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The Challenges of ReEntry


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The Challenges of ReEntry

  1. 1. Social Work Research – Professor M. Ragonese10/10/12Hillel GreeneExamining the Similarities of Negative Adjustment by Veterans and Ex-Offenders in the Re-Entry ProcessResearch Problem:The distress veterans encounter when returning home and re-integrating into societyhave been well documented (Doyle & Peterson, 2005; Ritchie,2005; Zajtchuk,1995).PostTraumatic Stress Disorder is much discussed (Riggs &Sermanian,2012), but a soldiers returnhome can also be accompanied by anxiety, adjustment disorder, psychotic behavior, andsubstance abuse, among other issues (Marshall, Prescott, Liberzon, Tamburrino, Calabrese,&Galea, 2012; Wain, 2005). While these problems arise from internal feelings,the complicationsgrow when interpersonal/relational situations are introduced. Interpersonal relationships betweenreturning veterans and spouses for example may be particularly troubled; extended separationcan lead to growing apart, infidelity, and divorce. Such conditionscan result in strained parent-child relationships with behavioral and adjustment problems becominga byproduct containedwithin the next generation(Galovski& Lyons, 2004).Of significant concern are the high levels of stress and severe adjustment veterans faceas they attempt to re-enter society,whichhave led them to experience depression and triggersuicide in increasingly higher numbers(National Guard, 2012; Zoroya, 2012). Prisoners recentlyreleased from custody have also been observed to be at higher risk for suicide than the generalpopulation (Konrad et al. 2007; Pratt, Appleby, Piper, Webb, Shaw, 2010).Thetroubles soldiersand ex-offenders face when re-integrating into society are quite similar (connecting with family,obtaining steady employment, substance abuse issues, loss of a peer group). Soldiersreturn with
  2. 2. 2health insurance via the VA, hopefully have some savings due to paychecks accumulated whileserving abroad where they had minimal expenses, possess valuable skills and confidence, andencounter supportive family members and a society appreciative of their service, with supportgroups in place for camaraderie.Conversely,ex-offenders have no insurance in place upon theirrelease,often suffer from a host of medical issues, and are forced to navigate the bureaucracy ofthe Medicaid system (Mellow, Schlager, and Caplan, 2008). They are normally lacking ineducation, have had little chance to save up any money (even if they were in a paying prison jobthe salary rate is notoriously low), and may have limited housing options(Baillargeon, Hoge, andPenn, 2010).Despite these differences, the two populations encounter similar challenges as theyattempt to reenter society and continue with their lives.Social Workersare committed to enhancing human wellbeing and helping to meet thebasic needs of all people. Attention to environmental forces that create and contribute toproblems in living is specifically identified by the NASW in the Code of Ethics(2008) as afunction of our profession. As both the military-industrial complex and the criminal justicesystem continue to grow with few signs of reform, an obligation exists for researchers to focuson alleviating the challenges individuals face as products of these systems. The perpetualreproduction of experiences with such adverse consequences requires that researchers examine--in the hopes of determining and eliminating--the causes of the issues that individuals face upontheir re-entry into society. Documenting the parallel difficulties faced by the two populations,this paper will examine and compare their re-entry processes, noting the barriers and supportsboth returning soldiers and ex-offenders face when returning home, with the aim ofidentifyinginterventions that may be effective when applied to an individual from either group.
  3. 3. 3Literature Review:Though one group is often vilified by society, and another is lionized, a review of theliterature shows that prisoners and soldiers are quite similar in many respects. Recent research(Doyle & Peterson, 2005; Ritchie, 2005; Zajtchuk,1995) has documented the troubles veteransface when attempting to transition to civilian life. Similarly, ex-offenders returning home fromprison have been shown to encounter difficulty as they attempt to reintegrate intosociety(Baillargeon, Hoge, and Penn, 2010;Mellow, Schlager, and Caplan, 2008). Thesimilarities extend not only to the troubles they face when attempting to reintegrate back intotheir home lives with loved ones and peers, but also to the environments that isolated them fromthe rest of society in the first place. The experiences that each group undergo marks themuniquely, and with stereotyped beliefs about the two populations becoming more prevalent in ourculture via portrayals in the media, may cause them to internalize a stigmatized label. Whilemuch research has been done on these two distinct populations independently, this review hasfound no studies comparing the two populations, the environments that shape them, how theycope with their struggles and the negative effects incurred during their respective reentryprocesses, or how they may come to view themselves as a result of their similar experiences.This study proposes that an examination of these populations together can be beneficial byexploring these aspects with an aim to identify effective interventions that can have a positiveimpact when applied to the alternative population. Programs and treatments for these populationstarget similar problems and either might benefit from an approach meant for the other;additionally, the comparison study may result in ideas for new interventions with both groups inmind.
