Abstract
This paper presents data from a systematic review and meta-analysis of 29 published studies of therapeutic community effectiveness using controls, including 8 randomised control trials. Meta-regressions suggest that the two types of therapeutic community, democratic and concept-based, and the age of the study, are the key sources of heterogeneity in the collection of studies analysed. Otherwise, heterogeneity is low and the meta-analysis confirms the effectiveness of therapeutic community treatment with overall summary log odds ratio for the 29 studies of −0.512 (95% ci −0.598 to −0.426).
Similar content being viewed by others
REFERENCES
Jones M: Social Psychiatry. London, Tavistock, 1952.
Bion WR: Experiences in Groups. London, Tavistock, 1960.
Foulkes SR: Introduction to Group Analytic Psychotherapy. London, Heinemann, 1948.
Main T: The Hospital as a Therapeutic Institution. Bulletin of the Menninger Clinic 10:66–70, 1946. (Reprinted in Therapeutic Communities 17(2):77–80).
Harrison T: Bion, Rickman, Foulkes and the Northfield Experiments. Advancing on a Different Front. London, Jessica Kingsley, 2000.
Black T: Sound and fury: Grief and despair in the large group, in Therapeutic Communities: Past, Present and Future. Edited by Campling P, Haigh R. London, Jessica Kingsley, 1999. pp. 107–115.
Coombe P: Glimpses of a Cassel Hospital Outpatient Group. Australian and New Zealand Journal of Psychiatry 29:309–315, 1995.
Rapoport RN: Community as Doctor. London, Tavistock, 1960.
Jones M: Beyond the Therapeutic Community. New Haven, Yale University Press, 1968.
Rapoport RN, Manning N: Rejection and re-incorporation: A case study in social research utilisation. Social Science and Medicine 10:458–468, 1976.
Haigh R: The quintessence of a therapeutic environment: Five universal qualities, in Therapeutic Communities. Past, Present and Future. Edited by Campling P, Haigh R. London, Jessica Kingsley, 1999, pp. 246–257.
Bloor MJ, McKeganey NP, Fonkert JD: One Foot in Eden. London, Routledge, 1988.
Chiesa M, Fonagy P: Cassel personality disorder study: Methodology and treatment effects. British Journal of Psychiatry 176:485–491, 2000.
Chiesa M, Iacoponi E, Morris M: Changes in health service utilization by patients with severe personality disorders before and after inpatient psychosocial treatment. British Journal of Psychotherapy 12(4):501–512, 1996.
Cullen E: Grendon: The therapeutic prison that works Therapeutic Communities 15(4)301–311, 1994.
Marshall P: A Reconviction Study of HMP Grendon Therapeutic Community (Research findings no. 53). London, Home Office Research and Statistics Directorate, 1997.
Newton M: Changes in Test Scores During Treatment at Grendon. Research and Development Unit, Grendon Underwood. Bucks, UK, HMP Springhill and Grendon, Unpublished research paper, 1997.
Shine J: A Compilation of Grendon Research. Aylesbury, UK, HMP Grendon, 2000.
Warren F, Dolan B: Perspectives on Henderson Hospital, 2nd ed. Sutton, Surrey, Henderson Hospital, 2001.
Yablonsky L: Synanon: The Tunnel Back. New York, Macmillan, 1965.
Sugarman B: Daytop Village: A Therapeutic Community. New York, Holt, Rinehart and Winston, 1974.
De Leon G: The Phoenix House Therapeutic Community: Changes in psychopathological signs. Archives of General Psychiatry 28:131–135, 1973.
De Leon G: Residential Therapeutic Communities in the Mainstream: Diversity and issues. Journal of Psychoactive Drugs 27:(1):3–15, 1994.
Ogbourne AC, Melotte C: An evaluation of a Therapeutic Community for former drug users. British Journal of Addiction 72(1)75–82, 1977.
Wilson S, Mandelbrote B: The relationship between duration of treatment in a therapeutic community for drug abusers and subsequent criminality. British Journal of Psychiatry 132:487–491, 1978.
Wexler H: Therapeutic Communities in American prisons, in Therapeutic Community for Offenders. Edited by Cullen E, Jones L, Woodward R. Chichester, Wiley, 1997.
Lees J: Practice evaluation of Therapeutic Communities, in A Culture of Enquiry. Research Evidence and the Therapeutic Community. Edited by Lees J, Manning N, Menzies D, Morant N. London, Jessica Kingsley, 2004, pp. 76–90.
Lees J: ‘Research. The Importance of Asking Questions,’ in Therapeutic Communities. Past, Present and Future. Edited by Campling P, Haigh R. London, Jessica Kingsley, 1999, pp. 207–222.
Lees J, Manning N, Rawlings B: Therapeutic Community Effectiveness: A Systematic International Review of Therapeutic Community Treatment for People with Personality Disorders and Mentally Disordered Offenders (CRD Report no. 17). York, NHS Centre for Reviews and Dissemination, University of York, 1999.
CRD (Centre for Reviews and Dissemination): Undertaking Systematic reviews of Research on Effectiveness (CRD Report no. 4). York, University of York, 1996.
Artus HM: Science indicators derived from databases. Scientometrics 37:297–311, 1996.
Seglen PO: Why the impact factor of journals should not be used for evaluating research. British Medical Journal 314:498–502, 1997.
Kahn HA, Sempos CT: Statistical Methods in Epidemiology. Oxford, Oxford University Press, 1989.
Thompson SG, Sharp SJ: Explaining heterogeneity in meta-analysis: A comparison of methods. Statistics in Medicine 18:2693–2708, 1999.
Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315:629–634, 1997.
Gunderson JG: Building structure for the borderline construct. Acta Psychiatrica Scandinavica 89(suppl. 379):12–18, 1994.
DoH/HO: Report of the Department of Health/Home Office working group on psychopathic disorder. London, HMSO, 1994.
Manning N: Psychiatric diagnosis under conditions of uncertainty: Personality disorder, science, and professional legitimacy. Sociology of Health and Illness 22(5):621–639, 2000.
Manning N: Actor-networks, policy networks and personality disorder. Sociology of Health and Illness 24(5):644–666, 2002.
Glaser AN: Therapeutic communities and therapeutic communities: A personal perspective. International Journal of Therapeutic Communities 4(2)150–162, 1983.
De Leon G: The research context for therapeutic communities in the USA, in A Culture of Enquiry. Research Evidence and the Therapeutic Community. Edited by Lees J, Manning N, Menzies D, Morant N. London, Jessica Kingsley, 2004, pp. 91–108.
Clarke RVG, Cornish DB: The Controlled Trial in Institutional Research—paradigm or pitfall for penal evaluators. London, HMSO, 1972.
Nieminen P: Therapeutic community research and statistical data analysis. Acta Universitatis Ouluensis Medica, Oulu: University of Oulu Printing Center, 1996.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lees, J., Manning, N. & Rawlings, B. A Culture of Enquiry: Research Evidence and the Therapeutic Community. Psychiatr Q 75, 279–294 (2004). https://doi.org/10.1023/B:PSAQ.0000031797.74295.f8
Issue Date:
DOI: https://doi.org/10.1023/B:PSAQ.0000031797.74295.f8