Modified TC for MICA offenders: crime outcomes

Sacks, Stanley; Sacks, JoAnn Y.; McKendrick, Karen; Banks, Steven M.; Stommel, Joe

doi:10.1002/bsl.599

Cited by 105 publications

(125 citation statements)

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“…First, the presence of CODs represents a significant problem for these programs (Sacks, Sacks, McKendrick, Banks, & Stommel, 2004). Second, previous research indicated a high prevalence of psychological symptoms among admissions to prison-based substance abuse treatment programs, with 59% reporting previous psychological treatment, 68% reporting serious depression, 61% serious anxiety, 46% trouble controlling violent behavior, and 11% a previous suicide attempt (Prendergast, Hall, Wexler, Melnick, & Cao, 2004).…”

Section: Participantsmentioning

confidence: 99%

Diagnostic profiles of offenders in substance abuse treatment programs

Grella¹,

Greenwell²,

Prendergast³

et al. 2008

Behavioral Sci & The Law

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This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.

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Section: Participantsmentioning

confidence: 99%

Diagnostic profiles of offenders in substance abuse treatment programs

Grella¹,

Greenwell²,

Prendergast³

et al. 2008

Behavioral Sci & The Law

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“…This raises the potential that sample differences, especially motivation for treatment and behavior change, contributed to treatment effects. Although an analysis of this threat to validity in Study 2 indicated that motivation was not related to either entry into aftercare or crime outcomes (Sacks et al, 2004), the potential exists that other unexamined sample differences favoring the MTC group were contributing to the differential effectiveness of MTC treatment. Thus, it is imperative to conduct further and appropriately rigorous MTC studies that overcome this limitation.…”

mentioning

confidence: 95%

Modified therapeutic community for co-occurring disorders: A summary of four studies

Sacks

Banks

McKendrick

et al. 2008

Journal of Substance Abuse Treatment

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This paper summarizes results from four research studies (N=902) that examined the effectiveness of the modified therapeutic community (MTC) for clients with co-occurring disorders (most with severe mental disorders). Significantly better outcomes for MTC were found across four E vs. C comparisons on 23.1% (12 of 52) of primary outcome measures of substance use, mental health, crime, HIV risk, employment and housing. Study limitations included the potential for selection bias, limited measurement of program fidelity and insufficient examination of the relationship between treatment dose and outcome. Future research should emphasize clinical trial replications, multiple outcome domains and further development of continuing care models. Given the need for researchbased approaches, the MTC warrants consideration when program and policy planners are designing programs for co-occurring disorders. KeywordsCo-occurring disorders; substance abuse; severe mental disorder; modified therapeutic community BackgroundThe modified therapeutic community (often abbreviated as "modified TC"; for consistency and the reader's convenience, "MTC" has been used throughout this paper) was developed in the early and mid-1990s as a treatment model and approach for those whose substance use Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript disorders co-occurred with mental disorders. The MTC approach described in this paper was based on the theoretical framework of the standard TC model, as documented in previous publications (e.g., De Leon, 2000), and adapted to treat individuals with co-occurring disorders (De Leon, 1993; Sacks, De Leon, Bernhard, & Sacks, 1997;Sacks, Sacks, & De Leon, 1999). The core principles and methods of the TC that are especially relevant to the treatment of co-occurring disorders include: providing a highly structured daily regimen; fostering personal responsibility and self-help in managing life difficulties; using peers as role models and guides with the peer community acting as the healing agent within a strategy of "community-as-method" (the community provides both the context for and mechanism of change); regarding change as a gradual, developmental process and moving clients through progressive treatment stages; stressing work and self-reliance through the development of vocational and independent living skills; and promoting prosocial values within healthy social networks to sustain recovery.Although most of the key elements, structure, and processes of the standard T...

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“…For example, Sacks and colleagues demonstrated significantly lower reincarceration rates and significantly greater reduction in substance abuse for offenders with COD in a modified therapeutic community (TC) program as compared to those in standard mental health treatment (Sacks, Sacks, McKendrick, Banks, & Stommel, 2004;Sullivan, McKendrick, Sacks, & Banks, in press). Before treatment can be matched to a client population that can derive its benefits, however, an instrument capable of identifying appropriate individuals for referral must be available.…”

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confidence: 99%

CJDATS Co-Occurring Disorders Screening Instrument for Mental Disorders

Sacks

Melnick

Coen

et al. 2007

Criminal Justice and Behavior

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Three standardized screening instruments-the Global Appraisal of Individual Needs Short Screener (GSS), the Mini-International Neuropsychiatric Interview-Modified (MINI-M), and the Mental Health Screening Form (MHSF)-were compared to two shorter instruments, the 6-item Co-Occurring Disorders Screening Instrument for Mental Disorders (CODSI-MD) and the 3-item CODSI for Severe Mental Disorders (CODSI-SMD) for use with offenders in prison substanceabuse treatment programs. Results showed that the CODSI screening instruments were comparable to the longer instruments in overall accuracy and that all of the instruments performed reasonably well. The CODSI instruments showed sufficient value to justify their use in prison substance-abuse treatment programs and to warrant validation testing in other criminal justice populations and settings.Keywords co-occurring disorders; criminal justice; mental disorders; substance abuse; screening; instrument Inmates with co-occurring substance use and mental disorders (COD) represent a significant problem in the criminal justice system, given the increasing numbers of prisoners diagnosed with co-occurring disorders and the difficulty of managing and treating offenders with © American Association for Correctional and Forensic PsychologyAddress all correspondence to Stanley Sacks, PhD, CIRP, NDRI, 71 West 23rd Street, 8th Floor, New York, NY 10010; stansacks@mac.com. Views and opinions are those of the authors and do not necessarily reflect those of Department of Health and Human Services, the NIH, NIDA, or other participants in CJDATS. This article has not been published elsewhere nor has it been submitted simultaneously for publication elsewhere. NIH Public Access Author ManuscriptCrim Justice Behav. Author manuscript; available in PMC 2011 October 3. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript concurrent disorders. It is estimated that, compared to the general population, prisoners are 2 to 4 times more likely to suffer from psychotic illness or major depression (Fazel & Danesh, 2002). Estimates from U.S. Department of Justice statistics indicate that 16% of those in state prisons, jails, and on probation suffer from some form of mental disorder (Ditton, 1999).Furthermore, the number of correctional clients with mental disorders appears to be increasing. As an example, reports from the Colorado Department of Corrections chronicle a steadily rising proportion of inmates with mental illness, from 4% in 1991, to 14% in 2001 (Kleinsasser & Michaud, 2002, to 20% more recently (J. Stommel, personal communication, March 16, 2005). Among the 20% of inmates with mental illness, three quarters were estimated to have a co-occurring substance-use disorder.The need to identify and treat these individuals is evinced in the risk to the community, problems of behavior management within the prison system, and poorer treatment outcomes. The increased risk of violence among individuals with COD has now been well-documented (Melnick, Sacks, & Banks, 2006;Mona...

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Modified TC for MICA offenders: crime outcomes

Cited by 105 publications

References 51 publications

Diagnostic profiles of offenders in substance abuse treatment programs

Diagnostic profiles of offenders in substance abuse treatment programs

Modified therapeutic community for co-occurring disorders: A summary of four studies

CJDATS Co-Occurring Disorders Screening Instrument for Mental Disorders

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