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Corrections in the Community.

C h a p t e r 1 1

[Community Residential Centers] play a vital role in the criminal justice system. They provide additional sentencing options for the court, protect public safety, provide individualized and intensive service aimed at reducing recidivism, and are cost-effective.

—Bobbie L. Huskey

Community residential programs for criminal offenders have a long history in the United States (Hartmann, Friday, & Minor, 1994; Latessa & Travis, 1992). Until recently, the typical residential community correctional facility was known as a “halfway house,” a transitional residence for criminal offenders (Wilson, 1985).

Community Residential Correctional Programs

community-based correctional facilities community-based treatment centers correctional program

“community residential centers” cost-effective day-reporting centers dual-diagnosed offenders halfway house

humaneness reintegration residential community restitution centers work furlough centers

Key terms

A halfway house is a community-based residential facility for offenders who are either about to be released from an institution or, immediately after release, are in the initial stages of return to society. In the past three decades, some halfway houses have been designed as alternatives to jail or prison incarceration, primarily for probationers. “Halfway” now could mean halfway into, or out of, prison.

Box 11.1 halfway house

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This chapter places such programs in the larger context of corrections in the community, explaining the historical factors that contributed to the emer- gence of the halfway house movements; models of halfway houses; and their current operations and practices, effectiveness, costs, and futures. We begin with an explanation of the development of the halfway house over time.

hIstorICal DeVelopmeNt of the halfway house IN amerICa The halfway house concept began first in England and Ireland during the early 1800s, advocating transitional residences for criminal offenders. It spread quickly across the ocean; in 1817, the Massachusetts Prison Commission rec- ommended establishing a temporary residence to house destitute offenders after release from prison (Cohn, 1973:2):

The convicts who are discharged are often entirely destitute. The natural prejudice against them is so strong that they find great difficulty in obtaining employment. They are forced to seek shelter in the lowest receptacles; and if they wish to lead a new course of life, are easily persuaded out of it; and perhaps driven by necessity to the commission of fresh crimes. It is intended to afford a temporary shelter in this building, if they choose to accept it, to such discharged convicts as may have conducted themselves well in prison, subject to such regulations as the directors may see fit to provide. They will here have a lodging, rations from the prison at a cheap rate, and … a chance to occupy themselves in their trade, until some opportunity offers of placing themselves there they can gain an honest livelihood in society. A refuge of this kind, to this destitute class, would be found, perhaps, humane and political.

The commission making this recommendation believed that ex-inmates needed an accepting transitional house immediately after release and a sup- portive environment to assist in the process of establishing a law- abiding and independent existence. It was also motivated by the intention to reduce the unacceptably high rate of recidivism among newly released inmates (Seiter & Carlson, 1977). Unfortunately, the Massachusetts legislature feared that ex- prisoners might “contaminate” each other if housed together, neutralizing their newly instilled crime resistance learned in prison.

The concept, however, found fertile ground in other locations and under private sponsorship. In 1845, the Isaac T. Hooper Home in New York City opened under the auspices of the Quakers and today operates as the Women’s Prison Association and Hooper Home, serving female clients.

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303Historical Development of the Halfway House in America

Perhaps the most significant halfway house pro- gram in this earlier era was Hope House, estab- lished by Maud Booth and Ballington Booth in 1896, in New York City. Supported both finan- cially and morally by the Volunteers of America, other Hope Halls opened across the nation (Chicago, San Francisco, New Orleans, etc.). This earlier movement and Hope Halls in particular did not last. Parole was introduced and imple- mented widely in the early 1900s as a means for controlling and helping ex-inmates after release from prison. The belief in likely and malevo- lent contamination from association with other parolees continued. The Great Depression weak- ened financial support for these privately oper- ated homes, already underfunded. Phase I of the development of the halfway house ended shortly thereafter, not to revive until the 1950s.

The rebirth of the halfway house movement resulted, in part, from a growing awareness of the ineffectiveness of institutional corrections. High- recidivism rates were interpreted as indications of ineffectiveness of prison as a venue for rehabili- tation. The growing dissatisfaction with prisons was buttressed by new evi- dence that parolees face problems in the transition from imprisonment to a free society, evidence of the need for supportive services in the transition to community life. In 1954, numerous halfway houses opened in America (such as Crenshaw House in Los Angeles and Dismas House in St. Louis, under the direction of Father Charles Dismas), England, and Canada. Private and reli- gious groups pioneered in both historical and revival phases of development of the halfway house.

Earlier in the revival phase, most houses used individualized treatment, coun- seling, employment referrals, and substance abuse counseling, reflecting the general correctional philosophy found within the prison: the medical model. Persons not yet committed to predatory criminal lifestyles, younger, and more malleable offenders were believed ideal clients for the medical model. Then Attorney General Robert Kennedy suggested in 1961 that federal funds be used to establish publicly operated halfway houses for juvenile and youth- ful offenders, leading to the establishment of the Prisoner Rehabilitation Act of 1965. This legislation authorized the Bureau of Prisons (BOP) to establish community-based residences for adult and youthful prerelease offenders, as well as to transfer federal prisoners to privately sponsored halfway houses.

Photo 11.1 A modern halfway house. Courtesy of Connecticut Halfway Houses, Inc.

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C h a p t e r 1 1 : Community residential Correctional programs304

In 1968, the Law Enforcement Assistance Administration began to provide substantial funds for establishing nonfederal houses, a thrust that continued until 1980.

Perhaps the most significant event in Phase II was development of the International Halfway House Association (IHHA) in 1964.1 This group, moti- vated by the absence of state and local support for halfway houses, established a voluntary professional organization of halfway house administrators and per- sonnel (Wilson, 1985). IHHA (now known as the International Community Corrections Association) conducted numerous training workshops, spon- sored training programs and conferences, and affiliated with the American Correctional Association.2 The organization grew from 40 programs in 1966 to more than 1800 in 19823 and now holds annual conferences that deal with “what works” in correctional intervention. As a result of these and related efforts, few cities and counties run their own residential treatment centers, and state programs that operate halfway houses usually contract with private- sector, nonprofit halfway houses to provide services.

The attorney general may extend the limits of the place of confinement of a prisoner as to whom there is reasonable cause to believe he will honor this trust, by authorizing him, under prescribed conditions, to

1. visit a specifically designated place for a period not to exceed 30 days and return to the same or another institution or facility. An extension of limits may be granted only to permit a visit to a dying relative, attendance at the funeral of a relative, the obtaining of medical services not otherwise available, the contacting of prospective employees, or for any other compelling reason consistent with the public interest; or

2. work at paid employment or participate in a training program in the community on a voluntary basis while continuing as a prisoner of the institution or facility to which he is committed.

Box 11.2 feDeral prIsoNer rehaBIlItatIoN aCt

1This organization is now known as the International Community Corrections Association; publishes the ICCA Journal; and sponsors local, state, regional, national, and international conferences and training programs concerned with halfway houses and community alternatives. Go to http://www.iccaweb.org/ for more information. 2American Correctional Association, 206 N. Washington Street, Alexandria, VA 22314. http://www.aca.org/ 3The National Institute of Corrections lists more than 1200 programs in its 1989 Directory of Residential Community Corrections Facilities in the United States. The directory does not list all small programs, particularly in rural areas. For more information, go to www.nicic.org.

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305Uses of Halfway Houses

uses of halfway houses Over the past 50 years, as suggested earlier, the numbers, roles, and uses of half- way houses increased considerably. There has been considerable role expansion in residential placements of adult (and juvenile) offenders. For the most part, the increase has been in the services provided to new groups: probationers, the accused awaiting trial, and offenders directly sentenced for treatment, ordered by a judiciary eager to secure services and supervision for offenders. Judges are usually unwilling to incarcerate clients likely to give up criminal behavior if a supportive and facilitating community environment could be provided in which the offenders remediate their needs and improve their functioning. These changes in roles, sentencing alternatives, clients, and use of halfway houses have rendered “halfway house” an obsolete term, one that has been replaced by the more accurate “community corrections residential facility.” Rush (1992) defines such facilities as

A correctional facility from which residents are regularly permitted to depart, unaccompanied by any official, for the purposes of using community resources, such as school or treatment programs, and seeking or holding employment. This definition not only deletes the term “halfway” but also defines a correctional mission for the facility. The definition does not require centers to provide direct services to

Day-reporting Centers These community centers are to which adults and sometimes juveniles report in lieu of incarceration or as a condition of probation. A variety of community or in-house programs may be offered, including individual and group counseling, job readiness training, Alcoholics Anonymous (AA) 12-step programs, drug abuse education, and so on. Participants usually return to their individual homes at night.

restitution Centers These community residential centers are for offenders ordered by the court to make financial payments to victims. Offenders may also be remanded as a condition of probation. The offender must seek and obtain employment, make restitution to victims, reimburse the center for room and board, and set aside any residual earnings for use after release. Center programs usually require curfews, strict alcohol and drug abstinence, and participation in community or in-house programs.

work furlough Centers This type of residential facility is for sentenced offenders released from a correctional institu- tion for work during the day. Residents typically spend nights and weekends in the facility and must participate in available community or in-house programs. Participants are generally charged a per diem fee for services, room, and board.

Box 11.3 types of CommuNIty CeNters

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clients. Halfway houses are thus subsumed under the larger umbrella term, further reflecting the more diverse populations served, as well as broader correctional mission and such newer programs as day, restitution, and work-release centers.

Another major factor influencing the development and use of community resi- dential centers in the United States has been a shift in the ideology of correc- tions, from rehabilitation to “reintegration,” a term introduced by the President’s Commission on Law Enforcement and Administration of Justice in 1967.

This correctional philosophy places priority on keeping offenders in the com- munity whenever possible rather than commitment to prison. It also stresses the role of the community in corrections. Thus the new ideology, new devel- opments stressing community placement in local correctional programs, and existing halfway houses contributed to an accelerating expansion of commu- nity correctional residential programs. This thrust was further expanded by three factors:4 (1) widespread correctional acceptance of the reintegration mis- sion, (2) success of the reintegration movement in the mental health field, and (3) the lower costs of halfway houses as compared to prisons.5 Prison over- crowding in the 1980s and early 1990s, resulting from the war on drugs, fur- ther accelerated the shift (Allen, Latessa, & Ponder, 2010).

This is a broad correctional ideology stressing acquisition of legitimate skills and opportunities by criminal offenders, and the creation of supervised opportunities for testing, using, and refin- ing those skills, particularly in community settings.

Box 11.4 reINtegratIoN

Community residential centers (CRCs) are nonconfining residential facilities to adjudicated adults or juveniles or those subject to criminal or juvenile proceedings. They are intended as an alternative for persons not suited to probation or who need a period of readjustment to the community after imprisonment. There are more CRCs providing transitional and extensive services for juveniles than for adults. Some CRCs specialize by client or treatment modality: for example, women, abused women, prerelease federal furloughers, drug-dependent or alcohol abusers, the mentally ill, those identified by the court diagnostic program, or the developmentally disabled.

Box 11.5 CommuNIty resIDeNtIal CeNters

4Allen, Carlson, Parks, and Seiter (1978). 5Halfway houses for juveniles tend to be more cost-effective than detention. Pratt and Winston (1999).

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307Uses of Halfway Houses

From 1980 through the present, prison inmates have increased dramatically, with well over two million prisoners held in federal or state prisons and local jails (Bureau of Justice Statistics, 2009), creating a lack of prison capacity and extensive prison overcrowding. The primary reason for the burgeoning prison population is believed to be the “war on drugs,” reflecting both the conservative emphases on retributive justice and the nation’s unwillingness to address the causes of crime (Allen, 1995). Three major results of this development have been (1) an increase in the number of offenders placed on probation and parole, (2) an increase in the seriousness and dangerousness of offenses of those placed into traditional community-based supervision,6 and (3) a height- ened demand for community residential treatment facilities to provide transi- tional placement for offenders and to respond to such special needs populations as narcotics and drug abusers, offenders driving under the influence of alcohol or other drugs, and mental health clients. Community residential facilities and programs expanded and changed to address these new demands,7 required programs, and heightened supervision levels (Huskey, 1992).

Before addressing programs for these clients, it is necessary to understand the models on which the programs operate. The exact number of halfway houses is unknown, and no government agencies routinely gather information on them. The most recent numbers are shown in Figure 11.1, which shows the num- ber of halfway houses in operation in about 30 states and the federal govern-

6Petersilia, Turner, Kahan, and Peterson (1985). 7Chapple (2000). (www.nicic.org/pubs/2000/period180.pdf).

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ment between 1997 and 2000 (Camp & Camp, 2000). The number of inmates served in these facilities is presented in Figure 11.2. These data indicate that in 2000, nearly 30,000 inmates were served in just over 50 percent of the states (Camp & Camp, 2000).

Figure 11.1 Halfway houses in operation, 1994–1999. Source: Camp and Camp (1997); and Camp and Camp (2000).

1200

1000

800

600

400

200

0 1994 1996 1999

Contracted Operated by State

This includes 30 States and the Federal Government.

Figure 11.2 Inmates located at halfway houses, 1994–1999. Source: Camp and Camp (1997); Camp and Camp (2000).

30,000

25,000

20,000

15,000

10,000

5,000

0 1994

Contracted Operated by State

This includes 30 States and the Federal Government.

1996 1999

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309Models of Community Residential Programs

moDels of CommuNIty resIDeNtIal programs It should be remembered that Phase II of the development of community resi- dential programs has been under way for more than 30 years. Thus, models under which halfway houses and related community programs operate have also undergone significant change. We start by examining an earlier model in a less complex environment.

