Walk the Walk and Talk the Talk: An Ethnography of a Drug Abuse Treatment Facility

As a counselor for more than two years at a residential drug abuse treatment facility located in a midwestern city, Geoffrey Skoll observed the many contradictions between the public image of the institution as a center for therapy and treatment and the actual day-to-day practices that go on inside. In this case study, he argues that the facility forces its residents to "walk the walk and talk the talk" by compelling them to subscribe to its rules and ideology, which emphasize the need for them to conform to the image of a dope fiend in order to show "progress" in treatment. Skoll contends that facilities like this do not produce a positive change in the character of their residents as claimed, but instead reinforce negative social identities, especially the residents' powerlessness and subordinate status.
Providing treatment mainly for cocaine and heroin abuse, the institution recruits most of its clientele from the criminal justice system and controls them with the threat of returning them to jail. Skoll demonstrates that behind the facility's ethic of caring and openness lurks a fear on the part of the staff that this is a deviant population that must be controlled and that their deviance (their pleasure in taking drugs, for example) may be contagious. He cites specific interactions that force residents to "snitch" on each other over petty misdemeanors in order to perpetuate negative identities such as whore or drug addict. This betrayal by peers further justifies the coercion of residents who resist reform.
The drop-out rate from this facility is so high that the "revolving door" has become part of the center's basic structure. Skoll observes that those who remain in the program tolerate its ideology because it is the only one they know. Any attempts to formulate alternative ideologies are simply repressed. Skoll's analysis reveals that this treatment facility aims at thought reform and behavioral control rather than therapy, and he concludes that this approach confirms the addict lifestyle for most of its patients.

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