Effectiveness of the Therapeutic Community Model in Addiction Treatment: A Retrospective Pilot Study in French Prisons

Background: In France, addiction care in prison usually consists of nurses' interventions, medical care and socio-educational programs, but new alternatives have arisen, namely the therapeutic community (TC) model. This pilot study aims to evaluate the effectiveness of this prison-based TC in comparison with classic and socio-educational care offered in French prisons. Methods: To compare these three types of prison-based care, two detention centers' files were screened for use of multiple drugs, willingness to participate and absence of psychiatric comorbidities incompatible with group therapy. A custom questionnaire was built based on the fifth version of the Addiction Severity Index. It investigates medical status, employment and support, primary addiction status, legal status, social/familial status and psychiatric status through various items. Results: Our sample only consisted of male repeat offenders with a mean age of 37.7 +/- (9.1) years. Primary addiction status improvement was observed for all care studied but was more important in TC than in classic care. Self-esteem and social/familial status saw significant improvement throughout TC care. Conclusions: The TC model represents an alternative to classic and socio-educational care in French prisons. More studies are needed to assess the extent of the benefits provided on both the medical side and economic side.

Automated summary

This pilot study compares the effectiveness of the therapeutic community (TC) model with classic and socio-educational care in French prisons for addiction treatment. Results show that TC care is more effective in improving the primary addiction status, self-esteem, and social/familial status of male repeat offenders.