1. Substance Abuse Treatment used as an Alternative to Incarceration for Females By: Tara Hawkins Alliant International University

2. Incarceration statistics According to the White House Office of National Drug Control Policy (ONDCP) as of 1999, 6.3 million individuals were either incarcerated or on parole or probation (ONDCP, 2001). In 1998, 236,800 (21%) were incarcerated in the state prison system and 55,984 (59%) were incarcerated in the federal prison system for drug related offenses (ONDCP, 2001).

3. Female Incarceration statistics In 1997, 6,436 females were incarcerated in federal prison and 66,242 females were incarcerated in state prison (ONDCP, 2001). Women in state prisons were more likely than men to report using drugs in the month prior to committing their offense and women in state prisons were more likely than men to report committing their crime while under the influence of a substance (ONDCP, 2001).

4. Relational Theory and Female Incarceration “Miller’s Relational Theory posits that mutual, empathic and empowering relationships are central to women’s healthy psychological development, and positions relational qualities and activities as strengths and pathways to growth” (Lichtenwalter, Garase, & Barker, 2010).

5. Relational Theory and Female Incarceration According to relational theory, imprisonment for females is much more detrimental to the psyche than it is for males (Lichtenwalteret. al., 2010). While imprisoned, females experience disconnection, isolation, violation, oppression, and unsympathetic conditions all which can resurface past psychological trauma for the individual (Lichtenwalter et. al., 2010).

6. Relational Theory and Female Incarceration Even if incarcerated females have not experienced past psychological trauma, the hostile, violent, and chaotic living conditions in prison, can create long lasting psychosocial dysfunction in the individual that include depression, PTSD, and inappropriate coping mechanisms. Prison is a violent place which permits “little opportunity for the development of supportive, empowering or mutually empathetic relationships” (Lichtenwalteret. al., 2010).

7. Incarcerated Mothers When a mother is separated from her children during her incarceration, this can cause her stress and anxiety. Mothers have concern for the safety and well being of their children and being incarcerated is another damaging affect for the females’ psyche. Maintaining contact with family during incarceration serves as a predictor to how well the individual will reintegrate back into the community after her release for jail or prison (Lichtenwalter et. al., 2010).

8. Program Description Rather than sending females to jail or prison for drug related offenses, residential treatment will be mandated. A Therapeutic community will be implemented where women will be mandated to a live in facility for 6 to 12 months. Women are permitted to bring their children if they are under 12 years of age. If there are children over 12 years of age, overnight stays are permitted with good behavior.

9. Program Description Women who have been sentenced for multiple non-violent drug related offenses are designed for this program. There are 3 phases of the program: introduction, transition, and finalization In order to gain privileges and have their sentence in a prison or jail dismissed, women must complete each phase Treatment staff is a very important aspect of this recovery program

10. Introduction phase Women are first screened and assessed for co-occurring mental disorders, HIV, AIDS, Hepatitis, STDs, and a general physical is required. Cognitive behavioral therapy is introduced for the treatment of substance abuse. Parenting, communication skills, anger management, trauma counseling, and self esteem counseling are introduced. Group therapy, individual therapy, and family therapy are all introduced in this phase. Individuals are required to pass random drug tests.

11. Transition phase Continued support for treatment staff is continued in this phase, however women in this phase become mentors and supporters for women entering into the program. Individual therapy becomes important in this phase and common themes and antecedents to drug use are explored. Women are required to participate in community service in this phase as well as keep up with responsibilities in the therapeutic community. Individuals are required to pass random drug tests.

12. Finalization Phase Women start to re-enter into their community. Job training is implemented into this stage and employment is desired at the completion of the program. If the individual, completes this phase their jail or prison sentence is dismissed. Individuals are required to pass random drug tests.

13. Post-Treatment Completion Once the individual has completed the residential program mandated by the courts, weekly therapy sessions are required. Rather than check in with a parole or probation officer, women are required to complete 4 hours per month of psychotherapy. Women must work closely with a case manager to develop a plan upon her completion and release of the program.

14. Modalities Used Therapeutic Community-The therapeutic community is used in this program to influence individuals regarding their attitudes, beliefs, and behaviors regarding drug use. The key agent of change in the therapeutic community comes from the individual, but also from guidance from others in the program and the staff. The goal in the therapeutic community is to reintegrate the individual into the community and prevent future criminal behavior and drug use.

15. Modalities Used Cognitive Behavioral Therapy (CBT)- CBT is used to help individuals recognize, avoid, and deal with situations where drugs and drug use will be present. This modality identifies behaviors where drugs are used to cope with certain situations or are used to meet a specific need. The individual then works with a therapist to develop healthy ways to cope and meet specific needs (Kaden, 2002).

16. Modalities Used Family Therapy-Women are permitted to include their children in the program so a sense of responsibility and pride are established. Women and their children complete household duties to develop a secure attachment for the child, who may have never experienced a positive, secure attachment to their mothers before. Women learn how to communicate with their children as well as appropriate behaviors for disciplining their children. Family therapy is important for the development of the sense of belonging, love, compassion, and empathy.

17. Rationale The rationale of this program is to prevent the individual from using drugs and preventing criminal behavior. The program strives to provide an opportunity for women to reenter the community and support herself and family. Children are included in the program because relational theory posits that “the communal living arrangement strives to foster a sense of responsibility for the lives of others as the women in residence and their children share household chores, cooking, and meals” (Lichtenwalteret. al., 2010).

18. Rationale The Federal Bureau of Prisons (BOP) conducted a study that explored the outcomes of incarcerated individuals who completed a residential substance abuse treatment. BOP found that only 3.3% who received treatment were rearrested in the first six months compared to 12.1% of inmates who did not receive treatment (ONDCP, 2001). The therapeutic community serves as a safeguard for the children as well. For example, children of convicted criminals have a significantly higher chance of being convicted themselves as adults (Lichtenwalter et. al., 2010).

19. References Kaden, R. M. (2002). Cognitive behavioral therapy for substance dependence: Coping skills training. Retrieved from: http://www.bhrm.org/guidelines/CBT-Kadden.pdf Lichtenwalter, S., Garase, M. L., & Barker, D. B. (2010). Evaluation of the house of healing: An alternative to female incarceration. Journal of Sociology and Social Welfare, 37(1), 75-94. White House Office of National Drug Control Policy. (2010). Drug treatment in the criminal justice system. Retrieved from: http://www.whitehousedrugpolicy.gov/publications/factsht/treatment/index.html