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Spectrum’s Integrated Cognitive Behavioral/Therapeutic Community Model

Spectrum Health Systems is a leader in creating integrated treatment models that bring together the best of therapeutic community (TC) and cognitive behavioral approaches (CBT).  I have recently had the pleasure of working with Spectrum senior staff Peter Paolantonio, Christopher Petrozzi and Cindy Buraczynski to write a groundbreaking article “Integrated Cognitive Behavioral Treatment in Prison-Based Therapeutic Communities” that was recently published in the “Offender Programs Report” a well-respected publication that is widely read by treatment professionals.  Publishing is important because it provides an opportunity to share what we have learned and helps bring national attention to the excellent work at Spectrum.

A long-standing controversy in the substance treatment field has been whether the TC or CBT models are more effective.  For a long time I have felt that this question is somewhat misleading and out of date since most effective programs usually include elements of both approaches.  Over the last few years while serving as Senior Research Advisor at Spectrum, I have had the opportunity to deepen my understanding and appreciation of Spectrum’s integrated approach.  Based upon the work at Spectrum, the decision was made to share its approach with the larger community of substance abuse and criminal justice professionals. 

A central goal of the article was to broaden the understanding of prison-based substance abuse treatment and recognize the value of integrating the best of both the TC and CBT approaches for high-risk offenders.  Both approaches have strong empirical support.  Furthermore, our Offender Programs Report article argues that the two models are complementary and, when integrated together, they enhance the effectiveness for treating high-risk substance abusing offenders.

Spectrum’s integrated treatment story began in 1991, when a project was launched to develop a new type of intervention for drug-abusing criminal justice populations based on “Recovery Training” prototypes developed at the Harvard School of Public Health (McAuliffe & Ch’ien, 1986).   The design was unique in its incorporation of cognitive behavioral interventions designed to reduce offender relapse to both substance abuse and crime.   The integration of this approach was formalized into Spectrum’s TC model in 1993 (referred to as the Correctional Recovery Academy™). 

The Correctional Recovery Academy™ combined the best elements of a TC’s social learning approach with an advanced CBT curriculum. Programming was designed to address criminogenic needs common among criminal offenders that are known contributors to relapse and recidivism.  The Correctional Recovery Academy™ focuses on recovery of the whole person, including his/her physical, emotional, mental, and spiritual domains.  The primary goal is for program participants to learn real-life ways to achieve a productive life, free of drugs and crime to acquire the knowledge, skills, and attitudes necessary to successfully integrate back into the mainstream of society.  Individualized continuing care plans help offenders make permanent lifestyle changes, including participation in recovery support programs, employment and pro-social activities.

Please visit to read the entire article. The work at Spectrum exploring and developing integrated approaches has also been applied in the area of co-occurring disorders.  This important work will be a topic in my upcoming blogs.

Readers are invited to send in reactions and questions to me at  I also welcome suggestions for future blog topics.


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