An Evaluation of a Therapeutic Community for Former Drug Users

Abstract

A descriptive account is given ofthe operation of one ofthefirst Concept-Based Therapeutic Communities to be estabtished in the U.K. The concept of a totat institution was found useful to understanding the practice of the program. The first 100 residents admitted to the house were followed up mainly by personal interview once the majority had left the house for al least six months. Overatl, the achievements ofthe house were simitar to those of Concept houses in the U.S. Onty a minority ofatt admissions completed the program and the majority of these were recruited onto the staff or left to work in similar houses. Of all admissions, about one third seemed, over the fottow-up period, to have abstained or to have used drugs less intensely than prior to their admission. Abstinence and infrequent drug use atfo.ttow-up were related to employment and the absence of criminal conviction. Factors associated with outcome are presented and discussed. Some concern is expressed about alcohol use among program graduates and those abstaining from other drugs.

The Effect of Treatment in a Therapeutic Community on Intravenous Drug Abuse

“…The present results are in line with other evidence from Concept Houses (Ogborne and Melotte, 1977;Smart, 1976) in suggesting that a treatment effect occurs which is closely related to the length of time an individual resides in the community. The present evidence indicates that those people staying for more than six months (approximately one third of all admissions) have the most successful outcome.…”

“…The programme is ofthe 'Concept House' type and has been briefly described in another publication (Jeffrey et al, 1977). More detailed descriptions of such programmes are provided by Sugarman (1974) and Ogborne and Melotte (1977).…”

Payment by results: Challenges and conflicts for the Therapeutic Community

“…As a result of the practical need to evaluate whether or not the TC 'works' a number of pragmatic research approaches have developed. For example, although it has been suggested that treatment success 5 should be defined and represented through the individual change that people make during and after programme participation (DeLeon, 2000) attempts to represent success though crude outcome measures such as relapse, reconviction and retention dominate existing empirical evidence (Ogbourne and Melotte, 1977;DeLeon, Wexler and Jainchill, 1982;Condelli and Hubbard, 1994; Page and Mitchell, 1998;Smith et al, 2006; Malivert et al, 2012;Vanderplasschen et al, 2013). The utilisation of absolute, standardised measures to demonstrate the success of a complex life-long process that begins within a person-centred environment has not only produced research with an array of conceptual and methodological issues but maintained the air of ambiguity which surrounds the day-to-day workings of a TC (Gosling, 2015).…”

Research in the concept‐based therapeutic community – its importance to European treatment research in the drug field1

“…In fact, however, several follow‐up studies from different TCs were published in Scandinavia and in England in the 1970s. Ogborne and Malotte (1977) conducted a study of the first 100 residents admitted to a TC founded on the concept‐based philosophy in London in 1970. In the follow‐up study, 87 of the former residents were personally interviewed at least six months after they had left the programme.…”