Correctional Rehabilitation and Therapeutic Communities

Reducing Recidivism Through Behavior Change

Jennifer Pealer

• Publisher: Taylor & Francis
• Year: 2017
• Print ISBN: 9781138393875
• eBook ISBN: 9781351973342
• Edition: 1
• Topic: Social Sciences
• Subtopic: Criminology
• Index: Social Sciences

Drawing on original research on the effectiveness of a therapeutic community (TC) in reducing recidivism among juvenile male offenders, Correctional Rehabilitation and Therapeutic Communities: Reducing Recidivism Through Behavior Change provides a comprehensive review of the current state of drug treatment for the offending population, especially the link between juvenile offending and substance abuse. The book assesses the factors predicting successful completion of treatment as well as the methodological limitation of previous TC program reviews, and suggests policy implication and routes for future research.

Using improvements such as multiple outcome criteria, long-term follow-up, matching groups on risk and needs, and the employment of a standardized instrument to measure program quality, Correctional Rehabilitation assesses the degree to which participation in the TC affects antisocial attitudes and reduces delinquency. Readers will explore how TCs can be designed to influence adolescent drug offenders and ultimately reduce recidivism. This book is essential reading for students, researchers, practitioners, and other stakeholders focusing on the development of treatment programs.

Chapter 1
The “Just Say No” War on Drugs Campaign, Juvenile Drug Use, and the Juvenile Crime Problem

Drug use in America has a long and storied history beginning with the rise of opium after the Civil War and cocaine in the 1880s. In 1971 President Richard Nixon declared a war on drugs when he stated: “America’s public enemy number one in the United States is drug abuse. In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive” (Sharp, 1994, p. 1). Following in Nixon’s footsteps, President Regan stated: “It’s far more effective if you take the customers away than if you try to take the drugs away from those who want to be customers” (Rosenberger, 1996, p. 26). Both presidents ushered in an era of “getting tough” on drugs and crime where punitive measures against drug users were emphasized.

Over the past 30 years, the “war on drugs” has resulted in a large number of drug-abusing offenders being processed in the criminal justice system. Many of these drug offenders were youth who were arrested and incarcerated. Drug law violations for youth more than doubled between 1985 and 1997 (Furdella & Puzzanchera, 2015). Beginning in 1984 and lasting for 13 years, the nation saw an increase in the number of juvenile arrests ranging from a low of 6,765 arrests per 100,000 juveniles to 9,405 arrests per 100,000 juveniles (Snyder, 2000). From 1998 to 2001, the number of juvenile arrests had declined 27 percent with an arrest rate of 6,889 in 2001 (Snyder, 2001). The number of juvenile arrests has dropped 37 percent since 2003 (Puzzanchera, 2014). However, even though the arrest rate has decreased, the juvenile justice system has seen an increase in the number of juveniles that are processed throughout the years. For example, the percentage of juveniles being formally processed through juvenile courts has increased from 64 percent to 71 percent from 1993 to 2003 (Stahl, 2003). In 2013 juveniles were adjudicated in 55 percent of the cases, which resulted in approximately 582,800 youth being judged delinquent of the criminal act (Furdella & Puzzanchera, 2015). Of these youth, many are sent to secure, residential facilities, such as the 60,227 youth who were committed to a juvenile correctional facility (Hockenberry, 2016). Many have speculated about the causes of the increase in juvenile processing within the juvenile justice system.

One possible explanation is the link between substance abuse and criminal behavior. Indeed, there is a strong correlation between substance abuse and criminal behavior (see Andrews & Bonta, 1994; Beck, Kline, & Greenfield, 1988; Elliott & Huizinga, 1984; Newcomb & Bentler, 1988). For example, Wanberg (1992) found that correlations between substance abuse and delinquency ranged from .47 to .63 with a large sample of juvenile offenders. Using the Rochester Youth Development Study, Phillips (2012) found that adolescent drug use was predictive of a variety of criminal behavior, such as attacking another with a weapon, throwing objects, and forcibly taking money from another. Accordingly, even though the overall juvenile arrest rate is declining, the juvenile arrest rate for substance abuse saw a substantial increase throughout the 1990s. Nationally, arrests for substance abuse among juveniles increased 145 percent from 1991 to 2000, whereas the same arrests for adults have increased only 42 percent (Snyder, 2000). The drug abuse rate declined 26 percent between 1997 and 2010, but the 2010 drug abuse violation rate was 76 percent more than the 1991 rate (Sickmund & Puzzanchera, 2014). Thus, there is a glaring problem with America’s youthful offenders and substance abuse.

