Framing Dropout

This article examines dropout from therapeutic communities for addiction treatment through the lens of institutional escape. In conventional treatment research, dropout is framed as evidence of patients’ non-compliance, lack of motivation, or personal weakness. Traditional evaluation methods emphasise predefined outcomes such as abstinence, programme completion, and relapse rates, sustaining a binary of success and failure that obscures complexity and silences alternative perspectives. In contrast, this article juxtaposes dropout with apostasy from high-control religious groups, where exit has long been studied as a morally charged and politically contested act. Apostasy not only signifies a departure from a group or movement but also challenges institutional authority, exposing how loyalty, identity, and resistance are inextricably bound with systems of control. Placing these two fields of inquiry side by side reveals how institutions frame disengagement in ways that protect their legitimacy and delegitimise the leaver. The article argues that dropout and apostasy share important features: both are constructed as deviance by the institution, both are subject to moral and ideological labelling, and both involve ongoing processes of identity work. Yet they also differ in legitimacy, as apostates often find organised support and recognition, while treatment leavers remain marginalised. Central to the analysis is the role of temporal distance. Experiences initially narrated as success may later be reframed as coercive or harmful, while episodes labelled as dropout or relapse may be reinterpreted as manageable or even compatible with recovery. By situating dropout within the anthropology of institutional escape, the article challenges dominant clinical framings and highlights exit as a meaningful act of agency, critique, and survival.