ERIC ED443057: Continuity of Offender Treatment for Substance Use Disorders from Institution to Community. Treatment Improvement Protocol (TIP) Series 30.

145 Pages·1998·1.8 MB·English

by  ERIC

DOCUMENT RESUME
CG 030 134
ED 443 057
Continuity of Offender Treatment for Substance Use Disorders
TITLE
from Institution to Community. Treatment Improvement
Protocol (TIP) Series 30.
Substance Abuse and Mental Health Services Administration
INSTITUTION
(DHHS/PHS), Rockville, MD. Center for Substance Abuse
Treatment.
SMA-98-3245
REPORT NO
1998-00-00
PUB DATE
144p.; For other documents in the TIP Series, see CG 030
NOTE
098-103 and CG 030 130-133.
270-95-0013
CONTRACT
National Clearinghouse for Alcohol and Drug Information,
AVAILABLE FROM
P.O. Box 2345, Rockville, MD 20847-2345. Tel: [phone]
(Toll Free).
Tests/Questionnaires (160)
Non-Classroom (055)
Guides
PUB TYPE
MF01/PC06 Plus Postage.
EDRS PRICE
Behavior Modification; *Correctional Rehabilitation;
DESCRIPTORS
Counseling; *Drug Rehabilitation; Individual Needs;
*Intervention; Motivation; *Prisoners; Program Design;
Social Problems; *Substance Abuse
Case Management; Substance Abuse and Mental Health Services
IDENTIFIERS
Admin; Treatment Verification
ABSTRACT
This TIP, on the best practice recommendations for the
treatment of substance abuse, presents guidelines for ensuring continuity of
care as offenders with substance use disorders move from incarceration to the
community. Research indicates that treatment gains may be lost if treatment
is not continued after the offender is released from incarceration. This TIP
is designed to educate and provide information for community service
providers on how to meet offender treatment needs in order to overcome the
obstacles to a successful transition. It details how members of a transition
team can collaborate to help with the transition to the community. Since
offenders generally have complex treatment needs, the TIP suggests that case
management is an ideal approach. Treatment guidelines specific to populations
such as offenders with mental illness, offenders with long-term medical
conditions, and sex offenders are also detailed. Appendixes include:
"Bibliography," "Instruments," "Resource Panel," and "Field Reviewers."
(Contains 14 figures and approximately 100 resource.)
(JDM)
Reproductions supplied by EDRS are the best that can be made
from the original document.
Substance Abuse and Mental Health Services Administration
US. DEPARTMENT
OF HEALTH AND
HUMAN SERVICES
Public Health Service
Center for Substance Abuse Treatment
Substance Abuse and
Mental Health Services
Administration
Continuity of
Offender
Treatment for
Substance Use
Disorders From
Institution to
Community
Treatment Improvement Protocol (TIP) Set'ies
30
U.S. DEPARTMENT OF EDUCATION
Office of Educational Research ano improvernem
EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
O This document has been reproduced as
received from the person or organization
originating it.
O Minor changes have been made to
improve reproduction quality.
Points of view or opinions stated in this
document do not necessarily represent
official OERI position or policy.
man
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BEST
Assessments in the Transition Plan
Offenders who receive substance use disorder
treatment in jail are at great risk for relapse and return
to crime unless they continue treatment after their
o
release. Among the most important elements of a
successful transition are assessments of substance use
as well as other areas of the offender's life. Assess-
ments should employ standardized, comprehensive
risk and need assessment tools appropriate to
17;
offender populations. Assessments for offenders
should be conducted within the institution as early and
often as possible and also 3-6 months before the
offender's release.
ca
oMultiple assessments of substance-using offenders are
necessary and should examine
en
Treatment needs
ar
Treatment readiness
Treatment planning
ea
Treatment progress
Treatment outcome
c.r)
0
Risk and needs assessments are ideally conducted by a
multidisciplinary team, with cooperation among all
players. Areas to be assessed include skills for daily
living, stress management skills, general psychosocial
skills, emotional readiness for the transition, literacy,
money management abilities, vocational skills, and the
family environment to which the offender is return-
=
ing. Criminal justice staff can contribute critical
a)
information on risk of relapse and the offender's
dangerousness to others. Assessment results should
follow the offender through the system(s).
Family
To the extent the offender's family (which includes
o
significant others) agrees to participate, a prerelease
assessment of the family environment should be
r
conducted. This assessment should measure
C5.4
Whether other family members have substance
use disorders
Whether there is domestic violence
o
Criminal activity of other people living in the
house
The level of support for sobriety
Hopes regarding family reunification
a.
