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Published on: January 5, 2018
Therapeutic communities for substance related disorder
L A Smith1, S Gates, D Foxcroft
1Oxford Brookes University, School of Health and Social Care, Jack Straws Lane, Marston, Oxford, UK, OX3 0FL. lesleysmith@brookes.ac.uk
The Cochrane Database of Systematic Reviews
|January 27, 2006
Summary
Therapeutic communities (TCs) show limited benefits over other treatments for substance dependence. Prison-based TCs may reduce re-offending rates post-release, but evidence is limited.
Area of Science:
- Addiction treatment research
- Rehabilitation science
- Public health interventions
Background:
- Therapeutic communities (TCs) are widely used for drug addiction rehabilitation in the US and Europe.
- Evaluating the comparative effectiveness of TCs is crucial for optimizing addiction treatment strategies.
Purpose of the Study:
- To assess the effectiveness of therapeutic communities (TCs) compared to alternative treatments for substance dependence.
- To explore how client and treatment characteristics influence TC effectiveness.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing TCs with other interventions, no treatment, or different TC models.
- Searched major databases (Cochrane, MEDLINE, EMBASE, Psycinfo, CINAHL, SIGLE) up to March 2004.
- Methodological quality assessed; data summarized using relative risks and means where possible.
Main Results:
- Limited evidence suggests TCs are not significantly superior to other residential treatments.
- Residential TCs showed higher attrition and lower abstinence rates than day TCs.
- Prison-based TCs demonstrated potential in reducing post-release re-offending compared to no treatment or standard mental health programs.
Conclusions:
- Current evidence provides little support for the superiority of TCs over other residential treatments or variations thereof.
- Prison TCs may offer benefits in reducing recidivism among inmates.
- Methodological limitations necessitate caution; further high-quality research is needed to draw firm conclusions.
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