The path of therapeutic community process experience to recovery capital and psychological well-being as mediated by group working alliance: the role of locus-of-hope.

Abstract

The therapeutic community (TC) is a social-learning treatment program for people with substance use disorders (PSUDs). Most studies focused on how the TC program facilitates positive recovery outcomes. Less emphasis was given to ethnically relevant patient dispositions that may influence the TC process from a collectivist context, especially from Asian developing countries like the Philippines. In this study, we tested the TC process experience's (TCPE) path to recovery capital (RC) and psychological well-being (PWB) as mediated by group working alliance (GWA). We also examined if PSUDs' locus-of-hope (LOH), or the person's goal-pursuit disposition involving external co-agencies like peers, family, and spirit, interact with this mechanism. A total of 451 male PSUDs from TC facilities in the Philippines were surveyed, with 406 participants included in the final analysis. Results showed that the participants' TCPE predicted RC and PWB. The direct pathways were mediated by GWA. There were no significant mediation effects among patients with high internal and external-peer LOH. Moreover, there were significant mediation effects among patients with high external-family and external-spirit LOH. The results suggest the contributions of PSUDs' LOH dispositions to the TC mechanism from a collectivist population, thus revealing nuances of the TC model applied in a vulnerable ethnic context.