Do dimensions of therapeutic community treatment predict retention and outcomes?
First-week Dimensions of Change Instrument (DCI) assessments from a cohort of 519 adults entering six therapeutic communities (TCs) were used to predict treatment retention and outcomes. A more positive first-week response to TC social processes (Community Responsibility; Resident Sharing, Support, and Enthusiasm; Group Process; and Clarity and Safety) and to one TC personal-development process (Positive Self-Attitude and Commitment to Abstinence) predicted retention for the first month. Improvement in Clarity and Safety and Resident Sharing, Support, and Enthusiasm scores at 30 days predicted retention in treatment for 3, 6, and 9 months. In multivariate analyses available to a subset of the entry cohort, a longer tenure in treatment was a robust predictor of posttreatment outcomes. First-week DCI scores on the community process scales predicted posttreatment alcohol-and-other-drug abstinence and functioning.
Mandell
Wallace
W
Johns Hopkins University, Baltimore, MD 21205-1900, USA. wmandell@jhsph.edu
Edelen
Maria O
MO
Wenzel
Suzanne L
SL
Dahl
James
J
Ebener
Patricia
P
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011594:Psychometrics / Q000295:instrumentation; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013808:Therapeutic Community; D013997:Time Factors; D016896:Treatment Outcome