During the past several years, a number of aggressive federal and state initiatives have been und... more During the past several years, a number of aggressive federal and state initiatives have been undertaken to expand substance abuse treatment within correctional settings. These efforts have been fueled by the high rates of substance involvement among offenders and the growing body of research literature suggesting that intensive, prison-based treatment efforts can significantly reduce postprison substance use and recidivism. However, the rapid expansion of these programs increases their vulnerability to common implementation problems that could lead to pessimistic, and erroneous, assumptions about their effectiveness. This article summarizes both the research literature and the experiences of the authors regarding six common barriers to developing effective correctional treatment programs and offers potential solutions for each.
Analyses of the National Criminal Justice Treatment Practices Survey found that correctional prog... more Analyses of the National Criminal Justice Treatment Practices Survey found that correctional programs that have higher scores on the integration of services for offenders in substance abuse programs had a greater probability of using more evidence based treatment practices. This relationship was studied using survey data from 430 corrections facility administrators, representing adult prisons (N=98), adult jails and community corrections agencies (N=191), juvenile secure residential facilities (N=49), and local juvenile jails and community corrections agencies (N=92), and 217 substance abuse treatment administrators, of which 122 were in county-level facilities and 95 represented prison-based programs. Survey respondents indicated whether they engaged in each of the activities with each of three other types of agencies (drug treatment, judicial, other correctional agency) potentially involved in offender drug treatment. The integration measure was designed as an additive scale with ...
This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which f... more This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which focuses on justice-involved persons with co-occurring mental and substance use disorders (CODs). It contains seven original articles examining CODs among justice-involved populations that vary by gender, age, setting (e.g., community/ court, jail, prison), environment (urban, rural), geographic region, and nationality. (PsycINFO Database Record
ABSTRACT This study is part of an ongoing effort to evaluate the growing number of prison-based s... more ABSTRACT This study is part of an ongoing effort to evaluate the growing number of prison-based substance abuse treatment programs from the perspective of the clients. The study tested whether 1,059 participants from 13 prison-based substance abuse treatment programs could be grouped according to elevated, moderate, or low perceptions of the treatment environment (i.e., their perception of the use of therapeutic community, cognitive-behavioral therapy, and 12-step treatment activities) and according to their perceptions of the program climate (i.e., a positive sense of community). It also tested whether those who observed higher levels of these treatment components had a higher evaluation of their treatment and of their rapport with counselors and, overall, higher levels of treatment satisfaction. Despite being coerced into treatment, the majority of participants were positive about their treatment experience.
ABSTRACT The current study replicates and refines earlier findings concerning the role of risk fa... more ABSTRACT The current study replicates and refines earlier findings concerning the role of risk factors as predictors of reincarceration following prison substance abuse treatment. Findings confirm that risk factors predict recidivism 3 years postprison and that positive treatment effects are more likely to be found among the higher risk participants. However, care must be taken in adopting this conclusion for policy as it does not hold when the powerful effects of aftercare are introduced. Specifically, impressive reductions in recidivism were also found for the lower risk offenders who completed after-care. Therefore, caution is urged in assuming that low-risk individuals would not benefit from continued treatment.
ABSTRACT Correctional policy in the United States has alternately emphasized rehabilitation and p... more ABSTRACT Correctional policy in the United States has alternately emphasized rehabilitation and punishment (Irwin, 2007). The current “tough on crime” era has led to steadily increasing numbers of imprisoned Americans and unsustainable costs (Garland, 2001; Lacey, 2010). Overcrowded prisons and bloated correctional budgets have drained money from educational and social programs, reaching unprecedented levels in the 1980s and becoming completely untenable in times of diminished resources. In response, many advocacy groups have called for correctional reform, including the Human Rights Watch, the Sentencing Project, the Justice Project, the Vera Institute of Justice, the Council of State Governments, the Pew Center for the States, and the Northpointe Institute for Public Management. The voices of these reformers have decried the overuse of incarceration and its costliness, compared with other sentencing alternatives that generally yield greater dividends with respect to community safety and offender rehabilitation. Within the federal government, the most reasoned and resonant voice for prison reform belongs to Senator James Webb (D-Virginia), who has encouraged a bipartisan approach to criminal justice changes through his proposed National Criminal Justice Commission (NCJC).
