A multistage therapeutic community treatment system has been instituted in the Delaware correctional system, and its effectiveness has captured the attention of the National Institutes of Health, the Department of Justice, members of Congress, and the White House. Treatment occurs in a three-stage system, with each phase corresponding to the client's changing correctional status—incarceration, work release, and parole. In this paper, 18 month follow-up data are analyzed for those who received treatment in: (1) a prison-based therapeutic community only, (2) a work release therapeutic community followed by aftercare, and (3) the prison-based therapeutic community followed by the work release therapeutic community and aftercare. These groups are compared with a no-treatment group. Those receiving treatment in the two-stage (work release and aftercare) and three-stage (prison, work release, and aftercare) models had significantly lower rates of drug relapse and criminal recidivism, even when adjusted for other risk factors. The results support the effectiveness of a multistage therapeutic community model for drug-involved offenders, and the importance of a work release transitional therapeutic community as a component of this model.
Get full access to this article
View all access options for this article.
References
1.
ABC World News Tonight1996News story, September 11.
2.
AnglinM.D.HserY.1987Addicted women and crime. Criminology25 (May), 359–397.
3.
AnglinM.D.HserY.1990Treatment of drug abuse. In Drugs and Crime, ed. TonryM.WilsonJ. Q., 393–460. Chicago, IL:University of Chicago Press.
4.
BallJ.C.RossA.1991The Effectiveness of Methadone Maintenance Treatment. New York:Springer-Verlag.
5.
BallJ.C.ShafferJ.W.NurcoD.N.1983Day-to-day criminality of heroin addicts in Baltimore: A study in the continuity of offense rates. Drug and Alcohol Dependence12:119–142.
6.
BrownB.S., ed. 1979Addicts and Aftercare: Community Reintegration of the Former Drug User. Beverly Hills:Sage Publications.
7.
ChaikenM.R.1989In-prison Programs for Drug-involved Offenders. Washington, DC:National Institute of Justice.
8.
ChavariaF.R.1992Successful drug treatment in a criminal justice setting: A case study. Federal Probation56(March):48–52.
9.
CondelliW.S.HubbardR.L.1994Client outcomes from therapeutic communities. In Therapeutic Community: Advances in Research and Application, eds. TimsF.M.De LeonG.JainchillN., 80–98. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 144,
10.
De LeonG.1984Program based evaluation research in therapeutic communities. In Drug Abuse Treatment Evaluation: Strategies, Progress, and Prospect, eds. TimsF.M.LudfordJ.P., 69–87. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 51.
11.
De LeonG.1994Therapeutic communities. In The American Psychiatric Press Textbook of Substance Abuse Treatment, eds. GalanterM.KleberH.D., Washington, DC:American Psychiatric Press.
12.
Department of Justice1996Residential substance abuse treatment for state prisoners fact sheet, September 11. Washington, DC:Office of Justice Programs.
13.
FieldG.1992Oregon prison drug treatment programs. In Drug Abuse Treatment in Prisons and Jails, eds. LeukefeldC.G.TimsF.M., 142–155. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 118.
14.
ForcierM.W.1991Substance abuse, crime and prison-based treatment: Problems and prospects. Sociological Practice Review2(2):123–131.
15.
GossopM.GreenL.PhillipsG.BradleyB.1990Factors predicting outcome among opiate addicts after treatment. British Journal of Clinical Psychology29:209–216.
16.
HallS.M.HavassyB.E.WassermanD.A.1990Commitment to abstinence and acute stress in relapse to alcohol, opiates, and nicotine. Journal of Consulting and Clinical Psychology58(2):175–181.
17.
HawkK.1993Drug treatment in prisons. 1993 Congressional Summit on U.S. Drug Policy, May 7. Washington, DC.
18.
HooperR.M.LockwoodD.InciardiJ.A.1993Treatment techniques in corrections-based therapeutic communities. The Prison Journal73(3/4):290–306.
19.
HosmerD.W.LemeshowS.1989Applied Logistic Regression. New York: Wiley and Sons.
20.
HubbardR.L.MarsdenM.E.RachalJ.V.HarwoodH.J.CavanaughE.R.GinzburgH.M.1989Drug Abuse Treatment: A National Study of Effectiveness. Chapel Hill:University of North Carolina Press.
21.
InciardiJ.A.1979Heroin use and street crime. Crime and Delinquency25:335–46.
22.
