Process Evaluation of Residential Substance Abuse Treatment Programs in Maine, 1999-2000
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The State of Maine Department of Corrections (MDOC) and the Office of Substance Abuse (OSA) at the Maine Department of Mental Health, Mental Retardation and Substance Abuse Services opened the Key Maine Therapeutic Community (TC) in March 1999, and its Transitional Treatment Program (TTP) for adult male inmates in January 2000. Spectrum Behavioral Services, Inc. (SBC) was subcontracted to implement the program, which was located at the Maine Correctional Facility in South Windham and the Pre-Release Center in Hallowell. The United States Department of Justice Residential Substance Abuse Treatment (RSAT) funded the initiative. This study was undertaken as a process evaluation of the program. To accomplish the aims of the process evaluation, research staff examined both program and client-level data that were collected throughout the first 15 months of the Key Maine TC's operation, a period that included the initial start-up period for the TTP. Part 1, Baseline Data, contains information on inmates, including age, ethnic group, education level, timing of all diplomas or degrees they had received, reasons for stopping school, marital and/or relationship status and history, and number and ages of children. The file also includes information on the last six months before being incarcerated, such as attendance at religious services, kind of housing and time spent there, as well as whom they lived with and the behavior of the inmate and their living companions in terms of alcohol and drug use. Also, there is information about how respondents supported themselves financially, including employment status and job information, such as number of days worked, number of jobs, part-time or full-time status, income, supplemental income, drug and alcohol use effects on employment, and whether they had dependants to support. In addition to information on the six months before incarceration, the file provides information on the inmate's substance abuse behaviors over his lifetime, including specific drugs used, the frequency used, and the age at which use of particular substances began. Information on substance abuse behaviors, such as specific substances used and frequency used in the last 30 days, is also recorded. Other variables in Part 1 focus on whether inmates' substance abuse had caused problems in major areas of their lives, such as family, employment, school, physical and mental health, relationships, and other substance abuse treatment received, including the type of treatment, duration of treatment, main substance abused, and reasons for entering treatment. Self-report data are available on each inmate's lifetime history of illegal activities, including, but not limited to, arrest history. This includes the offense(s) for which the inmate was currently serving time, as well as past offenses, jail time served, number of times incarcerated, illegal activities in which the inmate engaged during the last six months before incarceration, and time spent in probation during the last six months before incarceration. Information on visitors received during time in jail and contact (phone calls and letters) with others while in jail are included, as well as personal history information concerning the inmate's relationship with family and the activities they engaged in together. There is information on the friends the inmate had during the six months before incarceration, such as their education level, employment status, and relationship with family. Additional variables include whether the inmate reported having a history of child abuse, with details such as age at time of abuse, relationship with the abuser, frequency of abuse, perceived association of child abuse history to the inmate's substance abuse, the inmate's history as both victim of and perpetrator of violent crimes and weapon use, the inmate's sexual activity during the six months before incarceration, and his opinions about the chances of contracting HIV/AIDS. Other items pertain
Process Evaluation of the Residential Substance Abuse Treatment (RSAT) Program at the Illinois Youth Center, St. Charles, 1999-2000
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As part of the Violent Crime Control and Law Enforcement Act of 1994, Congress provided funding for the development of substance abuse treatment programs in state and local correctional facilities with the Residential Substance Abuse Treatment (RSAT) for State Prisoners Formula Grant Program. To be eligible for this funding, programs were required to last between six and 12 months, be provided in residential treatment facilities set apart from the general correctional population, be directed at the inmate's substance abuse problems, and be intended to develop the inmate's cognitive, behavioral, social, vocational, and other skills to address substance abuse and related problems. The Illinois Youth Center (IYC) in St. Charles started an RSAT program on September 30, 1999. The primary emphasis of this process evaluation was to describe why and