,

Module 1 Introduction to the TCC (OH#1-7) offers the following definition:

A TC is a structured method and environment for changing human behavior in the

context of community life and responsibility.

Traditional and modified TCs?

Gowing et al (2002 pp 50 - 51) in Towards better Practice in Therapeutic Communities,

provided a summary of the considerable discussion in the literature on traditional and

modified TCs. Related to the resistance to defining TCs the distinctions made between

traditional and modified TCs is in many ways a bid to ensure the evolving TCs remain true

to an approach. The development of the Essential Elements in America, and the

subsequent Australasian Essential Elements is a part of the process of ensuring the fidelity

of the TC approach. The following is a summary describing the distinctions made between

different TCs as presented in Gowing et al (2002).

In many cases the TC approach has been modified in specific ways to meet the needs of

certain population groups (including for adolescents, people with co-occurring drug and

alcohol and mental health issues, women with children, delivery in prisons, for Indigenous

peoples). As an example of considerations in a service for adolescents Jainchill and

colleagues (2000) identify the primary modifications made to address their unique needs

as:

• shortened recommended lengths of stay • participation of families in the therapeutic process • limited use of peer pressure • a more vertical authority structure, with adolescent clients having less input than their

adult counterparts in community management • the role of work is secondary to that of being a student and obtaining a high school

diploma.

The Drug Abuse Reporting Program (DARP) in the USA made distinctions between

traditional, modified and short-term TCs, primarily based on the duration of the program

(with traditional TCs offering 1-3 year program, modified TCs offering 6-8 month programs,

and short-term TCs offering 3-6 month programs). The duration of the program sees

different program goals able to be achieved and differing intensities or demands on the

residents.

TC Services in Australia and New Zealand


The history of TCs in Australia and New Zealand commenced with:

• We Help Ourselves (WHOs) in NSW, 1972 • The Buttery in NSW, 1975 • ADPACT (now ADFACT) established in Canberra 1976 and Karralika TC established

in 1978 • Odyssey House established in Australia & New Zealand, 1977 • Killara House in Vic and NSW, 1978-1979 • Cyrenian House in WA, 1981

In 1986 The Australasian Therapeutic Communities Association (ATCA) was established

to support and promote TCs. ATCA now has membership of 26 agencies providing 38 TC

programs across Australia & New Zealand.

TCs in Australia and New Zealand in general identify as being “modified” TCs. This is

primarily on the basis of the provision of services to specific population groups and the

length of the program able to be offered. Along with the sector’s desire for fidelity of the TC

model the term modified often seems to be interpreted negatively, however the modified

nature need not undermine the essential elements that inform a TC approach.

Working towards the strengthening of the TC model as it is applied at each service allows

TCs to draw from, and contribute to, an evidence based and evolving approach.


Appendix 2: Glossary of terms and definitions

Alcohol and other drugs (AOD)

The rational for the term, as opposed to alcohol and drugs, drug and alcohol, etc. is to reinforce that alcohol is a drug.

Australasian TC Essential Elements (ATCEEs)

The ATCEEs were developed as a part of a project initiated by ATCA and funded by the Commonwealth Department of Health and Ageing (Australia). The specific aims of the project were “to identify and define the essential elements of a therapeutic community model for the treatment of illicit drug abuse, evaluate the contribution of these elements to the efficacy of the model, and establish the minimal standards which serve as the bench mark for the delivery of a Therapeutic Community (TC) treatment”.

The ATCEEs were drawn from the Survey of Essential Element Questionnaire (SEEQ) which was developed in the USA by Melnick & De Leon (1999). The SEEQ has 139 statements and was designed to be self-administered. It records a respondent’s opinion or perceptions as to the importance of the statements to the therapeutic community concept. “Given the experience with the SEEQ in the USA, and the validation work, this instrument was chosen as the basis for defining the therapeutic community approach in Australia” (Gowing et al, 2002) Gowing and colleagues consulted with the Australasian TC sector and made recommendations for modifying the essential elements statements to better define the therapeutic community approach in Australia and New Zealand. The result was a reduced set of statements, totaling 79, reworded and reorganised into relevant categories. These were referred to as the Modified Essential Elements Questionnaire (MEEQ). As for the SEEQ, the MEEQ was designed to support research and evaluation activities. To support this, the statements were organised under the broad categories of: the TC ethos; program delivery; and quality assurance.

