Drug abuse day treatment: A randomized clinical trial comparing day and residential treatment programs.

Abstract

Clients entering a therapeutic community (TC)-oriented drug treatment program were randomly assigned to day or residential conditions and interviewed at 2 weeks and 6 months after admission. Outcomes included Addiction Severity Index composite scores and summary scores for the Beck Depression Inventory, Symptom Checklist-90-R, and a social support scale. Only clients who remained in treatment for at least 2 weeks were included. The mean age of the sample (N = 261) was 32.9 (SD = 6.7 years) and the mean education level was 12.1 years (SD = 1.9 years); 30% were women. Comparison of outcome scores at 6 months between groups, while controlling for baseline values, indicated greater improvement for residential clients on social problems and psychiatric symptoms. The groups were similar on the 8 remaining outcomes, including measures of alcohol and drug problems. Overall, the level of improvement among day treatment clients was not significantly different from that of residential clients.

A Randomized Clinical Trial of a New Behavioral Treatment for Drug Abuse in People With Severe and Persistent Mental Illness

“…41 In a large naturalistic study of veterans with dual diagnoses referred for outpatient treatment, 53% failed to become engaged in treatment. 42 Similar results have been reported for a state hospital sample 43 (42% attended their first outpatient visit), for patients discharged from a community hospital 44 (35% attended their first outpatient treatment session), and for patients entering a therapeutic community 45 (49% were lost to follow-up within the first 2 weeks).…”

Effectiveness of Therapeutic Communities: A Systematic Review

“…In comparison to a previous Cochrane review based on TC effectiveness [14] , including 10 publications grouped in 7 studies [12,23,24,27,[34][35][36][37][38][39] , 6 randomized controlled trials were not included in the present review based on inclusion criteria. These studies compared TC with other treatment modalities (pharmacological treatments, no treatment, other type of TC): 2 studies evaluated TC in prison [38,39] , 1 study included subjects with psychiatric disorder as main disease [37] , 1 study assessed attrition in TC without reporting substance use [34] , and 1 study did not evaluate substance use at baseline [36] .…”

“…These studies compared TC with other treatment modalities (pharmacological treatments, no treatment, other type of TC): 2 studies evaluated TC in prison [38,39] , 1 study included subjects with psychiatric disorder as main disease [37] , 1 study assessed attrition in TC without reporting substance use [34] , and 1 study did not evaluate substance use at baseline [36] . In addition, the study of Guydish et al [35] was excluded from our review as it concerned the same sample as the study of Greenwood et al [23] , but with a shorter followup period (6 months vs. 12 and 18 months). Four studies were included in both reviews [12,23,24,27] , and 9 studies were not included in the review of Smith et al [14] .…”

Outcomes in a Sample of Opioid-Dependent Clients Treated under California's Proposition 36

“…Admission and discharge dates for each participant were extracted from agency administrative datasets and confirmed by research records. As some clients dropped out of treatment and then returned, we regarded treatment as continuous until a client remained out of treatment for 14 days, a criterion used previously in this setting (Guydish, Werdegar, Sorensen, & Clark, 1998). For clients who did not return within this window, retention was calculated to the last day of treatment.…”