Part IV—Summaries of Programs

Chapter 8—Summaries of CSAT Women’s Programs for Offenders

This chapter provides an overview of the key components of nine women’s prison and jail demonstration programs supported by the Center for Substance Abuse Treatment (CSAT). The materials that these programs are prepared to share with others are listed at the end of each description. Contacts are also listed, so that program administrators and others may request additional information about these demonstration projects. More extensive program summaries, histories of program implementation, and costs and evaluation results from most of these grant programs are also contained in an unpublished document (CSAT’s Criminal Justice Program Briefs 1998).

Prison-based Demonstration Projects

Choices TC Program, Pine Bluff, Arkansas

The Choices Program, operated by the Arkansas Department of Community Punishment (DCP), offers a modified therapeutic community treatment program with a minimum stay of 90 days to 24 months. This institution is designed to serve only those offenders with nonviolent offenses. Many are first-time offenders—a population with a good opportunity to change their lives. The modified TC program, with a capacity of 50 clients, serves approximately 260 people per year and is available to both male and female residents in separate housing arrangements. To date, 149 residents have completed the program. Random drug testing occurs in this facility about once every 2 to 3 weeks. After completing the program, most participants proceed to probation and parole.

DCP and treatment staff have established linkages with mental health, substance abuse, and other health providers in the community to assist program participants with their transition back to the community. Many participants complete the treatment component before completing their sentence, and initially these women had to be released back into the general population in the facility before being released into their communities. In spring 1996, a separate dormitory was made available so those who have completed treatment can remain together while finishing their sentences without
returning to the general population.

The program offers a range of services from vocational counseling to parenting training. Choices is unique in part because it is the only residential treatment occurring in a secure community corrections setting, where the goal is rehabilitation and treatment. The institution is designed as an alternative to prison because of the lack of prison bed space.

Data from the CHOICES program show that as of July 30, 1997, 699 clients had been admitted to the program and 452 had successfully completed it, five had received participation certificates, 80 residents were currently participating, and 137 clients had been discharged. The discharged figure includes those who could not complete the program for reasons outside their control. Based on its initial success with the TC modality, all community punishment facilities in Arkansas are now being converted to modified therapeutic communities.

Materials available: A short guide on how to use and integrate a Rope Course into a treatment program.
Contact: Glenda L. Spratt,
Arkansas Department of Community Punishment,
105 West Capitol Ave.,
2 Union National Plaza,
2nd floor, Little Rock,
Arkansas 72201,
phone 501682-9570,
fax 501-682-9534

Delores J. Baylor Women’s Correctional Institution (WCI) Village TC Program, Wilmington, Delaware

Roughly 42 women at a time live and work together in this State prison-based modified therapeutic community (TC), where the women share a positive family environment for 6 to 18 months. The program combines TC therapy strategies with culturally sensitive approaches designed to meet the needs of women. A “women oriented” focus is used to deal with issues of self-esteem, sexuality/intimacy, interpersonal skills, relationships with family and significant others, cultural/ ethnic identity, parenting, health issues, empowerment, job skills, leisure time, and drug/alcohol use. Village staff is primarily female. Among the many techniques used are transactional analysis, psychodrama, branch groups, encounter and feelings groups, and seminars.

Recently, the Village added a new aftercare component. Prior to their release, an aftercare coordinator works with the women to arrange transitional care in community-based residential drug treatment programs. This includes preparing the women to go before the Parole Board, transferring them from WCI Village to the CREST Outreach Center, and providing them with educational, vocational, mental health, medical, and social services. Most residents enter a coeducational work-release TC. After this treatment phase is completed, the Village coordinator continues to assure that ongoing support services and social supports are available.

Materials available: A program manual for participants in English and in Spanish and curriculum outlines.

Contact: Gwen Empson,
Program Director,
WCI Village,
660 Baylor Boulevard,
New Castle, Delaware 19720,
phone
(302) 577-3004, ext. 1224,
fax (302) 577-5861

Forever Free Program, California Institution for Women, Frontera, California

Forever Free provides an intensive in-prison treatment program lasting for a minimum of 6 months, with women participating in drug treatment programming for 20 hours per week. The women also participate in the prison work program for an additional 20 hours. Since 1991, the program has served 1,723 women. Approximately 250 women enter the program each year; the monthly caseload is 120 women.

