Mapping Techniques to Improve Substance Abuse Treatment in Criminal Justice Settings
Pitre, Urvashi, Dees, Sandra M, Dansereau, Donald F, Simpson, D Dwayne, Journal of Drug Issues
Node-link mapping, a graphic representation tool, was used to improve mandated substance-abuse treatment in a 4-month residential criminal justice program. Three hundred eighty probationers (residents) were randomly assigned to either mapping-enhanced or standard counseling. Compared to those in standard counseling, residents receiving mapping gave more favorable evaluations to their group meetings, counselors, co-residents, and security staff. They also rated themselves higher on treatment effort and self-efficacy measures than did their counterparts. These findings suggest that mapping-enhanced counseling fosters more effective communication during meetings, promotes stronger therapeutic alliances, and thus enhances the perceptions of the effectiveness of the program and of the people associated with it.
Illicit drug use by criminal offenders is a major contributor to the national problems of overcrowding and high recidivism rates in the criminal justice system (Ball et al. 1983; Leukefeld and Tims 1993; Tonry and Wilson 1990; Wish and Johnson 1986). Drug offenders admitted to Texas prisons, for example, increased by 177% between 1984 and 1989 (Fabelo and Riechers 1989). Most drug users have extensive criminal histories (Lehman and Simpson 1990; Nurco et al.1991), and are more likely than non-users to commit violent crimes (Chaiken 1986). Additionally, many are injection drug users (IDUs) who, through their risky needle use and/or unsafe sexual practices, are at higher risk for contracting and spreading HIV (Anglin and Hser 1990).
Criminal justice authorities have addressed these problems by mandating substance-abuse treatment for incarcerated individuals. Previous studies have demonstrated the effectiveness of therapeutic community approaches with drug abusing offenders (De Leon 1995; Knight et al. n.d.; Tims et al. 1991). Research on the Stay'n Out program (Wexler and Williams 1986), the Cornerstone program (Field 1985, 1989), the AMITY program (Wexler et al. 1992), and the CHOICE program (Walters et al. 1992) has demonstrated the effectiveness of treatment for lowering both relapse and recidivism rates. Though initially somewhat more expensive, these treatment programs appear to be cost-effective in the long run. Lipton (1996) estimates that most programs pay for themselves in about 2 to 3 years.
Although evaluations of these programs reveal some success with treating incarcerated populations, there is considerable room for improvement. Leukefeld et al. (1992) note that, while public funding and support for treatment has grown, new treatment approaches have not been developed. One strategy that appears be wellsuited for use in residential treatment settings involves node-link mapping, a multipurpose visual communication technique applicable to a variety of counseling and educational situations. In using this technique, ideas are represented by "nodes" and are connected to each other by named links specifying interrelationships (see figure 1 for an example of a node-link map). Earlier research has demonstrated the effectiveness of using maps in educational applications (e.g., Evans and Dansereau 1991; Lambiotte et al. 1989), whereas more recent studies have focused on the application of mapping as an adjunct to traditional drug abuse counseling. In this latter case, counselors and clients develop maps that represent critical issues and potential solutions. Research in outpatient methadone clinics through the National Institute on Drug Abuse (NIDA) supported Drug Abuse Treatment and AIDS-risk Reduction (DATAR) project (Simpson, Chatham, and Joe 1993) has revealed that clients exposed to mapping-enhanced counseling attend more sessions; are rated by their counselors as having higher rapport, motivation, and self-confidence (Dansereau et al. 1993) and are less likely during treatment to have drugs detected in their urine specimens (Joe et al. 1994). Mapping sessions are also viewed by clients as having more depth than non-mapped sessions (Dansereau, Dees, et al. …