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Week 5a Readings
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Week 5a: Treatment of Offenders
Reading:
Over the past 30 years, a critical debate in the field of penology has been over the effectiveness of correctional treatment. Research findings and conclusions have varied, ranging from “nothing works” to “some things work” to “everything works.” This week’s readings provide snapshots into these varied conclusions, as well as overviews of treatment strategies that have been shown to be effective with specific types of offenders (i.e., drug addicted offenders). Beginning with Martinson’s classic work (Chapter 22 in Latessa et al.) that sought to ascertain what did work with treatment and his conclusion that nothing did work, to recent endeavors that seek to answer specific questions regarding effective treatment methods with special offender populations, the consumer of this literature is better equipped to understand elements comprising the effective treatment programs for correctional clients.
History/Overview
In 1974, Robert Martinson published a summary of an extensive research literature review that he conducted with his colleagues entitled “What Works?: Questions and Answers About Prison Reform.” The conclusions set forth by Martinson painted a dismal picture for American offender reform efforts. However, although Martinson’s conclusion was “nothing works” in American corrections, a close reading of his work relays another picture to consumers of the treatment literature: perhaps treatment is effective, but only with certain offenders, under certain circumstances, and under the auspices of certain organizations/agencies. Clearly, Martinson was attempting to dissuade the reader from concluding that some things may work; nevertheless, even a cursory reading of Martinson’s work indicates that such a conclusion is erroneous. Since the publication of Martinson’s work, many researchers, including Martinson himself, have sought to understand what exactly comprises effective offender treatment. Currently, penologists and psychologists do not have all the answers, but great strides have been made since the publication of Martinson’s review of treatment evaluation studies.
Since the early 1990s, great strides have been made in the area of treatment evaluation research, statistical meta-analyses of rehabilitation literature, and the overall confidence in the power of programming and service delivery. Leaders in this line of inquiry include Don A. Andrews, James Bonta, and Paul Gendreau (see Andrews et al., 1990). These researchers have conducted a vast amount of research indicating that treatment programs can effect positive change, but only in concert with three key conditions. These conditions are:
· Effective programs target high risk offenders (the risk principle) · Effective programs target criminogenic needs (the need principle) · Effective programs match the treatment modality to the offenders learning style and needs (the responsivity principle)
In their meta-analytic assessment of treatment programs, Andrews et al. found that community programs met the needs listed above more closely than institutional/residential programs. Clearly, this finding has not impacted the current imprisonment binge (link to Week 5: The Culture of Control).
What Works With Female Offenders?
Females are the fastest growing inmate population. Currently, females are incarcerated at a rate three times that of males. Hence, the need to understand what works in treating/rehabilitating female offenders is timely. Not surprisingly, this area of research and policy has been largely neglected. For many years, it was erroneously accepted that what worked for males also worked for females. However, qualitative work investigating treatment needs of females has uncovered several specific needs specific to females that must be addressed:
· Substance abuse treatment and education · Parenting and life-skill education · Abuse and victimization therapy
Researchers such as Dowden and Andrews (Chapter 26 in Latessa et al.) state that, as with males, effective programming for females must address the risk, need, and responsivity principles. However, specific criminogenic needs of females identified by Dowden and Andrews are family processes and victimization. Nevertheless, it remains unclear if the specific learning styles inherent to the female gender are a key factor of responsivity. Not surprisingly, much research is still needed concerning the effective treatment of female offenders.
Academic/Education, Vocational, and Work-Related Programs
A large number of treatment evaluation studies focus on prison educational initiatives, vocational training, and work/labor programs (Gerber and Fritsch, Chapter 28 in Latessa et al.; Wilson et al., Chapter 15 in Latessa et al.). Programs have met with mixed results, yet some findings are encouraging. The basic premise of such programming is that upon release, offenders will be deemed employable, thus they will have little incentive or time to engage in offending behavior. Furthermore, they will be skilled through the moral development inherent to such programming, and thus less likely to engage in physical altercations/violence upon release. In a review of recent research, Gerber and Fritsch note that, on the whole, adult prison education programs reduce recidivism. However, they do state that effective programs are strategically designed and contain elements that can be implemented in the community for service to the offender upon release from the institution. Unfortunately, Gerber and Fritsch do note that not all educational program participants have experienced success in the community. They specifically state that a GED program for female inmates had no effect on recidivism upon release from the institution. In fact, in a statistical meta-analysis of the extant literature concerning the effectiveness of adult basic education/GED programs, Wilson et al. found mixed results. They did, however, note that studies of this type were methodologically flawed (i.e., lack of adequate comparison groups/control groups, and a lack of control for selection bias).