how the St. Charles RSAT program was designed, implemented, and operated. To a lesser degree, attention was also directed toward examining the effects of program participation on offender pre-release behavior. This was considered to be a primary indicator of program impact. This project sought to answer the following research questions: (1) Did the program fit within the institutional environment? (2) Was the program operating as a therapeutic community? (3) Were the appropriate offenders selected for program participation? and (4) Were any short-term impacts evident within the youth? This study followed a process evaluation design with a focus on determining how a product or outcome was produced, rather than on assessing the product or outcome itself. Information in this data collection was collected from youth participants and youth files. Subjects consisted of the 44 youths who began the RSAT program in 1999 (the treatment group), as well as a matched sample of non-program participants (the comparison group). The comparison group was used to contrast institutional behavior of youths not in the treatment program and to establish a non-treatment cohort for an expected follow-up impact study. Part 1 contains data from two surveys of program youth only, and Parts 2-4 contained data on both program youth and the comparison group. Part 2 data were gathered from a review of the youths' master files at the correctional facility. Part 3 data were obtained from behavior action tickets (BATs), which were an institution-wide semi-formal mechanism to recognize positive and negative youth behavior. Part 4 data were collected from institutional disciplinary reports (IDRs). Part 1 surveyed youth about what they hoped to achieve in the RSAT program, whether they thought the program would help them, how well they understood the program, how they assessed their own substance abuse problems, what they liked and disliked about the program, their opinions about program staff, and their recommendations for changing the program. Demographic variables in Part 2 include age, race, and education level. Other variables record reading test scores, math test scores, IQ scores, location of parents, number of siblings, drug use and frequency, criminal history, types of prior substance abuse treatments, family history of drug use, suicidal ideations, and personality test scores. Part 3 contains monthly counts of positive and negative behavior action tickets. Part 4 contains information about the number and types of guilty institutional disciplinary reports, the severity of the offenses, and the number and types of punishments received.
Process Evaluation of the Residential Substance Abuse Treatment (RSAT) Program at the W.J. Maxey Boys Training School in Michigan, 1995-1998
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This study was an evaluation of a Residential Substance Abuse Treatment (RSAT) program intended to reduce substance abuse and recidivism among youth placed at the W.J. Maxey Boys Training School in Michigan. The purposes of the evaluation were to describe the activities of the RSAT program and the relationship between program participants and success in the new program. There were five primary evaluation questions: (1) Were the participants appropriate? (2) Was the staff trained to deliver the planned services? (3) How did service delivery vary over time? (4) Did the participants make timely progress? and (5) What organizational factors changed service delivery and participant progress? Residents were admitted to the RSAT program and its comparison group on the basis of three criteria: (1) the resident was not a sex offender, (2) he had a known substance abuse history, and (3) he was expected to be released within one year. Youth in the RSAT program underwent intensive substance abuse psycho-education and relapse prevention in addition to the treatment provided in the Maxey Model. Intake data from the Family Independence Agency Information System (Part 1) were gathered for youths who entered Maxey between 1995 and 1998. These data were used to determine if significant differences existed between the RSAT and comparison groups. Additional data were collected through a client survey (Parts 2 and 3), which included questions that evaluated youth satisfaction with services and their predictions for success. Variables in Part 1 include program admission date, whether the youth was a sex offender, substance abuse history, the group and wing to which the youth belonged, age of first offense, age of admission to Maxey, offense class, number of arrests, number of previous placements, number of truancies, legal status, and date of first and second offense. Demographic variables include race, age, marital status, and county. Variables in Parts 2 and 3 assess the youth's opinions about school, food, group sessions, hall staff, family sessions, family visits, the overall program at Maxey, teachers, police, and judges. Additional variables include last grade of school completed, expected educational goal upon leaving Maxey, family substance abuse history, and prevalence of substance abuse in neighborhood.
