Does Involuntary Treatment Work? A View from Staff and Inmates

By Barton-Bellessa, Shannon M.; Hogan, Nancy L. et al. | Corrections Today, July-August 2013 | Go to article overview

Does Involuntary Treatment Work? A View from Staff and Inmates


Barton-Bellessa, Shannon M., Hogan, Nancy L., Lambert, Eric G., Corrections Today


The 21st century has been overwhelmed by pressure for alternative methods of responding to crime and punishment. Diminishing resources at all levels of government necessitate that criminal justice agencies examine current approaches and implement evidence-based best practices to reduce crime. Methods of program referral bring into question offender capacity to determine whether individual selective participation (e.g., treatment) will accomplish the goal of reducing recidivism. With this in mind, correctional systems continue to explore the value of mandating, or forcing, treatment regardless of an offender's motivation or desire to change behavior. (1)

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The debate over the appropriateness of mandating treatment is not new. During the 1970s, the American Friends Service Committee argued that "state-enforced therapy" amounted to little more than the victimization of offenders. (2) While offender choice should be considered, evidence suggests that even minimal, incremental exposure to treatment can result in institutional pro-social and societal economic benefits. (3) Similarly, research suggests that treatment programs appear to be most effective with the highest-risk inmate. (4) Unfortunately, this high-risk group is least likely to self-refer to a program. Therefore, the debate of "who" and "how" individuals receive treatment continues.

The present study examined an involuntary cognitive-based program targeting high-security level inmates (as defined by their institutional misconduct) in a Midwestern state prison. A sample of staff members and inmates participating in the program were interviewed to gain insight into their perceptions of the effectiveness of the involuntary program.

Involuntary Programming

By definition, coercion or forced therapy occurs when institutional pressure is placed on individuals to participate in rehabilitative programs. Coercion happens through the use of positive and/or negative reinforcers. Positive reinforcers may include either the reduction in time served or the complete avoidance of incarceration. Negative reinforcers, such as the loss of or failure to receive good time, (5) may be warranted when an offender fails or refuses to participate in a program. Likewise, forced treatment occurs throughout the entire criminal justice system, from sentencing (plea bargaining) to parole. A survey of inmates that asked about their reasons for going into treatment found that approximately half entered treatment for a reduction in their sentence rather than to alter their behavior. (6) Similarly, research suggests that "social pressures" may play a role in influencing the decision to participate in a program. (7) These include legal social controls (e.g., mandated legal responses should an individual fail to complete a program), (8) formal social controls (e.g., loss of privileges outside the criminal legal sector such as the loss of custody of children, employment inside or outside of an institution, government benefits, or the threat of extended incarceration), and informal social controls (e.g., family, friends or neighbors). (9)

The idea of coerced therapy or treatment is subjective, differing from one individual to another. This begs the question: Can true change occur if an individual is not motivated? While the debate exists as to the effectiveness of programming based upon individual motivation to change, (10) evidence suggests that forced program participation has resulted in positive outcomes, such as longer program retention, lower misconduct, higher employment and lower recidivism rates than those who voluntarily participate. (11)

Research further indicates that motivation to change is not a singular event, rather it develops over time through a series of stages. (12) Individuals, therefore, may not acknowledge the extent of their issues until forced to confront them. The stages of change may be placed into five categories: precontemplation, contemplation, preparation, action and maintenance. …

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Does Involuntary Treatment Work? A View from Staff and Inmates
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