Substance Abuse Treatment Inside Correctional Facilities By Heather

Substance Abuse Treatment Inside Correctional Facilities By: Heather Jackson

Basic Info n n Substance Abuse Programs (SAP) are available to inmates, probationers and parolees with a history of substance abuse. SAP is a six to nine month residential substance abuse program that utilizes therapeutic community model to provide substance abuse services to those with a history of substance dependence. The Department of Corrections also recognizes the need to address substance abuse treatment for probationers and parolees. In addition to offering substance abuse treatment services in jails and prisons.

Basic Info Cont. n n SAP is located in 16 jails, 9 prisons, 11 community programs and 10 Recovery Kentucky Centers. Offenders who are within approximately 24 months of being paroled are admitted to SAP to gain the tools necessary to sustain long-term recovery from substance abuse and its negative consequences (unemployment, criminal behavior, etc).

Why should we do it? n n n Jurisdictions around the country continue to note the increased number of individuals incarcerated for drug crimes, or crimes related to drug use. Bureau of Justice statistics note that 83% of state inmates have a history of drug use and that over half (53%) of incarcerated state inmates meet the criteria for drug dependence or abuse based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV). The Kentucky Department of Corrections and the Division of Mental Health and Substance Abuse have determined that individuals with histories of substance abuse should have the opportunity for appropriate substance abuse intervention prior to release from custody or supervision. http: //www. youtube. com/watch? v=u. U 7 a. RJ 4 Wp. Uw&feature=related Now that we see the need how is it done?

Therapeutic Community Model n The therapeutic community (TC) for the treatment of drug abuse and addiction has existed for about 40 years. In general, TCs are drug-free residential settings that use a hierarchical model with treatment stages that reflect increased levels of personal and social responsibility. Peer influence, mediated through a variety of group processes, is used to help individuals learn and assimilate social norms and develop more effective social skills.

TC Communities Cont. n Therapeutic Communities differ from other treatment approaches principally in their use of the community comprising treatment staff and those in recovery, as key agents of change. This approach is often referred to as "community as method. " TC members interact in structured and unstructured ways they influence attitudes, perceptions, and behaviors associated with drug use. n TC members are expected to become role models who actively reflect the values and teachings of the community. Ordered routine activities are intended to counter the characteristically disordered lives of the offenders and teach them how to plan, set, and achieve goals and be accountable for actions.

In A Nut Shell n Ultimately, participation in a TC is designed to help people appropriately and constructively identify, express, and manage their feelings. The concepts of "right living" (learning personal and social responsibility and ethics) and "acting as if" (behaving as the person should be rather than has been) are integrated into the TC groups, meetings, and seminars. These activities are intended to heighten awareness of specific attitudes or behaviors and their impact on oneself and the social environment (National Institute on Drug Abuse Research Report Series: Therapeutic Communities, 2002).

Substance Abuse Program Curriculum n n n The curricula used by the jail, prison and Recovery Kentucky Centers and the community substance abuse programs must include the Twelve Steps (Alcoholics Anonymous/Narcotics Anonymous), Relapse Prevention and Cognitive Behavioral Therapy (CBT) is based on the idea that a persons distorted thoughts and beliefs lead to his or her negative moods and unhealthy behaviors. Cognitive behavioral therapy holds the person accountable for you feelings and behaviors-not other people. For those involved in the legal system, CBT provides an additional opportunity to intervene with offenders by also focusing on developing skills for living in harmony with the community and engaging in behaviors that contribute to positive outcomes in society (Cognitive-Behavioral Treatment, U. S. Department of Justice, National Institute of Corrections, May, 2007). Relapse Prevention focuses on identifying specific high-risk situations for each offender and enhancing his or her skills for coping with those situations and restructuring the client’s perceptions of the relapse process (Relapse Prevention, An Overview of Marlatt’s Cognitive-Behavioral Model, Larimer, Palmer and Marlatt, 1999).

Criminal Thinking Errors n n n We try to teach inmates to get out of their criminal thinking patterns and learn responsible thinking patterns. To do this we identify the thinking errors they may have. “Patterns of thinking aren’t given to us; they’re learned and created by us over” (Hazeldon, 2002) Criminal Thinking Patterns are what allow the criminal to indulge in thoughts of crime. Criminal thinking patterns are not exclusive to criminals. Non-criminals may have thoughts from time to time that fit this category the difference is we don’t act of them. (Hazeldon, 2002)

Criminal Thinking Patterns n n n n n Victimstance “Good Person” Stance “Unique Person” Stance Fear of Exposure Lack of time perspective Selective Effort Use of Power to control Seek excitement first Ownership stance

