Outcome Evaluation of the Iowa State Residential Substance Abuse Treatment (RSAT) Program, 1997-2001 (ICPSR 3368)

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Study Purpose View help for Study Purpose

The Other Way (TOW) program is an intensive residential substance abuse treatment program housed at the Clarinda Correctional Facility in Clarinda, Iowa. Inmates are referred to this program if they have an identified need for residential-level substance abuse treatment and are within 12 months of release consideration. TOW is a voluntary, six-month program that works with inmates to identify the causes of their addictive behaviors and encourage changes in unacceptable behaviors and criminal thinking. The Iowa Consortium for Substance Abuse Research and Evaluation conducted an evaluation of TOW from October 1997 through March 2001. The TOW project was undertaken to answer the following research questions: (1) What services were provided to which types of inmates? (2) Did the program accomplish its stated intermediate goals (i.e., influence attitude change) regarding substance abuse? (3) Were there differences between clients that completed the cognitive unit program at TOW versus the two 12-step-based units? and (4) Were certain types of clients better served by the TOW program than others?

Study Design View help for Study Design

The Iowa Consortium for Substance Abuse Research and Evaluation worked extensively with the Clarinda TWO treatment staff to identify valid and reliable instruments that measured substance use and abuse, mental health and personality characteristics, criminal behavior and attitudes, social support, and involvement in education, employment, and therapeutic activities. The instruments were used to measure the inmates longitudinally on variables relevant to TOW program goals. Criteria for selecting instruments included the reliability and validity of the instruments, ease of administration, amount of training required, potential for dual clinical and evaluation use, and duplication of existing program instruments. The following instruments were selected for inclusion in the intake, discharge, and follow-up assessments: the Addiction Severity Index (ASI), the Colorado Cognitive Assessment Questionnaire, Circumstances, Motivation, and Readiness Scales (CMR) for Substance Abuse Treatment, the Social Provisions Scale (SPS), the Self-Help Questionnaire, and the STEPS Questionnaire. A consumer satisfaction survey was also administered at the discharge interview. The assessment instruments were used to determine subject life history, subject lifetime and 30-day psychiatric and substance-abuse experiences, and subject change over the course of the program in areas such as criminal thinking, cognitive abilities, perceived social support, and readiness for change. Data were collected at five different points during the evaluation. An intake packet was administered to subjects during the first week of the program as part of the orientation. The instruments in the intake packet consisted of Likert-type scale self-report questions, and they were completed by the inmates during orientation. The Addiction Severity Index was administered by trained staff shortly after the completion of the intake packet. The ASI is a structured interview that assesses medical status, employment status, family relationships, psychiatric status, drug and alcohol use, legal status, and family history. The discharge packet given to subjects at the end of the final phase of treatment contained opinion-based assessment instruments identical to those found in the intake packet. Part 1 (Clinical and Recidivism Data) consists of a secondary analysis of selected variables from the intake and discharge assessments. Recidivism data were also gathered during January 2001 by querying the Department of Correction's computer database to gather additional demographic information on each subject and to determine recidivism rates of the participants. For Part 2 (Follow-Up Data), a telephone interview was conducted at least six months following subjects' release from the Clarinda facility. The phone interview consisted of a subset of the ASI questions and the intake packet. The telephone interviews gathered detailed information on the subjects' post-TOW experiences regarding substance use, mental health, and adjustment. The phone interviews lasted approximately one hour and were conducted by a trained consortium interviewer who telephoned inmates who had previously agreed to be contacted.

Sample View help for Sample

For Part 1, a total of 792 inmates completed at least one of the instrument packages, but this study centered around the 351 subjects who completed all three instruments. This sample represents people who had completed the entire TOW program. Dropouts and expulsions were not followed. For Part 2, 242 subjects out of 351 filled out a permission form to participate in a follow-up phone interview. Of the 242 subjects, 207 agreed to participate in the phone interview. Of the 207 who agreed to be interviewed, 73 were not released from prison by the time data collection had ended, 24 were released from prison but had not yet been out six months by the time data collection had ended, 72 could not be located using the contact information provided on their consent form or were unavailable due to reincarceration, and 17 declined to participate once contact was established. This left a sample size of 31 subjects who completed the follow-up interview.

Universe View help for Universe

All inmates from the Clarinda Correctional Facility who participated in The Other Way program.

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Description of Variables View help for Description of Variables

Demographic variables in Part 1 (Clinical and Recidism Data) include age, race, education, occupation, and marital status of the subject. Incarceration variables measure length of incarceration, number of felonies and misdemeanors committed prior to program participation, and number of personal, property, and chemical-related crimes committed prior to program participation. Substance abuse information includes whether the subject ever used alcohol, marijuana, and a variety of other drugs, and whether the subject ever participated in a substance abuse help program. Cognitive deficiency variables include scales of normlessness, self-concept, peer influence, external influence, powerlessness, problem-solving, empathy, attitudes toward police, criminal rationalization, victim awareness, and attitudes toward crime and drugs. Finally, recidivism variables include type of discharge, whether the subject recidivated, time to recidivism, and reason for recidivism. Information in Part 2 (Follow-Up Data) comes from the follow-up administration of the Addiction Severity Index. Demographic variables include gender, living situation, and length of residence. Other variables measure medical status, employment status, family and social relationships, psychiatric status, and drug and alcohol use since release from TOW.

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For Part 1, 44.3 percent of inmates were eligible for inclusion in the sample. For Part 2, data were collected for 15 percent of the subjects who initially agreed to participate in the follow-up study.

Presence of Common Scales View help for Presence of Common Scales

Scales used were the Addiction Severity Index (ASI), the Colorado Cognitive Assessment Questionnaire, the Circumstances, Motivation, and Readiness (CMR) Scales for Substance Abuse Treatment, the Social Provisions Scale (SPS), the Self-Help Questionnaire, the STEPS Questionnaire, and other Likert-type scales.

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Original Release Date View help for Original Release Date

2003-05-09

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