TY - JOUR
T1 - Treatment engagement in a prison-based Therapeutic Community
T2 - A mixed-methods approach
AU - Davidson, Kimberly M.
AU - Young, Jacob T.N.
N1 - Funding Information:
Financial support for this study was provided by the National Institutes of Health (Award Number R21AA023210 , PI: Derek Kreager). We thank Corey Whichard, Theodore Greenfelder, Elaine Arsenault, and Michaela Soyer for interview assistance. We thank Audrey Puckett for her assistance with preparing the manuscript. We also thank Bret Bucklen and PADOC for their valuable support of the TC-PINS project.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/8
Y1 - 2019/8
N2 - Given the high proportion of inmates with histories of substance use disorders in the era of mass incarceration, many correctional institutions have integrated the prison-based Therapeutic Community (TC) into their programming. While most evaluations provide evidence of lowered rates of relapse and recidivism, the majority of TC graduates still have negative outcomes post-release. Filling an important gap in the TC treatment literature, we analyze quantitative measures of treatment engagement alongside qualitative narratives from prison-based TC residents, providing an essential look into the black box of TC treatment mechanisms. Quantitative results show more between-person variation than within-person change, reflecting trivial increases in treatment engagement throughout time in the program. Qualitative results unpack these findings, pointing to processes of selection bias, heterogeneous treatment effects, and program fidelity lapses. In combination, our mixed data identify tangible modifications to program implementation that could strengthen desired post-release outcomes.
AB - Given the high proportion of inmates with histories of substance use disorders in the era of mass incarceration, many correctional institutions have integrated the prison-based Therapeutic Community (TC) into their programming. While most evaluations provide evidence of lowered rates of relapse and recidivism, the majority of TC graduates still have negative outcomes post-release. Filling an important gap in the TC treatment literature, we analyze quantitative measures of treatment engagement alongside qualitative narratives from prison-based TC residents, providing an essential look into the black box of TC treatment mechanisms. Quantitative results show more between-person variation than within-person change, reflecting trivial increases in treatment engagement throughout time in the program. Qualitative results unpack these findings, pointing to processes of selection bias, heterogeneous treatment effects, and program fidelity lapses. In combination, our mixed data identify tangible modifications to program implementation that could strengthen desired post-release outcomes.
KW - Corrections
KW - Mixed-methods
KW - Substance abuse
KW - Therapeutic Community
KW - Treatment engagement
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U2 - 10.1016/j.jsat.2019.05.011
DO - 10.1016/j.jsat.2019.05.011
M3 - Article
C2 - 31229190
AN - SCOPUS:85066028854
SN - 0740-5472
VL - 103
SP - 33
EP - 42
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
ER -