From the Institution to the Community: Studies Show Benefits of Continuity of Care in Reduced Recidivism, Relapse Rates
Field, Gary, Corrections Today
The effectiveness of jail and prison substance abuse treatment has been well-established over the years. Among inmate treatment programs, prerelease therapeutic communities (TC) have been the most studied, and have a well-documented record of success. For example, evaluations of New York's Stay'n Out TC examined the progress of more than 2,000 inmates during a 10-year period and found that the program was successful even with clients with extensive criminal records.
Studies also have shown that community-based offender drug treatment can be successful. Researchers Doug Anglin and his associates at UCLA present impressive long-term follow-up data on the California Civil Addict Program, a large-scale project involving programs across California that mandated long-term treatment for addicts in the 1960s and 1970s. More than 40 independent evaluations also have been conducted of Treatment Alternatives to Street Crimes (TASC) programs, which identify, assess and refer nonviolent offenders to treatment as an alternative or supplement to justice system sanctions. Studies of the TASC programs, which have been implemented throughout the country, have particular significance because they have focused on the transition of offenders from institutions to the community.
In short, there are institution pre-release models that work (e.g., TCs), and there are community models that work (e.g., intensive supervision with treatment). However, too little attention has been given to the process of transition from institution to community. Both criminal justice and substance abuse treatment experts have observed that important gains made during incarceration are not being sustained when offenders return to the community because continuity of care is either inadequate or nonexistent.
According to University of South Florida researcher Roger Peters, "Many offenders report feeling overwhelmed by the transition from a highly structured correctional environment to a less-structured environment following release. At this time of concentrated stress, an offender enters a culture where little or no support exists - no job, no money, weakened or broken family ties - with immediate needs to plan daily activities, to begin interacting constructively in nonadversarial relationships, and to manage personal or household finances and problems."
Authors in related fields of study have made similar observations. The juvenile justice field has been emphasizing the need for aftercare for several years. The recent and very intensive studies of boot camps and shock incarceration programs have begun to emphasize the critical component of aftercare and coordination to aftercare in both theory and research.
Continuity of Treatment
Only very recently have researchers begun to examine the specific effects of continuity of offender treatment from institution to community on outcome success rates. Jim Inciardi found that drug-involved offenders who participated in a continuum of drug treatment (prison-focused TC treatment followed by treatment in a work-release center) in the Delaware system had lower rates of drug use and recidivism than offenders in the institution program alone: "The findings indicate that at 18 months after release, drug offenders who received 12 to 15 months of treatment in prison followed by an additional six months of drug treatment and job training were more than twice as likely to be drug-free as offenders who received prison-based treatment alone. Furthermore, offenders who received both forms of treatment were much more likely than offenders who received only prison-based treatment to be arrest-free 18 months after their release (71 percent compared to 48 percent)."
In a similar study in California at the Donovan facility, researcher Harry Wexler found that drug-involved offenders who participated in both the coral Amity prison TC program and the Amity community-based TC program upon release had substantially reduced rates of recidivism over those offenders who participated in the prison-based program alone. …