Purpose: Women in the criminal justice system (particularly those charged with drug offenses) are frequently court-ordered to receive some form of treatment for their use of alcohol and other drugs. The growing awareness and support for the assessment of clients' readiness for change with the corresponding call for stage-appropriate intervention brings forth the need to assess clients and develop appropriate interventions.

This poster presents the assessment of stage of change readiness for a sample of women in jail.

Method: Investigators completed a study of women with substance abuse or dependence disorders with or without concurrent mental health disorders who were incarcerated in a full-service jail. The interview consisted of the Computerized Diagnostic Interview Schedule (C-DIS) and the SOCRATES 8. Demographics, legal, and treatment histories were also collected.

Results: A total of 198 women completed the study. Ninety-four percent of the sample met criteria for a substance dependence diagnosis with 79% meeting criteria for at least one SUD and at least one mental health disorder. The mean age of the women was 35 and their average number of children was 3. Most of the women had lived with family or friends (49%) in the month before they came to jail. On average, the women had been to jail 5 times, prison 2 times, and had 8 separate cases in the legal system. Over half (56%) were incarcerated for a drug offense with an additional 22% incarcerated for a theft or related offense. At the time of interview, the women had been in jail an average of 8.5 weeks. Well over a third (40%) were incarcerated for failing to adhere to the conditions of their probation (including treatment). Only 32% reported ever having completed court-ordered treatment.

Women endorsed high levels of readiness for change on the SOCRATES 8 – only 10 (5%) endorsed responses consistent with ambivalence, 123 (65%) recognition, and 57 (30%) taking steps. While on the surface, these rates appear high, they can best be understood when considered in context. The respondents were in a controlled environment free of substances on average 8.5 weeks. This not only allowed for the direct effects of the substances to have dissipated but also potentially allowed the women to see the negative effects of their use of substances (including incarceration, loss of freedom, potentially loss of their children and other relationships, etc.)

Implications: Evidenced-based practices emphasize the need to assess the stage of readiness for change in treating people with co-occurring substance use and mental health disorders. The location and situation of the person has a significant impact on her/his motivation for treatment and choice of intervention. While best practices indicate individuals court-ordered to treatment upon release be assumed to be in early persuasion, women who were incarcerated endorsed responses indicating a higher level of readiness for change. This, in combination with the length of stay in the jail setting of this subject pool provides support for starting stage-appropriate interventions while women are in jail.