Harry K. Wexler

Three-Year Reincarceration Outcomes for Amity In-Prison Therapeutic Community and Aftercare in California

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. In addition, 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 only at 12 and 24 months was not maintained at 36 months.

The Amity prison TC evaluation: reincarceration outcomes

This article is drawn from an ongoing evaluation of the effectiveness of the Amity prison therapeutic community (TC) and aftercare program for substance abusers located in San Diego, California. Data collection consisted of face-to-face interviews and reviews of criminal justice records on a sample of 715 male inmates. Subjects were randomly assigned to the prison TC intent-to-treat group and no-treatment control group from a waiting list of inmates who had volunteered for substance abuse treatment in the Amity program. Reductions in reincarceration rates of more than 40% at 12 months and more than 50% at 24 months after release from prison were found for the group that completed prison TC plus aftercare. These improvements remained significant after controlling for client characteristics that have been identified as predictors of recidivism. The findings support the efficacy of prison TC plus aftercare in reducing reincarceration rates among inmates treated for substance abuse.

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.

The Therapeutic Community: Success and Improvement Rates 5 Years after Treatment

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.

Barriers to Implementing Effective Correctional Drug Treatment Programs

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.

Screening, Assessment, and Referral Practices in Adult Correctional Settings A National Perspective

The use of screening and assessment tools to gauge substance abuse disorders and the risk for recidivism are two widely recommended practices. A national survey of adult prisons, jails, and community correctional agencies was conducted to examine the practices used to place offenders in appropriate treatment services. Study findings indicate that 58.2% of the surveyed respondents report the use of a standardized substance abuse-screening tool, and that 34.2% use an actuarial risk tool. The provision of higher intensity treatment programs, the use of standardized risk tools, and the provision of more community referral services were all independently associated with the use of a standardized substance abuse-screening tool. Because practices vary considerably, agencies desiring to improve correctional programming should consider different dissemination, implementation, and technology transfer strategies.

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

National Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) Overview

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

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

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

Organizational factors and collaboration and integration activities in criminal justice and drug abuse treatment agencies

51 per day relative to those that received in-prison treatment only.