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The Scientific World Journal
Volume 2013, Article ID 427817, 22 pages
Review Article

Therapeutic Communities for Addictions: A Review of Their Effectiveness from a Recovery-Oriented Perspective

1Department of Orthopedagogics, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium
2Boonshoft School of Medicine, Center for Interventions, Treatment and Addictions Research (CITAR), Wright State University, 3640 Colonel Glenn Highway, Dayton, OH 45435, USA
3Oxfordshire Complex Needs Service, Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, Manzil Way, Oxford OX4 1XE, UK
4Faculty of Education, Health and Social Work, University College Ghent, 9000 Ghent, Belgium

Received 28 October 2012; Accepted 9 December 2012

Academic Editors: Vittorio Di Michele, Serdar Murat Dursun, and Toshiki Shioiri

Copyright © 2013 Wouter Vanderplasschen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Therapeutic communities (TCs) for addictions are drug-free environments in which people with addictive problems live together in an organized and structured way to promote change toward recovery and reinsertion in society. Despite a long research tradition in TCs, the evidence base for the effectiveness of TCs is limited according to available reviews. Since most of these studies applied a selective focus, we made a comprehensive systematic review of all controlled studies that compared the effectiveness of TCs for addictions with that of a control condition. The focus of this paper is on recovery, including attention for various life domains and a longitudinal scope. We searched the following databases: ISI Web of Knowledge (WoS), PubMed, and DrugScope. Our search strategy revealed 997 hits. Eventually, 30 publications were selected for this paper, which were based on 16 original studies. Two out of three studies showed significantly better substance use and legal outcomes among TC participants, and five studies found superior employment and psychological functioning. Length of stay in treatment and participation in subsequent aftercare were consistent predictors of recovery status. We conclude that TCs can promote change regarding various outcome categories. Since recovering addicts often cycle between abstinence and relapse, a continuing care approach is advisable, including assessment of multiple and subjective outcome indicators.