U NIT 6 By: Amy Ng, ABD, MSCJA

O BJECTIVES Weekly Reminders Holiday Info Drug Treatment

T REATMENT O PTIONS 12 Step Stepped Care Aftercare after release Legislatively mandated programs

12 S TEP C ARE AA NA Faith Based Treatment

S TEPPED C ARE Stepped Care Approach: This approach finds the appropriate level of treatment for those addicted to substances Levels of Stepped Care outpatient treatment (level one), intensive outpatient treatment (level two), residential treatment (level three), and detoxification (level four).

S TEPPED C ARE C ONT. Stepped Care will reduce the amount of drug related offenders in society, therefore reducing the amount of drug related offenders in prison. If there are less drug related offenders in prisons there are less drug related illnesses that must be treated.

A FTERCARE T REATMENT Continuing treatment within the community is necessary once released from prison. Researchers have discovered there to be a treatment period or sobriety period, but to reduce the chances of relapse they need to be in recovery. This recovery idea is known as long term treatment after de-tox or a stay in some sort of residential program. Most programs are known to have treatment and some sort of graduation, but there is little follow- up after the graduation (Yashinsky, 2007).

A FTERCARE T REATMENT C ONT. There is significant evidence that individuals who complete treatment are likely to relapse if individuals do not follow-up with counseling services. Of all individuals who complete treatment it was found that percent will be readmitted into treatment within a 12 month period, and an overwhelming 50 percent within two to five years after treatment completion. With the above stated statistics, further counseling services are necessary (Yashinsky, 2007).

A FTERCARE T REATMENT C ONT. It is important to define and discuss what types of counseling services and community services should be rendered after the completion of an intensive inpatient or outpatient program. These consist of techniques for reducing isolation and improving self image, increasing support systems, as well as creating new social structures with the peer setting. Therapists can assist in these efforts, since the majority of therapists working with addicted individuals are also recovering addicts. These therapists must be client centered and empathetic to their needs. A strong relationship must be formed between them, or there is a strong probability for relapse. Further, the therapists must understand that the client has the ultimate say in their actions, but must make positive recommendations that coincide with addiction recovery (Yashinsky, 2007).

D RUG T REATMENT Drug programs have been deemed effective in both the prison setting, as well as the community setting for reducing overall recidivism. There have been conflicting results in the effectiveness of drug treatment. Petersilia (2003) found that there has been considerably lower drug treatment participation in prisons. This is due to lack of access to the specific programs. Overall drug treatment is considered to be effective including therapeutic communities in reducing recidivism. Overall therapeutic communities are seen to have a 43 percent less recidivism rate than non participants (Mitchell & McKenzie, 2003). Travis (2001) found that drug treatment is most effective when a continuum of treatment is present throughout the correctional, treatment, and community intervention phases. It is also noted that the understanding of relapse with continuum programs tend to be assist the overall recidivism. Therefore, this program can be seen as an effective tool for reducing recidivism, and implementation into a community reintegration program can lower the risk of recidivism overall.

M ANDATORY TREATMENT Mandatory Treatment Programs California’s Proposition percent agreed with this proposition Views substance abuse as a medical condition rather than a criminal act. Mandates drug treatment and probation for drug offenders. No drug dealers allowed to participate in the program. Cannot refuse treatment or have prior violent felony convictions.

T REATMENT CONT. Prohibits judges from sending offenders to prison or jail. Severely limited judicial discretion. Mandatory probation services Limits the probation revocation process.

T REATMENT C ONT. In 2006, 35k people have completed the Proposition 36 treatment program. Saved over million in costs. Number of inmates for drug offenses in California dropped 34 percent.

O THER P ROGRAMS C ONT. Only 1 in 4 graduated from the program. ¼ of participants did not show up for their initial assessment. 1/3 recidivism rate Drug courts have much lower recidivism rates.

CBT Cognitive behavioral therapy in relation to substance abuse?