The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program w... more The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program with aftercare using an intent-to-treat design with random assignment. Outcomes for 478 felons at 36 months replicated findings of an earlier report on 12 and 24-month outcomes, showing the best outcomes for those who completed both in-prison and aftercare TC programs. At 36 months, 27%of the prison TC plus aftercare completers recidivated, versus 75% for other groups. Additionally, a significant positive relationship was found between the amount of time spent in treatment and the time until return for the parolees who recidivated. However, the reduced recidivism rates for in-prison treatment found at 12 and 24 months was not maintained at 36 months.
During the past several years, a number of aggressive federal and state initiatives have been und... more During the past several years, a number of aggressive federal and state initiatives have been undertaken to expand substance abuse treatment within correctional settings. These efforts have been fueled by the high rates of substance involvement among offenders and the growing body of research literature suggesting that intensive, prison-based treatment efforts can significantly reduce postprison substance use and recidivism. However, the rapid expansion of these programs increases their vulnerability to common implementation problems that could lead to pessimistic, and erroneous, assumptions about their effectiveness. This article summarizes both the research literature and the experiences of the authors regarding six common barriers to developing effective correctional treatment programs and offers potential solutions for each.
ABSTRACT The national Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) is a multisite rese... more ABSTRACT The national Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) is a multisite research program to improve outcomes for offenders with drug problems who are reentering the community after incarceration. Baseline data from three ongoing CJ-DATS studies were pooled to examine the characteristics of study participants. These analyses suggest that CJ-DATS study participants have serious drug problems, criminal histories, and mental health problems that can decrease the likelihood of successful community reentry unless addressed. HIV-risk behavior was associated with several categories of criminal acts, suggesting that the relationship between sexual risk behaviors and crime may need further investigation.
Criminal Justice Treatment Practices survey are examined to describe types of services provided b... more Criminal Justice Treatment Practices survey are examined to describe types of services provided by three types of prisons: those that serve a cross-section of offenders, those that specialize in serving offenders with special psychosocial and medical needs, and those that specialize in serving legal status or gender specific populations. Information is presented on the prevalence and type of specialized prisons and services provided to offenders as reported by wardens and other facility directors drawn from a nationally representative sample of prisons. Additional analyses explore organizational factors that differentiate prisons that serve specialized populations including staffing, training, other resources, leadership, and climate for change and innovation. Implications for expanding and improving services for special populations in correctional settings and the values of specialized prisons are discussed.
Dropouts (N = 162) and graduates (N = 75) from the 1970-1971 residential population in Phoenix Ho... more Dropouts (N = 162) and graduates (N = 75) from the 1970-1971 residential population in Phoenix House were interviewed 5 years after treatment. Composite indices of criminality, drug use, and employment described client status on a four-point outcome scale. Success reflected absence of crime and drug use through all years of follow-up; improvement represented a positive change over pretreatment status. Graduate success and improvement rates were 75% and 93%, respectively. Among dropouts, the rates were 31% and 56%, respectively, but increased by time in program from less than 1 month to greater than 20 months (Success = 0-57%; Improvement = 5-89%). Results at 2-year follow-up were replicated in a 1974 cohort, providing convincing evidence for the effectiveness of treatment in the therapeutic community.
An AIDS prevention training program for parolees recently released from prison with histories of ... more An AIDS prevention training program for parolees recently released from prison with histories of drug injection was developed and evaluated. Key program elements included: a social learning approach to prevention which emphasized resistance skills training; a self-help orientation stressing individual responsibility; therapeutic community principles such as credible role models and community building; and job readiness training for the AIDS prevention/outreach field. A total of 394 eligible parolees (81% male, 19% female) were recruited, of whom 241 attended the program, including 164 completers. One year follow-up results showed that ARRIVE participation significantly decreased certain sexual and drug-related risk behaviors and improved parolees' community adjustment.
... describing what happens to military dependents when their husbands, sons, or fathers are call... more ... describing what happens to military dependents when their husbands, sons, or fathers are called ... The recent military action in the Middle East had many inherent uncertainties, with ... on trauma separations and certain aspects of Post-traumatic Stress Disorder (PTSD) suggest that ...
The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program w... more The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program with aftercare using an intent-to-treat design with random assignment. Outcomes for 478 felons at 36 months replicated findings of an earlier report on 12 and 24-month outcomes, showing the best outcomes for those who completed both in-prison and aftercare TC programs. At 36 months, 27%of the prison TC plus aftercare completers recidivated, versus 75% for other groups. Additionally, a significant positive relationship was found between the amount of time spent in treatment and the time until return for the parolees who recidivated. However, the reduced recidivism rates for in-prison treatment found at 12 and 24 months was not maintained at 36 months.
