Modified Therapeutic Community for Homeless Mentally Ill Chemical AbusersSociodemographic and Psychological Profiles

Sacks, Stanley; Leon, George De; Balistreri, E.; Liberty, Hilary James; McKendrick, Karen; Sacks, JoAnn Y.; Staines, Graham L.; Yagelka, John

doi:10.1016/s0740-5472(97)00314-0

Cited by 20 publications

(13 citation statements)

References 27 publications

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“…The multi-dimensional deficits of MICA offenders shown in Table 1 are similar to those reported by the investigators for homeless MICA samples (Sacks et al, 1998a). These deficits include problems of residential stability, psychiatric symptoms, substance abuse, and impaired functioning, all of which require comprehensive, multi-faceted treatment of relatively long duration.…”

Section: Social Dysfunctionsupporting

confidence: 75%

“…The modified TC for MICAs is one approach that has been well articulated and that has documented effectiveness in other studies of MICA clients in the community Sacks, 2000;Sacks, Sacks, De Leon, Bernhardt, & Staines, 1997b;Sacks et al, 1997aSacks et al, , 1998aSacks et al, , 1998bSacks et al, , 1999Sacks et al, , 2003a; the findings from this study support the extension and modification of this approach for MICA offenders. This study provides initial evidence that combining prison and aftercare modified TC treatment improves crime outcomes, which confirms the benefits that accrue from such integrated programs.…”

Section: Implications For Policy and Planningsupporting

confidence: 65%

“…This study documents rates of mental disorder in MICA offenders that compare to those reported for a sample of homeless MICAs in treatment (Sacks et al, 1998a), and that include high rates of Axis I mental disorder diagnosis (Axis I mental illness in 78% of both MICA populations). These profile data confirm that the study is reaching the target population (offenders with co-occurring serious mental and substance use disorders) and verifies their MICA status as established by the Colorado DOC assessment protocol.…”

Section: Mental Disorder Diagnosismentioning

confidence: 89%

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Modified TC for MICA offenders: crime outcomes

Sacks

Sacks²,

McKendrick³

et al. 2004

Behavioral Sci & The Law

105

120

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The study randomly assigned male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders to either modified therapeutic community (MTC) or mental health (MH) treatment programs. On their release from prison, MICA inmates who completed the prison MTC program could enter the MTC aftercare program. The results, obtained from an intent-to-treat analysis of all study entries, showed that inmates randomized into the MTC group had significantly lower rates of reincarceration compared with those in the MH group. The results also show that differences between the MTC + aftercare and comparison group across a variety of crime outcomes (i.e. any criminal activity, and alcohol or drug related criminal activity) are consistent and significant, and persist after an examination of various threats to validity (e.g. initial motivation, duration of treatment, exposure to risk). This study provides some support for the effectiveness of the prison TC only condition. The findings are encouraging and consonant with other studies of integrated prison and aftercare TC programs for substance abusing non-MICA offenders, although qualified by the possibility that selection bias (i.e. differences in motivation on entry into aftercare) may be operating. Nevertheless, given the available evidence and the need for effective programming for MICA offenders, program and policy makers should strongly consider developing integrated prison and aftercare modified TC programs for MICA offenders.

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Section: Social Dysfunctionsupporting

confidence: 75%

Section: Implications For Policy and Planningsupporting

confidence: 65%

Section: Mental Disorder Diagnosismentioning

confidence: 89%

See 1 more Smart Citation

Modified TC for MICA offenders: crime outcomes

Sacks

Sacks²,

McKendrick³

et al. 2004

Behavioral Sci & The Law

105

120

View full text Add to dashboard Cite

show abstract

“…Additionally, these clients are often recidivists because of the chronic, relapsing nature of addiction (McLellan, Lewis, O'Brien, & Kleber, 2000). Further, they typically have complex mental and physical needs that require counselors to coordinate the delivery of additional health services (Kessler, Chiu, Demler, & Walters, 2005;Sacks et al, 1998). These clinical complexities are likely to be highly prevalent in TC settings, as clients in residential programs tend to report more severe problems (Melnick, De Leon, Thomas, & Kressel, 2001).…”

Section: Conceptualizing Predictors Of Emotional Exhaustion and Turnomentioning

confidence: 99%

Counselor emotional exhaustion and turnover intention in therapeutic communities

Knudsen

Ducharme

Roman

2006

Journal of Substance Abuse Treatment

127

113

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“…One notable change has been the tailoring of TCs to meet the needs of specific subpopulations, such as women (Stevens, Arbiter & McGrath 1997; Stevens & Glider 1994; Coletti et al 1992), adolescents (Jainchill 1997; De Leon & Deitch 1985), and clients with co-occurring substance abuse and psychiatric conditions (De Leon et al 1999; Sacks et al 1998, 1997; De Leon 1993). To serve these client populations, many TCs have employed more professional staff, including physicians, psychiatrists, and counselors with postgraduate training.…”

mentioning

confidence: 99%

Modified Therapeutic Communities and Adherence to Traditional Elements

Dye

Ducharme

Johnson

et al. 2009

Journal of Psychoactive Drugs

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Traditional therapeutic communities (TCs) are characterized by confrontational group therapy, treatment phases, a tenure-based resident hierarchy, and long-term residential care. Many TCs have modified the structure and intensity of the traditional model, tailored services for specific client populations, and hired more professionally trained staff. This study examines the extent to which modified TCs are able to retain the underlying core technology of the TC. Using data from a nationally representative sample of 380 self-identified TCs, six traditional TC elements are identified. Results from a structural equation model indicate that offering services for specific populations and professionalization of staff has limited impact on the six TC elements. Modifications to structure and intensity of TC programming evidenced the strongest effect. Specifically, outpatient-only TCs showed significantly lower adherence to five of the six elements. Short-term residential programs showed a similar negative trend. Findings suggest selected modifications are possible without significantly impacting the TC model’s core technology.

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Modified Therapeutic Community for Homeless Mentally Ill Chemical AbusersSociodemographic and Psychological Profiles

Cited by 20 publications

References 27 publications

Modified TC for MICA offenders: crime outcomes

Modified TC for MICA offenders: crime outcomes

Counselor emotional exhaustion and turnover intention in therapeutic communities

Modified Therapeutic Communities and Adherence to Traditional Elements

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