In 1976, Allen, Bowman, Carlson, Parks, and Seiter studied halfway houses and probation. These researchers developed three alternative models of half- way houses, based on referral service. This trichotomy is useful in depicting how halfway houses interface with the criminal justice system, as well as the advantages and services these programs offer to their clients. The trichotomy can be found in Figure 11.3 (Latessa and Allen, 1982).

Figure 11.3 Alternative models of halfway houses. Source: Latessa and Allen (1982).

Model 1

Model 2

Model 3

Parole or release date

Imprisonment

Halfway house

Parole

A model is a picture or representation showing the parts of a system. Models suggest the ways that segments of the criminal justice system (courts, probation, prisons, etc.) fit together and interrelate. One implication of a model is that change in one part of the system will have an impact on other parts of the system. A simplified demonstration of this is seen when law enforcement agencies increase arrests; judicial personnel, probation officers, and jail facilities face increased workloads.

Box 11.6 moDel

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Model 1 is the standard and most frequent pattern of referral to halfway house programs. In this model, an inmate granted a conditional release (such as parole, shock probation, or shock parole) enters a halfway house during the initial parole period. This model provides services to parolees who need support during their period of release. The length of residency in the half- way house may be specified before referral but usually is a shared decision to be made collaboratively by the supervision officer, house staff, and cli- ent. Typically, this decision is based on such factors as the resident’s readi- ness to leave the house, employment, savings, and alternative residential plan. After leaving the house, the offender generally continues on parole supervi- sion. This model has been found to reduce recidivism successfully (Bouffard, MacKenzie, & Hickman, 2000).

Model 2 is similar to the first in that inmates’ release plans call for placement in a halfway house as the initial phase of their release process. Unlike the first, however, halfway house residency occurs prior to formal granting of parole and subsequent supervision as a parolee. Typically, these inmates have been sched- uled for a definite release date before moving from the prison to the halfway house. These clients remain inmates, serving the remainder of their sentences in residency at a halfway house. Halfway house residency provides needed and significant services in the prison–community transition. Additional benefits include continuation of jurisdiction by the referring correctional agency, abil- ity to return the inmate to incarceration without formal violation of parole, development of a more positive attitude toward the halfway house by the resi- dent, and less expensive after-care service that can be more legitimately com- pared to imprisonment rather than the costs of parole.8 The U.S. Bureau of Prisons was a leader in initiating this model for using halfway houses9 and continues to use this model on a prerelease basis.10

The third model of halfway house use, also based on the reintegration model of corrections, differs by time of placement into the program. With Model 3, offenders on probation and inmates granted parole are assigned to the

8This question is explored in more detail in Hicks (1987). See also Wilson, G. (1985); Latessa, E., and L. Travis (1992); Latessa and Allen (1982). 9Federal Bureau of Prisons (2001). See also Thevenot, C. (2001). 10Valentine (1991). The Bureau of Prisons underutilizes their contracted bed space, further exacerbating their prison overcrowding problem.

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311Models of Community Residential Programs

community without initially residing in a halfway house. If such clients may be reverting to criminal behavior or encounter unanticipated problems that might be resolved by program services of or a period of residency in a halfway house, the supervising agency may remand the offender to the residential set- ting for a short period. If and when conditions warrant, the client could then be returned to a lower level of supervision. It should be noted here that some residential correctional programs are large and can provide services and pro- grams at many points in the supervision process, as explored later. Model 3 appears to best suggest the organization and practices of multiservice agencies in larger urban settings.

In addition to the models described earlier, halfway houses take on a wide range of functions and services depending on their size, mission, and resources. Figure 11.4 illustrates a continuum of types of programs based on the ser- vices they provide. Some halfway houses provide shelter, food, and minimal counseling and referral services. These programs are considered supportive halfway houses. Examples of these types of programs might include shelters and drop-in centers. Halfway houses that offer a full range of services can be

Source: U.S. Government Accounting Office, 2000.

The goal of BOP’s halfway house program is to provide federal prison inmates a transition back to the communities where they will live upon release from federal custody. In addition to subsistence and housing, BOP guidelines state that halfway house operators are required to offer inmates job counseling, academic and vocational training, family reconciliation services, access to substance abuse programs, postrelease housing referrals, and community adjustment services.

Box 11.7 Bureau of prIsoNs aND halfway houses

Figure 11.4 Types of halfway houses based on services.

INTERVENTIVESUPPORTIVE

Total treatment Minimal services program Specialized staff Minimal staff Long-term stayShort-term

Referral service

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considered interventive programs. These are pro- grams that offer a full range of treatment services. Most programs fall somewhere in the middle.

It should be obvious that roles of halfway houses as residential probation and aftercare centers within the correctional process are varied in both opera- tion and focus. Although all three models acknowl- edge the need for a residential setting at some point in the transition back to the community, there are various approaches and strategies for meeting these needs. To understand the range of alternatives, we examine a rural community residential treatment center, as well as a larger urban counterpart.

rural CommuNIty programs Rural correctional programs serve a wide range of offenders and are them- selves diverse. Whereas the “Mom and Pop” stereotype possibly typical of the earliest developments of rural community corrections has surely died,11 what has emerged is an increasingly diversified pattern of local programs that solidly reflect the concept of “residential community corrections programs.”12

Community residential correctional programs in rural settings face differing challenges. They are generally smaller than urban programs and have fewer employment opportunities and treatment programs for offenders. Residents are drawn from a small pool of eligible offenders. These programs face and must overcome community suspicion that the center’s existence may attract recalcitrant offenders who will move their base of criminal activities to the local area, the “importation” reaction. Decreased societal tolerance for cer- tain offender types (such as rapists, child molesters, and drug pushers), cou- pled with concerns over public safety and demands for increased supervision,

11This nostalgic view of warm-hearted, older rural Americans trying to help the less successful, down- trodden, and sodden of the Depression years by feeding any who ask, putting transients to work chopping wood or hauling water, and allowing the more needy to sleep in the barn has many adherents. No doubt this pattern of early philanthropic assistance was found in many sites and continues in isolated locales. These “Mom and Pop” programs, often unofficial, were undoubtedly major sources of humanitarian assistance to the needy in some, if not most, of the nation during the early twentieth century, providing “three hots and a cot.” If they exist today, they are an endangered species. 12See the IARCA Journal for a description of some more successful programs in rural America and urban England (Leeds Alternative to Care and Custody Scheme, and Roundabout Group). IARCA Journal, 3 (July, 1990).

Photo 11.2 Substance abuse group. Courtesy of Talbert House, Inc.

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Rural Community Programs 313

has great potential to restrict treatment, job and educational placement, access to existing treatment programs, and funding from community sources. Many facilities must work hard to interface with referral sources (probation and parole agencies, for example) and develop liaisons with other services offered by mental health, illegal drug, alcohol, family counseling, and court agencies.

These opportunities and challenges face Hilltop House,13 a 28-bed private, nonprofit agency providing residential services to male offenders and outpa- tient services to delinquents and victims referred from local, state, and federal sources. In its earliest days, this small program would close in the winter and reopen in the spring, housing not more than 12 clients referred from one judi- cial district. It now serves a much wider catchment area, working with six dis- trict court judges.

Hilltop House began to grow in this environment, even though encountering the conservative political swing that demanded longer sentences, less diver- sion, and specialized programs to assist the higher-need clients the justice sys- tem was processing. This demand was met by:

n Developing liaisons with other court referral units and probation officers. n Working with nonincarcerated populations (such as misdemeanant

offenders, persons driving under the influence, self-referred persons with alcohol and other drug abuse problems, youths referred by their parents, and so on).

Community corrections in its rural expression is the remnant of the grassroots folk art of the original concept. Rural programs are generally not larger than 40 beds (a large rural program) and are concerned about the importation of offenders regularly into their community, the meeting of the next payroll, the expense of travel to training as opposed to the cost of training itself. The rural program generally is not faced with the challenge of adequately accessing and implementing brokerages to existing treatment in their community; we are worried about how to create, fund, and perpetuate treatment. Our “community” may be a town of 12,000 serving a catchment area of several hundred miles. Our worries are not typically of gang behavior between “Crips and Bloods.” They may, however, include the American Indian in any of its numerous tribal groups, the rural Hispanic or black, all in the delicately interwoven and overwoven social fabric of the lineages of a rural community. Every individual job truly means the future of our programs. The failure of one client can affect the future political support of our program; a single incident cannot only destroy a program but also the potential efforts of any program to replace it (Berry, 1990:6–7).

Box 11.8 rural CommuNIty CorreCtIoNs

13See Berry (1990).

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n Developing new service programs in the areas of incest treatment and domestic violence, and urinalysis collection and testing for a county youth home, private schools, social services, employers, individuals, and parents.

n Developing a sexual abuse treatment team, using workers from a number of agencies and providing service to offenders, their nonoffending spouses, victims, and other adults who had been molested as children (AMACs). This multiagency approach was expanded to include juvenile restitution, a program using many volunteers as mediators and providing subsidized employment and monitored restitution payments, as well as group therapy to reconcile victims and their offenders, and develop empathy among juvenile offenders.

Hilltop House appears to serve the specific needs of the community, develop resources to plan and initiate specialized services, and maximize therapeutic gains for clients, victims, and citizens. Individuals who resolve conflicts, per- sonal problems, challenges, development problems, and the impacts of being victimized are more likely to become constructive citizens and lower the crime rate in their community.

metropolItaN resIDeNtIal programs Residential community correctional programs for offenders located in urban areas are more numerous and diverse than those in rural areas. In addition, many of the largest programs make extensive use of existing community ser- vices, especially if these are needed adjuncts to a treatment plan for an indi- vidual client. Treatment generally falls into two categories—individual and group—and most halfway houses conduct detailed intake assessments to determine the needs of their clients. Figure 11.5 shows an example of a halfway house intake form.

Although halfway houses usually offer a range of programs and services, the most common include employment, substance abuse, and cognitive restruc- turing. Employment programming usually includes job readiness training, resume writing and interviewing skills, job placement, and transportation assistance.

Programs for drug abusers might include methadone maintenance, weekly and unscheduled urinalysis, 12-step programming, groups, Alcoholic Anonymous and Narcotics Anonymous, and detoxification. It should be noted that, on average, more than 60 percent of all male arrestees tested positive for at least one drug, including alcohol (Drug Use Forecasting, 2000), and about one in four tested positive for a major drug (PCP, heroin, crack, or cocaine). The rate for female jail inmates was even higher than for males; 28 percent tested

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Metropolitan Residential Programs 315

Figure 11.5 Halfway house intake form (form A-2).

GENERAL INFORMATION

(First) (Middle) (Last) Client Name

2. Client T.H. ID # 3. - - Client SS # 4. Admission Status:

(1) New Admission (2) Re-Admission (within fiscal year) (3) Re-Admittance after Escape/Absconding

(within fiscal year) (4) Legal Status Altered

5. / / Date of Birth (mo/day/yr) 6. Sex (1) Male (2) Female 7. Race

(AI) American Indian (OR) Oriental (BL) Black (WH) White (HI) Hispanic (Specify) Other _________

7a. Appalachian (1) Yes (2) No 8. Current Marital Status

(1) Single (4) Married (2) Divorced (5) Separated (3) Widowed (6) Common Law

9. Number of Dependents (financial responsibility other than self)

10. Number of Children 11. Legal Responsibility for Children? (1) Yes (2) No 12. Zip Code of Last Community Address 13. Homeless Before Arrest? (1) Yes (2) No 14. Place to Live When Discharged? (1) Yes (2) No 15. Primary Source of Income (at present)

(1) Public Assistance (5) Family (2) Investments (6) No Income (3) Full-Time Employment (7) Other ___________ (4) Part-Time Employment

15a. Total Income Last Year (Nearest Dollar)

16. Court Costs Owed (Nearest Dollar) 17. Restitution Owed (Nearest Dollar)

CRIMINAL HISTORY

Note: When answering questions 19-30, if the information is not available from the referral source, use client- reported answers.

18. . Ohio Revised Code for which convicted.

19. Number of prior felony convictions (adult/juvenile).

20. Number of prior adult felony commitments in a state or federal institution (when sentenced).

21. Age at admission to institution (or probation) for current offense.

22. Number of offenses (including current offense) committed while under parole/probation supervision.

23. Number of offenses (including current offense) involving drugs/alcohol.

24. Number of prior arrests during the past five years, prior to incarceration.

25. Number of offenses (including current offense) for auto theft.

26. Number of offenses (including current offense) involving serious injury to the victim.

27. Number of offenses (including current offense) involving the use of a weapon.

28. Has this individual been previously convicted for the same offense? (1) Yes (2) No

29. Was the current conviction for multiple crimes? (1) Yes (2) No

30. Was the offender employed at the time of arrest? (1) Yes (2) No

(Continued)

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EDUCATION AND EMPLOYMENT HISTORY

31. Years of education attained (last grade completed).

32. Highest diploma/degree received and name major subject area where applicable. (1) None (2) G.E.D. (3) High School (4) College Associate/Major _____________

Bachelor/Major _____________ Master’s/Major _____________ Doctoral/Major _____________

33. Years of vocational training.

34. Certification of vocational training awarded (1) Yes __________________________________ Trade (2) No

Enter 1 for YES 2 for NO for Questions 35-37 35. Physical/Health impairments (e.g., amputee, paraplegic, deaf, blind, serious illness, debilitating

effect of age)

36. Mental capacity impairment (e.g., diagnosed mental retardation, diagnosed borderline MR)

37. Behavioral impairment (e.g., mental and/or emotional condition or disorders that require the treatment of a qualified mental health professional).

