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Problematic substance use is associated with adverse outcomes that extend beyond the individual, resulting in significant cost to the community through health care, criminal justice and other psychosocial factors, including child protection and family support. These factors create concerns for treatment services, with an increasing demand for cost‐effective solutions to this problem. This paper seeks to address these issues.

This prospective cohort study examined the effect of client variables on retention within a short‐term (56 days) modified therapeutic community (MTC) in the Australian Capital Territory. A total of 28 residents (17 males, 11 females) took part in the study, which included quantitative and qualitative measures.

Results demonstrate a trend in favour of dynamic client variables as effective predictors of retention, with substance use severity being a significant predictor (p=0.023, d=0.91). Content analysis demonstrates that those with severe substance use have more intentions to engage in aftercare.

Short term treatments are seen as providing a gateway to further treatment, especially for chronic substance‐using clients.

The purpose of this paper is to provide an overview of the adolescent therapeutic community (ATC) literature – drawing on studies primarily from the USA with consideration made to the Australian context.

A review of the efficacy research for ATCs is considered, and the characteristics of Australians accessing ATC treatment are discussed in the context of developmental needs.

Similarities are found in what precipitates and perpetuates adolescent substance use in the USA and Australia, and therefore, what appears to facilitate effective treatment utilising the therapeutic community model.

The paper provides a valuable perspective for Australian services, and explores the application of the ATC model within the Australian treatment context.

The purpose of this paper is to explore the applicability of the Australasian Therapeutic Communities Association (ATCA) Standard to Australian youth-specific modified therapeutic communities (MTCs). An Interpretive Guide for Youth MTCs and Residential Rehabilitation (RR) Services was developed and a pilot trial conducted with three Australian youth MTC services.

Using a mixed-methods design, this study included three components: a consultation process with residential youth MTCs (N=15), which informed the development of the ATCA Standard Interpretive Guide for Youth MTCs and RR Services; a pilot trial of the materials with three Australian youth MTCs (N=53); and an evaluation of the interpretive guide and assessment of applicability of the ATCA standard to youth MTCs through pre- (N=32) and post- (N=19) pilot trial administrations of the Survey of Essential Elements Questionnaires (SEEQ), and post-pilot trial focus groups (N=21).

Results indicate that the ATCA Standard is applicable to youth MTC settings when applied with the Interpretive Guide, although no significant differences were found between the pre- and post-pilot trial administrations of the SEEQ.

Future research is recommended to explore active mechanisms of youth-specific MTCs, differences between adults and youth MTCs, and the development of TC-specific training.

To date, no standard for youth residential substance use services in Australia has been developed, and this is the first study of its kind internationally to explore the efficacy of standards in a youth MTC.

The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes.

A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues.

Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed.

Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts.

Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances.

The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes.

The purpose of this paper is to explore and develop appropriate responses to the workforce development needs of Aotearoa New Zealand Therapeutic Communities (TC).

Matua Raki took a workforce development design approach using principles of participatory/co-design.

A scoping exercise undertaken to explore the workforce development needs of Aotearoa New Zealand TC concluded that there was a shortage of addiction practitioners ready, willing and able to work in the TC environment and that a workforce development solution was desired by stakeholders. Following the scoping exercise a demand analysis found that there was a need for a TC training programme to be delivered in the Aotearoa New Zealand context. Outcome: a culturally appropriate TC training programme was developed in consultation with a wide range of stakeholders. The training programme was then piloted with a group of 23 practitioners. Evaluation of participant engagement and satisfaction indicated that the training programme was appropriate to both the needs of the workforce and the TC context.

The TC training, developed as a result of this workforce development design approach provides unique content and processes to meet the needs of the TC workforce in the New Zealand context.