  4. 4. 4Prevalence:Recent records (Bureau of Justice Statistics, 2010) indicate that the number of adultoffenders on parole or other post-prison supervision in the United States increased slightly (up0.3 percent), reaching about 840,700 parolees at year end. Approximately 13 percent of paroleeswere reincarcerated at some time during that year (BJS, 2010) and many incidents of paroleesviolating their conditions of release, including re-arrest, and abuse of drugs or alcohol, do notautomatically result in revocation or reincarceration. Few parolees complete their supervisionterms without an infraction of a technical violation and despite assistance upon their release,parolees encounter significant problems with substance abuse, employment, housing, depression,aggression, and interpersonal relations (Bahr, Harris, Fisher, Armstrong, 2010; Baillargeion,Hoge, Penn, 2010; Boxer, Middlemass, &DeLorenzo, 2009).Since October 2001, approximately 1.64 million U.S. troops have deployed as part ofOperation Enduring Freedom (OEF) in Afghanistanand Operation Iraqi Freedom (OIF)(Adamson et al. 2008). Deployments for these operations have been longer, used a higherproportion of the armed forces, commonly involved redeployment, and provided infrequentbreaks between deployments (Hosek, Kavanagh, and Miller, 2006). The advances made inmedical technology and military hardware translates to a greater number of servicememberssurviving experiences that would have led to death in prior wars (Regan, 2004; Warden, 2006).These experiences can last years due to multiple deployments and involve frequent exposure tothreatssuch as improvised explosive devices (IEDs) and attacks from supposed allies (green onblue attacks) which require a vigilant awareness of possible threats in ones surroundings.While advances allow more soldiers to return with fewer physical injuries, many returnwith hidden wounds, mental health conditions and impairments to reintegration resulting from
  5. 5. 5military experiences. Nearly 20 percent of military service members who have returned fromIraq and Afghanistan — 300,000 in all — report symptoms of posttraumatic stress disorder(PTSD) or major depression, yet only slightly more than half of those have sought treatment(Adamson et al. 2008; Wain et al. 2005). Certain literature (Galovski& Lyons, 2004; Khaylis,2011) has demonstrated the tendency of veterans to use negative coping mechanisms to deal withsuch symptoms. Future research focused on dealing with the stigma veterans associate withseeking mental health treatment could help alleviate some of the barriers they face whenreturning home. The combined number of individuals these phenomena affect seems to begrowing and would dictate that further research in this area is imperative.Environmental Similarities:The military and prison are both systems of rules and regulations; life is structured to apoint where routine almost becomes instinct. The shared living quarters lead to the formation ofstrong bonds between unit members (some of whom may know each other from previous periodsof deployment or incarceration). While passing downtime via gambling, talking and socializing,a sense of unity emerges against an explicit or subconsciously designated enemy, therebypromoting even greater cohesion amongst members of these two populations. Additionally, thesocial structure and atmosphere is highly affected by the fact that both populations arepredominantly male. More impactful than other parts of these highly regulated, testosterone-laden systems, is the fact that both soldiers and prisoners reside in dangerous environmentswhere they could encounter a life-threatening attack at any moment – such circumstances canlead to a level of hypervigiliance which produces an anxiety and ripeness for PTSD (Boxer,Middlemass, &DeLorenzo, 2009; Manderscheid, 2007; Wain et. al. 2012).