Evaluation of the New York City Department of Probation's Drug Treatment Initiative, 1991-1994
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This study was undertaken to evaluate the New York City Department of Probation's initiative to place clients in specialized Substance Abuse Verification and Enforcement (SAVE) units for treatment and management. The main analytical strategy of this study was to determine whether clients who were appropriately matched to outpatient drug treatment were less likely to recidivate after treatment in this modality. The focus of the research was not so much on developing powerful prediction models, but rather on determining whether outpatient drug treatment was appropriate and effective for certain types of probationers. The evaluation research involved an in-depth analysis of a sample of 1,860 probationers who were sentenced between September 1991-September 1992 and referred to contracting outpatient drug treatment programs one or more times as of December 31, 1993. The following types of data were collected: (1) the New York City Department of Probation's demographic and drug use information, obtained during the presentence investigation and at intake to probation, (2) the Department of Probation's Central Placement Unit (CPU) database records for each referral made through the CPU, as well as monthly progress reports filled out by the treatment programs on each probationer admitted to drug treatment, (3) the New York State Department of Criminal Justice Statistics' data on criminal histories, and (4) probation officers' reports on whether clients were referred to treatment, the kind of treatment modality to which they were referred, and the dates of admission and discharge. Demographic and socioeconomic variables include age at first arrest and sentencing, gender, race or ethnicity, marital status, family composition, educational attainment, and employment status. Other variables include drug use history (e.g., age at which drugs were first used, if the client's family members used drugs, if the client was actively using heroin, cocaine, or alcohol at time of intake into treatment), criminal history (e.g., age at first arrest, number of arrests, types of crimes, prior convictions, and prior probation and jail sentences), and drug treatment history (e.g., number and types of prior times in drug treatment, months since last treatment program, number of admissions to a CPU program, and number of AIDS education programs attended).
Process and Outcome Evaluation of the Residential Substance Abuse Treatment (RSAT) Program in Kyle, Texas, 1993-1995
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This study was undertaken to evaluate the treatment process and outcomes associated with a Residential Substance Abuse Treatment (RSAT) In-Prison Therapeutic Community (ITC) component of the 1991 Texas Criminal Justice Chemical Dependency Treatment Initiative, as well as to assess the effectiveness of prison-based drug treatment. Specifically, this study evaluated the RSAT ITC treatment process and outcomes in Kyle, Texas, using the prison-based treatment assessment (PTA) data systems. The study design included process and outcome evaluations using a sample of graduates from the first ITC treatment facility (Kyle cohort) and a matched comparison group of prison inmates who were eligible, but not selected, for assignment to an ITC. Data collection occurred at three points in time -- at the end of treatment in the Kyle ITC, and at six months and one year following an offender's release from the ITC program. Variables in the 19 files for this study include: Part 1 (Educational Demographic Data, Kyle Cohort): Highest grade level achieved by respondent, Texas Department of Criminal Justice education achievement and IQ scores, and the number of days at the Kyle ITC program. Parts 2-4 (Treatment Background Data, Kyle Cohort, Aftercare Treatment Data, Kyle Cohort, Treatment Condition Data, Kyle Cohort): Treatment condition, discharge codes, and whether there were three months of residential aftercare. Part 5 (Session One Interview Data, Kyle Cohort): Gender, ethnicity, age, marital status, whether the respondent was given medication, followed directions, made friends, or got into trouble while in elementary school, whether he held a job prior to prison, if either of his parents spent time with, yelled at, or sexually abused him, whether he used drugs, if so, specific drugs used (e.g., alcohol, inhalants, marijuana, or crack), and whether he did jail time. Part 6 (Session Two Interview Data, Kyle Cohort): Whether drugs kept the respondent from working, caused emotional problems, or caused medical problems, if people were important to the respondent, if he had trouble staying focused, felt sad or depressed, satisfied with life, lonely, nervous, or got mad easily, whether he felt the staff was caring and helpful, whether he showed concern for the group and accepted