Peer and sexual relationships in the experience of drug-dependent adolescents in a therapeutic community.

Introduction And Aims: Evidence for success of adolescent treatment programs, including therapeutic communities, has been found among those who complete treatment. However, there is a lack of research examining peer relationships as part of treatment experience. Given the central role of 'community', including peers, as agents of change in therapeutic communities, there is a need to better understand peer relationships in treatment. This ethnographic study provides a window into the dynamics of adolescent relationships in a residential treatment program.

Design And Methods: Four months of participant observation, including 21 residents (15 male and 6 female) aged between 14 and 18 years-comprising all residents admitted during the study. All the data in this paper are from those who were 16 years or over.

Results: The data reveal the complex peer relationships that form for some residents. Peer groups were found to provide a space for residents to feel included but more often were a mechanism to ostracise or bully others. In contrast to past studies, our study found sexual activity was widespread, in particular among girls. A lack of sex caused frustrations for some and sexual encounters were found to coincide with overt conflict between residents.

Conclusions: Treatment programs for adolescents need to more explicitly grapple with the complexity of resident's peer relationships, which may impact on treatment experience. Our study suggests sexual relationships may be common in treatment programs for adolescents and a cause of conflict. Further research about the mediating impact of peer relationships, including sexual relationships, is needed.