Purpose The purpose of this paper is to analyse the clinical outcome data collected as part of an 18-week, abstinence-based residential therapeutic community (TC) programme, Higher Ground Drug Rehabilitation Trust (Higher Ground) in New Zealand. Lessons and implications for routine collection of clinical outcome data are identified. Design/methodology/approach Higher Ground collects longitudinal data on all consenting clients using a battery of validated psychometric tools, with repeated measures at up to nine points in time from first presentation through to 12-month post-discharge follow up. Data analysis covered clients who entered Higher Ground between 1 July 2012 and 2 June 2015 (n=524). Findings Clients presented with histories of addiction which often had significant negative associations with their physical and psychological health, their relationships, work, accommodation and criminal behaviour. By the time they exited the programme, clinically and statistically significant improvements were seen across multiple indicators including: substance use and abstinence; symptoms of post-traumatic stress disorder, depression, anxiety and stress; and a range of social indicators. Research limitations/implications Attrition in follow-up research is a significant challenge, with people completing the TC programme being more likely to participate than those who do not. This limits generalizability in post-discharge data. There was no control group, making causal attribution a challenge. Identifying suitable benchmarks from the literature is challenging because of the variety of outcome measures and research methodologies used. Practical implications Tracking client outcomes longitudinally using psychometric tools is potentially valuable for TCs and their funding bodies, as it provides insights into patterns of client recovery that can inform ongoing service improvements and resource allocation decisions. However, significant challenges remain. Originality/value The study demonstrates the value, and practical challenges, of collecting high-quality outcome data in a TC setting.

The author of this book, Robert Schwebel, was involved in the Radical Psychiatry Collective in the early 1970s, and worked closely with Claude Steiner who, in many ways, represented the interface of radical psychiatry (RP) with transactional analysis (TA). Both RP, with its emphasis on power, and TA, with its emphasis on the contractual method, protection and permission, are evident throughout the book, from the 'Notes to Readers', which emphasises the reader's personal responsibility, onwards. We (the two reviewers) come to this book with different experiences and connections. Johnny as a psychotherapist and a chief operating officer of a large addiction treatment therapeutic community, and Keith as a transactional analyst with a strong interest in RP, and having known and worked with Claude Steiner (Tudor, 2020)-and, more recently, having corresponded with and met Robert Schwebel online. So, inevitably, so we have picked up on different aspects of the book, but woven our comments together. We mention Robert 'Bob' Schwebel's connection with Claude Steiner as, in a number of ways, this book draws on Steiner's own work on addictions and, specifically, alcoholism, including his two books on the subject: Games Alcoholics Play (Steiner, 1971) and Healing Alcoholism (Steiner, 1979). The book is framed in terms of seven challenges-which focus on honesty (about addiction), on what is likeable about alcohol and other drugs, and on what is harmful, on responsibility, on evaluation of one's direction in life, on making thoughtful decisions, and on taking action to succeed in life. The way the challenges are worded and elaborated in the seven chapters of the book is clear, kind in that is very accepting of the person, and, of course, challenging. In Chapter 1, Schwebel writes specifically about guarding against lying to one's self as well as to others, and the importance of self-awareness and honesty. These particular pages reminded me (Keith) of the old RP slogan which defined cooperative contracts: 'No lies, no power plays, and no Rescues' (see Tudor, 2020). We also note the importance of honesty with regard to treatment in therapeutic communities. Early on (in Chapter 1), the author introduces the concept and guiding principle of 'Mastery living' which he defines as 'a way of life that is practiced by people who want to take charge of their own destiny' (p. 12). This is very aligned with TA and one of its core principles, that is, that people can make decisions-and re-decisions and, therefore, decide their own destiny (see Berne [1972/1975] and Minikin [2020]) (in this special issue of the journal Psychotherapy and Politics International). Other influences from TA in the book include 'oppressive self-talk', which is a manifestation of the Critical Parent, and 'nurturing self-talk' which, traditionally, is viewed as a manifestation of the Nurturing Parent. The influences from RP in the book include viewing overcoming addiction as a form of liberation, the concept of 'privilegism', which Schwebel describes as 'the downside...