The influence of a therapeutic community on psychiatric disorder

Forty-eight residents of a therapeutic community took part in a prospective study aimed at assessing overall outcome and which components of the program were most helpful. All subjects had a DSM-III-R axis II diagnosis, usually borderline personality disorder (N = 34). As well, subjects had a mean of 1.3 axis I diagnoses, underlining the severity of their psychiatric disorders. Significant symptom reduction on the Brief Symptom Inventory occurred at discharge after a mean stay of 64 days, with further significant falls at three month follow-up. These changes were paralleled in the Hostility and Direction of Hostility Questionnaire, a measure of personality. Hospital admission rates fell significantly in the year after discharge. Clients rated group therapy as the most helpful component of the program.