38. Number of jobs held in the last 2 years in the community prior to incarceration.

39. Longest stay on the job in the last 2 years in the community (number of months).

CLIENT/STAFF ASSISTANCE ASSESSMENT

Enter 1 for YES 2 for NO for Questions 40-55 40. Does client feel he/she needs assistance while in residency? 41. Does this individual need employment assistance? 42. Does this individual need assistance in academic or vocational

training?

43. Does this individual need assistance in financial management? 44. Does individual need assistance in the area of domestic rela-

tions (e.g., marriage, family, etc.)?

45. Does this individual need assistance in the area of emotional or mental health?

46. Is this individual currently required to take medication for any psychological condition?

47. Does this individual need assistance for a substance abuse (alcohol/drug) problem?

48. Does this individual need assistance with securing suitable liv- ing arrangements?

49. Does this individual need assistance for a learning disability? 50. Has medication ever been prescribed for a psychological condi-

tion (e.g., nerves)?

51. Has client had prior psychiatric hospitalization? 52. Has client ever attempted suicide? 53. Was client ever a victim of child abuse? 54. Was client ever a victim of domestic violence? 55. Was client ever a victim of sexual abuse or incest?

DRUG/ALCOHOL HISTORY

56. # times client had prior drug/alcohol treatment. 57. # months prior outpatient treatment. 58. Successful? (1) Yes (2) No (3) NA 59. # months prior inpatient treatment. 60. Successful? (1) Yes (2) No (3) NA 61. # months prior Halfway House treatment. 62. Successful? (1) Yes (2) No (3) NA

63. Has client participated in a halfway house program before this occasion?

(1) Yes (2) No

64. Longest period of drug/alcohol abstinence in community (months) or (99) No problem

Staff member completing form

_________________________________________________

Date ______________________________ Rev. 061992

Figure 11.5—Cont’d

F O S T E R , C E D R I C 1 6 9 2 T S

Metropolitan Residential Programs 317

positive for opiates compared to 17 percent for males. Alcohol and other drug abuse is a risk factor for many offenders, and such clients have high needs for treatment that community residential correctional facilities can meet.14

In recent years, there has been increased attention to the effectiveness of cognitive behavioral programs. These interventions involve target- ing the antisocial attitudes, values, and beliefs that many offenders hold. Cognitive programming attempts to restructure the thinking of offenders and develop new skills that can be used to improve their problem-solving abilities. Many halfway houses today offer criminal thinking groups and other cognitive interventions aimed at anger and violence reduction, sex- ual behavior, negative peer associations, and improved problem-solving techniques.

Another group of problem offenders are those with both mental illness and substance abuse problems. County community health boards and criminal courts can both use services for these offenders. These offenders are called “dual diagnosed” and pose a special problem for community corrections. Although research indicates that major predictors of recidivism are the same for mentally disordered offenders as nonmentally disordered offenders (Bonta, Law, and

Many community corrections center programs focus on Alcoholics Anonymous as part of the overall abstinence program. This may mean requiring residents to work the 12 steps of AA, demonstrate understanding of the program, design a postrelease plan, chair an AA meeting, and participate in the affairs of the program. The latter might include house chores (vacuum- ing, cleaning restrooms, shoveling snow, cleaning ashtrays, etc.), attending house meetings, remaining sober and clean, working outside the program, and seeking specialized treatment. If the resident’s family unit is not broken, reconciliation counseling may be required. If appro- priate, the resident might be required to participate in meetings of Adult Children of Alcoholics (ACAs) or child sexual abuse and domestic violence programs. When alcohol is the underlying cause of criminal behavior, an individually designed, monitored, and supportive program may reduce criminal activity sharply.

Box 11.9 alCoholICs aND treatmeNt

14Barbara Owen found that alcohol frequently accompanied other drug use among parolees in California, leading to most parole violations. Owen (1991). See also Langworthy and Latessa (1993); and Division of Criminal Justice Office of Research and Statistics (2000).

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Hanson, 1998; Solicitor General of Canada, 1998), the availability of treat- ment services in the community is often lacking for this special needs group. Peters and Hills (1999:95) state:

Offenders placed under community supervision who have co-occurring mental health and substance abuse disorders are quite diverse in symptom presentation, severity and chronicity of disorders. These individuals often have severe mental health disorders, and simultaneously use different types of drugs, presenting considerable challenges to treatment programs for this population. Many offenders with co-occurring disorders would benefit from specialized treatment services in the community.

Unfortunately, relatively few programs are designed specifically to deal with the dual-diagnosed offender. Most of these programs are located in large urban areas. One such program is the Substance Abuse–Mental Illness (SAMI) program operated by Talbert House in Cincinnati, Ohio. This program has been in operation for more than 10 years and has served well over 500 offend- ers during that period of time.

Many urban communities across the nation face the problem of finding treat- ment opportunities that permit reintegration of high-need offenders, such as

described earlier. Increasingly, these counties are turning to private-sector, for-profit, and nonprofit residential programs for assistance. Figure 11.6 suggests how such residential and community programs can interface with traditional justice agencies in provision of services.

Community residential correctional programs of these types exist across the nation and will increase in number and importance in the coming years. The private sector providing these programs, facil- ities, and centers will grow as cities and counties, facing fiscal and policy crises, accept and intro- duce these programs in their local areas.

JuVeNIles IN resIDeNtIal plaCemeNt Although the population of juveniles in residential placement includes those in secure facilities, the use of group homes, halfway houses, and other forms of residential facilities are common in the juvenile justice system. Recent fig- ures released by the Office of Juvenile Justice and Delinquency Prevention (Sickmund, 2010) indicate a steady decline in the number of youths placed in such facilities between 1998 and 2008. Figure 11.7 shows that the number of juvenile in residential placement peaked in 2000 and has been declining

Photo 11.3 Mental health program. Courtesy of Talbert House, Inc.

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319Juveniles in Residential Placement

ever since. Some states, such as Missouri, have moved from large juvenile insti- tutions to smaller, residential facilities. Box 11.10 gives an example of some new evidenced-based residential programs for youths that the state of Ohio is developing in conjunction with the University of Cincinnati.

Figure 11.6 A reintegration model. Source: Allen and Simonsen (1995).

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Box 11.10 CommuNIty-BaseD treatmeNt CeNters (CBtC) IN ohIo The Ohio Department of Youth Services (ODYS), with the assistance of the School of Criminal Justice at the University of Cincinnati, is in the process of developing several community- based treatment centers. The impetus for developing these programs originated from a 2005 study that indicated that moderate-risk youths placed in ODYS institutions recidi- vated at a substantially higher rate than similar youths placed in the community. Hence, the vision of this initiative is to create an alternative placement for moderate-risk youths committed to ODYS. The CBTC project has the following three goals: to (1) provide a secure, intensive, high-fidelity, evidence-based treatment program for moderate-risk youths; (2) reduce the length of stay and recidivism for moderate-risk youths; and (3) provide high-quality, intensive aftercare services that support community and family reunification/stability. The first community-based CBTC was opened in October 2009. ODYS contracted with STARR Commonwealth to operate this program. It is located in Franklin County, Ohio. The target population for CBTCs is moderate-risk youths committed to the Department of Youth Services on a felony-level offense. Moderate risk is defined by results of an actuarial risk assessment and will include youths who fall within a moderate and high-moderate risk range. The program is based on a cognitive–behavioral therapy model with a focus on targeting criminogenic risk factors through cognitive restructuring and skill acquisition. The total dos- age of treatment approximates 300 hours. The length of the program is based on the youth’s risk and needs, as well as progress in treatment, but will average 120 days of residential

Figure 11.7 Juvenile offenders in residential placement. Source: Sickmund (2010).

1998

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321Effectiveness of Community Residential Programs

effeCtIVeNess of CommuNIty resIDeNtIal programs The question of the effectiveness of halfway houses, along with other commu- nity corrections programs, was addressed previously. A brief summary state- ment is included here to place both phases of the halfway house movement in perspective.

Evaluation of the effectiveness of halfway houses and, more recently, residential community correctional programs requires that they be considered across three dimensions: humaneness, recidivism, and cost studies (Latessa & Allen, 1982). There is little doubt that halfway houses, during both phases, were and are more humanitarian than imprisonment. Halfway house programs were estab- lished in part to address the devastating economic and psychological effects of prisons and prisonization on most inmates. Prison crowding, gross idleness of inmates, absence of meaningful work and vocational training, unhealthy and unsafe physical plants, prison rape, and gang conflicts within prisons make prisons less than the pinnacle of humanitarianism (Donnelly & Forschner, 1987). Halfway houses are more humane, although the conservative punish- ment emphasis in the last two decades raises policy questions about whether American correctional policy should be so (Latessa & Allen, 1982).

The weight of evidence to date demonstrates that halfway houses are cost-effec- tive in terms of expenditure of public funds when compared to institutional placement. Further, their programs achieve some, if not all, stated objec- tives, including the maintenance of offenders’ community ties and making community resources available to offender clients (Dowell, Klein & Krichmar,

Box 11.10 CommuNIty-BaseD treatmeNt CeNters (CBtC) IN ohIo—CoNt’D programming and 120 days of aftercare. STARR operates a 12-bed CBTC program. The program admits only local youths, which allows for emphasis on family intervention and aftercare. An intensive aftercare program is an integral part of the CBTC programs. Aftercare consists of parole supervision using the Effective Practices in Community Supervision (EPICS) model, which uses a cognitive–behavioral framework to supervise offenders in the community. Likewise, youths are required to attend an eight-week aftercare group that focuses on apply- ing those skills learned in the residential portion of the program. Finally, parole is responsible for brokerage with community resources. In order to ensure fidelity to the program model, several layers of quality assurance are incor- porated. Quality assurance consists of staff training, observation of treatment delivery with feedback, youth feedback, reassessment, program assessment, and recidivism follow-up. The University of Cincinnati is responsible for providing training and coaching of staff, as well as monitoring the fidelity of program implementation.

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1985). On average, halfway houses cost about $50 per day, and one study con- cluded that halfway houses tend to be more cost-effective under private rather than public management (Pratt & Winston, 1999).

The issue of recidivism is much more complex, particularly with regard to half- way houses. The diversity of halfway houses, as well as the range of types of offenders they serve (parolees, probationers, pretrial detainees, work releasees, and furloughees, not to mention state, county, and federal offenders), makes it difficult to develop adequate comparison groups for follow-up studies.15 Recidivism studies of CRC residents that exist indicate success with about 71 per- cent of the clients, and in-program rearrest rates of two to 17 percent (Huskey, 1992). Follow-up recidivism studies of alcohol-abusing clients show success rates ranging from 70 to 80 percent; driving-under-the-influence (DUI) rates can be reduced significantly with residential treatment, significantly raising DUI survival rates (Langworthy & Latessa, 1993, 1996; Pratt, Holsinger & Latessa, 2000). For clients who graduate from CRC programs, success rates can be as high as 92 percent (Friday & Wertkin, 1995). On the whole, follow-up recid- ivism studies indicate that halfway house residents perform no worse than offenders who receive other correctional sanctions. There is also some evidence that offenders placed in halfway houses have more needs than other offenders (Latessa & Travis, 1991). Latessa (1998) has examined a number of halfway houses across the country. He has several criticisms that are noteworthy:

n Many halfway houses fail to assess offenders adequately, and few distinctions are made between offenders based on risk.

n In general, qualifications of staff are low, and there is a great deal of staff turnover.

n Most halfway houses offer a wide range of “eclectic” treatment, with little if any theoretically based treatment models in place.

n Despite some notable exceptions, most halfway houses can be classified as one step above “three hots and a cot.”

[B]ecause of the difficulty of assessing humaneness and behavioral changes, most researchers tend to ignore these variables to pursue more quantifiable data. However, anyone who has worked in or around halfway houses has seen positive changes of the lives of many who enter these programs.

—george wilson

Box 11.11 humaNeNess of halfway houses

15It is important to note that studies that do not employ a control group make it very difficult to gauge the effectiveness of programs, at least in terms of recidivism.

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323Effectiveness of Community Residential Programs

In some studies of a halfway houses, Leon, Dziegielewski, and Tubiak (1999) and Munden, Tewksbury, and Grossi (1999) voiced similar concerns about poor offender assessment practices, frequent staff turnover, change in leader- ship, inadequate resources, and insufficient emphasis on treatment. In a 2002 study of residential programs in Ohio, Lowenkamp and Latessa (2004) dem- onstrated the importance of assessing the risk level of offenders before assign- ing them to community-based correctional facilities (CBCFs). Figures 11.8 and 11.9 illustrate recidivism rates for individual CBCF programs. Consistent with the risk principle, CBCF programs generally increased the recidivism rates of low-risk offenders by four percent but decreased the recidivism rates of higher- risk offenders by eight percent. In a 2010 replication study, Latessa, Smith, and Brusman (2010) examined 20 CBCFs and 40 halfway houses and a sample of more than 20,000 offenders. Results from this study were very similar to the earlier one: overall recidivism increased by three percent for low-risk offend- ers and was reduced by 14 percent for high-risk offenders. As with the previous study, some programs were extremely effective, whereas others were not. The quality and implementation of the program were major factors in determining the effectiveness of the program.

