William M. Burdon

Childhood Adverse Events and Current Traumatic Distress A Comparison of Men and Women Drug-Dependent Prisoners

This study describes the prevalence of childhood adverse events (CAEs) among men and women prisoners and assesses the relationship of CAEs to adult symptoms of traumatic distress. Interview data for 427 men and 315 women were analyzed assessing childhood abuse and household dysfunction, drug and criminal histories, and symptoms of traumatic distress. Women offenders had much greater exposure to CAEs than did men and more often reported continued sexual abuse in adolescence and as an adult. Linear regression results showed that the impact of CAEs on traumatic distress was strong and cumulative for both men and women (greater exposure to CAEs increased the likelihood of 6 out of 7 mental health outcomes, although women had higher levels of traumatic distress overall). The findings indicate the need for early prevention and intervention as well as trauma-based treatment within the correctional setting.

Identifying Predictors of Treatment Outcome in a Drug Court Program

Drug courts are popular for dealing with drug-abusing offenders. However, relatively little is known about participant characteristics that reliably predict either success or failure in these treatment settings. In this article, we report on 99 individuals who were enrolled in a drug court program (approximately one-half of whom successfully completed the program). Using, logistic regression techniques we identified 2 significant predictors of outcome. First, individuals who were employed at the time of their enrollment into the drug court program were more likely to successfully complete the treatment program. Second, individuals with a history of illicit intravenous drug use were less likely to complete the program.

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.

Coercion and Sex Offenders Controlling Sex-Offending Behavior Through Incapacitation and Treatment

Sex offenders represent a variable group of law violators, yet they are often viewed as suffering from a generalized mental illness and in need of treatment and management different from other types of criminal offenders. This often occurs within the context of some form of coercion. However, little is known about how coercion adds to or detracts from the successful treatment and control of sex offenders. This article explores the historical role of coercion in treating sex offenders and controlling their behavior along with the changing and evolving emphasis on treatment of sex offenders. It concludes with a discussion of the proper role that coercion can and should play relative to the overall effectiveness of treatment and a theoretical explanation of how coerced sex offenders may ultimately benefit from treatment.

Drug Courts and Contingency Management

Drug courts have become an increasingly popular response to the increased burden placed on the criminal justice system by substance abuse. However, evaluation findings have been less than consistent with respect to the ability of drug courts to have the desired impact on drug use and criminal behavior. This paper reviews the literature describing the growth, operations, and evaluations of drug courts. It concludes that, contrary to most “models,” drug courts emphasize punishment (e.g., graduated sanctions) and make limited positive, or at least inconsistent, use of reinforcement to promote behavior change and abstinence from drug use. Contingency management techniques that involve the systematic application of reinforcement based on the performance of specified behaviors are presented and reviewed. The success of this model in promoting pro-social behavior and abstinence from illicit drug use suggests that drug courts could benefit substantially from the integration of contingency management-based interventions.

Prison-Based Treatment for Drug-Dependent Women Offenders: Treatment Versus No Treatment

Abstract This outcome study compared six- and 1 2-month return-to-custody data for 171 treatment participants and 145 nontreated general population inmates at the Central California Womens Facility (implementing a traditional TC program). Findings showed that there were no differences between the TC treatment group and the no treatment comparison group with regard to six- and 12-month return-tocustody rates (six-month: 16% vs. 16% and 12-month: 36% vs. 27%). The only significant difference in six-month return-to-custody rates was found between treatment-only participants (21%) and the treatment plus aftercare participants (6%). Treatment participants who participated in community-based aftercare were significantly less likely to be returned to custody compared with those who did not participate in aftercare. Multivariate analysis was also used to control for the large difference in psychological impairment between the two groups and other background factors related to reincarceration, while assessing the effect of treatment group status on return-to-custody. Findings indicated that treatment/notreatment status was not significantly related to a six- or 12-month return-to-custody. However, success on parole was associated with participation in community-based aftercare. The lack of a prison-based treatment effect could be an indication that drug-dependent women offenders need gender-responsive treatment that is designed specifically for their complex needs.

Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

BackgroundResearch has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their drug/alcohol problem.MethodsSubjects were 4,165 male and female parolees who received prison-based therapeutic community substance abuse treatment and who subsequently participated in only outpatient or only residential treatment following release from prison. The dependent variable of interest was return to prison within 12 months. The primary independent variables of interest were alcohol/drug problem severity (low, high) and type of aftercare (residential, outpatient). Chi-square analyses were conducted to examine the differences in 12-month RTP rates between and within the two groups of parolees (residential and outpatient parolees) based on alcohol/drug problem severity (low severity, high severity). Logistic regression analyses were performed to determine if aftercare modality (outpatient only vs. residential only) was a significant predictor of 12-month RTP rates for subjects who were classified as low severity versus those who were classified as high severity.ResultsSubjects benefited equally from outpatient and residential aftercare, regardless of the severity of their drug/alcohol problem.ConclusionAs states and the federal prison system further expand prison-based treatment services, the demand and supply of aftercare treatment services will also increase. As this occurs, systems and policies governing the transitioning of individuals from prison- to community-based treatment should include a systematic and validated assessment of post-prison treatment needs and a valid and reliable means to assess the quality of community-based treatment services. They should also ensure that parolees experience a truly uninterrupted continuum of care through appropriate recognition of progress made in prison-based treatment.

Policies and practices in the delivery of HIV services in correctional agencies and facilities: results from a multisite survey.

HIV risk is disproportionately high among incarcerated individuals. Corrections agencies have been slow to implement evidence-based guidelines and interventions for HIV prevention, testing, and treatment. The emerging field of implementation science focuses on organizational interventions to facilitate adoption and implementation of evidence-based practices. A survey of correctional agency partners from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) revealed that HIV policies and practices in prevention, detection, and medical care varied widely, with some corrections agencies and facilities closely matching national guidelines and/or implementing evidence-based interventions. Others, principally attributed to limited resources, had numerous gaps in delivery of best HIV service practices. A brief overview is provided of a new CJ-DATS cooperative research protocol, informed by the survey findings, to test an organization-level intervention to reduce HIV service delivery gaps in corrections.

An Evaluation of Six Brief Interventions That Target Drug-Related Problems in Correctional Populations

Finding brief effective treatments for criminal justice populations is a major public need. The CJ-DATS Targeted Intervention for Corrections (TIC), which consists of six brief interventions (communication, anger, motivation, criminal thinking, social networks, and HIV/sexual health), was tested in separate federally-funded randomized control studies. In total, 1,573 criminal justice-involved individuals from 20 correction facilities participated (78 % males; 54 % White). Multilevel repeated measures analyses found significant gains in knowledge, attitudes, and psychosocial functioning (criteria basic to knowledge, attitude, and practices (KAP) and TCU treatment process models). While improvements were less consistent in criminal thinking, overall evidence supported efficacy for the TIC interventions.

Evaluating Fidelity to a Modified NIATx Process Improvement Strategy for Improving HIV Services in Correctional Facilities

In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.