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Drug and Alcohol Findings. (2012) Effectiveness Bank Bulletin [Effectiveness of therapeutic communities]. Effectiveness Bank Bulletin, 11 Aug,

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Effectiveness of therapeutic communities: a systematic review.
Malivert M., Fatséas M., Denis C. et al. European Addiction Research: 2012, 18, p. 1–11

Methodological shortcomings in the original studies prevented this review from reaching a firm conclusion on the lasting benefits of residential therapeutic communities, though it was clear that while residents stayed, substance use was significantly reduced.

Therapeutic communities are a type of drug-free residential service. Their objectives include maintaining abstinence and socially rehabilitating drug users. Unlike some other residential facilities with similar aims, in these communities the therapeutic system is based on treatment stages which afford residents increasing degrees of personal and social responsibility for the running of the service. Peer influence mediated through group processes is used to help individuals assimilate social norms and develop social skills, and social rehabilitation is promoted by daily activities. Residents have the opportunity to progress in the hierarchy to themselves managing group activities as a peer leader.

A previous systematic review found little evidence that therapeutic communities significantly improved on outcomes from other types of residential treatment, or that one type of therapeutic community was more effective than another. However, this review included services in prison or offered as an alternative to prison, possibly not comparable to those voluntary entered outside prison. It was also limited to studies which randomly allocated participants to therapeutic communities versus alternative or no treatments, and did not seek to establish which types of substance users might be best suited to therapeutic communities.

Using a similar methodology, the featured review focused on therapeutic communities for adult substance users outside the criminal justice system. Aims were to assess their effectiveness in terms of completion and retention in treatment as well as substance use, and to determine if any characteristics were associated with greater success in achieving abstinence. Studies had to report relevant outcomes and be available in English or French up to the end of January 2011, but not necessarily to have randomly allocated participants to therapeutic communities versus an alternative.

Twelve such studies were found investigating outcomes from 61 therapeutic communities and 3271 participants. All but two studies were conducted in the Americas, and in all but two cocaine was the dominant problem drug. Differences between the studies were such that it was not appropriate to combine their findings in a meta-analysis.

Item Type
Publication Type
International, Review, Article
Drug Type
All substances
Intervention Type
General / Comprehensive, Treatment method, Psychosocial treatment method, Rehabilitation/Recovery
11 August 2012
Drug and Alcohol Findings
Corporate Creators
Drug and Alcohol Findings
11 Aug
Accession Number
HRB (Electronic Only)

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