Prison-based Treatment Research Articles

How do drug-involved incarcerated and recently released offenders and correctional treatment staff perceive treatment? A qualitative study on treatment needs and motivation in Belgian prisons

The research seeks to identify the most common problem areas and associated treatment needs of incarcerated and recently released offenders, to determine the importance of prison-based treatment and to assess the motivation of offenders towards treatment. Interviews were scheduled with representatives of three participant categories: drug-involved incarcerated offenders (n=18), recently released prisoners (n=15) and treatment staff members (n=18), resulting in 1971 statements. Using the qualitative software package WinMAX98, these expressions were categorized in a tree structure, after a codification process of the raw material. The results suggest that there is a difference in opinion between offenders and service providers with regard to the most important problems related to incarceration and re-entry. The findings further indicate that released offenders struggle more often than incarcerated offenders with problems concerning their psychological status. Therefore, the need for continuous through-care and aftercare is apparent, as is the necessity to assess the participants’ support expectancies and their individual needs. Motivating offenders to take part in (prison-based) treatment initiatives and aftercare is a major challenge, which can be accomplished by cooperation and partnerships between the criminal justice system and community-based treatment providers.

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The Brown University Digest of Addiction Theory and ApplicationVolume 25, Issue 6 p. 1-8 Table of Contents First published: 16 May 2006 https://doi.org/10.1002/data.20021AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Utility of Clinical Significance Methodology in Alcoholism Treatment Trials Link Found between Adolescent AUD and Adult Borderline Personality Disorder Gender Differences Found among Substance Users in Prison-Based Treatment Program Table 1. Characteristics of Persons Engaged in RDAPs Study Finds Low Quit Rates among Methadone-Maintained Smokers Table 1. Seven-Day Abstinence Rates at 3 and 6 Months HIV Intervention Yields Positive Results among American Indians in SA Treatment Table 1. Total Change in Knowledge, Attitude and Behavior Scores Study: Alcohol Misuse by Young People Not Limited to College Undergraduates Recovery Status at the Six-Month Follow-up Period Taking a Developmental Perspective on Alcohol Involvement During Young Adulthood Volume25, Issue6June 2006Pages 1-8 RelatedInformation

Predictors of Prison-Based Treatment Outcomes: A Comparison of Men and Women Participants

The purpose of this study was to examine differences between men and women entering prison-based therapeutic community (TC) treatment and to explore the relationship of those differences to posttreatment outcomes (i.e., aftercare participation and reincarceration rates). Extensive treatment-intake interview data for 4,386 women and 4,164 men from 16 prison-based TCs in California were compared using chi-square analyses and t-tests. Logistic regression analyses were then conducted separately for men and women to identify gender-specific factors associated with post-treatment outcomes. Prison intake data and treatment participation data come from a 5-year process and outcome evaluation of the California Department of Corrections' (CDC) Prison Treatment Expansion Initiative. The return-to-custody data came from the CDC's Offender Based Information System. Bivariate results showed that women were at a substantial disadvantage compared with their male counterparts with regard to histories of employment, substance abuse, psychological functioning, and sexual and physical abuse prior to incarceration. In contrast, men had more serious criminal justice involvement than women prior to incarceration. After controlling for these and other factors related to outcomes, regression findings showed that there were both similarities and differences with regard to gender-specific predictors of posttreatment outcomes. Time in treatment and motivation for treatment were similar predictors of aftercare participation for men and women. Psychological impairment was the strongest predictor of recidivism for both men and women. Substantial differences in background characteristics and the limited number of predictors related to posttreatment outcomes for women suggests the plausibility of gender-specific paths in the recovery process.

Perception of Helpfulness Among Participants in a Prison-Based Residential Substance Abuse Treatment Program

The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates’ perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were surveyed. Overall, findings indicated that the early release incentive served to encourage inmates’ engagement in drug treatment and did not appear to distract inmates from perceiving their treatment as helpful or to hinder their pursuit of various treatment topics and skills. Statistically significant differences in what the inmates expected to learn or acquire, overall satisfaction and perceived helpfulness were found between those inmates who were provisionally eligible for the early release incentive versus those who were not. Emphasizing the importance of treatment engagement, an examination of qualitative data also revealed that those who had been in the program longer had higher rates of perceived helpfulness and suggests that at the six-month point in treatment inmates begin to experience and integrate their treatment gains.