The overall conclusions to be reached for vocational training upon review are similar. Completers of these programs tend to obtain post-release employment rates, maintain longer post-release employment, have fewer arrests, and have fewer parole violations. However, Gerber and Fritsch cited two studies of methodological rigor that do not indicate any effect of vocational training on post-release outcome. Nevertheless, Martinson, as well as Gerber and Fritsch, have noted that vocational training has more bearing on post-release success when offenders are able to obtain employment comparable to the training they have received while incarcerated. Wilson et al. reiterate this conclusion with their statistical meta-analysis, yet caution penologists from making broad conclusions from such studies due to their lack of generalizability.
Why are some educational, vocational, and work programs more effective than others? Gerber and Fritsch outline several key components to programming:
· More extensive educational programs are more likely to achieve their stated objectives · Programs separated from other prison programs are more effective · Programs that provide follow-up in the community upon release tend to be more successful · Programs that target offenders amenable to a particular treatment modality are more effective · Programs providing skills translatable to the current job market are more likely to be effective
Substance Abuse Treatment
Given the skyrocketing rate that America imprisons offenders (link to Week 5: The Culture of Control), it is no surprise that U.S. prisons house a great number of drug offenders. The imprisonment binge, coupled with the War on Drugs has resulted in record numbers of drug offenders behind bars, and hence the increased need for specialized treatment. Given the recognized medical nature of drug treatment by penologists, as well as the urgent unprecedented need of such treatment, it is a surprise that health organizations have very general and scarcely followed guidelines for the design and implementation of programs. A review of the literature by Peters and Steinburg (Chapter 23 in Latessa et al.) states that such programming can in fact be effective; however, certain conditions must be complied with. When these specifications are implemented on a widespread basis, penologist will begin to see more success with substance abuse treatment initiatives. These specifications include:
· Treatment of a cognitive-behavioral nature, occupying at least half of the offender’s time, and between three to nine months duration · Programs must target the criminogenic needs of offenders (substance abuse, antisocial attitudes/behaviors, peer associations, and self-control issues) · Treatment programs must be multi-modal service delivery · Treatment programs must have a structured incentive and sanction system · Therapists must be trained and have effective interpersonal skills · Programs must reduce negative peer influences · Programs must provide for relapse prevention and linkage to community resources
Treatment of Mentally Disordered Inmates
The number of mentally disordered offenders inhabiting American prisons has grown since the decarceration movement of the 1960s and 1970s. Thus, as with drug offenders, the need to know “what works?” with these offenders is especially salient. Yet, we know very little about programming for this special population of offenders. In a study of correctional officials in five states, Hartstone et al. (Chapter 27 in Latessa et al.) summarized the views and recommendations of study participants. Many officials felt that too many inmates live in the general prison population undiagnosed, and initiatives are need to help identify these special needs inmates. Furthermore, it was a pervasive belief of the staff members participating in the study that too few inmates are transferred to mental health facilities, as the correctional system is perhaps not equipped to manage and help these special needs inmates.
Peters and Steinburg cite an estimated 3-11% of inmates have co-occurring mental health and substance abuse disorders. As with mentally ill inmates, these special inmates often go undiagnosed, and thus untreated for both disorders. Mentally ill inmates with substance abuse problems need special programming, and staff must be specially trained to work with them. Recommendations cited by Peters and Steinburg include integrated approaches to assessment and treatment planning, long-term treatment, adequate provisions for after-care, and small client caseloads by specially trained staff.
What Does the Future Hold?
Clearly, the Martinson’s dismal conclusion has not been replicated in the empirical evaluations of the past 30 years. Penologists and psychologists have made great strides in determining “what works?” in treating offenders. Perhaps the most clear-cut conclusion one can make is that “one particular treatment modality will not work for all offenders.” More specifically, different types of offenders have different risks to consider, different criminogenic needs to be addressed, and different modes of responsivity. There is renewed interest in the questions and issues surrounding rehabilitation by penologists, even though retribution, incapacitation, and deterrence are at the forefront of penal public policy. Furthermore, although the public supports “get-tough” sentencing policies, evidence suggests equivocal support for rehabilitation programs for offenders once incarcerated (i.e., Applegate et al., Chapter 38 in Latessa et al.). Ethics and humane methods of treatment (i.e., Vaughn & Smith, Chapter 24 in Latessa et al.) must be of supreme focus when administering and evaluating rehabilitation programs. New advances in statistical applications will allow for adequate controls of study participants and study conditions. The advances made during the 1990s provide for a future in which penologist will be able to state with confidence that “under certain conditions, programs aiming to rehabilitate offenders do work.”
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