Un modèle français de communauté thérapeutique? Les communautés thérapeutiques expérimentales: Consensus des professionnels

Abstract

Introduction: Therapeutic communities (TCs) were introduced as a means of support for individuals with substance dependence a little over forty years ago and are still a common treatment modality in the world. In France, TCs had a bad press because of sectarian drifts. The French Government Plan to combat illegal drugs, tobacco and alcohol (2004-2008) planned the opening of TCs on an experimental basis. Objective: The objective of this study was to define guidelines for the operation of a TC in the French context, based on the expertise of professionals, 30 months after the opening of experimental TCs. Methods: The Delphi analysis that supports the identification of consensus among experts was used. In the context of this study, the experts were professionals of the TCs. It is the expertise of these professionals that was sought. Results: The consensus of professionals to ensure efficient functioning of a TC have been defined. The inclusion criteria should not be restrictive. A pluridisciplinary team of professionals with similar skills than those in outpatient addiction treatment centers should hold the definition of the treatment program. The TC should follow a democratic model inclusive of residents but with a leading of the professionals. To avoid the risks of sectarism and leadership, the TC should make the choice of openness, transparency and integration into the local community and should offer a somewhat limited place to residents to prevent leardership diversion. Conclusion: It is expected that the consensus reached in this Delphi analysis will evolve over the years of operation of TCs but they are a first basis for implementation of TCs in France. © De Boeck Université. Tous droits ŕserv́s pour tous pays.