4. Long-Term Outcomes and Outcome PredictorsSix controlled studies have investigated the outcomes of TC participants in comparison with controls beyond a period of 12 to 18 months (cf. Table 2). Five of these studies show significantly better legal outcomes selleck compound in favor of the TC group, while only three studies could demonstrate significantly lower levels of illegal drug use two years after TC treatment. One of these studies [40] found a higher prevalence of alcohol problems among TC participants at the two-year follow-up, when compared with controls who only followed a short detoxification period. Several studies have identified correlates of relapse and recidivism after TC treatment. Participation in aftercare [28, 35, 44], posttreatment employment [37], and older age [28, 33] were found to be the most common predictors of abstinence and absence of rearrest (cf.

Table 1). The effectiveness of completing treatment was shown in several studies, as TC + aftercare completers had better outcomes than aftercare drop-outs, who had in turn better outcomes than TC completers and TC drop-outs [33, 35]. Martin and colleagues [32] even found no differences between inmates who followed in-prison TC treatment without subsequent aftercare and controls who received usual work release. Relapse to drug use is often associated with reoffending and reincarceration [46]. 3.5. Type of Controls and TC ModalitiesEleven studies have compared TC treatment with some form of usual care (e.g., case management, standard treatment, and probation), and five studies compared one type of TC with another form of TC treatment (modified versus standard TCs, or short versus long TC programs).

In the latter case, the longest/most comprehensive TC program was regarded as the experimental condition, while the shorter/least intensive program was seen as the control condition. Only three comparisons of longer and shorter TC programs yielded significantly better substance use outcomes at the first follow-up moment [25, 41, 42], while overall few significant differences were observed in comparison with other TC modalities. Two studies found better employment outcomes compared with lower intensity TC models, and one study found fewer psychological symptoms and relational problems among the higher intensity treatment group.

Some studies have included multiple control conditions [29], but usually significant differences were only observed when the Dacomitinib most intensive intervention was compared with the least intensive treatment condition.Most controlled studies of TC effectiveness have focused on TCs in prison settings (n = 9) that prepare inmates for reintegration in society, while seven studies concerned TCs in the community. Whereas a substantial number of residents enter community TCs under legal pressure, TC treatment in prison can be regarded as a different context given the compulsory custody and conditional release term and privileges.