The Influence of Client Risks and Treatment Engagement on Recidivism

Abstract

The current study modeled 12-month postrelease rearrest (recidivism) in terms of pretreatment risk factors (i.e., criminal history, criminal thinking,) and during-treatment engagement in a sample of 653 subjects admitted to four prison-based substance treatment programs. Structural equation modeling was used to test during-treatment engagement as a mediator variable in explaining the relationship between the pretreatment risk factors and recidivism. Results indicated that (a) a long history of criminal conduct correlated with criminal thinking, which in turn had a significant negative relationship with engagement in treatment; (b) the level of criminal involvement had a significant positive relationship with rearrest, whereas the level of criminal thinking did not influence being rearrested directly; (c) the relationship between criminal history and rearrest was partially mediated by criminal thinking and treatment engagement, whereas the relationship between criminal thinking and rearrest was fully mediated by treatment engagement. The findings suggest that it is important to design interventions targeting criminal thinking and monitor treatment engagement as an indicator of treatment performance. Clinical implications also include the importance of facilitating treatment engagement and the utility of conducting prognostic assessment to inform treatment.