Modified Therapeutic Community (MTC) for co-occurring disorders: A synthesis of four studies

This presentation presents the results of a research synthesis of four studies (N=902) that examined the effectiveness of the modified therapeutic community (MTC) for clients with co-occurring disorders (most with severe mental disorders) compared to a control group. A descriptive synthesis found significantly better outcomes for the MTC group in every study, but noted that the measures and domains in which differences were detected varied from study to study. A quantitative synthesis (using meta analysis) detected significantly better outcomes for the MTC group in five of six outcome domains (substance abuse, mental health, crime, employment, housing); no significant differences were detected in HIV-risk. The effects were of moderate size and similar across the five domains (odds ratios<0.67), and consistent across studies within a domain. The overall findings increase the research base supporting the MTC program for clients with co-occurring disorders, while also demonstrating the value of assessing multiple outcomes when evaluating the effectiveness of comprehensive treatment models. Future research should emphasize independent replications, clinical trials, and multiple outcome domains. Given the need for research-based approaches, program and policy planners should consider the MTC when designing programs for co-occurring disorders.