The prevalence of drug and alcohol use among juvenile offenders creates many challenges for the already overburdened juvenile justice system. For example, drug testing conducted in 12 cities during 1997 revealed that 42 to 66 percent of male youths tested positive for at least one drug at the time of arrest (National Institute of Justice, 1998). Furthermore, the Survey of Youth in Custody project found that 39 percent of youth under age 18 were under the influence of drugs at the time of their offense, with more than 57 percent reporting using drugs in the month prior to their arrest (Crowe, 1998). Of the 2.4 million juvenile arrests in 2000, approximately 75 percent of those were substance involved, meaning that the youth was under the influence while committing the crime, tested positive at the time of arrest, was arrested for a substance abuse offense, or reported substance abuse problems (Center on Addiction and Substance Abuse, 2004).

Not only are juveniles being arrested for substance abuse, but they are also being processed through the juvenile court system. In 2013 the juvenile courts processed approximately 141,700 cases involving drug offenses (Furdella & Puzzanchera, 2015). These cases accounted for almost 14 percent of all juvenile cases in 2013. Although the system has seen a decline in the number of youth arrested, approximately 55 percent of the cases are still adjudicated (Office of Juvenile Justice and Delinquency Prevention, 2013). Of these cases, almost a quarter are adjudicated into residential facilities. Of the adjudicated drug cases, almost 10,000 youth were placed out of home into a secure residential facility (Office of Juvenile Justice and Delinquency Prevention, 2013).

The link between substance abuse and juvenile delinquency has been well established. If this population is left untreated, their chances of returning to criminal behavior and substance abuse ranges from 50 percent to 80 percent (Andrews & Bonta, 1994; Lillyquist, 1980). Furthermore, research has found that juveniles who use drugs and alcohol are more likely to be rearrested, and each felony conviction that a youth receives increases the likelihood of the youth becoming an adult felon by 14 percent (Washington State Institute for Public Policy, 1997). Accordingly, some type of treatment intervention is needed to break the drug–crime system.

Development of Residential Substance Abuse Treatment

One possible avenue for the treatment of substance-abusing juvenile offenders is residential treatment. Although this type of treatment has been established for many years, it has only been recently that many state and local agencies received federal monies to implement residential substance abuse treatment programs. Recognizing the link between continued drug use and recidivism, the federal government created the Violent Crime Control and Law Enforcement Act of 1994. Subtitle U of the act had significant national implications for treating drug-involved offenders, as it provided agencies with money to treat drug offenders. Thus, the residential substance abuse treatment (RSAT) grants represent the first national mandate to affirm the value of treatment for the criminal justice population (Harrison & Martin, 2003). Accordingly, it is believed that residential substance abuse programs have the potential to reduce criminal behavior and relapse among drug-abusing offenders.

With the availability of federal funds, many states began to implement residential substance abuse programs. As of 2003, all 52 states had implemented RSAT programs, and as of March 2001, more than 2,000 RSAT programs were in place. A recent evaluation conducted by the National Institute of Justice revealed that the majority of operational programs were directed at adults, with 30 percent targeting juvenile offenders (Harrison & Martin, 2003). In addition, about 60 percent of the RSAT programs were operating with, or at least incorporating, some elements of a therapeutic community.