Within the consultation that informed the development of the Australasian AOD TC Standards, and this Support Package, it became evident that the sector still did not have a sense of “ownership” of the MEEQ, and the term “modified” was confused with the category of modified TCs. It was felt that the term used with the essential elements implies a judgment of their validity. It was determined that the MEEQ be renamed as the Australasian TC Essential Elements or ATCEEs

Change management

Implementing a quality process implies implementing a process of change. It is generally appreciated that without effective change management and leadership there will be resistance to change, there may be reduced productivity, possible increased turnover of staff, and a reduced probability that the desired results will be achieved (Hiatt et al, 2003).

Change management is about helping people through change. It is the process, tools and techniques for proactively managing the people side of change in order to achieve the desired business results (Hiatt et al, 2003: pp 10 – 11).

Community as method

A profound distinction between the TC and other treatments and

communities is the use of community as a method for changing the


whole person (De Leon 2000: p 92).

The fundamental assumption underlying community as method is that

individuals obtain maximum therapeutic and educational impact when

they meet community expectations for participation in and use of the

community context to change themselves (De Leon 2000: p 98).

Continuous Quality Improvement (CQI)

As the term suggests, continuous quality improvement is the process of

continually improving the quality of service provided. It utilises standards

and accreditation processes, but more significantly ‘involves procedures

for the ongoing review and evaluation of the service delivered by an

organisation’ (Australian Council for Safety and Quality in Health Care,

July 2003a: p 4). It is a ‘structured organisational process for involving

personnel in planning and executing a continuous flow of improvements

to provide quality health care that meets or exceeds expectations’

(McLaughlin et al, 2004: p 3). As such continuous quality improvement is

the means by which standards are implemented.

Co-occurring mental health and AOD

The high rate of co-occurring or concurrent mental health and alcohol and other drug problems is increasingly recognised, yet continues to pose complex treatment and management issues for both the alcohol and other drug and the mental health sectors.

Other terms often used for co-occurring mental health and alcohol and other drug problems is “comorbidity” and “dual-diagnosis”.

Health and Safety Risk Management

Health and safety/clinical risk management was originally promoted as a

means of controlling negligence and litigation. It has since developed to

inform the approach taken by an organisation to improve the quality and

safe delivery of health care. This can be achieved through a multifaceted

approach to preventing adverse events and improving consumer safety.

The approach fundamentally includes identifying circumstances that put

consumers at risk of harm and putting measures in place to prevent,

control or minimise risk. To ensure the effective management of health

and safety risks the service needs to identify what they are, and analyse

and evaluate the risk likeliness and potential consequences. Appropriate

communication about risk management within the organisation and

continually monitoring and reviewing the process adds to the overall

continual quality improvement approach for health and safety risk

management (summary of issues from Health Department in Victoria

and WA).

Managers and leaders

For the purposes of the literature review report, the consultation report, the TC Standards and the Support Package, managers and leaders refers to board members or the equivalent organisation leaders the CEO and, as determined as appropriate by the organisation, the TC Service manager.

Leadership in a TC is in general much broader, representing leaders from resident members, staff and board members. The distinction is made in these resources for the purpose of ensuring roles for achieving different quality processes are the responsibility of the appropriate leaders.


It is the discretion of the TC to include a quality champion and/or a consumer advisor to support the activity of the managers and leaders in their quality processes.

Modified TC A modified TC is a service that continues to incorporate the essential elements of a TC and yet is modified, for example, to meet the needs of specific population group or in program length.

In many cases the TC approach has been modified in specific ways to meet the needs of certain population groups (including for adolescents, people with co-occurring drug and alcohol and mental health issues, women with children, delivery in prisons, for Indigenous peoples). As an example of considerations in a service for adolescents Jainchill and colleagues (2000) identify the primary modifications made to address their unique needs as:

- shortened recommended lengths of stay - participation of families in the therapeutic process - limited use of peer pressure - a more vertical authority structure, with adolescent clients having

less input than their adult counterparts in community management

- the role of work is secondary to that of being a student and obtaining a high school diploma.

The Drug Abuse Reporting Program (DARP) in the USA made distinctions between traditional, modified and short-term TCs, primarily based on the duration of the program. The duration of the program sees different program goals able to be achieved and differing intensities or demands on the residents.

