title: Peer and sexual relationships in the experience of drug-dependent adolescents in a therapeutic community.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. s.nathan@unsw.edu.au
authors.forename: Sally
authors.initials: S
authors.lastname: Nathan
authors.forename: Michael
authors.initials: M
authors.lastname: Foster
authors.forename: Mark
authors.initials: M
authors.lastname: Ferry
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D058445:Bullying / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D013808:Therapeutic Community