within the US correctional system, the Asklepion Foundation initiated therapeutic communities in the Marion Federal Penitentiary and other institutions that included clinical intervention based upon Transactional Analysis, the Synanon Game, internal twelve-step programs and other therapeutic modalities. Some of these programs lasted into the mid-1980s, such as the House of Thought in the Virginia Correctional system, and were able to demonstrate a reduction of 17% in recidivism in a matched-pair study of drug-abusing felons and sex offenders who participated in the program for one year or more. Modified therapeutic communities are currently used for substance abuse treatment in correctional facilities of several U.S. states including Pennsylvania, Washington, Colorado, Texas, Delaware, and New York. In New York City, a program for men is located in the Arthur Kill Correctional Facility on Staten Island and the women's program is part of the Bayview Correctional Facility in Manhattan. Main ideas The therapeutic community approach aims to help patients deal with social situations and to change perceptions they have about themselves. Difficult situations are re-enacted and experienced and patients are encouraged to examine and try to learn from them with the help of group and individual therapy. The communities function as a living-and-learning situations, where every interaction can serve as a learning moment. There is no encompassing definition of what a therapeutic community should be. Some have therefore also argued that it follows a family resemblance. A common conception of therapeutic community is a group of people living together in a non-hierarchical, democratic way that brings psychological awareness of individual as well as group processes. Furthermore, the community has clear boundaries of place, time and roles of the participants. They are democratic because the patients are involved in decision-making to encourage a sense of responsibility. This is fostered by the non-hierarchical structure that tries to minimise dependency on the staff. A key principle is the creation of a culture of enquiry. Everyone within the community is encouraged to reflect and ask question about themselves and others. In this way the participants are supported by continuous feedback to create better self-awareness. The therapeutic community approach is informed by systems theory, organisation theory and psychoanalytic practice. Effectiveness As an intervention model for drug-using offenders with co-occurring mental health disorders, therapeutic communities may help people reduce drug use and subsequent criminal activity. Research evidence for the effectiveness of therapeutic community treatment is substantial and a demonstration of