evaluations of cdcr substance abuse programs: lessons learned michael l. prendergast, ph.d. criminal...
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Evaluations of CDCR Substance Abuse Programs:
Lessons Learned
Michael L. Prendergast, Ph.D.Criminal Justice Research Group
UCLA Integrated Substance Abuse Programs
Presented at the First Annual National Therapeutic Community Conference
Denver, COOctober 5-9, 2008
Characteristics of CDCR TC Programs
• TC model adapted to prison setting
• Voluntary participation is encouraged, but most admissions are mandated
• Treatment occurs in the last 6 to 24 months of incarceration; 4 hours a day, plus optional activities
• Treatment services are provided by agencies under contract to CDCR
• Treatment clients are housed apart from the general population
• Graduates can participate in community treatment
Continuing Care
Community treatment provided for six or more months to SAP graduates
Participation in community treatment is voluntary
Treatment modalities: Residential, Outpatient, Sober Living
Substance Abuse Services Coordinating Agencies (SASCAs) contract for community services and provide case management to clients
SASCAs provide transportation for many parolees to treatment programs
Evaluations
• Amity
• Forever Free
• Substance Abuse Treatment Facility
• Expansion Programs (16)
• Female Offender Treatment and Employment Program
• Valley State Prison for Women (Gender Responsive)
• Database on ~28,000 treatment participants
SATF: Disciplinary Actions
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
Rate
per
100 In
mate
s
Treatment
Non-Treatment
Absenteeism among SATF and Non-Treatment Correctional Staff
5.2
6.9
6.2
10.1
7.4 7.5
8.1
5.2
6.8
5.1
10.2
6.1
4.8
5.4
3.9
5.1
5.7
4.4
0
2
4
6
8
10
12
Jul-98 Aug-98 Sep-98 Oct-98 Nov-98 Dec-98 Jan-99 Feb-99 Mar-99
Month
Rat
e P
er 1
00 S
hif
ts
Non-Treatment
SATF-SAP
Clients need to participate in prison treatment and in community
treatment (90+ days) for reductions in recidivism and drug use to
occur.
Lesson 2
Amity Program: 12-Month Return to Prison
50
34
4540 39
8
0
20
40
60
80
100
Controls Intent toTreat
Prison TCDropouts
Prison TCCompleters
Prison TCCompleters/Aftercare TC
Dropouts
Prison TCCompleters/Aftercare TCCompleters
% Returned
SATF: 12-Month Return to Prison by Aftercare Participation
49.7 46.3
22.2
0
20
40
60
80
100
None (n=4,146) 1-90 Days (n=1,351) 90+ Days (n=562)
Level of Aftercare ParticipationSource: CDC records; SASCA records
% R
TC
0
10
20
30
40
50
60
70
80
90
100
6-Mos 12-Mos 24-Mos 36-Mos 48-Mos
% R
TP
None < 90 Days >90 Days
Recidivism Among 2000 SATF Release Cohort by Aftercare Participation
Percent Positive
Study Groups
Control (n=59) 61.0
Intent-to-treat (n=170) 52.9
Treatment Groups***
Prison TC Drops (n=25) 76.0
Prison TC Completers (n=66) 63.6
Aftercare Drops (n=13) 53.8
Aftercare Completers (n=66) 33.3
*** p < .0001, likelihood ratio chi square
Amity: Positive Drug Tests at 12-Months
21.127.9
34.638.4
32.5 33.6 32.1
8.2 10.4 10.4 13.29.6 7.5 6.9
0
10
20
30
40
50
60
70
80
90
100
CY1999 CY2000 CY2001 CY2002 CY2003 CY2004 CY2005
%
Any Aftercare 90+ Aftercare
SATF: Aftercare Participation by Release Cohort (N=8,037)
SATF: Perceptions about Aftercare
• No interest in changing criminal lifestyle – found in younger prisoners
• Denial of drug problem
• Having a home and family to return to, so don’t need additional treatment or support
• Can do it by myself (no need for additional help)
•Having a home and family to return to, but worried about returning to prison
SATF: Barriers to Entering Aftercare
•Lack of information about the programs in a prisoner’s county of commitment
•Perception that family needs outweigh their need for additional treatment
•Family financial strain
•Few program choices in their county
•Seeing aftercare as continued incarceration
•Desire to start working and be productive right away
•Belief that they can make it with 12-step support only
Life Histories of
Women Offenders
Compared with men offenders, women offenders:
• Have more severe substance abuse histories
• Have more severe histories of sexual/physical abuse
• Have more severe psychological problems
• Have less education
• Have less employment experience and opportunities
• Have less severe criminal histories
• Are more likely to have custody of children
Forever Free Program: 12-Month Parole Performance
0 20 40 60 80
Arrested duringparole
Incarceratedduring parole
Incarcerated atinterview
Forever Free Comparison
***
1
***
*** p<.001 1 p=.07
Standard Prison TC Gender-Specific TC (n=29) (n=34)
In aftercare at 6 months 4% 25%
Reincarcerated at 6 months 48% 29%
Valley State Prison for Women: Gender-Responsive Study
(Preliminary Findings)
Psychological Symptoms at Admission by Mental Health Status (N= 8,093)*
80
38
76
4036
11
72
42 43
25
42
13
42
12
67
13
0%10%20%30%40%50%60%70%80%90%
100% CCCMS
Drug Off.
*Bivariate Comparisons significant at p<.001.
12-Month Return to Prison by Mental Health Status (N=4,408)
90
21
0%10%20%30%40%50%60%70%80%90%
100%
RTC
CCCMS (N=110)
Other (N=4298)
Organizational Factors
• Screening and assessment
• Staffing
• Institutional support
• Lockdowns
• Mission conflict
• Treatment maturity
SATF: 12-Month Return to Prison by Amount of Aftercare and Release Cohort
54.6 53
44.543.639.1
25 25.421.2 21.7 19.6 16.8
46.9 47
48.455.5
49.4 4348
0
10
20
30
40
50
60
70
80
90
100
CY1999 CY2000 CY2001 CY2002 CY2003 CY2004
% R
TC
None < 90 Days 90+ Days
Cohort 1 (1/1/99) 2 3 4 5 6(12/31/01)Population RTC RTC RTC RTC RTC RTC All Males 46.9% 44.0% 42.5% 40.9% 37.1% 37.4%
All Females 42.5% 37.2% 32.4% 30.0% 32.8% 29.9%
All SAPs 42.5% 40.9% 37.1% 35.0% 34.8% 33.5%
Expansion Programs: 12-Month Return to Prison by Release Cohort
1.Prison treatment improves prison management.
2.Clients need to participate in prison treatment and in community treatment (90+ days) for reductions
in recidivism and drug use to occur.
3.SAP graduates face personal and institutional barriers to enrollment in community treatment.
4.Correctional treatment needs to be responsive to the needs of different subpopulations [women, co-disordered].
5.Organizational factors heavily influence successful program performance [include maturity].
Lessons
Thank you
Questions?
www.uclaisap.org > Presentations
Supported by:CDCR Contracts C94.217, C97.243, C97.355, C98.346, C02.017, C06.229,C06.082 NIDA Grants R01DA11483, R21DA018699NIJ Grants 97-RT-VX-K003, 1999-RT-VX-K003