Effectiveness of therapeutic communities: A systematic review

Marion Malivert, Mélina Fatséas, Cécile Denis, Emmanuel Langlois, Marc Auriacombe
Eur Addict Res. 2012-01-01; 18(1): 1-11
DOI: 10.1159/000331007

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1. Eur Addict Res. 2012;18(1):1-11. doi: 10.1159/000331007. Epub 2011 Oct 13.

Effectiveness of therapeutic communities: a systematic review.

Malivert M(1), Fatséas M, Denis C, Langlois E, Auriacombe M.

Author information:
(1)Addiction Psychiatry, Laboratoire de psychiatrie et CNRS-USR-3413-Sanpsy,
Université Bordeaux Segalen, Bordeaux, France.

BACKGROUND: Therapeutic communities (TCs) are drug-free residential settings,
focused on psychosocial rehabilitation. While TCs are considered an effective
method, the bulk of the research evidence is from poorly controlled studies. The
goal of this study was to evaluate TC effectiveness in terms of abstinence and to
determine if there were predictive factors of abstinence.
METHODS: The search used Medline up to January 30, 2011 and was based on a
systematic review method. Studies on retention in treatment and/or substance use
were considered.
RESULTS: Of the 321 studies retrieved from Medline, 12 met selection criteria
including overall 3,271 participants from 61 TCs. On average, subjects stayed in
TC a third of the planned time. The completion rate ranged from 9 to 56%. All
studies showed that substance use decreased during TC, but relapse was frequent
after TC. Treatment completion was the most predictive factor of abstinence at
follow-up. Surprisingly, psychiatric comorbidities did not appear associated with
relapse or with dropout.
CONCLUSIONS: There was a drop in consumption after TC, but long-lasting benefits
were uncertain. Further studies are needed in order to compare the efficacy of TC
programs and other types of treatment settings for substance-related disorders.

Copyright © 2011 S. Karger AG, Basel.

DOI: 10.1159/000331007
PMID: 21997500 [Indexed for MEDLINE]


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