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Research on the effectiveness of the modified therapeutic community for persons with co-occurring substance use and mental disorders
- Authors:
- SACKS Stanley, SACKS JoAnn Y.
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 31(2), Summer 2010, pp.176-211.
- Publisher:
- Emerald
This article highlights the development of the modified therapeutic community (MTC) as an approach to the treatment of co-occurring disorders. Four research studies are presented, each of which investigated the effectiveness of the MTC. Nine hundred and two subjects had mental disorders co-occurring with substance use disorders, and all four studies were undertaken by the same investigative team. Better outcomes were observed for the MTC group in every study, but the measures and domains in which differences were detected varied from study to study. Analysis showed significant improvements in outcomes for the MTC group in five of six outcome domains – substance use, mental health, crime, employment and housing. However, no significant differences were detected in HIV-risk. The paper concludes with brief summaries of preliminary findings from two current studies. In ending, the paper presents a discussion of staff training, aftercare services, and future directions for research related to the MTC.
Modified therapeutic community aftercare for clients triply diagnosed with HIV/AIDS and co-occurring mental and substance use disorders
- Authors:
- SACKS Stanley, et al
- Journal article citation:
- AIDS Care, 23(12), December 2011, pp.1676-1686.
- Publisher:
- Taylor and Francis
This paper describes the evaluation of a clinical trial of a modified therapeutic community aftercare (MTCA) programme for triply diagnosed users with HIV/AIDS, a substance use disorder, and a mental disorder. Seventy six subjects were randomly assigned to MTCA or to standard aftercare. Follow-up interviews assessed eight outcome domains and adherence to prescribed HIV medication. At the six-month follow-up, clients with greater psychological functioning and stable physical health at baseline had greater improvement overall and for substance use and mental health than standard aftercare clients in the same stratum. In contrast, standard aftercare clients with poorer psychological functioning and improved physical health had more favourable outcomes overall and for substance use than their MTCA counterparts. Differences in HIV medication adherence were not detected. Clients with greater psychological functioning and stable health at treatment entry benefited more from the MTCA programme. The authors concluded that measuring physical and mental health during treatment and could be important in future research.