Figure 11.8 Treatment effects for a low-risk offender. Source: Lowenkamp and Latessa (2004).

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C h a p t e r 1 1 : Community residential Correctional programs324

the future of resIDeNtIal CommuNIty CorreCtIoNs Predicting future correctional trends is difficult due to possible national pol- icy changes, economic fluctuations, crime trends, and public sentiment. One thing is evident: public sentiment for increasing the punishment of offenders

In one of the more unusual attempts to provide residential treatment programs, Ohio has devel- oped a correctional alternative called community-based correctional facilities. Currently there are 19 operating CBCFs in Ohio. The size of the facilities ranges from 54 to 200 offenders, and several serve both males and females. Funding for the CBCFs is provided by the state; how- ever, the operation and management of the CBCF are left to a local judicial corrections board. In some instances, local courts operate the facilities, whereas private providers are retained in others. The CBCFs are secure facilities, but treatment is the primary focus. Ohio has also devel- oped similar juvenile programs called community correctional facilities. Some other states, such as Texas, have similar programs.

Box 11.12 CommuNIty-BaseD CorreCtIoNal faCIlItIes

Figure 11.9 Treatment effects for high-risk offenders. Source: Lowenkamp and Latessa (2004).

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325The Future of Residential Community Corrections

in the hope of lessening crime16 remains strong. Thus, it is reasonable to expect increased numbers of offenders in jails and prisons, and on probation, parole, and other community correctional programs.

Despite the increased use of punishment, the future of residential community correctional programs appears promising. Probation populations are at an all- time high, and approximately 95 percent of prison inmates will return to the community. Halfway houses and other community-based programs will be needed to assist in their reintegration. Early release programs, such as work and educational furlough and preparole release, will also increase, furthering the demand for services of halfway houses and related programs.

It is also likely that local units of government will increasingly turn to private- sector providers for correctional (and perhaps law enforcement) programs, contracting with larger numbers of halfway houses to provide lower-cost and diverse services that the government cannot otherwise fund. To do less would decrease reintegration services and increase the possibility of offenders return- ing to prisons for committing new crimes in local communities. Indeed, one of the issues facing community corrections is the increased privatization of services and programs. While nonprofit providers have always been the main- stay of traditional halfway houses, the influx of for-profit providers will likely change the face of this industry.

Halfway houses and related programs will also need to increase the quality and effectiveness17 of programs to serve the demands of clients, communities, and corrections. To do this, they will need to maintain relationships with justice agencies, strengthen community ties and acceptance, adopt treatment models that have demonstrated effectiveness, and assist in ensuring the safety of the community in reintegrating offenders. Future research will also be needed to address the roles and effectiveness of community residential correctional pro- grams. Fortunately, there is a movement under way to improve the effective- ness of community correctional programs. This movement is being supported by the National Institute of Corrections18 and the International Community Corrections Association and is based on the work of scholars such as Paul

16Judging from official crime statistics and victimization studies, the crime rate in the nation has been dropping for the past 10 years. However, politicians and agencies with vested interests in maintaining concern over crime have come to believe that public safety will be enhanced by “locking up criminals and throwing away the prison keys.” This assumption is at least debatable and could be patently wrong. 17There is some evidence that staff attributes within programs influence program effectiveness and recidivism. Staff selection and training, as well as program developments, could be improved by matching personality and attitudinal attributes. See Johnson and Bonta (1985). 18For more information about this movement, write NIC at 320 1st St. NW, Washington, DC 20534 (www.nicic.org).

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Gendreau, Don Andrews, Francis Cullen, and others. Through their research we continue to learn about “what works” with offenders (Cullen & Gendreau, 2001).

summary Halfway houses have been part of the correctional scene since the early 1800s. Originally designed to assist offenders who had been released from prison, today many halfway houses serve as both halfway “in” and halfway “out” facil- ities. Often called community residential correctional programs, these facili- ties include both privately and publicly operated programs and range from “three hots and cot” to programs designed to meet all of an offender’s treat- ment needs. Although halfway houses are often overlooked, they represent an important part of community corrections.

Community corrections centers serving high-risk clients have produced evi- dence of both lower recidivism and cost-effectiveness. Such centers are more humane, less expensive, and more effective in ensuring public safety. Community corrections centers will remain a major segment of community corrections and will be increasingly specialized to serve a wider variety of high- risk clients.

reVIew QuestIoNs 1. Why did Phase I of the halfway house movement die in the 1930s? 2. Explain the revival of the halfway house movement in the 1950s. 3. Define residential community correctional center. 4. What are some of the services offered by halfway houses? 5. What are the advantages of halfway houses? 6. What is “substance abuse?” Debate: is it a disease or a learned behavior? 7. Define “reintegration” and discuss ways that halfway houses can lower crime. 8. What are some of the criticisms of halfway houses? 9. Describe the CBTCs that Ohio is in the process of developing.

reCommeNDeD reaDINgs Lowenkamp, C., Makarios, M. D., Latessa, E. J., Lemke, R., & Smith, P. (2010). Community cor-

rections facilities for Juvenile Offenders in Ohio: An examination of treatment integrity and recidivism. Criminal Justice and Behavior, 37(6).

Lowenkamp, C. T., & Latessa, E. J. (2005). Increasing the effectiveness of correctional program- ming through the risk principle: Identifying offenders for residential placement. Criminology and Public Policy, 2(4).

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327References

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329References

Thevenot, C. (2001). Halfway house: Training for freedom. Las Vegas Review-Journal. www.lvrj .com/lvrj_home/2001/Apr-15-Sun-2001/news/15812376.html.

Valentine, H. (1991). Prison alternatives: Crowded federal prisons can transfer more inmates to halfway houses. Washington, DC: U.S. Government Accounting Office.

Wilson, G. (1985). Halfway house programs for offenders. In L. Travis (Ed.), Probation, parole and community corrections (pp. 151–164). Prospect Heights, IL: Waveland.

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Corrections in the Community.

C h a p t e r 1 2

[America’s War on Drugs] has, in fact, been responsible for a massive increase in prison populations that has been borne disproportionately by minority offenders.

—Robert Johnson and Hans Toch

Successful sex offender management requires more governmental funding. Unfortunately, public aversion to spending money on sex offenders undercuts their management.

—R.J. Konopasky

Special Populations in Community Corrections

binge drinking

child abuse

child molestation

criminalization of the

mentally ill

dangerous sex

offenders

date rape

developmentally

disabled offenders

drug abuse

drug addict

DWI

exhibitionism

forcible rape

incest

marital rape

Megan’s law

mentally handicapped

offenders

prostitution

psychopath

rape

relapse prevention

serial rapists

sex offender

special category

offenders

substance abuse

Key terms

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INtrODUCtION We now come to a chapter that deals with special populations of offend- ers. We have chosen to focus on four specific types of clients: sex offend- ers, substance abusers, mentally disordered offenders, and female offenders. These categories do not exhaust the list of possible types of special category offenders.1

the seX OFFeNDer Each state has differing laws that regulate sexual conduct, and correctional sys- tems typically deal with three special-needs groups of sexual offenders: rapists, child molesters (pedophiles), and prostitutes. Each of these categories has dif- fering motivations, modes of operation, challenges, and dangers. Almost all are handled, either initially or later, by community corrections. We begin with a brief discussion of public opinion and fear, two factors that color both legal and treatment issues with sex offenders.

Prostitution is offering, agreeing to engage in, or engaging in a sex act with another in return for a fee, money, or other consideration.

BOX 12.2 prOstItUtION

Sex offenders are persons who have committed a sexual act prohibited by law, such as rape, incest, child molestation, or prostitution for sexual, economic, psychological, or situational reasons. On a given day, there are approximately 234,000 offenders convicted of rape or sexual assault under the care, custody, or control of corrections agencies. Nearly 60 percent of these sex offenders are under conditional supervision in the community. The median age of the victims of imprisoned sexual assaulters was less than 13 years old; the median age of rape victims was about 22 years. An estimated 24 percent of those serving time for rape and 19 percent of those serving time for sexual assault had been on probation or parole at the time of the offense for which they were in state prison three years earlier.

BOX 12.1 seX OFFeNDers

Source: Bureau of Justice Statistics (2002).

1Other special needs offenders include geriatric offenders and HIV-infected clients. Gang members (security threat groups) are usually subsumed under institutional corrections.

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public Opinion and Fear

With the possible exception of the violent offender, no type of correctional client evokes more concern from the public than the sex offender. Sex offend- ers, especially child molesters, are treated with both disdain and violence. Few offenders are as stigmatized or reviled as child molesters.

Many Americans fear sexual assaulters, gang rapists, serial rapists, stranger rap- ists, child abductors, and child abusers. Rape is one of the most feared events as well as a frightening and misunderstood crime. Others feel that treatment of sexual assaulters is undeserved and ineffective. Politicians tend to follow public opinion,2 despite evidence that there is widespread support for treat- ment and rehabilitation of offenders ranging from the very young to geriat- ric prisoners. Opinion polls overestimate the amount of support for punitive approaches to special need clients, particularly for juveniles (Cullen & Moon, 2002). There is no doubt that public sentiment works against the establish- ment and funding of treatment programs and options. However, substan- tial evidence shows that treatment works (Lipton, Pearson, & Wexler, 1999; Sherman et al., 1997; Yates, 2002). Specifically, three meta-analyses on the topic have been conducted (Table 12.1), and results from each review indi- cate that treatment has an appreciable impact on recidivism. First, Gallagher, Wilson, Hirschfield, Coggeshall, and MacKenzie (1999) located a total of 25 studies and found a 21 percent reduction in sexual recidivism overall. Second, Hanson et al. (2002) reviewed 43 studies involving more than 9000 sex offend- ers and found a 12 percent reduction in sexual recidivism. More recently, Lösel

table 12.1 Meta-analyses Demonstrating Treatment Reduces Sexual Recidivism

Number of studies Percent reduction

Gallagher et al. (1999) 25 21% Hanson et al. (2002) 43 12% Lösel and Schmucker (2005) 69 37%

Exhibitionism is exposure of one’s genitalia or other body parts to others in inappropriate circumstances or public places. An exhibitionist is the one who exposes those parts to others.

BOX 12.3 eXhIBItIONIsm

2Kerschener (1996).

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and Schmucker (2005) quantitatively synthesized 69 studies and found a 37 percent reduction in sexual recidivism compared to controls.

the rapist

There are many different types of rapists, including date rapists, stranger rap- ists, family rapists, acquaintance rapists, gang rapists, homosexual rapists, and serial rapists. All have three things in common: a victim or victims, sexual inter- course or attempted sexual intercourse with persons against their will, and force or threat of use of force. Most of the victims are female and view rape as a brutal personal assault. Many rape victims feel that the act was not as much sexually motivated as much as it was a physical assault fed by a desire for vio- lent coercion and power. In this light, rape should be seen as an act of vio- lence, not an act fueled primarily by sexual arousal. Almost never is the female responsible for the act, although defense attorneys may use this line of argu- ment in their efforts to blame the victim.

Washington State’s 1990 Community Protection Act was the first law authorizing public notifi- cation when dangerous sex offenders are released into the community. It was thought that sex offender registration laws are necessary because:

n Sex offenders pose a high risk of reoffending after release from custody. n Protecting the public from sex offenders is a primary governmental interest, and the

rights of sex offenders take backseat to public interest. n Releasing certain information about sex offenders to public agencies and the general

public will contribute to public safety. It took the brutal 1994 murder–rape of Megan Kanka (1994) to prompt public demand for broad- based community notification. President Clinton signed Megan’s Law in 1996, which allows the states discretion to establish criteria for disclosure, but compels them to make personal and private information about registered sex offenders available to the public. It was believed that such notification:

n Assists law enforcement agencies during investigations. n Establishes legal grounds to hold offenders. n Deters sex offenders from committing new offenses. n Offers citizens information useful in protecting their children from victimization.

Some states mandate registration and penalize nonregistration with imprisonment. Sex offender registration has been criticized as a flawed strategy for controlling sex crime, reflecting a skewed view of sex offenders, and encouraging vigilantism. Probation and parole agents’ responsibilities were impacted negatively.

BOX 12.4 DaNgerOUs seX OFFeNDers

Sources: Presser and Gunnison (1999), and Zavitz and Farkas (2000).

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Forcible rape

The definition of rape and forcible rape varies across jurisdictions and the Federal Bureau of Investigation (FBI) (2009) defines rape as carnal knowledge of a female forcibly and against her will, including assaults and attempts to commit rape by force or threat of force. Not included are statutory rape (with- out force) and other sex offenses. This definition does not define rape of a male as forcible rape.

The extent of forcible rape in the nation is only estimated. In 2008, the FBI reported about 89,000 rapes of females, but the National Crime Victimization Survey (Rand, 2009) estimates that there were more than 200,000 of females age 12 and older. This suggests that not all incidents were reported to the police. Many victims fail to report because they are embarrassed, blame themselves, feel the police will not act, anticipate that they, as the victim, will be blamed for the crime, or know their rapist and fear retaliation (their assaulters were fathers, brothers, uncles, friends, or neighbors).