Current child care and child custody status
Those who have been occupying nurturing roles
o)
The family services already in place
Areas of potential vulnerability
o)t_
E.;
E-4
cn
Prisons, jails, and other incarcerating institutions must
work together with community substance
use disorder
treatment providers to set up and maintain transitional
services. This will be a new endeavor for many of the
E
representatives of both systems, and evaluation is
essential to the success of the transition. Below
are
guidelines for how to conduct an outcome evaluation
and a process evaluation.
Outcome evaluation determines the effectiveness of
a
program when comparing the group receiving services
1/1
11
to a control group receiving no treatment,
an alterna-
tive program, or standard treatment. Outcome
evaluation measures a program's ability to produce
expected changes in the clients who are part of the
program. Questions to be asked when conducting an
LW
outcome evaluation include
ti)
Gj
Do the transitional services reduce relapse and
recidivism among offenders?
What are the relapse and recidivism rates of
offenders?
Do the transitional services assist offenders in
successfully reintegrating into the community?
l)
Do the transitional services help offenders improve
their housing, financial, and employment status?
Do the transitional services assist offenders
4,)
in
accessing other necessary services, such as primary
medical and mental health services?
Are there differences in offender outcome by
participation in different services/program
compo-
C
C
vents?
a)
cid
O
Which program components
are associated with
4.*
positive outcomes?
Based on client profiles, which clients received the
most benefit from transitional services?
r.
Process evaluation examines the implementation
0
procedures and operations of a transitional services
C.)
program as it compares with the program's stated
goals and objectives. Process evaluation
can be used to
determine whether the people studied actually received
program services and measures the intensity and
duration of services provided. Questions to be asked
c.1
when conducting a process evaluation include
What services have been provided and by which
agency?
How often were services provided?
Who received services?
Was the program implemented as designed?
4
What are the program's strengths and weaknesses?
CLI
Was the program changed, and if so, how and why?
Z
What were the catalysts for the changes made?
E.;
How much did the program cost?
What were the barriers to implementation?
V
Continuity of
Offender
Treatment for
Substance Use
Disorders From
Institution to
Community
Treatment Improvement Protocol (TIP) Series
30
Gary Field, Ph.D.
Consensus Panel Chair
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Rockwall H, 5600 Fishers Lane
Rockville, MD 20857
5
This publication is part of the Substance Abuse
editor; Raquel Ingraham, M.S., project manager;
Virginia Vitzthum, former managing editor; and
Prevention and Treatment Block Grant technical
assistance program. All material appearing in
Mary Lou Leonard, former project manager.
this volume except that taken directly from
The opinions expressed herein are the views of
copyrighted sources is in the public domain and
the Consensus Panel members and do not reflect
may be reproduced or copied without
the official position of CSAT, SAMHSA, or the
permission from the Substance Abuse and
U.S. Department of Health and Human Services
Mental Health Services Administration's
(DHHS). No official support or endorsement of
(SAMHSA) Center for Substance Abuse
CSAT, SAMHSA, or DHHS for these opinions or
Treatment (CSAT) or the authors. Citation of
for particular instruments or software that may
the source is appreciated.
be described in this document is intended or
should be inferred. The guidelines proffered in
This publication was written under contract
this document should not be considered as
number ADM
Sandra Clunies,
270-95-0013.
substitutes for individualized patient care and
M.S., I.C.A.D.C., served as the CSAT
government project officer. Rose M. Urban, treatment decisions.
M.S.W., J.D., C.S.A.C., served as the CDM
DHHS Publication No. (SMA)
98-3245
project director. Other CDM TIPs personnel
Printed
1998
included Y-Lang Nguyen, production/copy
6
Contents
Contents
iii
vii
What Is a TIP?
Editorial Advisory Board
ix
Consensus Panel
xi
Foreword
xiii
Executive Summary and Recommendations
xv
Improving Transition to the Community
xv
xvi
Case Management and Accountability
xvii
Guidelines for Institution and Community Programs
xviii
Administrative Guidelines
xx
Ancillary Services
xxi
Special Populations
xxiii
Maintaining Sobriety
Chapter 1Introduction
1
Benefits of Offender Treatment
2
Why Continuity of Treatment?