However, this original program is now being expanded. In August 1997, the California legislature decided to double the in-prison program and to add $500,000 annually to the community aftercare component. This expanded treatment program will now serve 240 women per month in prison and will place 50 percent of program graduates into contracted community treatment. The in-prison treatment staff will double and the program’s annual capacity will expand from 250 to 500 women.

In prison, 60 women will start the intensive treatment program every 6 weeks, entering closed groups of 15 each. These groups will experience all six components of the program, which are: recovery education, relapse prevention, women’s workshops, Reasoning and Rehabilitation, 12-Step groups, and case management. In California, prison inmates are required to work 8 hours per day. The Forever Free participants receive 4 hours of work credit for the time they spend in treatment and, in addition, work 4 hours a day. Twenty program participants receive random drug testing each week, with additional urine testing performed if drug use is suspected. Over the life of the program, the overall rate of positive urines has been less than 2 percent among program participants.

Under the planned expansion, 50 percent of Forever Free participants will have access to 6 months of community aftercare through contracted treatment slots. The expanded program offers community aftercare placement in any California county, whereas the original placement program offered community aftercare in just four targeted southern California counties. Based on the availability of local county funding, it will be possible to make additional community referrals.

Over the program’s 6-year history, three separate outcome evaluations have looked at program effectiveness. Results have consistently indicated that length of time in treatment relates to success on parole, and that best outcomes occur when in-prison treatment is combined with 5 months or more of community aftercare. More than 91 percent of entering participants have completed the in-prison program. The dropout rate has been less than 6 percent, with 3 percent of participants removed for logistical or judicial reasons. Results indicate that 38 percent of program dropouts were successful on parole compared to a success rate of 62 percent among program graduates, of 72 percent among program graduates who enter residential community treatment, and of 90 percent success on parole among program graduates who remain in residential aftercare for 5 months or more.

Contact: Angela Knox or Dick Jeske,
Forever Free Program Coordinators,
California Institution for Women,
16756 Chino Corona Road,
Frontera, California 91720,
phone 909-597-1771, ext. 6570,
fax 909-597-7596.

Recovery In Focus Program, Salem, Oregon

This 6-month pre-release day treatment program is a modified TC serving incarcerated women who volunteer at Oregon Women’s Correctional Center. The program provides substance abuse treatment services, as well as family and life skills to female inmates within 4 to 6 months of release. Goals are to promote treatment and recovery; prevent recidivism, relapse, and homelessness; and to reunite women with their children. Pregnant women and women with children receive priority. Clients receive group and some individual therapy aimed at enhancing family, parenting, and life skills, as well as providing tools for job searches, self-esteem, and self-empowerment. Women receive family and child visitations supervised by a family therapist.

The transition component includes such elements as individual release/relapse prevention planning, transitional leaves, work release, and an individually matched mentor. The mentor is a volunteer from the woman’s home community who is assigned before the client leaves the Recovery In Focus Program. Volunteers, who make a 6-month commitment and receive training, serve as guides and role models as well as positive support persons for the women.

An outcome evaluation of In Focus clients found that those who complete the program have fewer subsequent arrests, fewer acts of absconding, and are better adjusted to community life than clients who do not complete the program (primarily because of institutional transfers) or than women offenders who need AOD treatment in prison but do not receive it (Finigan 1997). The study compared 211 women: 93 who had competed the program, 62 non-completers, and a comparison group of 56 women. In Focus was effective in referring women into community treatment and motivating them to complete it. Of program completers, 84 percent entered community treatment after their release and nearly half (46 percent) completed it, compared with 48 percent and 28 percent respectively for the comparison group.

During the 1-year period after release from prison, women who completed the In Focus program had significantly fewer rearrests for new crimes and fewer acts of absconding during parole—an act that signals not only loss of supervision but often the return to a criminal lifestyle. Data showed:

• Program completers: Only 30 percent had a new subsequent arrest, with 31 total acts of absconding per 100 participants
• Program noncompleters: 44 percent had a new subsequent arrest, with 101 total acts of absconding per 100 non-completers
• Comparison no-treatment women: 65 percent had a new subsequent arrest, with 121 total acts of absconding per 100 women who needed but did not participate in the In Focus program.