A darker side of rape can be seen when examining sexual assault of young children. The Bureau of Justice Statistics (2002) reported that in each sex- ual assault category except forcible rape, children below the age of 12 rep- resented about half of the victims. They represent one in eight forcible rapes, and females under age 12 represent one in six of reported rapes. Almost one-half of the offenders of victims under age six were family members, as were four in 10 offenders who sexually assaulted juveniles ages 12 through 17. Knowing that a child under age six was assaulted in the residence suggests the most likely offender was a juvenile acquaintance ages 12 through 17 or a family member ages 24 through 34. Schmalleger (1996:69) reports:

… 20 percent of female victims under age 12 had been raped by their fathers, 26 percent were attacked by other relatives, and 50 percent were assaulted by friends and acquaintances. Only four percent of rape victims under 12 were attacked by strangers.

Rape is sexual intercourse or attempted sexual intercourse with persons against their will, by force or threat of force. Date rape is forcible rape in which the victim has consented to the com- pany of the offender but has not agreed to have sexual intercourse. Statutory rape is sexual intercourse with a person who has consented in fact but is deemed, because of age, to be legally incapable of consent.

BOX 12.5 rape

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Both official and victimization statistics significantly underreport rape. Other victim studies suggest that at least 20 percent of adult women and 12 percent of adolescent girls have experienced sexual abuse or assault sometimes in their lives.3

Child molestation is any one of several forms of handling, fondling, or other contacts of a sexual nature with a child, including photographing children in lewd poses. The victim may be subject to rape, sodomy, indecent exposure, or murder. “Molester” refers to the one who commits these acts. Child neglect is any deliberate act by the parents or legal guardian of minors that deprives minors of life’s necessities, including protection, adequate sustenance, and behavioral regulation. This includes ignoring the minor. It is the willful failure to provide for one’s child or ward.

BOX 12.6 CrImes agaINst ChIlDreN

Child abuse is any act of commission or omission that endangers or impairs a child’s physical or emotional health and development: sexual abuse, exploitation, negligent treatment, and mal- treatment by a person who is responsible for the child’s welfare. The major forms are (a) physical, including neglect or lack of adequate supervision; (b) emo- tional, including deprivation; and (c) sexual. The abuser is someone usually close to the victim, such as mother, father, stepparent, grandparent, or other caretaker who engages in a repeated pattern of behavior. Rarely is the abuser a total stranger.

BOX 12.7 ChIlD aBUse

3Browne (1992).

Incest is sexual relations between close relatives other than husband and wife.

BOX 12.8 INCest

Offenders who had victimized a child are, on average, 5 years older than violent offenders who had committed their crimes against adults. Nearly 25 percent of child victimizers were age 40 or older, but about 10 percent of inmates with adult victims fall into that age range.

BOX 12.9 ChIlD VICtImIzers

Source: Bureau of Justice Statistics (2002).

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stranger-to-stranger rape

When victims are attacked by strangers, the attack is likely to be more violent and the attacker is likely to be armed and to threaten the victims. The offender is likely to be a substance abuser (Hsu & Starzynski, 1990); the victim is likely to be harmed physically; and the viciously harmed female is more likely to report the attack. Most victims were not provocateurs (Warren et al., 1999).

Serial rapists (offenders raping several victims in three or more separate events) are particularly problematic among the stranger-to-stranger cate- gory for many of the victims that are killed or simply “disappear.” Studies of serial rapists suggest that they are more likely to be white rather than minority status, select victims based on sexual attractiveness and vulner- ability (Stevens, 1999), rape their victims for longer periods of time, and use more profanity, be sadistic, and escalate levels of violence over time (Knight, Warren, Reboussin, & Soley, 1998). A study of United Kingdom serial rapists indicates itinerancy and mobility. A majority of attacks were initiated within five miles of the victim’s residence. Offenders tended to target locations where numbers of suitable victims were available, and rap- ists spent considerable time “prowling” or “hunting” over those larger areas in search of victims, occasionally stumbling over victims during relatively sophisticated property offenses. Perpetrators are more likely to have antiso- cial (“psychopathic”) personalities (Davies & Dale, 1996). Victims of serial rapists generally require extensive therapy over long periods of time, some- times in therapeutic communities (Winick & Levine, 1992).

Hare defines the clinical construct of psychopathy by a combination of interpersonal, affec- tive, and lifestyle characteristics. Interpersonally, psychopaths are arrogant, callous, dominant, grandiose, manipulative, and superficial. Affectively, they lack guilt or anxiety and are short- tempered and unable to form strong emotional bonds with others. Interpersonal and affective characteristics are frequently found with a socially deviant lifestyle that includes impulsive and irresponsible behavior and a tendency to ignore or flagrantly violate social conventions and mores. While not all psychopaths come to the attention of the criminal justice system, they are at high risk of violence and aggression. In maximum security prisons, they may constitute 20–25 percent of the general population.

BOX 12.10 psyChOpathy

Source: Hare (2002), Lanham, MD: American Correctional Association.

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acquaintance rape

At least one-half of the rapes reported to police involve someone known to the victim, including family members, friends, and suitors. Victimization incidents involving female victims under age 12 suggest that this type of rape is vastly under- reported. We focus briefly on date rape and marital rape in order to comprehend the dynamics of and treatment facing offenders and the correctional system,

Date Rape

Date rape, often defined as unlawful forced sexual intercourse with a woman against her will, occurs within the context of a dating or courting relation- ship. Date rape is a frequent event and is not limited to this nation. A survey of Canadian college women found that one in four had sexual relations when they did not want to during the past year.4 An estimated 15–25 percent of all college women in the nation are victims of rape or attempted rape. The actual incidence is probably higher, as many victims blame themselves for not being more forceful in their own defense or for using alcohol or other drugs prior to the rape. (Date rape differs from campus gang rape in that usually only one perpetrator is involved in date rape, the victim and victimizer know each other intimately, the event is not generally viewed by others, and the sexual assault is better viewed as a coercive sexual encounter than as a violent rape.)

The perpetrator may feel that he has invested so much time and money in his date that he is owed sexual relations, that sexual intimacy is a validating element in the progression of the relationship, that other couples in simi- larly lengthy dating processes had begun sexual activities, or that “she said ‘no’ but really meant ‘yes’.” Perhaps one in 10 date rapes is reported to the police because victims are embarrassed or frightened; some do not perceive date rape as “real rape,” which they believe requires an attack by a stranger; or fear they will be stigmatized or victimized by the police. Some men (particu- larly adolescents) have difficulty relating to women and treat them more as sexual objects who should be responsive to their sexual appetites rather than as worthy and independent partners who should be treated as such (Kerschener, 1996). Stereotyped relations and perceptions abound in the area of rape.

Marital Rape

Marital or spousal rape is rape by a male domiciled with his wife, although the rapist/victim role can be reversed. Generally, it is spousal rape if the hus- band forces his wife to have nonconsensual intercourse. Until recently, a legally

4DeKeseredy, Schwartz, and Tait (1993).

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married man could not be prosecuted for raping his wife under the “marital exemption”; a woman entering marriage was believed to implicitly give her consent to sexual intercourse at the behest of her husband. Over the past two decades, research into spousal abuse has identified marital rape as one part of a continuing pattern of spousal abuse, sometimes accompanied by sadistic and violent beatings. Every person is worthy of protection under the law, and almost every state has now enacted legislation defining marital rape as a crime.

The extent of marital rape is unknown, but is a persistent problem in a large number of marriages (Straus, 1988). It is underreported in part because soci- ety tends to blame and judge rape victims harshly. Women assaulted by their husbands have reported that the assault was one of a series of similar attacks (Riggs, Kilpatrick, & Resnick, 1992) occurring in three cycles: tension building, acute battering, and subsequent contrite behavior by the husband, with recur- rent cycles. Considerable evidence suggests that homes in which spousal rape occurs are characterized by high levels of tension and distrust among spouses and their children (Mahoney & Williams, 1998). A study in Great Britain found 13 percent of wives had sexual intercourse with their husbands against their will and, in total, one in five had been raped either inside or outside of mar- riage (Painter & Farrington, 1998). Finally, multiple sexual victimization (such as incest and marital rape) is a co-occurring problem among victims and, to some extent, among perpetrators. New psychotherapy models and treatments are needed (Walker, 2000).

treatment for sex Offenders

This review of sexual offenders suggests the heterogeneity of these crimes and acts of violence. As a result, treatment programs are as varied as crime type; some treatment programs fail to focus on those factors contributing to the

The extent of female sex offending, like that of males, is vastly underreported. Compared with men, very few women are convicted of sex offenses (except those associated with prostitution) and a substantial proportion of those convicted are convicted as accomplices of men. Only two to five percent of sex offenders are female. Female sex offenders have commonly been abused physically and sexually as children, are more likely to be young, poorly educated, from lower socioeconomic status, have few social supports, and be “willing to do anything to fit in.” They are less likely than men to use physical force (or will use it less) than men and are less likely to be predatory. Unlike male sexual offend- ers, females are less likely to deny what they have done and more likely to accept responsibil- ity earlier. They typically offend against female children; male, female infant, and adult victims are rare.

BOX 12.11 Female seX OFFeNDers

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commission of the crime and thus erroneously address objectives that would not lessen reoffending. A study of sex offender treatment in Vermont outlined the goals of an institutional treatment program:

n Get the offender to accept responsibility for his actions and the harm done to the victim and others.

n Deal with distorted thinking used to justify his actions. n Teach the offender to understand the impact of his behavior on

victims and show more empathic behavior with other people around them (recognize others’ emotional distress, identify another’s perspective, communicate empathy toward others, etc.).

n Address such competency issues as anger management, substance abuse treatment issues, communicating with opposite gender adults, improving dating skills, and seeking therapy.

n Deal with sexual arousal to reduce inappropriate object arousal and enhance arousal with an appropriate adult partner.

n Plan relapse prevention that teaches the offender how and when to intervene in his own patterns of behavior that lead up to a sexual offense (drinking and remaining aloof, alone and physically inactive can build up to fantasizing about a victim, and this requires such personal intervention as initiating counseling, attending Alcoholics Anonymous group meetings, and calling a designated crime prevention hotline). Relapse prevention includes teaching offenders how to recognize the chain of events leading up to their current offense and to practice strategies for breaking this chain.

n Plan for release into the community and set up a support team of people who know the offender’s issues and can provide support and monitoring, including sex offender-specific outpatient treatment.

Six years after release, five percent of the men who completed the Vermont treatment program had committed another sexual offense and were caught, in contrast to 30 percent of the men who got only partial treatment (left the pro- gram or were expelled from the program for rules violations). Thirty percent of the incarcerated men who refused to enter the program were arrested again for some form of sexual abuse (Cumming, 2001).

A study of adolescent sexual assaulters from a Wisconsin (Nisbet, Wilson, and Smallbone (2004) secure juvenile correctional institution included perpetrators of sexual assault against children, rapists of same-age or older victims, and nonsex offense- adjudicated adolescents. The rapists and child offender groups completed a mandatory, serious sex offender treatment program that included group psychotherapy, general education, sex educa- tion, behavior management programming, and individual and family ther- apy. Eight years later, adolescent sex offenders were found to less frequently

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offend sexually than the nonsex-offending adolescent delinquents, although all three groups were significantly more likely to be involved with sexual assaults than was the general male population in the nation.

Perhaps the most sophisticated review of effectiveness of treatment on vari- ous types of sexual offenders was undertaken by Yates (2002). She concluded that treatment can significantly reduce sexual reoffending for a variety of offenders, both juvenile and adult, if behavioral-specific treatments are based on diagnosis of needs, development of a treatment plan, delivery of treat- ment in a coherent fashion by competent therapists under direction of a supervisor, and review and revamping of treatment if it is not working. She concluded that dynamic risk factors are amenable to change and will lower criminal reoffending. These factors include attitudes, values, and beliefs; criminogenic peers; and instability of employment. For juveniles, treatment targets include:

n Increasing responsibility and accountability for behavior n Addressing cognitive, affective, and behavioral factors that support

sexual offending n Reducing deviant sexual arousal n Improving relationships among family members n Enhancing victim empathy n Improving social skills n Developing healthy attitudes toward relationships and sex n Reducing the effects of personal trauma n Targeting cognitive distortions

Yates reported on treatment effectiveness of adolescents 6 years after a com- prehensive, cognitive–behavioral, relapse prevention sexual offender pro- gram. Effectiveness was measured by recidivism, comparing a treatment group with a similar nontreatment group. Results are found in Table 12.2. Treated sex offenders recidivated significantly less frequently and less violently.

table 12.2 Comparison of Recidivism of Treated and Untreated Adolescent Sex Offenders

Group: Recidivated sexually

Recidivated violently but not sexually

Recidivated nonviolently

Treated 5.2% 18.9% 20.7% Untreated 17.8 32.2 50.0

Source: Yates (2002: 148).

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Sex offender criminal behavior is amenable to intervention, and the prepon- derance of evidence is that treatment works for most perpetrators (although there remain considerable challenges to develop effective treatment for the relatively rare psychopathic sex offender).

sUBstaNCe aBUsers Substance abuse is the unauthorized possession of any controlled substance, whether it is nonmedical use of psychotherapeutic drugs, illicit substances, or inhalation of common household products. Alcohol, probably the most com- monly abused substance, is illegal for minors to possess but is widely used by Americans. There are significant social, economic, and personal costs in sub- stance abuse. Substance abuse has also been cast in a legal perspective, rather than the set of medical problems it represents, and has given rise to “dope fiend” stereotypes and frequent incarceration.