Although there is no set model for a therapeutic community, there are some commonalities. DeLeon (1986, 2000) describes this treatment modality as emerging out of the self-help movement in which the offender is to make a global lifestyle change. Substance abuse is a major target, but the therapeutic community also seeks to increase prosocial conduct, such as obtaining employment, achievement in education, and increasing prosocial attitudes and values (Pan, Scarpitti, Inciardi, & Lockwood, 1993). The therapeutic community may be distinguished from other drug treatment programs in two ways. First, the primary agent of change is the community of peers and staff who are to act as role models (DeLeon, 1986). Thus, the offender experiences a 24-hour learning environment. Second, therapeutic communities are very structured and offer a systematic and holistic approach to changing the offender (DeLeon, 1986).

In corrections research, there has been a great deal of focus on this type of treatment modality for drug offenders. Furthermore, a meta-analysis revealed that, on average, therapeutic communities reduced recidivism approximately 13 percent compared to no or minimal treatment (Pearson & Lipton, 1999).

Criticisms of Drug Treatment Programs

Although the number of therapeutic communities for correctional populations has increased, the research on their effectiveness has been criticized on four points by Inciardi, Martin, Butzin, Hooper, and Harrison (1997). First, studies have failed to incorporate multiple outcome criteria to measure program success. Second, the follow-up time frames have been inadequate for the majority of the studies. Third, the comparison group fails to account for important differences between groups that are likely to affect program outcome. Finally, there has been a lack of multivariate designs, which leave us with little information concerning the significant predictors of recidivism. In addition, research into therapeutic communities and drug treatment in general has been plagued by the insufficient attention given to the measure of program quality (Faupel, 1981; Moon & Latessa, 1994).

The research on RSAT programs has also revealed some difficulties (Harrison & Martin, 2003). A national evaluation of 12 RSAT programs was conducted by the National Institute of Justice. The findings revealed that many programs lack a structured aftercare program. However, according to the RSAT grant, the monies could only be used for residential substance abuse treatment and did not fund aftercare programs (Harrison & Martin, 2003). Instead, many offenders return to the general population and then are released into the community without any type of step-down program (Harrison & Martin, 2003). Furthermore, a survey of the RSAT programs revealed that programs were often eclectic. Fifty-eight percent of the programs were mixed models (i.e., elements of a therapeutic community combining cognitive-behavioral group work and 12-step meetings), 24 percent were therapeutic communities, 13 percent were designed as cognitive-behavioral approaches, and 5 percent were 12-step programs (Harrison & Martin, 2003).

Another area of concern was that many programs reported problems delivering the intended services to the participants (Harrison & Martin, 2003). For example, there were fewer group and individual counseling sessions held than had originally been planned in many programs. The evaluation found that this problem was mainly due to the lack of experienced staff and significant staff turnover.

The last problem area noted by the national evaluation was that many programs did not use a standardized substance abuse assessment instrument that had been validated (Harrison & Martin, 2003). The lack of assessment resulted in many inappropriate offenders entering the program. A related concern was that many offenders entered the program with too little or too much time left on their sentence (Harrison & Martin, 2003). The issue of time is problematic because many offenders could not finish the program or upon completion of the program were sent back to the general population, which may serve to “undo” any treatment effect experienced.

One final area of concern is the lack of research on therapeutic communities for juvenile offenders. To date there have only been a handful of published studies examining this treatment modality for juvenile offenders (see Lemieux, Barthelemy, Schroeder, & Thomas, 2012; Molloy, Sarver, & Butters, 2012). Many of these studies have the same issues that were listed previously. In addition, these studies only focus on the characteristics of the youth within a therapeutic community, or the studies focus on failure after treatment. The current study provides a unique perspective of a modified therapeutic community designed for juvenile offenders who were incarcerated within a secure residential facility by 1) describing the characteristics of the youth who participated in the treatment; 2) incorporating a matched-comparison group design to study the effectiveness of the therapeutic community; 3) providing a longer follow-up period for recidivism (up to 3 years) to examine the robust effect of the TC; 4) measuring multiple outcomes such as changes in attitudes to determine if participation in a TC improved the lives of the juveniles; and 5) opening up the “black box” of programming and provide a detailed narrative of the type of programming and activities that the youth encountered while participating in the program.