confrontation by the group, whether the respondent felt the counselor was easy to talk to, respected him, or taught him problem-solving, and whether the respondent viewed himself as thinking clearly, clearly expressing thoughts, and was interested in treatment. Part 7 (Session Three Interview Data, Kyle Cohort): How the respondent saw himself as a child, whether he was easily distracted, anxious, nervous, inattentive, short-tempered, stubborn, depressed, rebellious, irritable, moody, angry, or impulsive, whether the respondent had trouble with school, was considered normal by friends, ever lost a job or friends due to drinking or drug abuse, or was ever arrested or hospitalized for drug or alcohol abuse, and in the last week whether the respondent's mood was one of sadness, satisfaction, disappointment, irritation, or suicide. Parts 8 and 9 (Six-Month Follow-Up Interview Data, Kyle Cohort, and One-Year Follow-Up Interview Data, Kyle Cohort): Organization of meetings and activities in the program, rules and regulations, work assignments, privileges, individual counseling, the care and helpfulness of the treatment staff and custody staff, the respondent's behavior, mood, living situation, drug use, and arrests within the last six months, whether the counselor was easy to talk to, helped in motivating or building confidence, or assisted in making a treatment plan, whether the respondent felt a sense of family or closeness, if his family got along, enjoyed being together, got drunk together, used drugs together, or had arguments or fights, if the respondent had a job in the last six months to a year and if he enjoyed working, whether he was on time for his job, whether he had new
Process Evaluation of the Residential Substance Abuse Treatment Program at the Minnesota Department of Corrections, 1999
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The objective of this process evaluation was to evaluate the integrity of the Minnesota Correctional Facility (MCF)-Red Wing Residential Substance Abuse Treatment (RSAT) program service delivery system in order to (1) provide feedback designed to enhance the existing strengths of the RSAT program and improve any existing or potential weaknesses, and (2) prepare for a subsequent outcome evaluation. The process evaluation data consist of two administrations of the Correctional Institution Environment Scale (CIES) (Parts 1 and 2) and three rounds of Rating of Facilitation of RSAT Groups (Parts 3-5). Resident-participants in this study were male juvenile offenders incarcerated at the MCF-Red Wing who had been determined to have significant substance abuse problems as an aspect of their delinquency. A total of 69 residents participated in the RSAT program during the course of the evaluation. All RSAT program residents were required to participate in all aspects of the program. Four caseworkers, one chemical dependency counselor, and two teachers participated in all aspects of the process evaluation. Ten corrections officers and three administrators participated in the CIES administration. There are four forms of the Correctional Institution Environment Scale (CIES): (1) The Real Form (Form R), (2) the Short Form (Form S), (3) the Ideal Form (Form I), and (4) the Expectations Form (Form E). Form R and Form I were employed in this study. Form R measures resident and staff perceptions of the current or "actual" climate of the program. Form I is worded to allow residents and staff to answer questions in terms of an ideal program. Both forms are comprised of 90 true-false statements. The CIES was administered twice for this study, with the first administration in September 1999. Participants in this administration of the CIES were 28 residents of the Princeton Cottage (the cottage that housed the RSAT participants) and 12 staff (administrators, caseworkers, and corrections officers). The second administration was in December 1999. Participants in this administration were 25 residents of the Princeton Cottage and 10 staff (administrators, caseworkers, and corrections officers). The surveys were collected and sent to Marquette University investigators for scoring and interpretation. An extensive evaluation of group facilitation was undertaken, with all groups videotaped between May 1999 and September 1999. These videotapes were shipped to Marquette University for review. In total, 122 videotapes were reviewed and rated. Two randomly selected raters evaluated each tape on the 22-item Red Wing Global Scale developed for this evaluation. The primary components of the sessions evaluated by the rating scale involved (1) the adherence of the facilitators to the treatment model, (2) the skill level of the facilitators, and (3) the contribution of the residents to the group processes. Following training, the raters began rating the videotapes in a progression of three rounds (each round consisting of a month) conducted in June, August, and October of 1999.