Each year, alcohol and other drug abuse contribute to the death of more than 120,000 Americans. These substances cost taxpayers more than $300 billion annually in preventable health care costs, extra law enforcement, auto crashes, crime, and lost productivity. Families of victims of drunk drivers suffer

The typical justice response to sex offenders involves punishment and incapacitation by elimi- nating offender access to victims. Because almost all sex offenders return to the community, incapacitation without treatment does not reduce reoffending. In Vermont, the cost of a relapse (justice and victim services) is estimated to be more than $138,000. McGrath (1995) provides a synopsis of 68 outcome studies and clearly shows that treatment in the community is effective, particularly more recent programs that use relapse prevention treatment models delivered in group therapy sessions. Typical treatment goals include accept- ing responsibility for the offense, developing empathy with the victim, improving social compe- tence, controlling deviant sexual arousal, and developing relapse prevention skills. More recent treatment programs (since 1980) appear to be more effective. Reoffending rates for treated offenders are 80 percent less than for untreated offenders; persons who complete treatment programs (vs. dropping out) are 77 percent less likely to recidivate. Sex offenders treated in relapse prevention (vs. behavioral change) groups are 73 percent less likely to reoffend. Finally, the reoffending rate for sex offenders treated since 1980 is six percent. Furby, Weinrott, and Blackshaw (1989) argue it is no more than 10 percent but argue for longer follow-up periods after treatment. McGrath concludes that results from the 68 sex offender outcome studies reviewed show that treatment works, is cost effective, and can be provided in communities under probation control.

Source: McGrath (1995).

BOX 12.12 seX OFFeNDer treatmeNt: DOes It WOrK?

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enormous hurt, not to mention the crimes of higher insurance premiums and costs, lost productivity, jail and prison overcrowding, and repeat criminal behaviors from unaddressed alcohol problems.

In 2008, an estimated 20 million Americans were current illicit drug users, meaning they had used an illicit drug during the month prior to an interview. This is more than six percent of the population age 12 or older. According to data from a 2008 survey, more than 110 million Americans age 12 or older report using illicit drugs at least once in their lifetime (SAMHSA, 2009). Furthermore, a total of 15 percent of the general population reported using an illicit drug in the past year, and eight percent reported use within the past month. Drug use varies by employment. An estimated 19 percent of unem- ployed adults were current illicit drug users in 2008 compared with 10 percent of part-time-employed adults and eight percent of full-time-employed adults.

Just about four million Americans are dependent on illicit drugs, represent- ing almost two percent of the total population age 12 and older. Another eight million Americans are depen- dent on alcohol (about four percent of the population). Overall, almost five percent of American people are dependent on either alcohol or other drugs.

Marijuana is the most commonly used illicit drug, used by about 75 percent of current illicit drug users. Men continue to have higher rates of current illicit drug use than women. Finally, some two million youths ages 12 through 17 had used inhalants (glue, shoe polish, gaso- line, lighter fluid, etc.) at some time in their lives as of 2008; this constitutes about nine percent of youths. The good news is that among youths ages 12–17, the current illicit drug use rate remained stable from 2007 (9.5 per- cent) to 2008 (9.3 percent). The majority of high school seniors report they can obtain drugs fairly easily or very easily (see Table 12.3).

Drug. Any chemical substance used for psychological or physical purposes. Drug abuse. Any offense involving the use, possession, manufacture, or distribution of illegal or controlled substance (e.g., cocaine, crack, marijuana, heroin, methamphetamine). Includes “designer” drugs. Drug addict. A person with dependency upon a given substance, including narcotics and controlled substances, alcohol, or prescription medicines.

BOX 12.13 DrUg aBUse

Photo 12.1 Drug abuse is a contributing factor to outcome supervision. Photograph by Beth Sanders.

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alcohol abuse

Slightly more than one-half of Americans ages 12 or older report being cur- rent drinkers of alcohol, translating to an estimated 129 million people. Overall, heavy drinking was reported by almost seven percent of the popu- lation ages 12 and older. Almost seven million were binge drinkers, and two million were heavy drinkers. (Binge drinking is defined as consump- tion of the equivalent of one-half gallon of liquor in a single day.) Young adults age 18–22 enrolled full time in college were more likely than their not-enrolled peers to report any use, binge drinking, and heavy use of alco- hol. Unfortunately, about 12 percent of Americans age 12 and older (2009) had driven under the influence of alcohol at least once in the 12 months prior to the national survey, a figure even more concentrated in the age group 18–25 (26%).

Among the nine million convicted offenders under the jurisdiction of corrections agencies in 2003, nearly 2.6 million, or about 36 percent, were estimated to have been drinking at the time of the offense. The vast majority (about two million) of these alcohol-involved offenders were sentenced to supervision in the community: 1.7 million on probation and more than 260,000 on parole. Alcohol use at the time of the offense was commonly found among those convicted of public- order crimes, a type of offense most highly represented among those on probation and in jail. Among violent offenders, 41 percent of probationers and 41 percent of those in local jails, 38 percent of those in state prisons, and one in five of those in federal prisons were estimated to have been drinking when they committed the crime.

Source: Bureau of Justice Statistics (2002). Data extrapolated from 1996 statistics.

BOX 12.14 Use OF alCOhOl By CONVICteD OFFeNDers

table 12.3 Percent of High School Seniors Reporting They Could Obtain Drugs Fairly Easily or Very Easily (2000)

Drug Percent

Marijuana 49% Cocaine 22% LSD 13% Heroin 13%

Source: Substance Abuse and Mental Health Services Administration (2009). F O S T E R , C E D R I C 1 6 9 2 T S

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In 2008, more than 23 million persons ages 12 or older needed treatment for an illicit drug or alcohol problem. Of these, 2.3 million received treatment at a spe- cialty facility. Thus, 20.8 million persons needed treatment but did not receive it.

Criminal Justice system Involvement

Despite generally declining rates of drug use (and stable rates of alcohol use) over the past two decades, drug arrests have risen significantly over the same time period. These arrests have resulted in a dramatic increase in prison and jail populations. According to the Bureau of Justice Statistics, an estimated 250,000 state and federal inmates were imprisoned for drug-related offenses, compared to 148,600 in 1990. About 112,000 people were held in jails for drug-related offenses, compared to 20,400 in 1983.

treatment for substance abuse

Offenders coming to the attention of the correctional system are, in general, involved extensively in the abuse of alcohol and other drugs. The further the offender penetrates into the correctional system, the greater the risk posed, and the higher the personal needs, the more difficult management issues become. The difficulty is in part due to the filtering system by which offenders are processed and in part to the impacts of incarceration and imprisonment on offenders, their families, and their economic situations and prospects. In addi- tion, many offenders are made more hostile, recalcitrant, and hardened by the experience of imprisonment, particularly in institutions providing few services. We examine the relationship between substance abuse and crime by legal sta- tus: probationers, jail inmates, prisoners, and parolees.

Acupuncture is defined as “the Chinese medical art of inserting fine needles into the skin to relieve pain or disability” (Wensel, 1990:5). A number of advocates claim that acupuncture can be an effective remedy for drug addiction (Smith, Squires, Aponte, Rabinowitz, and Bonilla- Rodriquez, 1982; Smith et al., 1984). In 1992, Latessa and Moon published results from a study they conducted on a outpatient drug treatment program for felony probationers. Program participants were divided randomly into three groups: an experimental group, which received acupuncture on a regular basis; a control group, which did not receive acupuncture; and a placebo group, which received an acupunc- ture-like simulation. They concluded that “With regard to outcome there is no evidence that acupuncture had any appreciable effect on program completion, arrests, convictions, or proba- tion outcome” (1992:330).

Source: Latessa and Moon (1992).

BOX 12.15 aCUpUNCtUre treatmeNt FOr DrUg-DepeNDeNt OFFeNDers

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probationers and substance abuse

The first national survey of adults on probation in 1995 found that nearly 70 percent reported past drug use (Bureau of Justice Statistics, 2000). One in three said they were using illegal drugs in the month before the offense, and slightly more than one in seven were on drugs when they committed their offense. More than 20 percent (one in five) were on probation for driving under the influence of alcohol or other drugs, and one in four said they had been drinking at the time of their offense. One-third reported prior binge drinking; one-fifth were on probation for a DWI offense. In sum, about two- thirds of probationers may be characterized as alcohol- or drug-involved offenders. The survey also found that one in six probationers reported hav- ing participated in a drug treatment program while serving their sentence, and one in three said they had received treatment for alcohol abuse. Overall, almost four in 10 had received some treatment for substance abuse since beginning their probation. Details on probationer abuse of alcohol and other drugs can be found in Table 12.4.

Jail Inmates and substance abuse

In 2002, the date of the most recent national survey, 68 percent of jail inmates were found to be dependent on alcohol or other drugs at the time of their offense (Bureau of Justice Statistics, 2005). This represents an increase from 1996. About 30 percent of convicted jail inmates were under the influence

table 12.4 Percent of Probationers under the Influence at Time of Offense

Offense Alcohol Drugsa

All probationers 40% 14% Non-DWI offenders 25 16 Severity of Offense Felony 28 18 Misdemeanor 58 8 Type of Offense Violent 41 11 Property 19 10 Drug 16 32 Public order 75 6 aIncludes marijuana/hashish, cocaine/crack, heroin/opiates, barbiturates, stimulants, hallucinogens, and other illegal drugs. Source: Mumola and Bonczar (1998).

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of drugs at the time of the offense. Specifically, 13.6 percent of convicted jail inmates had used marijuana, and 10.6 percent had used cocaine or crack cocaine.

Offenders in local jails reported extensive prior drug use. More than one-half said they used drugs in the month before the offense. Jail inmates were even more likely than probationers to report using drugs in the month before the offense. A total of 16.4 percent reported committing their offense to get money to buy drugs (see Table 12.5). Among inmates who had used alco- hol or other drugs in the month before their offense, 47 percent participated in treatment or programs while under correctional supervision (Bureau of Justice Statistics, 2005). A total of 18 percent of jail inmates who met criteria for illicit drug dependence or abuse and 17 percent who met the criteria for alcohol dependence or abuse had received treatment since their admission to jail. Some jail inmates manage to continue to use drugs in jail, and about one in 10 were positive when tested for drugs. Major sources of drugs smug- gled into jails are staff; almost half of jails dismiss employees when they test positive for drug use.

prisoners and substance abuse

The latest survey on substance abuse by and treatment of state and federal prison inmates found that 32 percent of state prisoners and 26 percent of fed- eral prisoners reported the use of alcohol or other drugs while committing their offense (Durose & Langan, 2005). While only one-fifth of state prisoners were drug offenders, 83 percent reported past drug use, and 57 percent were using drugs in the month before their offense. These are somewhat higher fig- ures than an earlier (1991) survey. About 40 percent of state and 30 percent

table 12.5 Drug Use among Jail Inmates, 2002

Convicted inmates

Under the influence at the time of offense 28.8%

Use in the month before 54.6%

Active drug involvement 68.7%

Drug used at the time of offense

Marijuana/hashish 13.6%

Cocaine/crack 10.6%

Heroin/opiates 4.1%

Source: Karberg and James (2005).

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of federal prisoners reported prior binge drinking experiences; more than 40 percent of both had driven drunk in the past. Overall, three in four state and four in five federal prisoners may be characterized as alcohol- or drug-involved offenders.

In 2004, an estimated 269,200 prisoners who had used drugs in the month before the offense reported taking part in drug treatment or other drug pro- grams since admission to prison (Durose & Langan, 2005). This figure repre- sented a one-third increase since 1997. See Figure 12.6.

parolees and substance abuse

Many drug-involved offenders are sentenced to imprisonment for the instant offense, which may or not be a drug law violation. While in prison, most will receive little treatment, treatment of inadequate duration, or inef- fective treatment and will be released into the community, typically with little effort to link treatment needs with community resources. Reentry ser- vices may well not have coordinated with existing social services, and parol- ees fail to receive the support and supervision needed. In some states, such as California, more prison inmates return as parole revocations than as new commitments from court. The 2000 national survey of illicit drug use

table 12.6 Substance Abuse and Treatment among State and Federal Prisoners over Time

Self-reported drug use

Percentage of prisoners

2004 1997

In month before offense

State 56 57 Federal 50 45

At the time of the offense

State 32 33 Federal 26 22

Uses regularly

State 69 70 Federal 64 57

Ever used

State 83 83 Federal 79 73

Source: Durose and Langan (2005).

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found that more than one in five on parole or other supervised release from prison had used an illicit drug in the past month, a rate four times that of adults not on parole.

In general, the number of correctional facilities that operated primarily as substance abuse treatment programs increased eight percent from 233 in 1995 to 249 in 2000. Furthermore, facilities with alcohol or other drug treatment as a main focus increased from 192 to 200, whereas commu- nity-based facilities with this specialty rose from 41 to 49. More than 80 percent of these facilities were state operated, whereas about 10 percent were private contract facilities and eight percent were federal institutions. Community-based facilities, however, were nearly evenly split between pri- vately operated institutions (55%) and state facilities (45%)(Bureau of Justice Statistics, 2003).

Overall, a total of 96 percent of correctional facilities offered counseling in 2000. Both illicit drug and alcohol counseling were available in about 90 per- cent of the facilities. This pattern was similar among federal, state, and pri- vately operated facilities (Bureau of Justice Statistics, 2003).

Driving While Intoxicated

No discussion of the relationship between substance abuse and crime would be complete without exploring driving while under the influence of alcohol or other drugs (DWI). In 1997, an estimated 513,200 offend- ers were on probation or in jail or prison for DWI: 454,500 on probation, 41,100 in jail, and 17,600 in state prison. DWI offenders accounted for nearly one in seven probationers, one in 14 jail inmates, and two percent of state prisoners.