3
Obstacles to Effective Postrelease Transitions
4
Program Strategies
10
Chapter 2Case Management and Accountability
17
Case Management in Transition Planning
17
Transition Plan Elements
20
The Transition Planning Process
31
Chapter 3Guidelines for Institution and Community Programs
33
Reaching Out From the Institution
33
Special Considerations by Type of Incarceration and Population
34
Guidelines for Community Programs
40
7
iii
Contents
Chapter 4Administrative Guidelines
45
45
Building an Effective Partnership
47
Policy and Procedural Issues
52
Legislative Issues
55
Funding Transitional Programs
57
Confidentiality Issues
Program Evaluation for Transitional Services Programs
59
Chapter 5Ancillary Services
63
Housing
64
Employment
65
67
Family
68
Peers
Transportation
69
Education
70
Primary Health Care
71
Recommendations for Coordinating Ancillary Community Services
72
Chapter 6Special Populations
73
74
Women
77
Elderly Offenders
Offenders With Mental Illness
77
Offenders With Mental Retardation
80
80
Sex Offenders
Long-Term Medical Conditions
81
Offenders With Physical Disabilities
82
Appendix ABibliography
83
Appendix BInstruments
93
94
Substance Use Survey (SUS)
Adolescent Self Assessment Profile (ASAP)
98
Sample Substance Use Disorder Program Discharge Summary
99
Powder River Transition Plan
106
Contacts Directory
116
Appendix CResource Panel
117
Appendix DField Reviewers
119
8
iv
Contents
Figures
3
1-1: Criminal Justice System Definitions
10
1-2: Characteristics of Both Outreach and Reach-In Models
26
2-1: Indicators of Treatment Success
29
2-2: Benefits of Alcoholics Anonymous
30
2-3: Commonly Used Sanctions
47
4-1: An Example of Effective Partnership
50
4-2: State Level Case Management
53
4-3: State Legislatures and the Delivery of Transtional Services
58
4-4: Information on Confidentiality in Other TIPs
59
4-5: Process Evaluations Questions
60
4-6: Data Sources for Process Evaluation
61
4-7: Outcome Evaluation Questions
62
4-8: Data Sources for Outcome Evaluation
79
6-1: A Review of Treatment Programs for Offenders With Coexisting Disorders
v
What Is
TIP?
a
of discussions; the information and
Treatment Improvement Protocols (TIPs)
recommendations on which they reach
are best practice guidelines for the
consensus form the foundation of the TIP. The
treatment of substance use disorders,
members of each Consensus Panel represent
provided as a service of the Substance Abuse
substance use disorder treatment programs,
and Mental Health Service Administration's
hospitals, community health centers, counseling
Center for Substance Abuse Treatment (CSAT).
programs, criminal justice and child welfare
CSAT's Office of Evaluation, Scientific Analysis
agencies, and private practitioners. A Panel
and Synthesis draws on the experience and
Chair (or Co-Chairs) ensures that the guidelines
knowledge of clinical, research, and
mirror the results of the group's collaboration.
administrative experts to produce the TIPs,
A large and diverse group of experts closely
which are distributed to a growing number of
reviews the draft document. Once the changes
facilities and individuals across the country.
recommended by these field reviewers have
The audience for the TIPs is expanding beyond
been incorporated, the TIP is prepared for
public and private substance use disorder
publication, in print and online. The TIPs can be
treatment facilities as substance use disorders
accessed via the Internet on the National Library
are increasingly recognized as a major problem.
of Medicine's home page at the URL:
The TIPs Editorial Advisory Board, a
http://text.nlm.nih.gov. The move to electronic
distinguished group of substance use disorder
media also means that the TIPs can be updated
experts and professionals in such related fields
more easily so that they continue to provide the
as primary care, mental health, and social
field with state-of-the-art information.
services, works with the State Alcohol and Drug
Although each TIP strives to include an
Abuse Directors to generate topics for the TIPs
evidence base for the practices it recommends,
based on the field's current needs for
CSAT recognizes that the field of substance use
information and guidance.
disorder treatment is evolving, and research
After selecting a topic, CSAT invites staff
frequently lags behind the innovations
from pertinent Federal agencies and national
pioneered in the field. A major goal of each TIP
organizations to a Resource Panel that
is to convey "front-line" information quickly but
recommends specific areas of focus as well as
responsibly. For this reason, recommendations
resources that should be considered in
proffered in the TIP are attributed to either
developing the content of the TIP. Then
Panelists' clinical experience or the literature. If
recommendations are communicated to a
there is research to support a particular
Consensus Panel composed of non-Federal
approach, citations are provided.
experts on the topic who have been nominated
by their peers. This Panel participates in a series
vii
10