Parolee Treatment Outcomes: The Impact of Programs, Practice and Practitioners
The doctrine of futility that emerged from outcome studies of poorly designed and implemented programs for offenders (Marlow, 2006) and their less than rigorous evaluations (Martinson, 1974) drove a reduction in community based rehabilitation and placed greater emphasis on increased supervision and incarceration for parolees (Petersilia, 2003). States spent millions of dollars for in-prison substance abuse treatment programs and research found these had little to no effect on recidivism without community aftercare treatment (Prendergast, 2009). Over the past decade there have been efforts to reverse many of the draconian policies concerning drug users and some of the innovative programs that offered drug treatment as an alternative to incarceration. Yet, even with these initiatives in place there continued to be a high number of parole revocations that resulted in incarceration for drug use offenses. The need to reduce recidivism has stimulated an interest in understanding the programmatic factors that increase treatment effectiveness as well as which treatment process factors influence outcomes for criminal justice involved offenders (Hser et al., 2004; Marlow, 2011).This research analyzes data from a two-year evaluation of an innovative program for parolees identified with substance use disorders . Two primary questions are addressed: first to examine the extent and types of EBPs that were used in the contracted programs and second to determine whether or not the use of evidence-based practices (EBP) by community based providers are associated with parolee outcomes.
Methods
The evaluation utilized a multi-method quasi-experimental longitudinal design employing interviews; field observation & document procurement; review of documents, official records; and surveys. Program implementation and early operational elements and the use of EBP were addressed through Community Based Provider interviews (n=98), site visits, and surveys. Parolee participants (n=1012) characteristics were gathered through surveys and government databases provided recidivism data. Regression modeling examined the research questions.
Results
Results from the regression analysis examining EBPs and successful program completion suggested only stress management training and criminal thinking interventions, were significant predictors of successful program completion. The use of evidence based practices varied significantly by region with more urban regions employing significantly more EBP and consequently those programs had lower rates of recidivism. Of the 934 program completers recidivism rates after one year was 25% (n=153) for men and 16% for women (n=48). Furthermore, the three year recidivism rate for the program participants were between (44% – 49 %) among men and 31%-32% among women.
Implications
Aftercare is an essential component of programming for offenders identified with substance use disorders to facilitate reintegration into the community. Models that include both supervision and evidence based substance use treatment services are effective at reducing recidivism. There is a need to support the professional development of the addiction workforce and increase community based program use of empirically supported services for offenders particularly in non-urban regions.