and Criminal Justice Supervision."
INTEGRATED
PUBLIC HEALTH-PUBLIC SAFETY
STRATEGIES:
Work-Release Therapeutic Communities (TC)
Encouraging results have been reported for therapeutic community (TC) programs targeted to individuals paroled from prison or conditionally transferred to a correctional work-release facility in the community.
TCs are residential treatment programs that:
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isolate clients from drugs,
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drug paraphernalia,
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and affiliations with drug-using associates.
The peers in TCs influence each other by:
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confronting negative personality traits,
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punishing inappropriate behaviors,
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rewarding positive behaviors,
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and providing mentorship and camaraderie.
Clinical interventions commonly include:
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confrontational encounter groups,
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process groups,
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community meetings,
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and altruistic volunteer activities.
Three-year longitudinal evaluations of geographically diverse correctional TC programs (Knight et al., 1999; Martin, et al., 1999; Wexler et al., 1999) suggest that, to be maximally effective, TC services should be provided along the full continuum of reentry, ranging from in-prison treatment, through work-release treatment, to continuing outpatient treatment. In all studies, in-prison TC treatment without aftercare had no appreciable effect on drug use or rates of return to custody. However, offenders who completed a work-release TC exhibited significant reductions-of approximately 10 to 20 percentage points-in rearrests, returns to custody, and drug use. Moreover, completion of both in-prison and work-release programs was associated with a reduction of 30 to 50 percentage points in new arrests or returns to custody.
As with drug courts, these TC studies made inherently biased comparisons, such as contrasting TC dropouts with graduates, and comparing offenders who voluntarily entered aftercare to those who did not. As a result, it is difficult to be confident of the actual magnitude of the effects. Nevertheless, the results underscore the importance of providing aftercare services to offenders once they are released from prison.
It is not sufficient to provide inmates with referral to a community treatment program. It is essential to prepare them for
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what to expect,
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to facilitate the referral by transferring the relevant paperwork and clinical information to the referral source,
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and to follow up to ensure that the individual has completed the referral (Cornish and Marlowe, in press).
Moreover, as noted earlier, providing in-prison TC treatment may increase the probability that an inmate will continue in aftercare services. It would seem optimal to begin the continuum of drug treatment, including initial assessments and motivational enhancement interventions, prior to the inmate's release.
Unfortunately, TCs are the only community-reentry programs that have been systematically studied. There are virtually no outcome data available on other types of postprison initiatives.
Recently, NIDA released a request for applications to develop the Criminal Justice-Drug Abuse Treatment Services Research System, which is intended to, among other things, provide support for controlled studies of various community-reentry strategies for drug-involved offenders.