Background

The Therapeutic Community (TC) is a common treatment modality for incarcerated individuals with substance use disorders. TCs rely on peer group processes to promote lasting behavioral and identity change, yet prior research has not adequately tested the peer influence mechanisms underlying the theoretical model. This study applied dynamic network analysis to estimate peer influence processes central to TC philosophy.

Methods

A stochastic actor-oriented model (SAOM) was applied to ten months of social network data collected from prisoner surveys within a TC unit (N = 62) in a medium-security Pennsylvania prison. Respondents (N = 177, 84% of unit) completed at least one prison survey and provided network and community role model nominations.

Results

Although residents' levels of treatment engagement were significantly correlated with their nominated peers, estimates of peer influence for treatment engagement were non-significant in longitudinal network models. Nor were estimates of peer influence significantly greater for peers perceived as community role models. Rather, inmates connected with peers who were of similar treatment engagement as themselves (i.e., a peer selection process), and the latter primarily resulted from racial homophily in the TC social network.

Conclusions

Inconsistent with the desired treatment model, treatment engagement diffusion was not evident in the sampled TC. Results suggested that highly-engaged residents clustered together at the center of the TC's social structure but had little impact on less-engaged and peripheral inmates. The relatively short (i.e., four-month) program length and moderate-to-low treatment fidelity likely contributed to the lack of peer influence processes.

Prison-based therapeutic communities (TCs) are a widespread, effective way to help incarcerated individuals address substance abuse problems. The TC philosophy is grounded in an explicitly relational paradigm that entails building community and conditioning residents to increasingly take responsibility for leadership therein. Although TCs are based on cultivating a network that continuously integrates new residents, many common structural features can jeopardize TC goals and are hence discouraged (e.g., clustering, homophily). In light of this tension, analyzing the TC from a network perspective can offer new insights to its functioning, as well as to broader questions surrounding how networks integrate new members. In this study we examine a men's TC unit in a Pennsylvania prison over a 10-month span. Using data on residents' informal networks, we examine: (1) how well individuals integrate into the TC network across time, (2) what predicts how well residents integrate into the TC, and (3) how well the TC network structure adheres to theoretical ideals. Results suggest that individual integration is driven by a range of hypothesized factors and, with limited exceptions, the observed TC is able to foster a network structure and integrate residents consistent with TC principles. We discuss the implications of these results for evaluating TCs and for understanding the process of network integration.