Connection in therapeutic communities.

The success of therapeutic community treatment is based on trust. Trust underlies the willingness of residents to endorse and profit from confrontations of their denial. Lack of trust can be seen to underlie the high dropout rate of many therapeutic communities. Social learning theory, which is usually cited as a theoretical foundation for therapeutic communities, does not explain the role of trust. Instead, we need an explanation of trust based on a logic of emotion rather than the cognitive, calculating logic of social learning. This logic can be found in the process of connection. Trust, in the theoretical orientation of connection, grows out of the resident's perception that community members care. This caring is revealed in their empathy for the resident, their willingness to take responsibility for helping the resident, and their nurturance. The resident's level of trust determines his (her) willingness to be open and responsive to the community. The implications of the connection process for the development of trust between new residents and old residents and between residents and staff are developed.