Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Substance Use Outcomes

Abstract

Correctional systems nationwide have increasingly turned to therapeutic community (TC) programs for the treatment of addiction in prisons. TC treatment, with modifications, has shown considerable promise in treating offenders who have co-occurring mental and substance use disorders, a group that has a mounting prevalence in prison populations. This article reports data from a study that randomly assigned male inmates with mental illness and chemical abuse (MICA) disorders (n = 139) to either a Modified TC (MTC) or a comparison group. Analyses revealed that the MTC group had significantly greater declines in alcohol and drug use at 12-months post-prison release. Additional analysis related positive substance use outcomes to reduced contact with the justice system and self-reported criminal activity. Implications for treatment and policy are discussed.

Keywords:

• Co-occurring disorders
• mental illness and chemical abuse disorder
• modified therapeutic community
• substance use disorder
• treatment outcomes

Notes

¹Further analyses of potential threats to validity (e.g., treatment retention, motivation, attrition) were carried out to assess the robustness of the results presented here. In general, the results of these tests supported the validity of the positive outcomes observed for MTC treatment. All observed effects were consistent with the main outcome analyses and, in some instances, the MTC group retained its statistically significant advantage over the C group (e.g., attrition). (Results available from the first author upon request.)

The work reported in this manuscript was supported by a grant (P50 DA 7700.0003 Center for Therapeutic Community Evaluation Research: Modified TC for MICA Inmates in Correctional Settings) from the National Institute on Drug Abuse (NIDA).

Views and opinions are those of the authors and do not necessarily reflect those of the Department of Health & Human Services, SAMHSA, CSAT, or the National Institutes of Health, NIDA.