Modifying the therapeutic community for the mentally ill substance abuser

McLaughlin, Peggy; Pepper, Bert

doi:10.1002/yd.23319915009

Cited by 7 publications

(2 citation statements)

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“…McLaughlin and Pepper described a modified therapeutic community for DDI (Harbor House) that integrates the twelve‐step approach with the standard therapeutic community (TC) approach 71 . Investigators randomly assigned homeless DDI to this TC vs. two community residences 72,73 .…”

Section: Resultsmentioning

confidence: 99%

The Role of Twelve‐Step Approaches in Dual Diagnosis Treatment and Recovery

2006

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The authors reviewed the empirical literature concerning the use of twelve-step programs and treatments by patients with co-occurring substance use disorders and other psychiatric disorders. Strong evidence was found that dually diagnosed individuals (DDI), with the possible exception of those with psychotic disorders, attend twelve-step programs at rates comparable to non-DDI. Twelve-step involvement is consistently associated with improved substance use outcomes. Although there have been numerous clinical trials involving twelve step-oriented interventions for DDI, most of the studies suffered from substantial methodological limitations. More work is needed to determine what kinds of twelve-step treatments and programs are effective for various types of patients and elucidate the mechanisms by which these approaches facilitate recovery.

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Section: Resultsmentioning

confidence: 99%

The Role of Twelve‐Step Approaches in Dual Diagnosis Treatment and Recovery

2006

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“…Although early therapeutic communities were designed to treat a range of psychiatric disorders, their focus shifted progressively toward treating substance abuse disorder, which is now the main emphasis (Fals-Stewart & Schafer, 1992;McLaughlin & Pepper, 1991). However, a few therapeutic communities still treat psychiatric illness in general (Isohanni & Nieminen, 1992;Karterud, 1988), and several of these specialize in personality disorders.…”

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confidence: 99%

The influence of a therapeutic community on psychiatric disorder

Hafner¹,

Holme²

1996

J. Clin. Psychol.

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Forty-eight residents of a therapeutic community took part in a prospective study aimed at assessing overall outcome and which components of the program were most helpful. All subjects had a DSM-III-R axis II diagnosis, usually borderline personality disorder (N = 34). As well, subjects had a mean of 1.3 axis I diagnoses, underlining the severity of their psychiatric disorders. Significant symptom reduction on the Brief Symptom Inventory occurred at discharge after a mean stay of 64 days, with further significant falls at three month follow-up. These changes were paralleled in the Hostility and Direction of Hostility Questionnaire, a measure of personality. Hospital admission rates fell significantly in the year after discharge. Clients rated group therapy as the most helpful component of the program.

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Treating prison inmates with co-occurring disorders: an integrative review of existing programs

1997

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The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3–11% of prison inmates have co‐occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven ‘dual diagnosis’ treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive–behavioral interventions such as restructuring of ‘criminal thinking errors’, self‐help groups, medication monitoring, relapse prevention, and transition into institution or community‐based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross‐training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs. © 1997 John Wiley & Sons, Ltd.

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Modifying the therapeutic community for the mentally ill substance abuser

Abstract: Most integrated treatment programs originate in the mental health system; this chapter describes a dual diagnosis program that originates in the addiction system as a modfication ofa traditional therapeutic community.

Cited by 7 publications

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The Role of Twelve‐Step Approaches in Dual Diagnosis Treatment and Recovery

The Role of Twelve‐Step Approaches in Dual Diagnosis Treatment and Recovery

The influence of a therapeutic community on psychiatric disorder

Treating prison inmates with co-occurring disorders: an integrative review of existing programs

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