The present prospective study explored whether a specific class of client subjective assessments ... more The present prospective study explored whether a specific class of client subjective assessments predicts later recovery. Measures of client perceptions of self-change in substance abusers were obtained a year after release from a prison-based therapeutic community. Analyses assessed the contribution of these perceptions-along with motivation, age, and risk index of social deviancy-in predicting reincarceration at 3-year follow-up. Results showed that two factors (Individual Growth and Socialization) significantly differentiated reincarceration and nonreincarceration at 1-year postrelease and significantly predicted reincarceration at 3-year follow-up. Findings underscore the relevance of perceptions of self-change early in recovery to later recovery behaviors. Research on recovery factors needs a uniform assessment protocol, which organizes client perceptions, beliefs, and attributions in accordance with a recovery stage framework.
Two nonspecific organizational factors-consensus, defined as agreement within staff and client gr... more Two nonspecific organizational factors-consensus, defined as agreement within staff and client groups, and concordance, defined as agreement between staff and client groups-were shown to influence client engagement in treatment in a national sample of 80 residential substance abuse treatment programs including 595 staff and 3,732 clients. Agreement was tested using a combined therapeutic community, cognitive-behavioral therapy, and 12-step treatment scale completed by staff and clients. Treatment engagement was measured by the combined scores on the three scales completed by the clients, including engagement, rapport with the counseling process, and confidence in treatment. Within-group consensus was measured by the standard deviations of the mean scores, whereas between-groups concordance was measured by the standard error of the difference between staff and client mean scores. Regression analyses showed that staff consensus was a significant independent predictor of client treatment engagement (p < .05), whereas client consensus approached significance (p < .10). Concordance was also a significant predictor of client engagement (p < .002) after controlling for staff and client consensus. The potential contribution of the findings to a better understanding of program quality and effectiveness of programmatic interventions is discussed.
Previous studies demonstrated the relationship between consensus among both staff and clients wit... more Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.
During the past several years, a number of aggressive federal and state initiatives have been und... more During the past several years, a number of aggressive federal and state initiatives have been undertaken to expand substance abuse treatment within correctional settings. These efforts have been fueled by the high rates of substance involvement among offenders and the growing body of research literature suggesting that intensive, prison-based treatment efforts can significantly reduce postprison substance use and recidivism. However, the rapid expansion of these programs increases their vulnerability to common implementation problems that could lead to pessimistic, and erroneous, assumptions about their effectiveness. This article summarizes both the research literature and the experiences of the authors regarding six common barriers to developing effective correctional treatment programs and offers potential solutions for each.
Analyses of the National Criminal Justice Treatment Practices Survey found that correctional prog... more Analyses of the National Criminal Justice Treatment Practices Survey found that correctional programs that have higher scores on the integration of services for offenders in substance abuse programs had a greater probability of using more evidence based treatment practices. This relationship was studied using survey data from 430 corrections facility administrators, representing adult prisons (N=98), adult jails and community corrections agencies (N=191), juvenile secure residential facilities (N=49), and local juvenile jails and community corrections agencies (N=92), and 217 substance abuse treatment administrators, of which 122 were in county-level facilities and 95 represented prison-based programs. Survey respondents indicated whether they engaged in each of the activities with each of three other types of agencies (drug treatment, judicial, other correctional agency) potentially involved in offender drug treatment. The integration measure was designed as an additive scale with ...
This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which f... more This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which focuses on justice-involved persons with co-occurring mental and substance use disorders (CODs). It contains seven original articles examining CODs among justice-involved populations that vary by gender, age, setting (e.g., community/ court, jail, prison), environment (urban, rural), geographic region, and nationality. (PsycINFO Database Record
ABSTRACT This study is part of an ongoing effort to evaluate the growing number of prison-based s... more ABSTRACT This study is part of an ongoing effort to evaluate the growing number of prison-based substance abuse treatment programs from the perspective of the clients. The study tested whether 1,059 participants from 13 prison-based substance abuse treatment programs could be grouped according to elevated, moderate, or low perceptions of the treatment environment (i.e., their perception of the use of therapeutic community, cognitive-behavioral therapy, and 12-step treatment activities) and according to their perceptions of the program climate (i.e., a positive sense of community). It also tested whether those who observed higher levels of these treatment components had a higher evaluation of their treatment and of their rapport with counselors and, overall, higher levels of treatment satisfaction. Despite being coerced into treatment, the majority of participants were positive about their treatment experience.
