Therapeutic communities for substance related disorder
Sübutlu məlumatların xülasələri
10.07.2017 • Sonuncu dəyişiklik 10.07.2017
Editors
Therapeutic communities may not provide any significant benefits in comparison with other residential treatment for substance dependents. In prison setting, a therapeutic community may be effective in preventing re-offending post-release.
A Cochrane review included 7 studies with a total of 4 792 subjects. The individual trials included the following comparisons:
- Therapeutic community (TC) versus community residence: no significant differences for treatment completion
- Residential versus day TC: attrition (first two weeks), and abstinence rates at six months significantly lower in the residential treatment group
- Standard TC versus enhanced abbreviated TC: number of employed higher in standard TC RR 0.78 (95% CI 0.63, 0.96)
- Three months versus six months programme within modified TC, and six months versus 12 months programme within standard TC: completion rate higher in the three months programme and retention rate (40 days) significantly greater with the 12 months than 6 months programme
Two trials evaluated TCs within a prison setting: one reported significantly fewer re incarcerated 12 months after release from prison in the TC group compared with no treatment, RR 0.68 (95% CI 0.57 to 0.81). In the other, people treated in prison with TC compared with Mental Health Treatment Programmes showed significantly fewer re-incarcerations RR 0.28 (95% CI 0.13 to 0.63), criminal activity 0.69 (95% CI 0.52 to 0.93) and alcohol and drug offences 0.62 (95% CI 0.43 to 0.90) 12 months after release from
prison.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by limitations in study quality (high drop-out rates, inadequate follow-up, poor reporting).
Ədəbiyyat
- Smith LA, Gates S, Foxcroft D. Therapeutic communities for substance related disorder. Cochrane Database Syst Rev 2006 Jan 25;(1):CD005338.