Modified therapeutic community for co-occurring disorders: A summary of four studies

Sacks, Stanley; Banks, Steven; McKendrick, Karen; Sacks, JoAnn Y.

doi:10.1016/j.jsat.2007.02.008

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Volume 34, Issue 1 , Pages 112-122, January 2008

Modified therapeutic community for co-occurring disorders: A summary of four studies

Stanley Sacks, Ph.D
- Center for the Integration of Research and Practice (CIRP), National Development and Research Institutes, Inc. (NDRI), New York, NY 10010, USA
- Corresponding author. Center for the Integration of Research and Practice (CIRP), National Development and Research Institutes, Inc. (NDRI), New York, NY 10010, USA. Tel.: +1 212 845 4400; fax: +1 212 845 4650.
Steven Banks, Ph.D
- University of Massachusetts Medical School, Worcester, MA 01655, USA
- Tel.: +1 508 856 1784.
Karen McKendrick, M.P.H.
- Center for the Integration of Research and Practice (CIRP), National Development and Research Institutes, Inc. (NDRI), New York, NY 10010, USA
- Tel.: +1 212 845 4400; fax: +1 212 845 4650.
JoAnn Y. Sacks, Ph.D
- Center for the Integration of Research and Practice (CIRP), National Development and Research Institutes, Inc. (NDRI), New York, NY 10010, USA
- Tel.: +1 212 845 4400; fax: +1 212 845 4650.

Received 8 August 2006; received in revised form 1 February 2007; accepted 2 February 2007. published online 18 June 2007.

Abstract

This article summarizes results from four research studies (n = 902) that examined the effectiveness of the modified therapeutic community (MTC) for clients with co-occurring disorders (most with severe mental disorders). Significantly better outcomes for MTC were found across four experimental versus control comparisons on 23.1% (12 of 52) of primary outcome measures of substance use, mental health, crime, HIV risk, employment, and housing. Study limitations included the potential for selection bias, limited measurement of program fidelity, and insufficient examination of the relationship between treatment dose and outcome. Future research should emphasize clinical trial replications, multiple outcome domains, and further development of continuing care models. Given the need for research-based approaches, the MTC warrants consideration when program and policy planners are designing programs for co-occurring disorders.

Keywords: Co-occurring disorders, Substance abuse, Severe mental disorder, Modified therapeutic community