  6. 6. 6Adjustment Difficulties:As noted above (Adamson et. al. 2008), PTSD seems to be a pervasive diagnosis inveterans returning from deployment and recent literature has indicated that PTSD symptoms arepredictive of alcohol abuse (Marshal, 2012), associated with greater marital distress (Riggs,Byrne, Weathers, & Litz,1998), and lead to higher rates of intimate partner violence (Taft, Street,Marshall, Dowdall, Riggs, 2007) and higher rates of divorce (Prigerson,Maciejewski&Rosenheck, 2001). Additionally, studies of children of veterans with PTSD showthey experience greater rates of behavioral problems, academic difficulties, and socialimpairments (Harknass,1991; Jordan,1992). Further stress is added to the family whenemployment is factored in – previous literature documents soldiers difficulties coming back towork (Manderscheid, 2007), concerns with finances (Doyle & Peterson, 2005), and spousesfeelings of sole responsibility for meeting financial needs of the family (Solomon et al.,1992;Solomon, Kotler, and Mikulincer,1998). While much literature (Dettbarn, 2012;Mental Health,2012) has discussed the prevalence of mental health disorders within the prisoner population, asignificantly smaller amount of attention has been devoted to the damaging effects incarcerationcan have on the psyche. Existing research (Woolddredge, Wolff et al., & ODonnell and Edgar ascited in Boxer, Middlemass, &DeLorenzo, 2009) would indicate that between 10 to 20% of theprison population experience physical victimization, thereby creating an environment with anever-present threat of physical harm. These encounters with violent victimization and traumainducing conditions while incarcerated very well could lead to elevated anxiety for a significantnumber of prisoners.Securing full-time employment continues to be one of the most formidable tasks ex-offenders face when returning to society (Travis, Solomon, Waul, 2001), and previous research
  7. 7. 7records their difficulty engaging with family (Phillips and Lindsay, 2011; Kleis, 2010).Turney,Schnittker, and Wildeman (2012) documented that recent paternal incarceration increases amothers risk of a major depressive episode and her level of life dissatisfaction while a majorityof domestic violence crimes are committed by those who have previously been arrested, with asignificant number having previously violated community supervision (Feder& Henning, 2004).Exposure to parental incarceration is also associated with higher rates of maladjustment inchildren. Similar to the children of certain soldiers mentioned above who experience behavioralissues, the offspring of incarcerated parents are more likely than their peers to drop out of school(Trice and Brewster, 2004) and to be arrested (Murray and Farrington, 2005).Ex-offenders alsocite staying away from negative influences, and abusing drugs or alcohol (Bahr, Harris, Fisher,Armstrong, 2010) as common issues during community supervision.Studies (Phillips and Lindsay, 2011) characterize the use of drugs and alcohol ascoping mechanism for ex-offenders in the reentry process and indicate that the onset ofalcohol/substance abuse has been shown to parallel the onset of PTSD in combat veterans(Gaylord, 2006; Bremner, Southwick, Darnell, Charney,1996). Moreover the level at which oneengages in self-destructive behavior correlates to the severity of ones PTSD symptoms(Galovski& Lyons, 2004).Theory:Modified labeling theory (as described in Winnick& Bodkin, 2008) presumes stereotypedbeliefs are pervasive, and even shared by those so labeled. To account for or manage a highlydiscredited status, those labeled will adopt some sort of stigma management strategy, includinghiding the discredited status (secrecy), avoiding social interaction (withdrawal), and education
  8. 8. 8(preventative telling). Some ex-offenders deal with their label as an "ex-con" by immediatelyowning up to their status; rather than a boss or new personal contact finding out about theirconviction somehow, they will preventatively inform them about their crime or parole status withthe belief that their honesty and forthrightness will be proof of their reform. While this method ofstigma management could result in immediate rejection and further stigmatization, it also givesthe individual greater prospects than withdrawal, which keeps one positioned outside theopportunity structure, and secrecy which increases tension and precludes close personalrelationships. In modified labeling theory, secondary deviance, such as an arrest or substanceabuse while on parole, is not a direct result of the internalization of the negative label, but ratheran indirect result of coping or stigma management which make deviant behavior more likely (forexample, a parolee who avoids talking to his childs mother might put additional stress on therelationship, thereby prompting further arguments and her reporting any non-compliance by theex-offender to police or parole). Phillips and Lindsay (2011) studied