National Development & Research Institutes, Inc. (NDRI), New York, New York 10010, USA.
Subst Abus. 2010 Jul;31(3):146-61. doi: 10.1080/08897077.2010.495662.
This paper presents the results of a meta-analysis for a single investigator examining the effectiveness of the modified therapeutic community (MTC) for clients with co-occurring substance use and mental disorders (COD). The flexibility and utility of meta-analytic tools are described, although their application in this context is atypical. The analysis includes 4 comparisons from 3 studies (retrieved N = 569) for various groups of clients with COD (homeless persons, offenders, and outpatients) in substance abuse treatment, comparing clients assigned either to an MTC or a control condition of standard services. An additional study is included in a series of sensitivity tests. The overall findings increase the research base of support for the MTC program for clients with COD, as results of the meta-analysis indicate significant MTC treatment effects for 5 of the 6 outcome domains across the 4 comparisons. Limitations of the approach are discussed. Independent replications, clinical trials, multiple outcome domains, and additional meta-analyses should be emphasized in future research. Given the need for research-based approaches, program and policy planners should consider the MTC when designing programs for co-occurring disorders.
本文介绍了一位研究人员对同时存在物质使用和精神障碍(COD)的客户进行改良治疗社区(MTC)有效性的元分析结果。描述了元分析工具的灵活性和实用性,尽管它们在这种情况下的应用并不典型。该分析包括来自 3 项研究的 4 项比较(共检索到 569 名参与者),涉及接受物质滥用治疗的不同 COD 客户群体(无家可归者、罪犯和门诊患者),比较了被分配到 MTC 或标准服务对照组的客户。另外一项研究被纳入一系列敏感性测试中。总的研究结果增加了 MTC 项目对 COD 客户的研究基础,因为元分析的结果表明,在 4 项比较中的 6 个结果领域中的 5 个领域中,MTC 治疗效果显著。还讨论了该方法的局限性。在未来的研究中,应强调独立复制、临床试验、多个结果领域和进一步的元分析。鉴于对基于研究的方法的需求,项目和政策规划者在为共病设计项目时应考虑 MTC。