Methadone Maintenance in a Men’s Prison in Puerto Rico: A Pilot Program

A pilot methadone maintenance program for heroin-dependent sentenced inmates in a men's prison in San Juan, Puerto Rico, was begun in 2002. One year later, data were collected from all 20 program partici-pants and a random sample of 40 inmates who did not participate. The data included (a) inmate self-reports concerning their drug use, attitudes about drug treatment, and expectations about behaviors upon release from prison, and (b) urine specimens for heroin and methadone testing. It was found that inmates enrolled in the program had been heavy users of heroin and reduced their heroin use by more than 94%. There was a high correlation between self-report and urine test results. Program participa-tion was associated with increased acceptance of methadone maintenance as a prison-based treatment for heroin dependence. The program appeared successful in reducing heroin abuse among heroin-dependent prisoners. Prison officials planned to expand the program.

Transferring the Principles of Effective Treatment into a “Real World” Prison Setting

The principles of risk, need, and responsivity have been empirically linked to the effectiveness of treatment to reduce reoffending, but the transference of these principles to the inside of prison walls is difficult. Results from a sample of 620 incarcerated male offenders—482 who received either a 5-week, 10-week, or 15-week prison-based treatment program and 138 untreated comparison offenders—found that treatment significantly reduced recidivism (odds ratio of .56; effect size r of .10) and that the amount of treatment (e.g., “dosage”) played a significant role (odds ratios between .92 and .95 per week of treatment; adjusted effect size r of .01 and .02). These results indicate that prison-based treatment can be effective in reducing recidivism, that dosage plays a mediating role, and that there may be minimum levels of treatment required to reduce recidivism that is dependent on the level of an offender’s risk and need.

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AbstractPrison‐Based Treatment Program Reduces RecidivismNIAAA Survey Finds That Many Recover From AlcoholismAlcohol Counseling in ER Could Save Hospitals $2 Billion AnnuallyReport Finds Increase in Methamphetamine‐Related AdmissionsA ‘StoryCorps’ interview with NCADD President Stacia MurphyResourcesNames in the NewsBriefly NotedComing Up

Cost-Effectiveness of Connecticut's In-Prison Substance Abuse Treatment

Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the Connecticut Department of Correction and the Connecticut Department of Mental Health and Addiction Services (DMHAS), we compared the cost-effectiveness of four tiers (levels) of substance abuse treatment programs for a sample of 831 offenders who were released during FY1996-FY1997. Effectiveness, measured by reductions in the likelihood of rearrest within six months, one year and 18 months post-release, was compared for inmates who had received treatment while incarcerated (n = 358) and those who had not (n = 473). At all intervals, offenders who attended any of the higher tier programs (two, three and four) had significantly lower rates of rearrest when compared to offenders who attended Tier One only or who had attended no tier programs, even after controlling for background characteristics that may have differentiated the two groups. The benefits to the State of Connecticut correctional system alone, measured in terms of the costs of avoided re-incarcerations, were from 1.8 to 5.7 times the cost of implementing the programs, ranging from $20,098 (Tier Four) to $37,605 (Tier Two). Since society receives a favorable return on its investment in prison-based treatment programs, we should find ways to ensure that more drug-involved inmates receive treatment.

Treatment Motivation and Therapeutic Engagement in Prison-Based Substance Use Treatment

Studies of community-based substance use treatment show that motivation for treatment is critical for clients becoming therapeutically engaged. Little research, however, has been conducted on therapeutic engagement in corrections-based substance use treatment. The current study examines the association between internal treatment motivation and therapeutic engagement for a sample of 220 male substance-using offenders enrolled in a corrections-based treatment program. Findings showed that problem recognition and desire for help were associated with cognitive indicators of therapeutic engagement, specifically confidence in and commitment to treatment. Increased focus on internal motivation for treatment may lead to more effective treatment for substance-using offenders. Pretreatment motivational interventions therefore are recommended for substance-using offenders with low internal motivation for treatment.