the struggles of those whowere not successful during reentry to identify how these parolees coped when faced with animpediment to their success reintegration. They identified avoidance as the predominant method,in which people seek to evade the precipitators of stress with methods such as abusingsubstances, avoiding stressors, such as family and treatment, isolating oneself from friends orfamily, and engaging in high risk sexual behavior. While avoidance may produce positiveoutcomes shortly after applying the strategy, it is associated with negative long-term outcomes(Suls& Fletcher, 1985).Ex-offenders internalization of societys label as pariahs leads them to anticipaterejection and believe they will be better off if they can hide their status or withdraw from socialsituations where their presence may create a negative reaction. Veterans of OIF and OEF may be
  9. 9. 9experiencing modified labeling theory in similar ways for various reasons; encounteringtremendous fanfare and proclamations of heroism may reinforce the military culture into whichthey were indoctrinated, which trains them to think they should be able to withstand any amountof pressure and manage any challenge. This mindset increases the stigma surrounding obtainingmental health treatment and may result in a soldier who is suffering from PTSD, depression oranother disorder, to resort to alternative coping mechanisms. Alternatively, the increased reportsby news media and scholarly journals has drawn attention to the numbers of soldiers returningfrom deployment with PTSD and other issues – an individual may seek to avoid beingcollectively diagnosed with a group of cohorts simply due to his/her veteran status with a labelthat society has characterized as damaged. As with ex-offenders, coping by avoidance may leadveterans to further isolation and secrecy, the maintenance and stressors of which compel them tocope via maladaptive mechanisms (e.g. lashing out at family, drug/alcohol abuse, etc.).Rational for Research:The similarities in environment and perpetual reproduction of experiences resulting in negativeadjustment requires that researchers examine--in the hopes of determining and alleviating--thecauses of the issues that individuals face upon their reentry into society. Ex-offendersinternalization of societys label as pariahs leads them to anticipate rejection and believe they willbe better off if they can hide their status or withdraw from social situations where their presencemay create a negative reaction. Veterans of OIF and OEF may be experiencing modified labelingtheory in similar ways for various reasons; encountering tremendous fanfare and proclamationsof heroism may reinforce the military culture into which they were indoctrinated, which trainsthem to think they should be able to withstand any amount of pressure and manage anychallenge. This mindset increases the stigma surrounding obtaining mental health treatment and
  10. 10. 10may result in a soldier who is suffering from PTSD, depression or another disorder, to resort toalternative coping mechanisms. Alternatively, the increased reports by news media and scholarlyjournals has drawn attention to the numbers of soldiers returning from deployment with PTSDand other issues – an individual may seek to avoid being collectively diagnosed with a group ofcohorts simply due to his/her veteran status with a label that society has characterized asdamaged. As with ex-offenders, coping by avoidance may lead veterans to further isolation andsecrecy, the maintenance and stressors of which compel them to cope via maladaptivemechanisms (e.g. lashing out at family, drug/alcohol abuse, etc.). This study proposesexploratory research to examine and compare the reentry processes, with particular attention tothe barriers and supports both returning soldiers and ex-offenders encounter when returninghome, seeking to determine if they are negatively affected by their label. It will considerapproaches that may allow for other means of coping with an aim of identifying treatmentmodels that would be effective when applied to both populations. Research questions willinclude: Do veterans associate a level of stigma with their label which precludes them fromobtaining mental health treatment? If so, is it due to a feeling of invulnerability inculcated bymilitary culture, or their anticipation of being classified as part of a damaged population? Doveterans, like ex-offenders, incur problems during reentry due to developing maladaptive copingmechanisms due to avoidance and secrecy? Would the preventative education strategysuccessfully used by many ex-offenders produce positive results for veterans or would they feelfurther stigmatized? Are there coping mechanisms veterans have used successfully duringreentry which ex-offenders might attempt to use? These questions indicate further research isneeded in this area and that these populations could benefit from being studied in conjunction.What is Negative Adjustment?