Lynne Magor-Blatch (power-point presentation December 2008) summarises:

Traditional TCs have

- a goal of total resocialisation - one to three years in duration - treatment that includes high demands, confrontation and

sanctions

Modified TCs have

- a goal of developing practical skills, - six to eight months duration - treatment that includes moderate demands and sanctions

Short-term TCs have

- a goal of providing skills to allow the client to survive in society and re-establish family relationships

- three to six months duration - treatment demands that are moderate to high

Objective Facilitation

Gowing et al (2002: p 95) provides a discussion on the development of objective facilitation being identified as a role for staff at Australasian TCs. An equivalent role presented in the SEEQ (Melnick and De Leon, 1999) was one of “rational authority”. Gowing et al identified the term rational authority as presenting some confusion, varied responses, and some discomfort. The consensus was to change the wording.

The essential element that uses the term (ATCEE 29) is:


In general decision-making processes are consultative, with staff as objective facilitators and the final decision-maker only where necessary

De Leon (2000: p 123) discusses rational authority:

The unique requirement of staff as decision makers is that they are rational authorities. Rational authorities make decisions grounded in the TC perspective to protect the community and specifically to foster the goals of individual growth.

Occupational Health and Safety (OH&S)

Occupational safety and health (OSH) is a cross-disciplinary area

concerned with protecting the safety, health and welfare of people

engaged in work or employment. As a secondary effect, OSH may also

protect co-workers, family members, employers, customers, suppliers,

nearby communities, and other members of the public who are impacted

by the workplace environment (http://www.jobs.net.au).

Occupational health should aim at: the promotion and maintenance of

the highest degree of physical, mental and social well-being of workers

in all occupations; the prevention amongst workers of departures from

health caused by their working conditions; the protection of workers in

their employment from risks resulting from factors adverse to health; the

placing and maintenance of the worker in an occupational environment

adapted to his [or her] physiological and psychological capabilities (Joint

International Labour Organisation / World Health Organization

Committee on Occupational Health)

Recovery

There were some concerns with the use of the term “recovery” in the TC Standards and Support Package, primarily due to perceived connotations associated with the term. The intent of the term as it is used is consistent with that described by The UK Drug Policy Commission Recovery Consensus Group A vision of recovery (July 2008) which identifies recovery as a process with the following key features:

- Recovery is about the accrual of positive benefits, not just reducing or removing harms caused by substance use.

- Recovery requires the building of aspirations and hope from the individual drug user, their families and those providing services and support.

- Recovery may be associated with a number of different types of support and interventions or may occur without any formal external help: no ‘one size fits all’.

- Recovery is a process, not a single event, and may take time to achieve and effort to maintain. The process and the time required will vary between individuals.

- Recovery must be voluntarily-sustained in order to be lasting, although it may sometimes be initiated or assisted by ‘coerced’ or ‘mandated’ interventions within the criminal justice system.

- Recovery requires control over substance use (although it is not sufficient on its own). This means a comfortable and sustained freedom from compulsion to use. This is not the same as controlled use, which may still be harmful. Having control over one’s substance use means being able to make the choice to use a substance in a way that is not problematic for self, family


or society. For many people this will require abstinence from the problem substance or all substances, but for others it may mean abstinence supported by prescribed medication or consistently moderate use of some substances (for example, the occasional alcoholic drink).

- Recovery maximises health and well-being, encompassing both physical and mental good health as far as they may be attained for a person, as well as a satisfactory social environment. The term ‘maximises’ is used to reflect the need for high aspirations to ensure that users in treatment are enabled to move on and achieve lives that are as fulfilling as possible.

- Recovery is about building a satisfying and meaningful life, as defined by the person themselves, and involves participation in the rights, roles and responsibilities of society. The word ‘rights’ is included here in recognition of the stigma that is often associated with problematic substance use and the discrimination users may experience and which may inhibit recovery. Recovery embraces inclusion, or a re-entry into society and the improved self-identity that comes with a productive and meaningful role. For many people this is likely to include being able to participate fully in family life and be able to undertake work in a paid or voluntary capacity.

The vision statement for recovery as presented by The UK Drug Policy Commission Recovery Consensus Group is

- The process of recovery from problematic substance use is characterised by voluntarily-sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.

For further information on the discussion please see http://www.ukdpc.org.uk/resources/A%20Vision%20of%20Recovery.pdf

Resident Member

TC service representatives variously used the term resident, client, consumer, community member, participant and resident member. Resident member was determined by the ATCA board as the most appropriate term to use predominantly throughout the TC Standards and the Support package resources. The other terms are used occasionally, however, reflected in quotes and feedback and where the other terms better supported the discussion.

