Welsh, Zajac and Bucklen (2014) focus on the effectiveness of prison-based therapeutic community (TC) drug treatment. The researchers state that although TC drug treatment is more intensive, it appears to be less effective that outpatient group counseling. The TC drug treatment is based on the evidence-based approach. Peer community is the principle aspect of the treatment. Clients go through a number of phases.
The treatment includes individual as well as group daily meetings, life skills groups, “participation in a therapeutic milieu with well-specified roles, privileges, and responsibilities” (Welsh et al., 2014, p. 152). This treatment also presupposes sanctions and rewards to facilitate the desirable behaviors. The researchers also note that the treatment is associated with reduced drug use. The participants of the research were male inmates in medium security prisons who had a documented history of alcohol or drug abuse (Welsh et al., 2014).
The patients did not have severe mental issues. Detainers were also excluded from the research. The treatment involved a mandatory aftercare program that lasted six months. The researchers compared the TC drug treatment and outpatient group counselling. The latter approach turned out to be more effective as it was associated with longer abstinence, increased motivation to change and become an effective member of the community.
To measure the effectiveness of this kind of treatment, it is necessary to apply relapse treatment outcome model. This model focuses on lifelong outcomes and the client’s abstinence (Hanser, Mire & Braddock, 2011). This model is the most suitable to measure TC drug treatment as the latter also focuses on lifelong abstinence since substance abuse is seen as one of contributing factors to criminal activity of the offenders (Welsh et al., 2014).
Brocato and Wagner (2008) note that motivation plays an important role in retention among drug abused. Hence, it can be effective to identify the extent to which participants of the TC drug treatment are motivated to avoid using drugs. This will help researchers predict the risk of retention.
Importantly, relapse treatment outcome model can help counsellors identify cost effectiveness of the TC drug treatment since it is possible to identify a particular period when offenders refrain from using drugs. Admittedly, more extended periods of abstinence mean that the program is effective. It is important to add that the TC drug treatment is an intensive program that is associated with quite substantial funding (meetings with counsellors, aftercare program) and, hence, it is important to identify exact periods of abstinence.
It is noteworthy that the model is associated with certain limitations, as individual characteristics of clients are not considered. Welsh et al. (2014) stress that characteristic features play a very important role in treatment and individuals may differently respond to it. Therefore, it is possible to include this aspect to the relapse treatment outcome model to be able to measure effectiveness of the treatment in a more efficient way.
In conclusion, it is possible to note that the effectiveness of TC drug treatment can be measured with the help of the relapse treatment outcome model if it is modified slightly. The model and the treatment focus on the major outcome, which is complete and lifelong abstinence. However, apart from identifying particular periods of abstinence, the model should also include (at least, brief) analysis of motivation as well as characteristic features of individuals.
Reference List
Brocato, J., & Wagner, E.F. (2008). Predictors of retention in an alternative-to-prison substance abuse treatment program. Criminal Justice and Behavior, 35(1), 99–119.
Hanser, R.D., Mire, S.M., & Braddock, A. (2011). Correctional counseling. Upper Saddle River, NJ: Pearson Education.
Welsh, W.N., Zajac, G., & Bucklen, K.B. (2014). For whom does prison-based drug treatment work? Results from a randomized experiment. Journal of Experimental Criminology, 10(2), 151-177.