Compared to other offenders, DWI offenders are older, better educated, and more commonly white and male. Of DWI offenders, about one-half of those in jail reported drinking for at least 4 hours prior to their arrest, while about one-half on probation reported drinking for at least 3 hours. About one-half of the DWI offenders in jail reported consuming about six ounces of etha- nol (equivalent to about 12 beers or six glasses of wine); about one-half of those on probation reported consuming four ounces of ethanol. The esti- mated average blood alcohol concentration of DWI offenders in jail was 0.24 g of alcohol per deciliter of blood; for those on probation, it was 0.19. Most states have legal definitions of drunk driving that presume drunk driving at the 0.08 level.

One-third of DWI offenders on probation (compared to about two-thirds of those in jail) reported prior DWI sentences. Of DWI offenders, one in three in jail and one in 12 on probation reported three or more prior DWI offenses;

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more than one in three on probation and almost half in jail exhibited indica- tors of past alcohol dependence. More than two-thirds of the DWI offenders in jail and almost one-half on probation reported a domestic dispute while under the influence of alcohol.

Of DWI offenders on probation, more than one-half reported receiving alco- hol treatment or participating in a self-help program sometime in their lives. More probationers than jail inmates reported that, since their sentence began, they had received alcohol treatment (46% vs. 4%) or had participated in such self-help groups as Alcoholics Anonymous or Narcotics Anonymous (62% vs. 17%). Because these data were obtained primarily from self-reports, they should be interpreted as minimal estimates. The true figures of use and abuse are probably much higher.

Substance abusers pose many problems for corrections. Alcohol use, commonly viewed as a recreational behavior, has pharmacological characteristics that include loss of coordination, reduction of inhibitions, impairment of judgment, confused understanding, and psychological excitation. Thus, a drunk driver’s trip home can become vehicular homicide. In fact, drunk drivers killed just over 15,000 persons in 2008. A domestic dispute can become domestic violence and aggravated assault, and a night of drinking can become an auto theft.

Even when drug offenders are referred to treatment instead of prison, treat- ment is not always forthcoming. In California, an initiative was passed in 2000 requiring treatment instead of jail or prison for first- and second-time nonvio- lent drug offenders. More than one in three such offenders were not in treat- ment in 2002, a rate better than results in Arizona, which started a similar program in 1997. Other states may have treatment programs that provide bet- ter compliance between constitutional requirements and treatment.

Programs that treat drunk driving fall into one of three major categories: (1) long-term treatment designed to cure pathological drinking, (2) pro- grams that prevent the drunk driver from driving, and (3) educational pro- grams intended to correct poor judgment. Outcome studies suggest that individualized treatment over an extended time period generally elicits promising results from chronic drunk drivers.

Langworthy and Latessa (1990, 1993, 1996) evaluated the effectiveness of the Turning Point Multiple DWI Treatment Program in Cincinnati, Ohio, which is an alternative correctional program for dealing with the convicted and sen- tenced habitual drunk driver in a community-based residential setting. This chemical dependency program for multiple DWI offenders requires clients to serve a minimum of 30 days in county jail and then enter a mandatory 28-day residential program. The program is a comprehensive treatment regimen and includes individualized alcohol treatment, family counseling, and educational

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Mental Health Disorders 351

service. Clients are required to develop and implement an individual treat- ment plan that promotes personal change and requires active participation in Alcoholics Anonymous (or Narcotics Anonymous). Pratt, Holsinger, and Latessa (2000) followed the Turning Point cohort for 10 years. In contrast to a comparison group, treatment group member with three or more DWIs and 30 days in jail avoided new offenses. The treatment’s effect was found to be stable, contributing from 10 to 30 percent in the reduced reoffending of the group.

Substance abusers present problems for probation and parole officers as well as community treatment providers. Because some abusers (such as cocaine users and alcoholics) can become assaultive when under the influence, dealing with them can be dangerous. Much remains to be done to create, fund, and continue public and private service providers, as well as to get individuals to recognize the pattern of their own substance abuse and to decide to change that pattern. This is a major thrust behind drug courts, drug therapy, counseling, and employment programs.

Probation and parole officers (POs) consider illicit drug and alcohol monitor- ing for use and abuse of substances (as well as treatment) to be major parts of their job requirements. Because few probation and parole officers are equipped for or skilled in substance abuse assessment, urinalysis, and treatment, existing social services must be identified, accessed, and utilized. POs help clients iden- tify their alcohol or other drug problems through assessment, obtain needed services, refer clients to agencies, and monitor compliance. After addressing substance abuse problems, POs can then address the offender’s lack of employ- ment, marital difficulties, and emotional issues, which are usually secondary to the problems of alcoholism or drug addiction.

meNtal health DIsOrDers The Bureau of Justice Statistics (2005) estimated that more than 1.2 million offenders with mental illnesses were incarcerated in the nation’s jails and pris- ons (James & Glaze, 2006). About 56 percent of state prisoners, 45 percent of federal prisoners, and 64 percent of local jail inmates reported having a men- tal health problem. Most have co-occurring substance abuse problems, either alcohol or other drugs (or both).

For constitutional and policy reasons, most mental health facilities existing at mid-twentieth century have closed; those remaining primarily service court- ordered forensic patients remanded by courts, including those not guilty by reason of insanity or guilty but mentally ill, those who are a danger to self and others, and those transferred by probate court order due to mental illnesses associated with or as a result of imprisonment. A few are dangerous sex offend- ers who have completed their sentences but were ordered into mental health facilities due to the perceived probability of their repeating heinous crimes.

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The Sentencing Project (2002:2) argues that mental disorders among prisoners occur at least five times the rate found in the general population and represent criminalization of the mentally ill: “the increased likelihood of people with mental illness being processed through the criminal justice system instead of through the mental health system.” Criminalization of the mentally ill has occurred because:

n the deinstitutionalization movement that began in the 1960s was predicated on local communities providing sufficient mental health services, but funding was not forthcoming to underwrite treatment in the community.

n of reductions in treatment spending and availability, including fragmentation of treatment services.

n barriers arose to involuntary commitment, including a court-ordered finding that the detained are either a clear and present danger to self or others or are so markedly disabled by their conditions as not to be able to care for themselves. Involuntary hospitalization also requires legal representation and a full judicial hearing.

In addition, U.S. Supreme Court decisions require that persons detained invol- untarily under the color of treatment must receive treatment. Many states can- not or will not fund treatment services.

Source: Latessa (1996).

Despite claims by mental health advocates that “people with mental illness pose no more of a crime threat than do other members of the general public” (National Mental Health Association, 1987), strong evidence suggests that this is not the case. However, for the correctional system, the issue of whether the mentally ill are more “dangerous” than members of the general public is not a particularly relevant question. For mentally ill individuals who have been convicted of an offense, a more appropriate question is whether they pose more of a risk than other offender groups being supervised in the community. Latessa (1996) compared arrest, conviction, and probation outcome data for several groups under probation supervision. The probation groups included sex offenders, drug offenders, high-risk offenders, regularly supervised offenders, and mentally disordered offenders. He found that mentally disordered offenders performed as well, and in some cases better, than other probation groups. He concluded that mentally ill offenders can and are being supervised in the community without increasing risk to public safety.

BOX 12.16 prOBatION sUperVIsION OF the meNtally DIsOrDereD OFFeNDer

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Source: Center for Behavioral Health Services Criminal Justice Research Policy Brief, April 2010. Rutgers University.

Morgan, Fisher, and Wolff (2010) studied 414 adult offenders with mental illness (265 males, 149 females) and found:

n 66% had belief systems supportive of criminal life style (based on Psychological Inventory of Criminal Thinking Scale).

n When compared to other offender samples, male offenders with mental illness scored similar or higher than nonmentally disordered offenders.

n On Criminal Sentiments Scale, 85% of men and 72% of women with mental illness had antisocial attitudes, values, and beliefs, which were higher than incarcerated sample without mental illness.

They concluded: n Criminal thinking styles differentiate people who commit crimes from those who do

not, independent of mental illness n Incarcerated persons with mental illness are both mentally ill and criminal n Mental illness and criminality need to be treated as co-occurring problems

BOX 12.17 CrImINal thINKINg aND meNtal IllNess

Few jails or prisons have sufficient facilities and programs to handle the special needs of devel- opmentally disabled offenders, and hospitals and other health facilities are seldom capable of administering correctional programs with sufficient security to protect society’s rights. Without alternatives, judges are left with no other choice than to sentence those individuals to prison. n Some mentally retarded offenders require incarceration because of the seriousness

of their crimes or their records as repeat offenders, but most other mentally retarded offenders could be diverted from prison to community treatment programs while still ensuring the safety of the community.

n There is tremendous variation in estimates of the number of mentally retarded persons incarcerated in prison: earlier research indicates that the percentage of those offenders is higher than the percentage within the general population, while the most recent studies place the percentage at about the same level as that within the general population.

n Mentally retarded offenders are often used by their peers, reflecting their great need for approval and acceptance. They have no long-term perspective and little ability to think in a causal way to understand the consequences of their actions.

n Retarded persons are often victimized or abused by other inmates. n Identifying offenders who have special needs is essential for planning individualized

programs. Due process, functional diagnosis, and evaluation performed by specially trained staff utilizing sophisticated assessment tools and procedures are essential.

BOX 12.18 DeVelOpmeNtally DIsaBleD prIsONers

(Continued)

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Female OFFeNDers Male offenders constitute the majority (84%) of adults under correctional control. The much smaller female offender population is handled primarily within the community corrections system, although the number of impris- oned females is increasing faster than that of male prisoners. This section looks at the crimes that place females under correctional control, the process by which they are assigned to and exit from community corrections, and the special problems female offenders face.

Female Corrections populations

There are more than one million women under care, custody, or control of adult criminal justice authorities, and almost 9000 juvenile females were under secure and nonsecure state-managed and contract institutions. This translates into a rate of nearly one percent of American adult females having some correctional status on any given day. About 85 percent were supervised in the community, and 15 percent were confined in jails and prisons. Most violent female offenders are not confined; about 65,000 women convicted of violence are under supervi- sion by probation authorities compared to some 3300 in local jails, 21,000 in state prisons, and almost 1000 in federal prisons. Among convicted female drug traffickers, almost 58,000 are on probation, 5300 in local jails, 13,500 in state prisons, and almost 5300 in federal prison (see Table 12.7).

n Because the developmentally challenged are usually undetected, violations of the legal rights of such persons are frequent.

n Criminal justice and corrections personnel are not presently trained to handle the special problems and needs of such offenders.

n Matters of competency relating to diminished mental capacity should be considered at the first point of contact with the criminal justice system and at each decision point in the continuum.

n Developmentally disabled offenders should be assigned to programs that meet their individual needs; some may be mixed in with the regular prison population; some need a segregated environment; some would benefit most from a community setting; and others might be placed in a regular mental retardation group home or guardianship arrangement.

n A survey of local jurisdictions revealed the need for training about the developmentally challenged for criminal justice personnel who normally do not distinguish between the developmentally challenged and mental illness; the need for early identification of such persons once they come into contact with the criminal justice system; and the need for more community resources, particularly residential programs, to serve this category of offenders.

BOX 12.18 DeVelOpmeNtally DIsaBleD prIsONers–CONt’D

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Female Offenders 355

Women serving a sentence

Nearly two-thirds of women under probation supervision are white, but nearly two-thirds of those confined in local jails and state and federal prisons are minority: black, Hispanic, and other races. Those on probation or in local jails are younger than those in prisons; nearly one-quarter of federal prison inmates are at least 45 years old. Adult women under correctional control are substan- tially less likely than the general population to never have been married.

Yet nearly seven out of 10 women under correctional sanction have minor chil- dren under the age of 18. These females report an average of 2.1 minor chil- dren; these estimates translate into more than 1.3 million minor children as the offspring of women under correctional sanction. About two-thirds of state prison inmates had lived with their children prior to entering prison.

Female prisoners generally have more difficult economic circumstances than male prisoners prior to entering prison. About four in 10 women in state prison

table 12.7 Types of Sentences Imposed by State Court, Female Felons

Percent of Felons Sentenced to:

Most serious

Conviction offense

Incarceration Nonincarceration

Prison Jail Probation Other

All Offenses 25% 31% 40% 3%

Violent offenses 32% 31% 34% 3% Murder 81 7 11 1 Sexual assaulta 44 27 25 4 Robbery 50 24 24 1 Aggravated assault 23 35 39 3 Other violent 37 31 29 3

Property offenses 22 31 44 3 Burglary 39 43 25 3 Larceny 19 33 45 3 Fraud 22 27 48 3

Drug offenses 26 28 41 5 Possession 21 30 43 6 Trafficking 29 27 40 4

Weapons 27 33 35 5

Other offenses 27 39 33 3 aIncludes rape Source: Durose and Langan (2005).

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reported that they had been employed full time prior to their arrest, but more than one-third of the employed females had earned incomes of less than $600 per month prior to arrest. Nearly 30 percent of female inmates reported receiv- ing welfare assistance.