In the year after release, In Focus program completers, compared to the noncompleters and comparison women, had entered or participated in more community-based self-improvement programs and had made more efforts to gain employment, to be involved in training, or to gain financial stability.

Materials available: An information packet and guidelines for mentors in the aftercare program. Client materials include a self-rating behavioral assessment tool (for personal accountability), a behavioral treatment contract, AA/NA meetings attendance report form, recovery worksheets, and a personal release/ relapse prevention discharge plan form.

Contact: Linda Clays,
Recovery In Focus Program,
2809 State St.,
Salem, Oregon 97310,
phone 503373-1928,
fax 503-378-8370.

Jail-based Demonstration Projects

Sisters in Sober Treatment and Empowered Recovery (SISTER) TC Program, San Francisco, California

The SISTER Program is a jail-based modified therapeutic community for women operated by the San Francisco Sheriff ’s Department in County Jail Number 8. The program, set in a separate pod in the jail, has a capacity of 56 clients; the average length of stay is 53 days. Clients have a presentence or sentenced status, and the program is voluntary. About 225 clients were served during the 1994-95 fiscal year.

Within this modified therapeutic community, a wide range of clinical and ancillary services are provided, including group and individual counseling; acupuncture 5 days a week; parenting programs; GED, literacy, and writing training; HIV education and counseling; and specific counseling for prostitutes in a group called “EX-SEX Workers Group.” The program has special groups for lesbian and bisexual women; culturally specific groups for African Americans, Hispanics, and Pacific Islanders; and AA/NA meetings in the facility in both English and Spanish. Clients are tested for drugs if staff suspect use.

Aftercare is an important component of the program. Pre-release planning includes vocational and educational assessment, job training, and relapse prevention work 5 days a week. Residential treatment is provided in the community for some women at Walden House, and residential treatment for pregnant women is provided in the community by Jelani House. The program is beginning new initiatives for women unable to access these limited community services, including an outpatient alumnae group that will meet in the evenings and a SISTER support group.

A 3-year outcome evaluation of the SISTER Program concluded that this “in-custody jail- based substance abuse treatment is effective in decreasing substance use and decreasing the involvement of women in the criminal justice system due to substance abuse problems” (Santiago et al. 1996). This study analyzed the county arrest records of 146 out of 811 participants at 1 year after their successful discharge from the SISTER program. To analyze recidivism factors, the evaluation team studied 104 women who went through SISTER, looking at rearrest data 1 year after the women were discharged from the program. The program was most effective for African-American women between 30 and 40 years of age who had substance abuse problems but were not diagnosed with severe depression. Findings included:

• Decrease in recidivism. Women treated in the SISTER program were rearrested 50 percent less often than comparison group women. In addition, there was a longer period before rearrest for the SISTER women than for the comparison group.
• Decrease in violent crimes. The SISTER women were rearrested for less severe or violent crimes than the comparison group women. The program was also effective in reducing drug-related crimes.
• Importance of post-release treatment. The SISTER participants who were most successful were those who went to a community residential treatment program after discharge from the SISTER program.

The evaluators found that women who received acupuncture and participated intensively in treatment program activities were less likely to be rearrested.

Materials available: A program manual. Also an introductory booklet for women entering the SISTER Project titled “SISTER Project ABCs,” which contains a warm and welcoming explanation about women’s treatment and the caring family environment the program provides, as well as program/contract rules and worker assignments.

Contact: Ramona Massey,
Program Director,
SISTER Project,
SISTER Project/Sheriff’s Department,
425 Seventh Street,
San Francisco, California 94103,
phone 415-522-8000,
fax 415-5228056

Stepping Out TC Project, San Diego, California

This in-custody residential treatment program for women is operated at Las Colinas Detention Facility by the Community Connection Resource Center. Stepping Out is a 64-bed modified therapeutic community for sentenced inmates who have a minimum of 50 days remaining to serve. Women average 62 days in treatment, but have stayed as long as 179 days. The program is eclectic in design, incorporating elements of the TC and social model modalities in a cognitive behavioral framework.