The rationale for not selecting the other terms include:

- Resident did not make a distinction between TC and residential rehabilitation participants

- Clients, it was felt, maintained a power distinction between the staff and the resident members

- Consumer and participant were less personal and specific than residential member

- Community members in the literature is inclusive of staff and resident members

While a TC does not have to be in a residential setting at present in Australian and New Zealand TC services are all residential.

TC Model

The therapeutic community (TC treatment model is its social and psychological environment. Each component of the environment reflects an understanding of the TC perspective and each is used to transmit


community teachings, promote affiliation, and self-change (De Leon, The Therapeutic Community: Theory, Model, and Method, 2000: p 99).

Lynne Magor-Blatch (power point presentation 2008) provides a summary of the TC model:

- Provides a combination of therapeutic involvements between residents and staff and among residents (especially senior and junior residents) through living in a caring and challenging community as the principal means to encourage change and personal development

- Provides a multidimensional treatment involving therapy, education, values and skills development

- The common theme to all TCs is one of self-help and the notion that residents play an integral, active role in their own therapy and in the therapy of other residents

- Social-cognition approach, comprising attitudinal, normative and behavioural control components

- Process involves five main areas of primary treatment: o socialisation in terms of developing attitudes and values

of a mainstream, prosocial lifestyle o psychological improvement, in terms of heightened

insight, self-esteem and self-efficacy o recognition of triggers to drug taking o the development of self-efficacy through new coping skills o the development of drug-free networks.

TC Principles

The term was often used by the Australasian TC sector representatives in the consultation process. The intent of the term as it is used in the TC Standards and the Support Package, includes that:

- change is supported - there is open and transparent communication - there is broad and inclusive consultation - significant participation expectations are supported and promote

empowerment.

Such principles, while not stated directly, are implied throughout the ATCEEs and literature on TCs.

The Australasian Therapeutic Communities association (ATCA)

The Australasian Therapeutic Communities Association (ATCA) was

established in 1986 as a membership association whose purpose was to

bring together Therapeutic Communities (TC) across Australia & New

Zealand and to support and promote the TC as the method of treatment

for substance dependency.

The ATCA’s key functions are professional development and

maintaining the fidelity of the TC model. The Association is cognisant of

the need to foster evidence-based practices as the foundation for

treatment.

Therapeutic Community (TC)

The ATCA Website offers the following aspects of what makes up a TC:

- A Therapeutic Community is a treatment facility in which the

community itself, through self-help and mutual support, is the

principal means for promoting personal change.

- In a therapeutic community, residents and staff participate in the

management and operation of the community, contributing to a


psychologically and physically safe learning environment where

change can occur.

- In a therapeutic community, there is a focus on the bio-

psychosocial, emotional and spiritual dimensions of substance

use, with the use of the community to heal individuals and

support the development of behaviours, attitudes and values of

healthy living.


Appendix 3: TC Standards Feedback Form

ATCA hopes that you have found the TC Standards of benefit and use to your TC. We would appreciate your feedback and comments. These will be carefully considered and incorporated wherever possible when the TC Standards and the support resources are next reviewed. 1. Have you found the TC Standards useful? Yes No

2. What do you think are the strengths of the TC Standards?

Please comment 3. Can you identify any key gaps in the TC Standards that you feel would improve

them or areas that can be made more relevant to TCs?

4. Do you have any general suggestions for improving the TC Standards? 5. What is your interest in the TC Standards, e.g. resident member, staff member,

organisation leader? If you would like to make further comment than the space allows please do so on additional pages. Thank you for completing this feedback form. Please photocopy and return to the Australasian Therapeutic Communities Association, PO

Box 42, Bangalow, NSW 2479, or email to [email protected].


Appendix 4: TC Standards Self-Review Worksheet Feedback Form

ATCA hopes that you have found the Self-Review Worksheet of benefit and use to your TC. We would appreciate your feedback and comments. These will be carefully consider and incorporated wherever possible when the TC Standards and the support resources are next reviewed. 1. Have you found the Self-Review Worksheet useful? Yes No

2. What do you see are the strengths of the Self-Review Worksheet?

Please comment 3. Can you identify any key gaps in the Self-Review Worksheet that you feel would

improve it, or approaches that can better support your TC?

