Abstract
Therapeutic communities (TCs) for substance abuse incorporate a system of peer feedback through written affirmations and corrections. Previous research has found that TC residents show a response to affirmations that is detectable for roughly 8 weeks, with response to corrections being of shorter duration and weaker overall. It is not clear whether and to what extent response to feedback in TCs varies between men and women. Previous research in other settings suggests that women should be more responsive to feedback than men. In order to test this hypothesis we draw on a large dataset of affirmations and corrections sent and received in three 80 bed TC units, two of which house men and one of which houses women. The analysis uses a multilevel negative binomial model, treating affirmations and corrections that TC residents receive as predictors of affirmations that they send over a 9 week period (week 0, the week during which affirmations and corrections are actually sent, and eight subsequent weeks). The model controls for gender, age, race, unit and scores on the Level of Service Inventory-Revised (LSI-R). The relationship between affirmations received and those sent is stronger for women during the initial week and on lags 1-2 and 5-8. The relationship between corrections received and affirmations sent is stronger for women on lags 2 and 8. Graphs suggest that response to affirmations falls off in an exponential curve, while that to corrections appears to include a periodic element. These results indicate that both men and women respond to feedback, but that the strength of the women's response is somewhat greater. These results suggest that any difference in suitability by gender to the feedback approach that characterizes TCs may favor women.
Highlights
Therapeutic communities (TCs) are residential programs for substance abuse recovery in which mutual aid within the community of peers forms the core approach to treatment [1, 2]
There is no evidence of non-linearity in this relationship, and the analysis found no relationship between Level of Service Inventory-Revised (LSI-R) score or race and the number of affirmations that residents send
Consistent with laboratory research, this study found that female residents of TCs have a stronger response to peer feedback than male residents of TCs, and that the difference in response to affirmations in particular is statistically detectable over 8 weeks
Summary
Therapeutic communities (TCs) are residential programs for substance abuse recovery in which mutual aid within the community of peers forms the core approach to treatment [1, 2]. The repeated finding that women are more active in their social networks than men suggests that women place a high value on relationships [13, 14] Given this evidence, it is not surprising that that both peer and staff interactions are significant for retention among women in substance abuse treatment [15]. Difficulty in forming peer relationships appears to be a challenge in other correctional settings, with women sometimes reporting that it is easier to form relationships with staff than with peers [18] This issue is likely to be salient for TCs, given the programs’ emphasis on the entire community of staff and peers as the method of treatment [1, 2]
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