Health issues were more problematic for female than male offenders. About 3.5 percent of the female inmate population was HIV positive. About one-half of the confined female offenders reported they had been using alcohol, other drugs, or both at the time of the offense for which they had been incarcerated. Illicit drug use was reported more often than alcohol use. On every measure of illicit drug abuse (ever used, using regularly, using in the month before the offense, and using at the time of the offense), female offenders had higher rates of use than male offend- ers. Male offenders, however, had higher alcohol use on every measure of alcohol ingestion. An estimated 25 percent of women on probation, 30 percent of women in local jails and in state prisons, and 15 percent of women in federal prison had been consuming alcohol at the time of their offense. Nearly one in three women serving time in state prisons said that they had committed the offense that brought them to prison in order to obtain money to support their need for drugs.

Nearly 56 percent of women substance abusers in state prisons reported hav- ing received treatment for their alcohol and other drug abuse, and one in five said treatment had occurred since entry to prison. Another one-third said they had joined a voluntary program (such as Alcoholics Anonymous and Narcotics Anonymous) since entering prison.

Forty-four percent of women under correctional author- ity reported that they were assaulted physically or sexu- ally at some time during their lives. Forty-eight percent of women reporting an assault said that it had occurred before age 18.

Women in Jail

The number of women in local jails declined from just over 100,000 in 2007 to just under 94,000 in 2009. More than one in three females were in jail in 2000 for drug offenses, an increase from one in eight in 1983. Among convicted female inmates, nearly two-fifths reported that they had committed their first offense under the influence of drugs. Approximately four in 10 used drugs daily. About one in four convicted female jail inmates reported that they committed their current offense to get money to buy drugs. Some two-thirds of the jailed women had children under the age of 18, and most of these were with either a grandparent or father.

Photo 12.2 Sixteen-year-old youthful offender on electronic monitoring in lieu of detention.

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Female Offenders 357

A study of mental illness among female jail inmates (Teplin, Abrams, & McClelland, 1997) in Chicago found that 80 percent of their representative sample met criteria for at least one lifetime psychiatric disorder, most com- monly substance abuse or dependence, and posttraumatic stress disorder. Rates for all psychiatric disorders (particularly depression) were significantly higher than those of the general population. Investigators concluded that few female jail inmates received in-facility treatment, primarily because inmate’s needs far exceeded current resources.

Women who use drugs often have low self-esteem and little self-confidence and may feel powerless. In addition, minority women may face additional cul- tural and language barriers that can hinder or affect treatment and recovery. Many drug-using women do not seek treatment because they are afraid. They fear not being able to take care of or keep their children, reprisals from their spouses or boyfriends, and punishment from the authorities in the commu- nity. Many women report that their drug-using male partners initiated them into drug abuse. Finally, research indicates that drug-dependent women have great difficulty abstaining from drugs when the lifestyle of their male partner is one that supports drug use.

Approximately 40 percent of female jail inmates grew up in a single-parent household, and an additional 17 percent lived in a household without either parent. Close to one-third of all women in jail had a parent or guardian who abused alcohol or other drugs, and four in 10 reported that another family member (usually brother or sister) had been incarcerated.

This brief examination of jail inmates suggests a group of offenders with high needs who were victimized frequently as they were growing up. Broken homes, sexual and physical abuse, minority status, and parental/guardian abuse of alcohol or drugs characterize a large portion of the female popu- lation. This segment of offenders is not generally likely to receive effective treatment for the major, underlying problems. After an average stay of less than 6 months, most will be returned to the community to continue to break their drug dependences and, for the most part, their efforts will fail without intensive assistance. It is possible for drug-dependent women, of any age, to overcome the illness of drug addiction. Those who have been most successful have had the help and support of significant others, family members, treat- ment providers, friends, and the community. We discuss specific issues later in this chapter.

Women on parole

Despite the recent emphasis on studying female offenders, relatively lit- tle is known about females on parole. In 2008, females were an estimated 12 percent of all parolees, up from eight percent in 1990. That translates

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into more than 100,000 female parolees. The growth in the number of female paroles reflects higher offend- ing rates, arrests per offense, increased commitments to prison per arrest, and parole recommitments (parol- ees who failed on parole were returned to prison, from which they will be reparoled later). The lifetime like- lihood of a female going to state or federal prison is now more than one percent, although Hispanic women have a 50 percent higher likelihood than white women. Black, non-Hispanic women have a likelihood seven times that of white women.

Most women sent to prison have several factors that will work against successful reintegration following parole. Alcohol and other drug use, unemployment and few occupational skills, a history of sexual abuse, and incomplete education are difficult to overcome when treatment is a low priority to resource-strapped systems. A gap exists between institutional treatment and transition to the community. Absent meaningful treatment, one should not be surprised at recidivism indicators.

Women and substance abuse treatment

There is widespread need for effective treatment programs for substance abuse by female offenders. Research has shown that women receive the most benefit from drug treatment programs that provide comprehensive services for meet- ing their basic needs, including access to the following:

– food, clothing, and shelter – transportation – job counseling and training – legal assistance – literacy training and educational opportunities – parenting training – family therapy – couples counseling – medical care – child care – social services – social support – psychological assessment and mental health care – assertiveness training

Photo 12.3 Female on street-cleaning work detail, San Francisco jail. San Francisco Sheriff’s Department/Sheriff’s Work Alternative Program. Photograph by Harry Allen.

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359What Works and What Doesn’t with Substance Abuse Offenders

A comprehensive spectrum of services is needed for female offenders at every level of the criminal justice system. After all, almost all return to unconditional release into the community. Traditional drug treatment programs may not be appropriate for female offenders because those programs may not provide the services needed. In addition, research also suggests that a continuing relation- ship with a treatment provider is an important factor throughout treatment for female offenders. Any individual may experience lapses and relapses during the treatment process. Learning how to identify and avoid circumstances that may lead to relapse is important. This is a treatment thrust for many community pro- grams, particularly therapeutic communities (Lockwood & Inciardi, 1998).

Jail-based projects include therapeutic communities (Sisters in Sober Treatment and Empowered Recovery or SISTERS, San Francisco, California; and Stepping Out, San Diego) have a wide range of treatment programs (modalities). Aftercare (postjail release) components provide intensive outpatient services and sober living, job development and placement assistance, referrals to supportive ser- vices, and a mutual-help group created for and by ex-offenders (Kassebaum, 1999). Prison-based therapeutic communities are becoming more numer- ous, and their clients have significantly lower relapse and recidivism rates than those who do not enroll (Nielsen, Scarpitti, & Inciardi, 1996).

The state of Georgia faced a correctional population with 10 percent of males and 27 percent of females classified as mental health cases. The Georgia Board of Pardons and Parole reported on the Georgia Treatment and Aftercare for Probationers and Parolees (TAPP) program to boost postprison support for Georgia’s mentally ill and retarded offenders. A TAPP mental health profes- sional in each service area acts as case manager to nonviolent mental health offenders returned to the area, monitoring offenders’ behavior and arranging ongoing community support and treatment. Such transitional programs are examples of the needed coordination between incarceration and gradual rein- tegration into the community for female offenders (Georgia Board of Pardons and Parole, 2000). Such coordination is needed throughout the community corrections system.

What WOrKs aND What DOesN’t WIth sUBstaNCe aBUse OFFeNDers In a review of substance abuse treatment, Lightfoot (1999) identified effective and ineffective types of treatment (Table 12.8). Interestingly, the types of effec- tive and ineffective treatment models for substance abusers mirror the findings from studies of other offender types. Similarly, Taxman (2000) made similar conclusions when she reviewed the research on substance abuse treatment. Her findings are summarized in Table 12.9.

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table 12.8 Review of Drug Treatment Effectiveness by Lightfoot (1999)

What treatment types were effective in quasi-experimental and/or controlled studies:

n Social-learning based treatments n Aversion therapy: Electrical/chemical counterconditioning n Covert sensitization n Contingency management/contingency contracting n Broad-spectrum therapies n Individualized behavior therapy n Community reinforcement n Behavior self-control thinking n Relapse prevention

What treatment types showed no clear evidence of effectiveness from controlled studies:

n Acupuncture n Education n Lectures n Bibliotherapy n Self-help n Alcoholics Anonymous n Narcotics Anonymous n Al-Anon n Adult Children of Alcoholics n Psychotherapy n Supportive n Confrontational n Pharmacotherapies

Source: Lightfoot (1997).

table 12.9 Review of Drug Treatment Effectiveness by Taxman (2000)

What treatment types were successful at reducing recidivism?

n Directive counseling n Behavior modification n Therapeutic community n Moral reasoning n Social competency cognitive behavior models n Emotional skill development n Cognitive skills n Behavioral skills

What treatment types showed no clear evidence of effectiveness of reduced recidivism?

n Nondirective counseling n Reality therapy n Psychosocial education n Twelve-step or other self-help groups n Psychoanalytical

Source: Taxman (2000).

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361Summary

It appears from these summaries that the most effective approaches are based on cognitive–behavioral, social learning approaches, and skill-building tech- niques rather than talk therapy and self-help approaches.

sUmmary Our discussion of the special needs offender suggests that they are not a uni- tary group of similarly situated offenders, but a complex combination of indi- viduals facing problems of living complicated by self-defeating behaviors that require change. Each group has certain distinct characteristics and problems that are related to offense situations and basic needs, almost all of which are not addressed effectively. While they are alike in that they have been convicted of criminal activities, underlying those events are unaddressed social, personal, and medical needs best handled through treatment. Future corrections will need to apply a range of classification systems to determine the most effective way to manage any group of offenders and maximize public safety. Because substance abuse is evident across special populations, the chapter ends with a synopsis of what works in treating substance-abusing offenders.

General estimates indicate that as many as 80 percent of all offenders have some form of sub- stance abuse problem (particularly alcohol and other drugs). Mauser, van Stelle, and Moberg (1994) estimate total annual societal losses at $144 billion, not including pain and suffering of victims and family members, costs of crimes to victims, diminished health of substance abus- ers, or use of medical resources. As a result, the justice system has responded with specialized probation caseloads and counseling, community substance abuse programs, chemical depen- dency counseling, and so on. Halfway houses offer residential settings for delivery of substance abuse and family counseling, life skills and crisis management training, and so on. Jail programs usually include Alcoholics Anonymous and Narcotics Anonymous, sober living programs, and transfer to specialized care treatment centers. Despite the stereotypical belief that nothing works, many studies show that substance abuse treatment can be effective in reducing recidivism rates. The research on substance abuse treat- ment can be summarized as follows:

n There is no “magic bullet”—no one treatment approach works with everyone. n In general, treatment is superior to no treatment. n Drug addiction is a chronic relapsing condition. Applying short-term, education-based

treatment services will not reduce it effectively. Treatment should be at least 100 h of direct service over a 3-4-month period; however, intensive treatment programs lasting over 1 year might begin to see diminishing results.

n Traditional models used by substance abuse programs, such as drug/alcohol education and 12-step programs, have not been found as effective as cognitive– behavioral models.

n Aftercare services increase treatment effectiveness. n Criminality is a significant factor that independently affects a treatment outcome.

BOX 12.19 sUBstaNCe aBUse prOgrams

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C h a p t e r 1 2 : special populations in Community Corrections362

reVIeW QUestIONs 1. Explain “special needs” offenders. 2. What effects have public fears had on treatment of sex offenders? 3. Differentiate between date rape and campus gang rape. 4. Defend the proposition: The first responsibility of probation officers is to

force the client to address his or her alcohol/drug dependency. 5. Does treatment for sex offenders work? 6. How has substance abuse increased both jail and prison populations? 7. Why are offenders with mental health disorders concentrated in

correctional systems? 8. Explain why criminalization of the mentally ill has occurred. 9. How can corrections better respond to developmentally disabled

offenders? 10. Why are diversion programs the most effective means to integrate

substance abusers?

reCOmmeNDeD reaDINgs Hammett, R., Roberts, C., & Kennedy, S. (2001). Health-related issues in prison reentry. Crime &

Delinquency, 47(3), 390–409.

Lowenkamp, C., Holsinger, A., & Latessa, E. (2001). Risk/need assessment, offender classification, and the role of childhood abuse. Criminal Justice and Behavior, 28(5), 543–563.

Sentencing Project, The. (2002). Mentally ill offenders in the criminal justice system: An analysis and prescription. Washington, DC: TSP, www.sentencingproject.org/news/pub9089.pdf.

Travis, J. (2000). But they all come back: Rethinking prisoner reentry. Washington, DC: Office of Justice Programs.

reFereNCes Allen, H. (Ed.). (2002). What works? Risk reduction: Interventions for special needs offenders. Lanham,

MD: American Correctional Association.

Browne, A. (1992) Violence against women. Journal of the American Medical Association, 267, 3184–3189.

Bureau of Justice Statistics (2000). Probation and Parole in the United States. Washington, D.C. Bureau of Justice Statistics (2002). Criminal offenders statistics. www.ojp.usdoj.gov/bjs/crimoff.htm.

Bureau of Justice Statistics (2003). Census of state and correctional facilities, 2000. www.ojp.usdoj. gov/bjs/dcf/dt.htm.

Bureau of Justice Statistics (2005). Substance dependence, abuse, and treatment of jail inmates, 2002.

Cullen, F., & Moon, M. (2002). Reaffirming rehabilitation: Public support for correctional treat- ment. In H. Allen (Ed.), What works? Risk reduction: Interventions for special needs offenders (pp. 7–26). Lanham, MD: American Correctional Association.

Cumming, G. (Ed.). (2001). Sex offender treatment in Vermont. www.mountainpridemedia.org/ oitm/issues/2001/sep2001/fea03_treatment.htm.

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