TREATMENT LEVEL PROGRESS AND TIME SPENT IN TREATMENT IN THE PREDICTION OF OUTCOMES FOLLOWING DRUG-FREE THERAPEUTIC-COMMUNITY TREATMENT

Previous research has suggested that time spent in treatment is the mo st important predictor of therapeutic community treatment outcomes. Al though level divisions or treatment stages represent the basic structu re for segmenting responsibility and authority within traditional ther apeutic communities, the relationship of this treatment component to t reatment outcome has not previously been investigated Aim. To test the hypothesis that higher treatment level attainment, more time spent in treatment and additional time spent within a treatment level has a li near association with improvements at outcome. Design. Retrospective q uasi-experimental. Participants. Four hundred and twenty-seven ex-resi dents, stratified according to their highest level of treatment in the Melbourne Odyssey House therapeutic community between 1984 and 1988 w ere targeted for follow-up and 60% were successfully located and inter viewed an average of 5.6 years after their first Odyssey entry. Analys is of official records of methadone treatment, convictions and incarce rations demonstrated no post-treatment differences comparing those int erviewed with those not interviewed Measurement. Drug we, criminal inv olvement and employment. Findings. Although both level attainment and time spent in treatment had a linear relationship to improved outcomes , level attainment was a better predictor of outcomes at treatment exi t. An unexpected finding was that those who had spent the median time or longer in particular levels demonstrated worse outcomes on official conviction records and on self-reports of employment compared to thos e remaining for less than the median time. Conclusion. The results sug gest that it may be level progress rather than simply time spent in tr eatment that best explains improved functioning following exit from th e therapeutic community.