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

Prison treatment improves prison management.

Lesson 1

0.2%

8.0%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

Percent Positive

SATF CA Prison GP

SATF: Drug Use

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

53.5 51.9

0

20

40

60

80

100

SATF (N=398) Comparison (N=403)

% R

TC

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)

SAP graduates face various barriers to enrollment in community treatment.

Lesson 3

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

Correctional treatment needs to be responsive to the needs of different

subpopulations.

Lesson 4

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 heavily influence successful program performance.

Lesson 5

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