Outcome Data for MICA Clients After Participation in an Institutional Therapeutic Community

The current study assessed the effectiveness of a prison-based substance abuse treatment therapeutic community (TC) providing treatment to male inmates dually diagnosed with both substance abuse and mental health disorders. The findings show a short-term impact of the program on arrest after release, with program participants significantly less likely than comparison group offenders to be arrested or returned to prison within three months of release. Logistic regression analyses confirmed that program participants are more likely than the comparison group to be medication compliant, abstinent from substances, and more stable at three months after release. The analyses suggest that participation in the program increases the likelihood of medication compliance after release. The mediational model resulting from this study suggests that treatment participation directly impacts medication compliance. Medication compliance impacts substance use, and these two factors then combine to improve mental health stability. For this population, mental health stability leads to positive outcomes in the community. Medication compliance not only improves mental health stability, but also leads to a reduction or elimination of mental illness symptoms that decreases the need to self-medicate with substances. For these men, medication compliance is the pivotal factor in reducing recidivism after release. These outcome evaluation results indicate that program participation has a significant positive impact on the lives of participants after release. The primary outcome findings suggest that programs treating dually diagnosed offenders should continue to emphasize the importance of medication compliance. Medication compliance should be stressed not only during residential TC services, but during the provision of aftercare and outreach services as well. The current findings demonstrate the effectiveness of the treatment model for dually diagnosed offenders.

Client Perceptions Of Prison-Based Therapeutic Community Drug Treatment Programs

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.

The California Treatment Expansion Initiative: Aftercare Participation, Recidivism, and Predictors of Outcomes

This study explored possible predictors of participation in aftercare and 12-month return-to-custody (RTC) among 4,155 inmates who participated in prison-based therapeutic community treatment in California. The most consistent theme that emerged from this study was the importance of duration of time spent in treatment. Increased time spent in prison-based treatment predicted increased participation in aftercare and decreased 12-month RTC. Similarly, increased time spent in aftercare predicted decreased 12-month RTC. Those who participated in aftercare in urban counties spent longer periods of time in treatment and were less likely to be returned to custody within 12 months. The findings suggest that Hispanics rely more successfully on social and/or familial support systems than on aftercare postrelease. The findings also highlight the importance of education in facilitating postrelease reintegration and ensuring successful outcomes.

Amity Prison-Based Therapeutic Community: 5-Year Outcomes

Few studies have examined outcomes of prison-based treatment programs over a 5-year observation period. The present analysis was based on a sample of 715 prisoners randomly assigned either to the Amity therapeutic community program or to a notreatment group. At 5-years postrelease, 90% of the original participants were located and 81% were interviewed. The main findings were based on a conservative intent-to-treat approach. On measures of recidivism, the Amity treatment group had significantly lower rates of reincarceration than the control group, but in multivariate analysis of time to first reincarceration, this main treatment effect disappeared and other factors (age and postrelease treatment) became significant predictors of delayed time to reincarceration. As in previous reports on this cohort, those who attended aftercare had lower levels of reincarceration, longer time to reincarceration, and higher levels of employment.

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity, arrest type, and number of months incarcerated. Days to first reincarceration and type of reincarceration are based on official records. Drug use variables included self-report data of the time to first use and drug testing results. Prisoners randomly assigned to treatment performed significantly better than controls on: days to first illegal activity, days to first incarceration, days to first use, type of reincarceration, and mean number of months incarcerated. No differences were found in type of first arrest or in drug test results. Subjects who completed both prison-based and community-based treatment performed significantly better than subjects who received lesser amounts of treatment on every measure. Survival analysis suggested that subjects were most vulnerable to recidivism in the 60 days after release. Although the overall results from the analyses presented support the effectiveness of prison-based treatment, conclusions about the effectiveness of a treatment program may vary depending on which outcomes are selected. The results of this study argue for including more rather than fewer outcomes in assessing the impact of prison-based substance abuse treatment.