Overcoming the Criticisms of Previous Research

This study will add to the literature on RSAT programs and therapeutic communities in a number of ways. First, whereas much of the research examining the effectiveness of therapeutic communities has been for adult male offenders, the literature on the effectiveness of the treatment modality for juveniles is scarce. Accordingly, this research will examine an RSAT program for juvenile offenders implemented at Mohican Youth Center in Loudonville, Ohio. As did many other RSAT programs, the facility chose to implement a therapeutic community as the treatment modality.

Second, as research has shown, programs tend to be more effective when they have high program integrity (Antonwicz & Ross, 1994; Holsinger, 1999). For that reason, this study will attempt to address the issue of the black box of treatment by using a standardized instrument to measure program quality (the Correctional Program Assessment Inventory; CPAI). This technique will allow the researcher to determine if the program was adhering to the principles of effective intervention and may help explain the presence or absence of a treatment effect.

Third, whereas many programs have examined the long-term outcomes of therapeutic communities (e.g., recidivism), few have determined if participation in the therapeutic community results in changes in intermediate outcomes. Therefore, this research will determine if participation in the program results in lower levels of cognitive distortions and changes in psychological and social functioning.

Fourth, research has been mixed concerning the types of individuals who benefit from participation in the therapeutic community. Furthermore, this research will be one of the first to examine specific characteristics of the juveniles to determine if the treatment provided by the therapeutic community is more effective for certain types of juveniles.

Finally, to address the concerns from previous research on therapeutic communities, this research attempts to overcome the common shortcomings by 1) including multiple outcome criteria (periods of new incarceration, time to incarceration, and seriousness of new incarceration; 2) following the juveniles for a period up to 3 years after program completion, which allows the researcher to examine behavior from adolescence into adulthood; 3) using a matched (i.e., risk and need) comparison group drawn from a sample of youth who did not receive treatment; and 4) using multivariate designs, which will identify significant predictors of recidivism.

Research Questions

Although the main goal of this study is to determine if the therapeutic community reduced the recidivism rates for juvenile male offenders, the following specific research questions will be answered:

1. What are the characteristics of the treatment group and the comparison group? What, if any, differences exist between the treatment and comparison groups?
2. Did participation in treatment significantly affect the youths’ levels of cognitive distortions and psychological and social functioning?
3. What factors predict successful completion of treatment?
4. What are the rates of new incarcerations for the treatment group and the comparison group? Are there significant differences in the rates of new incarcerations for the treatment group and the comparison group?
5. What factors predict a new incarceration?
6. Does the effectiveness of the treatment provided at Mohican Youth Center differ among the different types of juveniles?

Conclusion

Although the number of juvenile arrests has decreased since the 1990s, the juvenile justice system still processes a large number of cases each year. Furthermore, many of these youth have experienced substance use, with 56 percent of the adolescent males and 40 percent of adolescent females testing positive for drugs at the time of arrest (Chassin, 2008). Furthermore, these juveniles are being processed for drug offenses and being placed on detention and in residential centers. In response to the link between substance abuse and criminal behavior, states have received monies to implement residential substance abuse treatment programs. With the money received from the federal government, the state of Ohio implemented a therapeutic community for adolescent males. Although much research has been conducted on this type of treatment modality, little insight has been given into the effectiveness of therapeutic communities for juveniles. As such, the present study will present the results of a 3-year follow-up to examine the effectiveness of therapeutic communities for drug-involved adolescents.

Table of contents

• Cover
• Title
• Copyright
• Contents
• List of Figures
• List of Tables
• Acknowledgments
• Introduction: Promoting Behavior Change
• 1 The “Just Say No” War on Drugs Campaign, Juvenile Drug Use, and the Juvenile Crime Problem
• 2 From Rehabilitation to Punitive Measures: Combatting Juvenile Crime and Drug Use
• 3 How Were Treatment Effectiveness and Fidelity Measured for the Evaluation of the Juvenile Therapeutic Community?
• 4 Did Participation in the Therapeutic Community Affect Outcomes?
• 5 What It All Means: Summary and Conclusions
• Appendix A: Data Collection Instruments
• Appendix B: Tables
• Appendix C: Program Integrity Measure
• References
• Index