InciardiJ.A.1992The War on Drugs II: The Continuing Epic of Heroin, Cocaine, Crack, Crime, AIDS, and Public Policy. Mountain View, CA:Mayfield Publishing Co.
23.
InciardiJ.A., ed. 1993Drug Treatment and Criminal Justice. Newbury Park, CA:Harcourt Brace.
24.
InciardiJ.A.LockwoodD.MartinS.S.1994Therapeutic communities in prison and work release: Some clinical and policy implications. In Therapeutic Community: Advances in Research and Application, eds. TimsF.M.De LeonG.JainchillN., 259–267. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 144.
25.
InciardiJ.A.McBrideD.C.RiversJ.E.1996Drug Control and the Courts. Newbury Park, CA:Sage.
26.
InciardiJ.A.PottiegerA.E.1986Drug use and crime among two cohorts of women narcotics users: An empirical assessment. Journal of Drug Issues16:91–106.
27.
InciardiJ.A.PottiegerA.E.1991Kids, crack, and crime. Journal of Drug Issues21:257–270.
28.
InciardiJ.A.PottiegerA.E.1994Crack cocaine use and street crime. Journal of Drug Issues24:273–292.
29.
JohnsonB.D.GoldsteinP. J.PrebleE.SchmeidlerJ.LiptonD.S.SpuntB.MillerT.1985Taking Care of Business: The Economics of Crime by Heroin Users. Lexington, MA:Lexington Books.
30.
LeukefeldC.G.TimsF.M. (eds.) 1988Compulsory Treatment of Drug Abuse: Research and Clinical Practice. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 86.
31.
LeukefeldC.G.TimsF. M., eds. 1992Drug Abuse Treatment in Prison and Jails. Rockville, MD: National Institute on Drug Abuse Research Monograph No. 118.
32.
LockwoodD.InciardiJ.A.1993CREST Outreach Center: A work release iteration of the TC model. In Innovative Strategies in the Treatment of Drug abuse, eds. InciardiJ.A.TimsF.M.FletcherB.W., 61–69. Westport, CT:Greenwood Press.
33.
MartinS.S.ButzinC.A.InciardiJ.A.1995Assessment of a multistage therapeutic community for drug involved offenders. Journal of Psychoactive Drugs27:109–116.
34.
McLellanA.AltermanA.I.1991Patient treatment matching: A conceptual and methodological review with suggestions for future research. In Improving Drug Abuse Treatment, eds. PickensR.G.LeukefeldC.G.SchusterC.R., 114–135. Rockville, MD:National Institute on Drug Abuse. Research Monograph 106.
35.
RenoJ.1993Testimony. 1993 Congressional Summit on U.S. Drug Policy. May 7, Washington, DC.
36.
RouseJ.J.1991Evaluation research on prison based drug treatment programs and some policy implications. The International Journal of the Addictions26(1):29–44.
37.
SimpsonD.D.SavageJ.LloydM.R.1979Follow-up evaluation of treatment of drug abuse during 1969 to 1972. Archives of General Psychiatry36:772–780.
38.
SimpsonD.D.SellsS.B.1982Effectiveness of treatment for drug abuse: An overview of the DARP research program. Advances in Alcohol and Substance Abuse2:7–29.
39.
SpeckartG.AnglinM.D.1986Narcotics use and crime: An overview of recent research advances. Contemporary Drug Problems, Winter:741–769.
40.
TimsF.M.De LeonG.JainchillN., eds. 1994Therapeutic Community: Advances in Research and Application. Rockville, MD:National Institute on Drug Abuse. Research Monograph No. 144.
41.
WexlerH.K.FalkinG.P.LiptonD.S.RosenblumA.B.GoodloeL.P.1988A Model Prison Rehabilitation Program: An Evaluation of the “Stay'n Out” Therapeutic Community. New York: Narcotic and Drug Research, Inc.
42.
WexlerH.K.FalkinG.P.LiptonD.S.1990Outcome evaluation of a prison therapeutic community for substance abuse treatment. Criminal Justice Behavior17(1):71–93.
43.
WexlerH.K.WilliamsR.1986The “Stay'n Out” therapeutic community: Prison treatment for substance abusers. Journal of Psychoactive Drugs18(July-September):221–230.
44.
YablonskyL.1989The Therapeutic Community: A Successful Approach for Treating Substance Abusers. New York:Gardner Press.
