Therapeutic community drug treatment success in Peru: a follow-up outcome studyReport as inadecuate

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Substance Abuse Treatment, Prevention, and Policy

, 3:26

First Online: 03 December 2008Received: 20 August 2008Accepted: 03 December 2008DOI: 10.1186-1747-597X-3-26

Cite this article as: Johnson, K., Pan, Z., Young, L. et al. Subst Abuse Treat Prev Policy 2008 3: 26. doi:10.1186-1747-597X-3-26


BackgroundThe purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community TC model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-up study.

MethodsThis outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test RPT follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data.

ResultsMedium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling HGLM results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success.

ConclusionThis study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should be placed on the importance of implementing the TC drug abuse treatment model with fidelity. Further, the results strongly suggest that TC drug abuse treatment programs should incorporate follow-up activities that attempt to neutralize community negative reactions perceived stigma independent of other factors.

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Author: Knowlton Johnson - Zhenfeng Pan - Linda Young - Jude Vanderhoff - Steve Shamblen - Thom Browne - Ken Linfield - Geetha Sur


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