Residents' evaluation of a therapeutic community

To determine former residents' views of a therapeutic community and factors associated with a good response to therapy.

Retrospective, using a self-report questionnaire.

Of 51 contactable former residents, 32 completed the questionnaire. Responses were generally very positive, although the best outcome was reported by those who held a social-interpersonal rather than a biological view of psychiatric disorder, and who scored close to normal on a measure of intropunitiveness. Respondents emphasized the crucial role of feedback and confrontation by staff and co-residents in changing their unhelpful behaviour and attitudes, although a few thought that confrontations were too forceful. The mean duration of psychiatric disorder (mainly substance abuse and personality disorder) was more than 4.5 years. Many respondents emphasized the failure of orthodox treatments to help them, adding that their disorders would probably have continued indefinitely without treatment in a therapeutic community.