  11. 11. 11Merriam-Webster defines adjusted as having achieved an often specified and usually harmoniousrelationship with the environment or with other individuals. A negative adjustment thereforewould involve a person with a disharmonious relationship with their environment and/or otherindividuals. The literature documents individuals from these populations having issues in theirpersonal lives regarding employment, substance abuse, a predilection for risk-taking behavior,their personal behavior within the family unit, and how the family unit is affected by the personsbehavior. These categories are explored below with operationalized definitions as indicators ofnegative adjustment.Variables:Population:In attempting to examine the difficulties faced by veterans and ex-offenders for this study wemust first look at the existing literature to see how previous researchers have defined thesepopulations and measured their adjustment to reentering society. The term veteran can apply toindividuals associated with a host of many different branches of service and time periods. For thepurposes of this study, U.S. military servicemembers who were deployed overseas since 2001,with Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF) will be focused onbased on their recent experiences and the possible therapeutic implications this study may findfor this population which continues to struggle with issues of readjusting to society. Most studiesinvolving ex-offenders utilize individuals on parole, or those reentering society from prison,jail,or another detention facility of some kind. Participants of this study will be on federalsupervised release following a custody term in the Bureau of Prisons. As these populations areboth heavily compromised of men, the study will focus on recruiting men over the age of 18.Reentry is often referred to as the process after which prisoners are released and return back to
  12. 12. 12the community, for the purposes of this study it will be expanded to refer to the time periodveterans return home from deployment.Employment:As mentioned above, securing and maintaining full-time employment continues to be a majorchallenge for both ex-offenders face and veterans,(Travis, Solomon, Waul, 2001; Manderscheid,2007). Concerns with finances (Doyle & Peterson, 2005), and spouses feelings of soleresponsibility for meeting financial needs of the family (Solomon et al.,1992; Solomon, Kotler,and Mikulincer,1998) has been documented as well. As such, the variable for participantsemployment status will be considered with unemployment for a period over 6 months or havingworked numerous jobs since the start of reentry with each lasting on average less than 3 months,as measures of indicators of negative adjustment.Personal Behavior within Family:The most notable effects currently being reported regarding veterans returning from Iraq andAfghanistan are portrayed as symptoms of Post-Traumatic Stress Disorder (PTSD). Adamson (2008), notes that PTSD seems to be a pervasive diagnosis in veterans returning fromdeployment and recent literature has indicated that PTSD symptoms are associated with greatermarital distress (Riggs, Byrne, Weathers, & Litz,1998), lead to higher rates of intimate partnerviolence (Taft, Street, Marshall, Dowdall, Riggs, 2007) and higher rates of divorce (Prigerson,Maciejewski&Rosenheck, 2001). Previous research (Phillips and Lindsay, 2011; Kleis, 2010)similarly records the difficulty ex-offenders encounter engaging with family upon returninghome.Turney, Schnittker, and Wildeman (2012) documented that recent paternal incarcerationincreases a mothers risk of a major depressive episode and her level of life dissatisfaction whilea majority of domestic violence crimes are committed by those who have previously been
  13. 13. 13arrested, with a significant number having previously violated community supervision (Feder&Henning, 2004). In order to measure any stress in the relationship between the participant and hisspouse, researchers would include reports of withdrawal by participant from family activities,and changes in marital status such as divorce or separation, complaints by participants spouse ofdecrease in their own mental wellbeing or abuse by the participant (physical, verbal oremotional), and conversely, reports of feeling supported by loved ones.Effects on Family:The presence of children in the home adds an additional factor to measure in the participantsreintegration into the family unit. The offspring of incarcerated parents are more likely than theirpeers to drop out of school (Trice and Brewster, 2004) and to be arrested (Murray andFarrington, 2005).Similarly, studies of children of veterans with PTSD show they experiencegreater rates of behavioral problems, academic difficulties, and social impairments(Harknass,1991; Jordan,1992). Measurement of academic or behavioral problems beingexperienced by participants children would include drug or alcohol use, arrest, formal disciplineby school officials (including academic probation for poor grades), and an uncharacteristicallynegative attitude toward other family members/withdrawal from family activities.Substance Abuse:Ex-offenders advise that abuse of drugs or alcohol (Bahr, Harris, Fisher, Armstrong, 2010) is acommon recurring problem during community supervision. Phillips and Lindsay, (2011)characterize the use of drugs and alcohol as coping mechanism for ex-offenders in the reentryprocess and research that indicates that the onset of alcohol/substance abuse has been shown toparallel the onset of PTSD in combat veterans (Gaylord, 2006; Bremner, Southwick, Darnell,Charney,1996), is indicative that soldiers may similarly be using alcohol to cope with PTSD