Evaluation of the Residential Substance Abuse Treatment (RSAT) Program at the Southern New Mexico Correctional Facility, 1997-1998
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The goal for this study was to conduct a process evaluation of the Residential Substance Abuse Treatment (RSAT) program, called the Genesis program, at the Southern New Mexico Correctional Facility (SNMCD) by examining the program's structure and assessing its intermediate impact upon participating inmates. The study focuses on answering three research questions: (1) Who were the program participants? (2) What were the characteristics of the program? (3) Was the program reaching the most appropriate offenders, or were its participants primarily offenders who were not likely to become recidivists? The study contains information on every inmate who entered the Genesis program from July 31, 1997, to July 31, 1998. For evaluation purposes, the researchers designed their own data collection form which they used to collect relevant information from each participant's treatment program file. Each participant's file was maintained by Genesis program staff and was kept for the duration each inmate was in the program. From each program participant at intake, using the data collection instrument, the researchers collected demographic information, substance abuse history, and criminal history. The data are provided in two parts. Both parts are from the same data collection instrument. Part 1 covers Questions 1 through 15 of the data collection instrument, while Part 2 covers Questions 16 through 34 of the data collection instrument. Part 1 includes demographic variables about the inmate such as birth date, age, ethnicity, citizenship, years of education, prior employment status, longest employment, and average weekly income. It also includes incarceration information such as confinement date, length of current sentence, RSAT admission date, and expected parole date, and criminal history information such as age at first adult arrest, number of juvenile arrests, number of adult arrests, date of first adult arrest, date of last adult arrest, and number of years served in prison. There are also variables to address the inmate's drug use history as a juvenile and as an adult. Part 2 continues with the drug use history of the inmate as an adult with information about drugs used by IV injection, number of alcohol withdrawals, number of drug overdoses, number of detoxes, inpatient treatment received, outpatient treatment received, average amount of money spent on drugs, percentage of income spent on drugs, number of family members who use alcohol or drugs, and how they were related to the inmate. In addition, the file contains demographic information, such as current marital status and number of children, and the inmate's psychological history including depression, anxiety, anger, trouble understanding, concentrating, or remembering, attempted suicide, prescribed medication, and hospitalization. Criminal career variables include length of criminal career, all past charges, weapons used during any crime, number of times a weapon was used, and total number of convictions.
Evaluation of the Iowa State Residential Substance Abuse Treatment Program, 1998-1999
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This study sought (1) to set up a system to evaluate the operations and effectiveness of The Other Way (TOW) residential substance abuse treatment program at the Clarinda Correctional Facility in Clarinda, Iowa, and (2) to assist program staff in developing and implementing intake, discharge, and follow-up instruments and evaluation protocols to document inmate characteristics and changes over time related to substance use/abuse, mental health, social functioning, and criminal behavior and attitudes. Inmates are referred to this program if they have an identified need for residential-level substance abuse treatment and are within 12 months of release consideration. TOW is a voluntary, six-month long program that works with inmates to identify the causes of their addictive behaviors and encourage changes in unacceptable behaviors and criminal thinking. The sample for this study consists of adult male inmates at the Clarinda Correctional Facility between January 1998 and March 1999. The first point of data collection was the intake assessment. At intake, each subject completed an intake packet consisting of several instruments that measured variables relevant to TOW program goals. Each inmate was also given an Addiction Severity Index (ASI) interview by a counselor at intake. Upon discharge from the program, each subject completed a discharge packet, which contained instruments slightly different from those in the intake packet. Instruments were chosen for reliability and validity, ease of administration, potential for dual clinical and evaluation use, and whether they duplicated any existing efforts. Versions of the following instruments were included in both the intake and discharge packets: the Colorado Cognitive Assessment Questionnaire, Circumstances, Motivation, and Readiness (CMR) Scales for Substance Abuse Treatment, the Social Provisions Scale (SPS), the Self-Help Questionnaire, and the STEPS Questionnaire. A consumer satisfaction survey was also administered at the discharge interview. Variables obtained from answers to the ASI include gender, living situation, date of birth, race, religion, length of incarceration, medical status, education and employment history, sources of financial support, family/social relationships including abuse history, psychiatric status, drug and alcohol use including kinds of drugs used, length of use, age at first use, and frequency of use for each drug, personal problems caused by drug use, drug treatment history, legal history, and family history of drug, alcohol, and psychological problems. Intake assessment variables included are related to social attitudes, and include variables on life goals and the subjects' own views of their achievability, how subjects thought their friends viewed them, how wrong subjects thought certain illegal acts were, and criminal acts by the subjects' friends in the past six months. Discharge packet variables include the same variables on social attitudes as the intake packet as well as variables obtained from answers to the SPS relating to the amount of social support subjects felt they had, past involvement with self-help groups, and life attitudes related to drug/alcohol use.
