Experimental evaluation of a vocationally integrated therapeutic community

Abstract

Purpose – Retrospective studies of therapeutic community (TC) treatment for drug abuse found reductions in drug use, criminality, and increased work participation after treatment completion. These studies have also shown treatment benefits, even without completion, are correlated with days of stay in residential treatment. However, others have found that high rates of early leaving from TC treatment reduce the proportion of clients with positive outcomes, raise the total cost per treated client, and lower the treatment benefit-to-costs ratio. The purpose of this paper is to describe an experimental approach to raising the days in residential treatment using earlier vocational access for clients. Design/methodology/approach – The current study used a random assignment design to compare earlier integration of on-site vocational training in a vocationally integrated therapeutic community to off-site vocational training initiated after one year of residence in a traditional therapeutic community. Findings – The resulting data support the hypotheses that client expectations and early training in job skills increase rate of treatment affiliation, the proportion of clients having effective lengths of stay, and the rate of treatment completion. Research limitations/implications – Research limitations/implications include the difficulty of assuring unbiased selection and controlling treatment assignment and conditions. Practical implications – Practical implications of this research project are to support practitioners striving for longer, more effective lengths of stay, while at the same time attempting to reduce treatment time and increase effectiveness. Social implications – Social Implications of this project are to encourage social support for addiction treatment and emphasize the value of paired residential treatment and vocational education. Originality/value – The originality and value of this research project lies in the adoption of a working model at Phoenix House TC (in-house vocational preparation), which utilizes early in-house vocational education as a means to increase residential program participation, increase employment skills and prospects, and decrease overall length of treatment.