ABSTRACT The current study replicates and refines earlier findings concerning the role of risk fa... more ABSTRACT The current study replicates and refines earlier findings concerning the role of risk factors as predictors of reincarceration following prison substance abuse treatment. Findings confirm that risk factors predict recidivism 3 years postprison and that positive treatment effects are more likely to be found among the higher risk participants. However, care must be taken in adopting this conclusion for policy as it does not hold when the powerful effects of aftercare are introduced. Specifically, impressive reductions in recidivism were also found for the lower risk offenders who completed after-care. Therefore, caution is urged in assuming that low-risk individuals would not benefit from continued treatment.
ABSTRACT Correctional policy in the United States has alternately emphasized rehabilitation and p... more ABSTRACT Correctional policy in the United States has alternately emphasized rehabilitation and punishment (Irwin, 2007). The current “tough on crime” era has led to steadily increasing numbers of imprisoned Americans and unsustainable costs (Garland, 2001; Lacey, 2010). Overcrowded prisons and bloated correctional budgets have drained money from educational and social programs, reaching unprecedented levels in the 1980s and becoming completely untenable in times of diminished resources. In response, many advocacy groups have called for correctional reform, including the Human Rights Watch, the Sentencing Project, the Justice Project, the Vera Institute of Justice, the Council of State Governments, the Pew Center for the States, and the Northpointe Institute for Public Management. The voices of these reformers have decried the overuse of incarceration and its costliness, compared with other sentencing alternatives that generally yield greater dividends with respect to community safety and offender rehabilitation. Within the federal government, the most reasoned and resonant voice for prison reform belongs to Senator James Webb (D-Virginia), who has encouraged a bipartisan approach to criminal justice changes through his proposed National Criminal Justice Commission (NCJC).
The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program w... more The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program with aftercare using an intent-to-treat design with random assignment. Outcomes for 478 felons at 36 months replicated findings of an earlier report on 12 and 24-month outcomes, showing the best outcomes for those who completed both in-prison and aftercare TC programs. At 36 months, 27%of the prison TC plus aftercare completers recidivated, versus 75% for other groups. Additionally, a significant positive relationship was found between the amount of time spent in treatment and the time until return for the parolees who recidivated. However, the reduced recidivism rates for in-prison treatment found at 12 and 24 months was not maintained at 36 months.
During the past several years, a number of aggressive federal and state initiatives have been und... more During the past several years, a number of aggressive federal and state initiatives have been undertaken to expand substance abuse treatment within correctional settings. These efforts have been fueled by the high rates of substance involvement among offenders and the growing body of research literature suggesting that intensive, prison-based treatment efforts can significantly reduce postprison substance use and recidivism. However, the rapid expansion of these programs increases their vulnerability to common implementation problems that could lead to pessimistic, and erroneous, assumptions about their effectiveness. This article summarizes both the research literature and the experiences of the authors regarding six common barriers to developing effective correctional treatment programs and offers potential solutions for each.
ABSTRACT The national Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) is a multisite rese... more ABSTRACT The national Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) is a multisite research program to improve outcomes for offenders with drug problems who are reentering the community after incarceration. Baseline data from three ongoing CJ-DATS studies were pooled to examine the characteristics of study participants. These analyses suggest that CJ-DATS study participants have serious drug problems, criminal histories, and mental health problems that can decrease the likelihood of successful community reentry unless addressed. HIV-risk behavior was associated with several categories of criminal acts, suggesting that the relationship between sexual risk behaviors and crime may need further investigation.
Criminal Justice Treatment Practices survey are examined to describe types of services provided b... more Criminal Justice Treatment Practices survey are examined to describe types of services provided by three types of prisons: those that serve a cross-section of offenders, those that specialize in serving offenders with special psychosocial and medical needs, and those that specialize in serving legal status or gender specific populations. Information is presented on the prevalence and type of specialized prisons and services provided to offenders as reported by wardens and other facility directors drawn from a nationally representative sample of prisons. Additional analyses explore organizational factors that differentiate prisons that serve specialized populations including staffing, training, other resources, leadership, and climate for change and innovation. Implications for expanding and improving services for special populations in correctional settings and the values of specialized prisons are discussed.