  14. 14. 14symptoms. As such, abuse of alcohol or prescription medication (having 5 or more drinks peroccasion at least once per week/taking medication that was prescribed for someone else or takingones own prescription in a manner or dosage other than what was prescribed), and use of anyillegal drug would be included as a measure of negative adjustment under this studys variables.Predilection toward Risk:Ex-offenders also cite staying away from negative influences as an issue during communitysupervision (Bahr, Harris, Fisher, Armstrong, 2010) as association with others who have beenpreviously incarcerated can often lead to poor decision making and a groupthink mentalityleading to adverse consequences. Veterans are not as notorious for criminal behavior when theyare in one anothers company as ex-offenders, however Killgore et al. (2008), found that soldierswho saw combat were more likely to engage in risky behavior upon their return fromdeployment. This finding, coupled with the idea that only a fellow soldier can truly understand aveterans experiences, may lead to evidence of cohorts of veterans engaging in various dangerousactivities and risky behavior that has negative costs similar to the groups of ex-offenders. Thefinal determinant of negative adjustment will be the participants self-report of association withcohorts previously convicted of a felony, involved in criminal activity, or consistently (at leastonce a month) engaged in risky behavior (driving while under the influence, promiscuous sexualbehavior without protection, fighting, carrying a weapon, regular gambling(weekly), arrest,incarceration, and hospitalization – depending on circumstances).Methodology:As no research has yet been undertaken comparing this populations, this study would use amixed methods approach seeking to administer surveys and perform qualitative interviews asneeded for follow-up purposes with a minimum of ten and as many as twenty participants from
  15. 15. 15each population over the course of six weeks in order to determine if further studies with largergroups are warranted.Participants:Criteria for ex-offenders would include a term of imprisonment of at least 6 months and veteranswould need to have been deployed overseas for at least the same amount of time. Participantsfrom both populations would have begun the reentry process at least 6 months prior to theinterview in order to provide adequate time for assessment.Data Collection:Possible participants will be screened at a local parole office and veterans hospital (permissionto be obtained by administrators) following which interviews will take place either immediatelyonsite or at a time and place convenient to the interviewee. If needed, additional participants maybe collected via snowball sampling. Upon IRB approval, the Coping Inventory for StressfulSituations (Endler& Parker, 1999) would be purchased and administered to determine ifparticipants are coping via avoidance or other methods, and a customized questionnaire(attached) would be utilized to assess level of difficulty participants have experienced inadjustment.Analysis:Participants of the study would need to indicate a moderate level of difficulty in adjustment in atleast 2 out of the 5 variables defined above (employment, personal behavior within family,effects on family, substance abuse, and predilection towards risk) or severe difficulty in onevariable on the attached survey to qualify as experiencing a negative adjustment during reentry.This data would be broken down into the two populations and compared with one another tomeasure where each is having issues adjustment issues, the possible causes, and the supports
  16. 16. 16each have received to evaluate where further resources should be focused for future research andprogramming.As such, it is this researchers contention that this study will appropriately measure trouble inreintegration based on the previous literature with a definition of negative adjustmentincorporating the factors of employment status, home life, abuse of alcohol and illegalsubstances, and association with peer groups in which they engage in self-destructive behavior asexplained above. Follow-up qualitative interviews of veterans who have experienced little issuein adjusting upon their return may help shed light on how they have avoided the pitfalls intowhich their comrades are becoming increasingly entrenched. Such information on positivesupports or coping strategies may also be helpful for ex-offenders returning to society from longperiods of incarceration who have a history of failing to positively reintegrate during reentry.Simultaneously, the previous research and continued study of ex-offenders, who have long-suffered negative effects due to ill-repute, can possibly benefit veterans who are currentlyexperiencing their own epidemic of stigmatization and assist them in obtaining the interventionsneeded to make their safe return home successful.
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