The women participate in educational and process groups and receive individualized case management services. Elders in the program assist with orientation, housekeeping duties, and other assignments. The program’s own registered nurse provides comprehensive medical screening, tests for STDs and other communicable diseases, and health education. Two deputies are assigned to the program, who assist with screening and movement of the inmates. Recommended levels of treatment following release are assessed by the Adult Substance Abuse Survey (ASUS) and the Level of Supervision Inventory (LSI), combining substance abuse severity and criminogenic factors. These instruments serve as a guide for treatment planning. Aftercare case managers facilitate transition into the community, driving participants from the jail at release to their appointed destinations. The Stepping Out Project uses bilingual program materials.

Stepping Out operates an aftercare component which provides intensive outpatient treatment services and sober living. Up to six Stepping Out participants can live in the program’s own women’s sober living house, or be placed in other sober living environments paid for by the program for the first 30 days. The program provides a holistic continuum of care facilitated by Community Connection’s extensive service network for offenders in San Diego County. Additional services for Stepping Out clients include job development and placement assistance, referrals to supportive services, clean and sober recreation, and “Freedom 1st,” the agency’s mutual-help group created by and for ex-offenders.

An outcome evaluation was conducted for 174 women inmates who participated in the Stepping Out program between August 15, 1994 and August 15, 1995 (Paredes 1997). The study used criminal justice followup data for 1 year after participants’ release. Outcomes were compared with those for a comparison group of 52 inmates who met the same basic criteria as Stepping Out participants, but who had not received AOD treatment in jail.

The evaluation showed a marked improvement in the arrest rates of women participants in months 4 through 12 of the followup period. The Stepping Out participants who had continued into community aftercare after their release were significantly less likely to be arrested and, if arrested, were less likely to be found guilty and convicted of their alleged crimes. The provision of clean and sober housing for the first month and a half of aftercare significantly increased a woman’s total time in treatment. Women who were provided only with aftercare treatment stayed in treatment for an average of 33 days. Women provided with both aftercare treatment and safe and sober housing stayed in treatment for 80 days, more than double the time for those in aftercare alone.

Contact: Anita Paredes,
Deputy Director,
Community Connection Resource Center,
4080 Centre Street,
San Diego, California 92103,
phone 619-2914790;
fax 619-291-4704

OPTIONS TC Program, Philadelphia, Pennsylvania (a family-oriented program affiliated with CSAT’s Target Cities grant program)

More than 8 of every 10 women offenders in the Philadelphia county jail system are chemically dependent. Since October 1992, more than 1,500 offenders have received intensive treatment in this nontraditional, 70-bed TC specifically designed for women. This TC employs a communal, noncompetitive approach instead of a more traditional hierarchical TC structure. The Center encourages clients to share leadership and responsibility in nonauthoritarian and nonabusive ways. Program committees give participants a chance to exercise leadership and practice cooperation.

Clients are referred to the Center by the courts, by social workers or other staff, and through self-referral. Each potential client is assessed for chemical use/misuse/abuse, psychiatric problems, and the woman’s ability to handle the intense TC experience. Women enter the program at any time through a Newcomers group. This group allows staff to assess each new client’s needs and adjustment problems and to determine suitable placement.

The program’s treatment structure—a series of 8-week cycles— is designed to fit the rapid turnover in a county prison population. Cycles are built around recovery and other issues, although some concerns remain constant (e.g., abuse, self-image, parenting, and codependency). Clients can enter at any stage in any cycle. Group therapy is the principal mode of treatment, supported by individual counseling and 12-Step meetings. Clients eligible for an early release program may also receive family therapy. An innovative video therapy project is used to enhance self disclosure, family reunification, and relapse management skills.

During incarceration, clients receive a wide array of services from other components of the Philadelphia Prisons System. An outreach coordinator provides for community resources, including education and services. In addition, a multi-agency, early parole project called Forensic Intensive Recovery provides access to community treatment slots for female offenders with substance abuse problems.
Materials available: Program contract and rules, cycle materials, information related to the special video project, and smoke-cessation materials.

