Predictors and treatment outcomes of perceived ward atmosphere among therapeutic community residents

Poor retention has been an impediment to the effectiveness of therapeutic communities (TCs) for substance use disorders. We assessed the impact of the resident's perception of the therapeutic environment through the Ward Atmosphere Scale (WAS) on TC retention and examined predictors of the WAS in order to better understand this construct. Among a sample of admissions (N=123) to a 9-month residential TC, forward entry logistic regression analyses using WAS, demographic and clinical variables revealed that heightened perceptions of the orderliness of the therapeutic environment (i.e., the WAS domain of system maintenance) best predicted treatment completion. Furthermore, scores on WAS variables were best explained by the formal therapeutic elements of the TC (as measured by the Survey of Essential Elements Questionnaire) using linear regression. Efforts to improve the resident's perception of these aspects of the ward atmosphere may assist in improving TC completion rates.