Perceptions of a Prison-Based Substance Abuse Treatment Program Among Some Staff and Participants

Almost 90% of all State and Federal prisons in the U.S. offer some form of substance abuse counseling, and one in eight prisoners have participated in a substance abuse treatment program while incarcerated. Evidence indicates that these programs can be successful in stopping prisoners' substance abuse. While some data are available about the success of these programs, little is known about program administrators', counselors' and participants' experiences with and perceptions of these treatment programs. These experiences and perceptions remain important because they may be helpful for understanding areas of agreement and conflict in staff-participant relationships. The more understanding we have for these relationships, the more likely it is that we will be able to improve staff-participant communications, program effectiveness, and participant success. The results suggest similarities and differences between staff and participants in the areas of participant motivation, staff-participant communication, race, institutional support, and counselor contacts. Implications of the results of this inquiry for prison-based substance abuse treatment programs are discussed.

The promise of prison-based treatment for dually diagnosed inmates

The Stay'n Out therapeutic community was created 25 years ago, the first rigorously evaluated prison program that demonstrated recidivism reduction. Since then, there has been a growing appreciation for the recidivism-reducing benefit of substance abuse treatment and the general understanding has been reached that prison treatment for substance abuse is good for the public interest. A number of replicated outcome studies have led to increases in treatment capacity in most state correctional systems, primarily utilizing the therapeutic community model. In contrast, efforts to introduce treatment for offenders with co-occurring mental illness and substance abuse disorders (COD) are only beginning. This article describes developments in prison substance abuse treatment and reentry programs and offers some guiding observations from prison substance abuse treatment history that could facilitate the development of COD treatment. Lessons learned include that: public safety (i.e., recidivism reduction) is a primary goal; personal accountability as a basic treatment value facilitates cooperation between treatment and correctional staff; self-help approaches foster more ambitious treatment goals than just symptom reduction; and well-run treatment programs often ease the burden of correctional administration.

Evaluation of a National Prison-based Treatment Program for Sexual Offenders in England and Wales

Treatment efficacy is described for a sample of sexual offenders who had undertaken treatment in United Kingdom prisons (N = 647) and for a retrospectively selected comparison group (N = 1,910). The outcomes under observation in this study were sexual, sexual and/or violent, and general reconviction. Treatment impact was also examined in relation to offenders' risk of reconviction. The treatment group had slightly lower 2-year sexual reconviction rates than the comparison group, but these differences were not statistically significant. Significant differences were found between the treatment and comparison group for sexual and/or violent reconviction. Further analysis suggested that treatment produced a reduction in the probability of sexual and/or violent reconviction (p <.05) when other relevant variables were controlled for. General reconviction rates were consistently lower in the treatment group, but these differences were not significant.

Science Is Revolutionizing Our View of Addiction—and What to Do About It

Science Is Revolutionizing Our View of Addiction—and What to Do About It

Is In‐Prison Treatment Enough? A Cost‐Effectiveness Analysis of Prison‐Based Treatment and Aftercare Services for Substance‐Abusing Offenders

This study performed a cost‐effectiveness analysis (CEA) of the Amity in‐prison Therapeutic Community (TC) and Vista aftercare programs for criminal offenders in California. For the average treatment participant, the cost of treatment was $4,112, which led to approximately fifty‐one fewer days incarcerated (36% less) than the average individual in the control group. This implies that, for the average offender, treatment reduced recidivism at a cost of $80 per incarceration day. For participants who received both in‐prison treatment and aftercare services, an additional day of incarceration was avoided at a cost of $51 per day relative to those that received in‐prison treatment only.

Evaluating component effects of a prison-based treatment continuum.

A continuum of correctional-based therapeutic community (TC) treatment programs for drug-involved offenders has been functioning for several years in Delaware. Previous evaluations have shown the efficacy of the full continuum for up to three years posttreatment, though there has been some question of the benefits of treatment within prison. The particular focus here is on the relative impact of the within-prison, transitional, and aftercare treatment components upon criminal recidivism and relapse to illicit drug use. The relative benefit of participation in each component is supported, over and above the effects of differences in demographics and histories of criminal behavior and illicit substance use. However, the residential transitional program effects are generally larger and more long lasting. Additionally, the two outcomes appear differentially sensitive to the degree of completion of the continuum.