A multi-site, randomized study of strengths-based case management with substance-abusing parolees

Abstract

ObjectivesTo test whether strengths-based case management provided during an inmate’s transition from incarceration to the community increases participation in community substance abuse treatment, enhances access to needed social services, and improves drug use, crime, and HIV risk outcomes.MethodsIn a multi-site trial, inmates (men and women) in four states (n = 812) were randomly assigned (within site) to receive either Transitional Case Management (TCM group), based on strengths-based principles, or standard parole services (SR group). Data were collected at baseline and at 3 and 9 months following release from prison. Analyses compared the two groups with respect to services received and to drug use, crime, and HIV risk behavior outcomes.ResultsThere were no significant differences between parolees in the TCM group and the SR group on outcomes related to participation in drug abuse treatment, receipt of social services, or drug use, crime, and HIV risk behaviors. For specific services (e.g., residential treatment, mental health), although significant differences were found for length of participation or for number of visits, the number of participants in these services was small and the direction of effect was not consistent.ConclusionIn contrast to positive findings in earlier studies of strengths-based case management with mental-health and drug-abuse clients, this study found that case management did not improve treatment participation or behavioral outcomes for parolees with drug problems. The discussion includes possible reasons for the findings and suggestions for modifications to the intervention that could be addressed in future research.

The efficacy of case management with persons who have substance abuse problems: A three-level meta-analysis of outcomes.

“…In order to maintain gains made while in treatment, case management has also received attention as an important part of the aftercare period (Siegal, Li, & Rapp, 2002). Given the legal involvement of many persons with substance abuse problems, case management has also been provided along a continuum of criminal justice interventions, from preincarceration probation (Guydish et al, 2011) to parole for persons returning to the community from prison (Martin & Scarpitti, 1993;Prendergast et al, 2011).…”

“…In clinical trials, standard-of-care conditions serve as the baseline with which to compare an experimental intervention's effects. The standard-of-care services in meta-analysis studies varied widely in intensity, from a nonintensive paper referral (Coviello et al, 2006) and passive referral-HIV/ AIDS education (Sorensen et al, 2003) to more intensive examples, including community care coordination (Morgenstern et al, 2006) and standard parole supervision and referral services (Guydish et al, 2011;Prendergast et al, 2011).…”

A Systematic Review of Randomized Controlled Trials of Interventions to Improve the Health of Persons During Imprisonment and in the Year After Release

“…142 In substance-abusing adult parolees, strengths-based case management during the transition from incarceration to the community had no greater effect than standard parole services on substance abuse treatment received, substance use, and HIV risk behaviors. 112 Other-Four other studies focused on health care use after release (S. A. Kinner, unpublished data, June 2014), 36,135,136,138,139 3 of which had positive findings (S. A. Kinner, unpublished data, June 2014). 36,135,136,139 In persons with LTBI, a financial incentive improved rates of follow-up at a tuberculosis clinic after release compared with usual care, and those who received tuberculosis education were more likely to attend a first tuberculosis clinic after release and to complete treatment than those who received usual care.…”

Using Randomized Controlled Trials to Evaluate Interventions for Releasing Prisoners

“…RCTs that bridge prison and community contexts usually require coordination with multiple prisons and community agencies to meet sample size and data needs (Prendergast et al, 2011;Roman, Fontaine, Fallon, Anderson, & Rearer, 2012). Recruiting in prison and providing an intervention after release leaves the study vulnerable to high attrition rates between release from prison and the first community-based study contact (Wilson & Davis, 2006).…”