Dropouts (N = 162) and graduates (N = 75) from the 1970-1971 residential population in Phoenix Ho... more Dropouts (N = 162) and graduates (N = 75) from the 1970-1971 residential population in Phoenix House were interviewed 5 years after treatment. Composite indices of criminality, drug use, and employment described client status on a four-point outcome scale. Success reflected absence of crime and drug use through all years of follow-up; improvement represented a positive change over pretreatment status. Graduate success and improvement rates were 75% and 93%, respectively. Among dropouts, the rates were 31% and 56%, respectively, but increased by time in program from less than 1 month to greater than 20 months (Success = 0-57%; Improvement = 5-89%). Results at 2-year follow-up were replicated in a 1974 cohort, providing convincing evidence for the effectiveness of treatment in the therapeutic community.
An AIDS prevention training program for parolees recently released from prison with histories of ... more An AIDS prevention training program for parolees recently released from prison with histories of drug injection was developed and evaluated. Key program elements included: a social learning approach to prevention which emphasized resistance skills training; a self-help orientation stressing individual responsibility; therapeutic community principles such as credible role models and community building; and job readiness training for the AIDS prevention/outreach field. A total of 394 eligible parolees (81% male, 19% female) were recruited, of whom 241 attended the program, including 164 completers. One year follow-up results showed that ARRIVE participation significantly decreased certain sexual and drug-related risk behaviors and improved parolees' community adjustment.
... describing what happens to military dependents when their husbands, sons, or fathers are call... more ... describing what happens to military dependents when their husbands, sons, or fathers are called ... The recent military action in the Middle East had many inherent uncertainties, with ... on trauma separations and certain aspects of Post-traumatic Stress Disorder (PTSD) suggest that ...
The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program w... more The study assessed 36-month recidivism outcomes for a prison therapeutic community (TC) program with aftercare using an intent-to-treat design with random assignment. Outcomes for 478 felons at 36 months replicated findings of an earlier report on 12 and 24-month outcomes, showing the best outcomes for those who completed both in-prison and aftercare TC programs. At 36 months, 27%of the prison TC plus aftercare completers recidivated, versus 75% for other groups. Additionally, a significant positive relationship was found between the amount of time spent in treatment and the time until return for the parolees who recidivated. However, the reduced recidivism rates for in-prison treatment found at 12 and 24 months was not maintained at 36 months.
The present prospective study explored whether a specific class of client subjective assessments ... more The present prospective study explored whether a specific class of client subjective assessments predicts later recovery. Measures of client perceptions of self-change in substance abusers were obtained a year after release from a prison-based therapeutic community. Analyses assessed the contribution of these perceptions-along with motivation, age, and risk index of social deviancy-in predicting reincarceration at 3-year follow-up. Results showed that two factors (Individual Growth and Socialization) significantly differentiated reincarceration and nonreincarceration at 1-year postrelease and significantly predicted reincarceration at 3-year follow-up. Findings underscore the relevance of perceptions of self-change early in recovery to later recovery behaviors. Research on recovery factors needs a uniform assessment protocol, which organizes client perceptions, beliefs, and attributions in accordance with a recovery stage framework.
Two nonspecific organizational factors-consensus, defined as agreement within staff and client gr... more Two nonspecific organizational factors-consensus, defined as agreement within staff and client groups, and concordance, defined as agreement between staff and client groups-were shown to influence client engagement in treatment in a national sample of 80 residential substance abuse treatment programs including 595 staff and 3,732 clients. Agreement was tested using a combined therapeutic community, cognitive-behavioral therapy, and 12-step treatment scale completed by staff and clients. Treatment engagement was measured by the combined scores on the three scales completed by the clients, including engagement, rapport with the counseling process, and confidence in treatment. Within-group consensus was measured by the standard deviations of the mean scores, whereas between-groups concordance was measured by the standard error of the difference between staff and client mean scores. Regression analyses showed that staff consensus was a significant independent predictor of client treatment engagement (p < .05), whereas client consensus approached significance (p < .10). Concordance was also a significant predictor of client engagement (p < .002) after controlling for staff and client consensus. The potential contribution of the findings to a better understanding of program quality and effectiveness of programmatic interventions is discussed.
Previous studies demonstrated the relationship between consensus among both staff and clients wit... more Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.
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