In Detail n n n Victimstance: You view yourself as a victim, it doesn’t matter what you did to victimize yourself. “Someone else” was stupid. “Bad Luck” got you arrested. “Fate” was against you. Anything to make it not your fault. n n n Good Person Stance: You consider yourself to be a good person no matter what. “ I’m a good person. Look, I help my grandmother with groceries all the time. ” “There’s nothing wrong with my behavior. I sold my pain pills because I didn’t need them and I was helping someone else out that might” “So I made a little money I had to pay for the prescription when filled”

Thinking Errors Cont. n n n Unique Person Stance: “No one has ever gone through what I have, so no one could ever understand me” “ I am a loner, I don’t need anybody” “The more I know that others don’t, the better. I’m not about to share information” “I won’t get caught because I am to smart” n n Fear of exposure: fear that you are a nobody, fear that others will find you out, fear of all your thoughts and actions being brought out into the open and judged. This is broken down into: fear of vulnerability, lack of trust, criminal pride, and zero state. (Hazeldon 2002)

Thinking Errors Cont. n n Lack-of-time Perspective: You don’t learn from past experiences, you believe in instant gratification, you expect to be a big success with only minimal effort and preparation. Use Power to Control: Power gotten from manipulation, intimidation, humiliation, or any way to dominate others for your own excitement and to get what you want. n n Selective Effort: You may do almost anything you can to avoid responsible effort. You put of great deal of energy in your criminal pursuits but when it comes to effort, you tend to avoid it at all costs. You say “I can’t” when you really mean “I won’t” If you become bored with a project you just quit and make up an excuse why you can’t finish.

Thinking Errors Cont. n n n Seek Excitement First: You can’t tolerate boredom, You can’t stand being alone for more than short periods of time. You avoid obligations because they’re too dull, you live for today and crime, drugs, and sex excite you. Your thoughts of excitement are so powerful, they push away any thoughts about consequences or what your conscience tells you. n n n Ownership Stance: You have distorted ideas about what are your rights and your property and what are the rights and property of others. “What’s mine is mine, and what’s yours is mine” People are property “she’s mine so she has to do what I tell her” People with problems with this also carry it over into sexual needs. Your partner has to satisfy your needs when you say to.

Twelve Steps (Alcoholics Anonymous/Narcotics Anonymous) n 1. We admitted we were powerless over alcohol -- that our lives had become unmanageable. n 2. Came to believe that a Power greater than ourselves could restore us to sanity. n 3. Made a decision to turn our will and our lives over to the care of God as we understood Him. n 4. Made a searching and fearless moral inventory of ourselves. n 5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

n 6. Were entirely ready to have God remove all these defects of character. n 7. Humbly asked Him to remove our shortcomings. n 8. Made a list of all persons we had harmed and became willing to make amends to them all. n 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. n 10. Continued to take personal inventory and when we were wrong promptly admitted it. n n 11. Sought through prayer and meditation to improve our conscience contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

So does it work? n n n Treatment participants are mostly male (64%) and about 32 years old. Over three-quarters (79%) are white and 41% are single, never married. Nearly three-quarters (71%) reported having a GED or 12 or more years of education. About three-quarters of participants were not re-incarcerated in the 12 months following their release: 76% for those who received substance abuse treatment in jail and 72% of participants who received treatment in prison. The overall recidivism (reincarcerated on a felony charge in the 12 months following release) rate decreased to 26% for treatment participants in FY 2009 compared to 31% in FY 2008. The percentage of jail and prison treatment participants reporting abstinence at 12 months post release increased 9 times from preincarceration reports of drug use.

Does it work? n n Self-reported illegal drug use during the 12 month post-release period decreased by 64% for jail participants and 61% for prison participants from pre-incarceration reports of drug use. Overall, the percentage of treatment participants reporting any illegal drug use in the 12 months following release decreased to 36% in FY 2009 from 46% in FY 2007. Most treatment participants (82% of jail participants and 77% of prison participants) reported attending AA/NA meetings in the 12 months after release. Almost half (45%) of jail and prison treatment participants reported entering community treatment after release. Estimates for this study indicate that the victim crime cost offset of jail and prison substance abuse treatment completion during FY 2008 saves an average of $21, 927 per year per participant.

References n n Hazeldon. (2002). A new direction: A cognitivebehavioral treatment curriculum. Center City, Minnesaota: Hazeldon. Cognitive-Behavioral Treatment, U. S. Department of Justice, National Institute of Corrections, May, 2007. National Institute on Drug Abuse Research Report Series: Therapeutic Communities, 2002 Relapse Prevention, An Overview of Marlatt’s Cognitive-Behavioral Model, Larimer, Palmer and Marlatt, 1999).