Contact: Deborah Raddock,
Director,
OPTIONS Program,
Philadelphia Industrial Correctional Center,
8301 State Road,
Philadelphia, Pennsylvania 19136,
phone 215-685-7111;
fax 215-685-7199

Incarcerated Women’s Recovery Program, Seattle, Washington

This short-term, intensive program for women is housed in the North Rehabilitation Facility, a Seattle detention center. Average length of stay in the program is 14 to 17 days, although the model is designed for stays of 90 days or more. In 1995 approximately 1,000 women were admitted to the facility, and about 400 were involved in the Women’s Recovery Program. Up to 39 women can be provided substance abuse services at one time.

The primary treatment modality within the institution is “outpatient care,” with a focus on reducing recidivism. There is a special treatment group for chronic recidivists. Readiness for treatment is a major issue. Services include group counseling for substance abuse, chemical dependency education, relapse prevention, 12 step groups, anger management, an STD outreach project (including testing and on-site treatment), family counseling, adult basic education, GED testing and preparation for testing, general medical health services, acupuncture, mental health counseling, and housing placement assistance. Clients are tested for drugs if staff suspect use.

The program uses a 5-day “triage” process to assess clients. On day 1, clients fill out a two-page triage form. If necessary, a multi-page assessment is conducted in one or more topic areas. A four-person triage team—made up of three chemical dependency counselors and an employment development specialist—meets every day, reviewing all new admissions. The team looks for chemical dependency and vocational, educational, and mental health issues, among others. On day 2, the client receives a case manager and recommendations for programs and on days 3 and 4, she receives a detailed program briefing. A client begins classes on the fifth or sixth day.

The program has designed transition services that minimize service interruption. The case management strategy is to link the client to a community-based substance abuse provider. Residential treatment is provided at one facility and outpatient treatment at three locations. The program pays for some of these placements. In addition, two mental health counselors and a housing counselor begin working with the clients while they are in the institution, and continue to work with them while they are in the community.

Materials available: Cognitive-based women’s program curriculum based on stages of change and mastery of skills; participant materials for a group concerning “boosters” (chronic shoplifters).

Contact: Lucia Meijer,
North Rehabilitation Facility,
2002 N.E. 150th St., Building No. 23,
Seattle, Washington 98155,
phone 206296-6826,
fax 206-296-7585

Women’s Acupuncture and Awareness Center, Baltimore, Maryland

This short-term, 2-week intensive intervention program targets female substance abusers who are awaiting trial in the Baltimore City Detention Center (BCDC), primarily for drug-related offenses. Inmates selected for the program are those with less extensive histories of drug use and crime, who are likely to be released back to the streets at the time of trial.

Whenever possible, the women live in a single dormitory while they participate in the program, which combines structured individual and group rehabilitation services with acupuncture treatment 5 days per week. The program uses a short-term educational, skills-building, and motivational model, with special emphasis on enrolling women in community substance abuse services after their release. Twelve women participate in each cycle, and currently, 90 percent of participants graduate. More than 600 women graduated from the program between August 1993 and August 1995.

The daily psychosocial sessions address not only drug dependency, but related issues that the women must resolve if they are to achieve long-term improvement. Educational groups focus on such relapse prevention skills as anger management, assertive communication, drug refusal skills, and daily planning. In addition, clients participate daily in a 1-hour group therapy session to process women’s issues and concerns related to recovery. Finally, each client participates in a minimum of five individual counseling/case management sessions for treatment and aftercare planning with her assigned master’s-level therapist.

Women who remain incarcerated at the Detention Center after this intensive treatment receive aftercare. This aftercare includes a weekly acupuncture group and twice-weekly psychosocial groups that focus on motivating the women to enter post-release treatment in the community. When released, many graduates receive supportive services and sentencing inducements, with most aftercare provided by the Johns Hopkins Hospital Comprehensive Women’s Center. Clients initially participate in an intensive day treatment program and graduate to less intensive care based on attendance, evidence of drug abstinence, and progress on critical goals of their individual treatment plans.

Contact: Mary E. McCaul, Ph.D.,
Comprehensive Women’s Center,
911 N. Broadway,
Baltimore, Maryland 21205,
phone 410-955-5439,
fax 410-9554769.

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