4. Do you have any general suggestions for improving the Self-Review Worksheet? 5. What is your role at the TC, e.g. resident member, staff member, organisation

leader? If you would like to make further comment than the space allows please do so on additional pages. Thank you for completing this feedback form. Please photocopy and return to the Australasian Therapeutic Communities Association, PO



Appendix 5: Peer-Review Feedback Form

ATCA hopes that you have found the Peer-Review process of benefit and use to your TC. We would appreciate your feedback and comments. These will be carefully considered and incorporated wherever possible when the TC Standards and the support resources are next reviewed. 1. Have you found the Peer-Review process useful? Yes No

2. What do you think are the strengths of the Peer-Review process?

Please comment 3. In what ways would you suggest the Peer-Review process is changed to better

support your TC?

4. Do you have any general suggestions for improving the Self-Review Worksheet? 5. What is your role at the TC, e.g. resident member, staff member, organisation

leader? If you would like to make further comment than the space allows please do so on additional pages. Thank you for completing this feedback form. Please photocopy and return to the Australasian Therapeutic Communities Association, PO



Appendix 6: APPLICATION FOR MEMBERSHIP OF AUSTRALASIAN

THERAPEUTIC COMMUNITIES ASSOCIATION INC

(name of applicant Organisation)

(hereinafter referred to as Applicant), of

(address)

desires to become a member of Australasian Therapeutic Communities Association Inc

(Association)

In the event of admission of the Applicant as a member of the Association, it agrees to be

bound by the Constitution of the Association for the time being in force.

(Name & signature of duly authorised person for and on behalf of the Applicant)

Date

I , a member of the Association, nominate the applicant,

for (name) membership of the Association.

Signature of Proposer

Date

I , a member of the Association, second the nomination

for (name) the applicant, for membership of the

Association.

Signature of Seconder

Date


APPLICATION FOR MEMBERSHIP

ORGANISATION DETAILS

Name of Organisation:

Address:

Nominated Representative:

Phone Number: email:

Nature of Program:

Aims of Program:

Residential Capacity:

Target Groups:

Facilities:


Number of Staff:

Staffing Structure:

Chairperson's Name: Phone Number:

Please indicate whether you are applying for:

Full Membership Provisional Membership Affiliate

(see details of membership classifications below)

Please enclose the following information:

• Constitution

• Program details

• Management Flow Chart

• Annual Report

• Brochures or promotional material

Application Fees:

• Full Membership and Provisional Membership $110 (incl GST)

• Affiliate $55 (incl GST)

Cheques should be made payable to the Australasian Therapeutic Communities Association

and sent to;

Australasian Therapeutic Communities Association

PO Box 42

Bangalow NSW 2479

Direct Deposits can be made to:

ATCA Management Account

BSB: 032 005

Account Number: 768234


BECOME AN ATCA MEMBER

FULL MEMBERSHIP is for organisations that provide a service embracing the values of

“Community as Method” and whose practice identifies with standards as defined by the

Association.

Rights: Full Members receive notice of meetings, attend meetings, be heard and vote at

meetings of the members of the Association. They can nominate and be nominated to stand

for election to the Board

PROVISIONAL MEMBERSHIP is for organisations that embrace the values of

“Community as Method” but do not yet meet the standards of practice as defined by the

Association. These organisations must express the intention of becoming a Full Member

within two years.

Rights: Provisional Members have the same rights as Full Members except they can not

nominate or be nominated to stand for election to the Board. They may however be

seconded onto the Board for a defined period.

BENEFITS OF MEMBERSHIP

FULL & PROVISION MEMBERS receive:

o Discounts when attending ATCA Conferences and workshops o Quarterly Newsletter o Benefits from the projects undertaken by ATCA o Access to Peer reviews

PROVISIONAL MEMBERS also receive:

o Peer support and assistance with attaining Full Membership.

You can also join ATCA as an AFFILLIATE

AFFILIATES are individuals or organisations who support and/or are interested in the

“Community as Method” model but do not work within this regime.

Affiliates can not nominate or be nominated to stand for election to the Board. They may however be seconded onto the Board for a defined period.

AFFILIATES receive:

o Discounts when attending ATCA Conferences and workshops o Quarterly Newsletter

FOR A SCHEDULE OF MEMBERSHIP FEES SEE THE ATCA WEBSITE

www.atca.com.au