Sacks Stanley, Banks Steven, McKendrick Karen, Sacks Joann Y
Center for the Integration of Research and Practice, National Development and Research Institutes, Inc., New York, NY 10010, USA.
J Subst Abuse Treat. 2008 Jan;34(1):112-22. doi: 10.1016/j.jsat.2007.02.008. Epub 2007 Jun 15.
This article summarizes results from four research studies (n = 902) that examined the effectiveness of the modified therapeutic community (MTC) for clients with co-occurring disorders (most with severe mental disorders). Significantly better outcomes for MTC were found across four experimental versus control comparisons on 23.1% (12 of 52) of primary outcome measures of substance use, mental health, crime, HIV risk, employment, and housing. Study limitations included the potential for selection bias, limited measurement of program fidelity, and insufficient examination of the relationship between treatment dose and outcome. Future research should emphasize clinical trial replications, multiple outcome domains, and further development of continuing care models. Given the need for research-based approaches, the MTC warrants consideration when program and policy planners are designing programs for co-occurring disorders.
本文总结了四项研究（n = 902）的结果，这些研究考察了改良治疗社区（MTC）对患有共病障碍（大多数患有严重精神障碍）的患者的有效性。在物质使用、心理健康、犯罪、艾滋病毒风险、就业和住房等23.1%（52项中的12项）主要结局指标的四项实验与对照比较中，发现MTC的结局显著更好。研究局限性包括存在选择偏倚的可能性、对项目保真度的测量有限，以及对治疗剂量与结局之间关系的研究不足。未来的研究应强调临床试验的重复、多个结局领域，以及持续护理模式的进一步发展。鉴于对基于研究的方法的需求，当项目和政策规划者为共病障碍设计项目时，MTC值得考虑。