Experimental Evaluation of Drug Testing and Treatment Interventions for Probationers in Maricopa County, Arizona, 1992-1994
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This data collection represents a combined experimental evaluation of a drug court program, implemented in 1992 in cooperation with the Maricopa County Adult Probation Department, in comparison to standard probation with different levels of drug testing. The experiment's objective was to compare the drug use and criminal behavior of probationers assigned to four alternative regimes or tracks: (1) standard probation, but no drug testing, (2) standard probation with random monthly drug tests, (3) standard probation with testing scheduled twice a week, and (4) drug court, an integrated program of drug testing, treatment, and sanctions that utilized a carefully structured set of rewards and punishments. The experiment was limited to first-time felony offenders convicted of drug possession or use (not sales) and sentenced to a term of three years' probation. A total of 630 probationers from Maricopa County were randomly assigned to one of the four experimental regimes and tracked for a 12-month period. Data collection efforts included: (1) background information on each participant, (2) process information on the characteristics of supervision and services provided under each experimental condition, and (3) follow-up data on subsequent drug use, crime, and pro-social activities for 12 full months. Background Data (Part 1) include demographic variables such as race, sex, education, marital status, living arrangements, and employment history. In addition, there are variables on prior drug use and abuse, drug treatment, criminal histories as both a juvenile and an adult, and risk and need assessment scores. Other variables include the results of drug testing and any sanctions taken for a positive result (Part 2), new arrests while on probation and corresponding disposition and conviction (Part 3), and technical violations and any actions taken for these violations (Part 4). For probationers assigned to drug court (Part 5) there are variables measuring probationers' status, probation recommendations, and judges' decisions at 11 different progress assessments. The follow-up information (Parts 6-8) includes monthly data on the status of the probationer, the number of face-to-face office contacts, phone contacts, work/school contacts, and community contacts, collateral checks, employment/school verification, counseling sessions, alcohol tests, drug tests, substance abuse treatment, the number of hours the probationer spent job hunting, in educational training, in vocational training, and in community service, the number of days employed full- and part-time, and the amount of earnings, fines paid, restitution paid, and fees paid.
Evaluation of the Focused Offender Disposition Program in Birmingham, Phoenix, and Chicago, 1988-1992
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The Drug Testing Technology/Focused Offender Disposition (FOD) program was designed to examine two issues regarding drug users in the criminal justice system: (1) the utility of need assessment instruments in appropriately determining the level of treatment and/or supervision needed by criminal offenders with a history of drug use, and (2) the use of urinalysis monitoring as a deterrent to subsequent drug use. This data collection consists of four datasets from three sites. The FOD program was first established in Birmingham, Alabama, and Phoenix, Arizona, in December 1988 and ran through August 1990. The Chicago, Illinois, program began in October 1990 and ended in March 1992. These first three programs studied probationers with a history of recent drug use who were not incarcerated while awaiting sentencing. The subjects were assessed with one of two different treatment instruments. Half of all clients were assessed with the objective Offender Profile Index (OPI) created by the National Association of State Alcohol and Drug Abuse Directors (NASADAD). The other half were assessed with the local instrument administered in each site by Treatment Alternatives to Street Crime (TASC), Inc. Regardless of which assessment procedure was used, offenders were then randomly assigned to one of two groups. Half of all offenders assessed by the OPI and half of the offenders assessed by the local instrument were assigned to a control group that received only random urinalysis monitoring regardless of the drug treatment intervention strategy prescribed by the assessment instrument. The other half of offenders in each assessment group were assigned to a treatment group that received appropriate drug intervention treatment. The Phoenix pilot study (Part 4), which ran from March 1991 to May 1992, was designed like the first Phoenix study, except that the sample for the pilot study was drawn from convicted felons who were jailed prior to sentencing and who were expected to be sentenced to probation. These data contain administrative information, such as current offense, number of arrests, number of convictions, and prior charges. The need assessment instruments were used to gather data on clients' living arrangements, educational and vocational backgrounds, friendships, history of mental problems, drug use history, and scores measuring stakes in conformity. In addition, the study specifically collected information on the monitoring of the clients while in the FOD program, including the number of urinalyses administered and their results, as well as the placement of clients in treatment programs. The files also contain demographic information, such as age, race, sex, and education.