Managing MICA clients in a modified therapeutic community with enhanced staffing

Jerome F.X. Carroll, John J. McGinley

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


To determine how effective a modified therapeutic community (TC) with enhanced mental health staffing would be in treating mentally ill chemical abusing (MICA) clients in a 'mainstream' program, Project Return Foundation, Inc. (PRF) conducted a treatment outcome evaluation study involving 438 residents. Client admissions were screened by mental health specialists for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnoses and then placed into one of three diagnostic groups: non-MICA; general MICA (not requiring psychotropic medication); and, severe MICA (requiring psychotropic medication). Clients were administered the Tennessee Self-Concept Scale (TSCS; Roid and Fitts, 1991) after admission and at 6-month intervals thereafter. Results indicated that: (a) the three diagnostic groups were significantly different at initial TSCS testing, with the non-MICA group evidencing the least lowest measures of self-esteem and lesser degrees of psychopathology; the severe MICA group had the lowest psychological scores; (b) all three diagnostic groups showed significant improvement in their TSCS scores after 6 to 7 months of treatment; (c) covariance analyses observed that the three diagnostic groups did not significantly differ at 6 month testing when the initial TSCS testing was taken into account; and, (d) significant gender differences on several TSCS scales were noted, in that women scored lower than men in self-esteem and higher than men in psychopathology. Research limitations and clinical observations are considered.

Original languageEnglish (US)
Pages (from-to)565-577
Number of pages13
JournalJournal of Substance Abuse Treatment
Issue number6
StatePublished - Nov 1998
Externally publishedYes


  • MICA
  • Mental health services
  • Modified therapeutic community
  • Tennessee Self-Concept Scale
  • Treatment outcome

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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