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1 Rehabilitation: The Ideal vs. The Context Faye S. Taxman, Danielle S. Rudes, Catherine Salzinger, Michael Caudy, & Amy Murphy George Mason University www.gmuace.org www.gmuace.org
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Rehabilitation 1.Educate in basic or vocational skills; 2.Involve in therapeutic activities to facilitate changes in attitudes, behaviors, or values; or, 3.Alter through punishment. The rehabilitation ideal provides a punitive experience with opportunities to learn to become a contributing member of society. 2
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Challenges: Providing rehabilitative services within correctional settings. Correctional settings do not allow for autonomy, they focus on control. (Toch, 1987; Goffman, 1961; Dahlen & Johnson, 2010) Correctional settings replace client-centered efforts with programming suitable for a punitive setting. (Dahlen & Johnson, 2010) Correctional settings affect staff actions and behaviors by emphasizing control. (Rudes, Lerch, & Taxman, 2011) Can “what works” (evidence-based practices) thrive within a correctional culture? 3
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Study—Mixed Methods Used RNR Program Tool for Adults to assess use of evidence-based practices and quality programming in one community (N=38) Content analysis of 4 common curriculums: Seeking Safety (SS), A Cognitive Behavioral Approach: Treating Cocaine Addiction (CBT), Thinking for a Change (T4C), & Strategies for Self-Improvement and Change (SSC) 4
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RNR Program Tool for Adults Ranks Programs Based on EBPs and “What Works” 5
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Average quality score (lowest scores in implementation and needs) 55/100 Average # of therapeutic approaches used3.5 % programs that use more controls than therapeutic approaches 53% % programs that use more sanctions than rewards53%
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Curriculum Review: Positive & Forward vs. Negative & Backward Criminal Justice Curricula Non-Criminal Justice Curricula T4CSSCSSCBT Present/Fwd Looking38%11%26%25% Positive/Supportive31%28%18%23% Backward Looking48%29%16%6% Negative Lang/Dir---17%45%38% Present/Positive 54%46% Backwd/Negative 47%52% 7
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Curriculum Review: Therapeutic Direction 8 “Show them how to do this” (T4C). “If the patient becomes upset, emphasize the emotional pain and then redirect the conversation to a neutral, present topic” (SS). Minimal use in CJ curricula (just 13 times total, <1%) More common in non-CJ curricula (59 occurrences; about 3% of codes).
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Implications of the Culture of Control Affects treatment programs in untold ways Structurally, programs reinforce the notion of control Difficult to build programs that focus on motivation and client-centered care Emphasis on risk management is directed at staff; privileging controls over incentives Curriculums reinforce the notion that individuals must change regardless of content 9
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Thank you! Questions & Comments Catherine Salzinger ssalzing@masonlive.gmu.edu 10
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