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53 Fed. Probation 51 (1989)
The Effects of Intensive Treatment on Reducing the Criminal Recidivism of Addicted Offenders

handle is hein.journals/fedpro53 and id is 337 raw text is: The Effects of Intensive Treatment on Reducing the Criminal Recidivism of Addicted Offenders BY GARY FIELD, PH.D. Alcohol and Drug Services Manager, Oregon Department of Corrections HE IMPACT of substance abuse on crime is profound. A 1974 Census Bureau study of 10,400 state prison inmates found that 39 percent of robberies, 47 percent of burglaries, 53 percent of homicides, and 61 percent of assaults were reported to be commit- ted under the influence of alcohol (Roizen and Schneberk, 1977). A survey of 13,700 state prison inmates in 1986 found that 35 percent of inmates admitted using drugs at the time of their crime and that 43 percent reported using drugs on a daily or nearly daily basis within the month prior to committing the crime that led to their incarcera- tion (Innes, 1988). According to a recent National Institute of Justice report on its Drug Use Fore- casting System, 73 percent of male arrestees in 11 U.S. cities who voluntarily submitted urine sam- ples tested positive for drugs (Wish, 1988). Indi- viduals with established patterns of both drug abuse and criminality have been shown in studies in Baltimore and Los Angeles to have increases or reductions in criminality with corresponding in- creases or reductions in drug abuse (Gropper, 1984). Effective treatment for addicted offenders can be part of the solution to the problems of reducing crime and turning offenders into productive citi- zens. The most effective treatment programs re- ported to date with addicted offenders have been intensive treatment programs of considerable du- ration that are designed as modified therapeutic communities. The Stay N' Out program in New York (Wexler, Falkin, and Lipton, 1988) and the Cornerstone program in Oregon (Field, 1985) have both reported substantial reductions in crimi- nality by successfully treated inmates. This article presents a followup study on re- duction of criminal recidivism by inmates treated in the Cornerstone Program. It also presents methods for measuring changes in criminal activ- ity over time that may be helpful to other researchers. Program Description The Cornerstone Program has been described extensively elsewhere (Field, 1985). The program is a 32-bed modified therapeutic community lo- cated on the grounds of Oregon State Hospital in Salem. Successful residents typically spend the last 10 to 12 months of their sentence in the program, are paroled directly from the program, and are provided with 6 months of aftercare/tran- sitional services while they are on parole. Corner- stone is coeducational, but most of the program participants (95 percent) are male. The following treatment principles summarize the program's characteristics and style: 1. Separating inmates from the general population. State prison inmate cultures are antithetical to the envir- onment that is needed for successful treatment. Inmate cultures value lying to authority, glamorizing drugs and crime, and an atmosphere of negativeness and nihilism. Hope for personal change has a difficult time surviving in this kind of context. The cultures of successful treatment programs center around peer support and pressure for personal change, rather than around an obsession with fighting the system. The social environment of treat- ment is as important as the information presented. 2. Clearly understood rules and consequences. Inmates need to clearly understand what is not acceptable and what the consequences are for breaking rules. Inmates do better at managing themselves and learning new infor- mation or behaviors when clear limits are established and held to. 3. A clear system for earning freedom a little at a time. It is important for addicted inmates to earn privileges for behavior that supports their recovery and to lose privileges when they begin to relapse into criminal thinking or the early stages of addictive behavior. By this process, sys- tematically managed, the inmates can best learn that they have control over their own lives. 4. Formal participation by inmates in running the program. Inmates need to feel ownership in the program to fully invest themselves in it. Responsibility for self is a key treatment goal, and inmates need to be given as much responsibility as they can manage. 5. Intensive treatment. Addicted inmates need a wide variety of treatment interventions as well as a full weekly schedule. Aside from these people needing habilitation or rehabilitation to a number of life skills, they do best when their days are fully structured and the demand level of what is expected of them is kept high. 6. Treating addiction and criminality. Both of these problems exist in the drug dependent inmate. If both are not simultaneously addressed, the untreated one will consistently undermine the other. That is, a criminal lifestyle tends to yield alcohol/drug abuse, and alcohol/ drug abuse tends to yield a resurgence of criminal activity.

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