Interventions/Wilmer: A Continuum of Care for Substance Abusers in the Criminal Justice System

Abstract

This article describes a 300-bed substance abuse treatment program that is part of a continuum of care focused on preventing drug and criminal recidivism in substance abusing criminals incarcerated in Dallas County, Texas. It is the product of a joint effort of the judiciary, the Dallas County Supervision and Corrections Department, the State of Texas Criminal Justice Division, and Interventions Co., a not-for-profit treatment provider. The program is rooted in over 25 years of treatment experience and incorporates therapeutic community (TC) technology combined with 12-Step programming, behavior modification, job training (having a job is required for graduation), educational, and medical/psychiatric elements. Treatment is conceived as part of a continuum of care to provide substantial and sustained support for the inmate in the difficult process of adapting to the community post incarceration. Treatment plans are individualized and are based on an extended workup in which the individual's status in a number of domains is assessed. Specialized services, such as transportation and childcare, facilitate recovery. Once in the community, urine monitoring, groups, and counseling continue. The program is beginning its fourth year of operation and approximately 600 inmates have started the program. A formal evaluation is in process.

Motivation as a Predictor of Therapeutic Engagement in Mandated Residential Substance Abuse Treatment

“…Treatment methods include group and individual counseling, behavior modification, peer-to-peer therapy, life skills training, vocational and educational instruction, and regular meetings with onsite probation officers while emphasizing 12-step recovery, criminal thinking patterns, and relapse prevention. Other traditional TC techniques also are used, including confrontation groups, "pull-ups," and morning and evening meetings (Barthwell et al, 1995). Offenders advance through a hierarchical treatment sequence whereby they receive progressively more responsibilities and privileges as they become more senior members of their community.…”

Recidivism Following Mandated Residential Substance Abuse Treatment for Felony Probationers

“…Offenders at CREST are monitored closely by correctional authorities and tested frequently for drugs (Lockwood et al, 1997). A similar balance between treatment and probation supervision has been achieved at the Dallas County Judicial Treatment Center (DCJTC; Barthwell et al, 1995)-the evaluation site of this study. At the DCJTC, felony offenders are court mandated to receive 6 months of treatment in a TC environment where treatment and probation staff work together to facilitate the individual's recovery.…”

Randomized Controlled Pilot Study of Cognitive-Behavioral Therapy in a Sample of Incarcerated Women With Substance Use Disorder and PTSD

“…This study extended the treatment to the period after release from prison because post-release participation in mental health treatment has been found to decrease women’s substance use (Pelissier et al, 2001). Inmates newly released from prison are known to face multiple challenges, such as simultaneous recovery and reentry into society, return to high-risk drug neighborhoods, and families that may offer little support for continued involvement in treatment (Barthwell et al, 1995; Peters, Strozier, Murrin, & Kearns, 1997), all of which place these women at high risk for relapse (Osher, Steadman, & Barr, 2003). Although aftercare appears to be crucial for individuals who have received in-prison drug treatment, Pelissier, Jones, and Cadigan (2007), in a review of drug treatment aftercare in the criminal justice system, concluded that much more research is needed to support this claim.…”