RE: Therapeutic Communities/ Co-Occurring Diagnosis Effective Clients seeking admission with a mental health evaluation that reflects an Axis-I diagnosis within the past year, in addition to a Chemical Dependency, must obtain a letter from a Licensed Physician M.D. stating they are appropriate for a Therapeutic Community treatment environment. This letter should list the diagnosis, medications prescribed, and any follow-up recommendations. The Licensed Physician M.D. needs to understand that The Texas House Therapeutic Community is a work based, highly structured program with intense confrontation, and strict accountability standards. You will be working along inter-state highways picking up litter and performing light landscaping. Your Doctor must state in their letter that you are appropriate to do this type of work while in treatment and that you do not pose a threat to yourself or others.