Examining a Filipino therapeutic community: The role of attachment styles in client clinical progress as mediated by treatment motivation among recovering patients with substance use disorder

The therapeutic community (TC) is a widely used intervention program in managing and treating substance use disorders. Despite its documented utility, researchers and practitioners are still perplexed on how it exactly works. Several studies suggest the possible role of attachment styles and treatment motivation in the TC process. This research hypothesized that attachment styles influence client clinical progress through treatment motivation in the TC context. Applying an explanatory correlational research method, this notion was tested by examining the responses of 200 patients with substance use disorder undergoing treatment in a TC. Using mediation analysis, the results revealed that attachment styles indirectly affect client clinical progress by path of treatment motivation. Although the current study cannot conclude causality, the results provide empirical evidence suggesting that attachment styles activate motivation in treatment within the social dynamics of the TC, thus influencing client clinical progress. From these findings, clinical recommendations for the modification of TCs along with considerations for further research, and socio-political implications are discussed