Process Evaluation of Residential Substance Abuse Treatment Programs in Maine, 1999-2000 (ICPSR 3281)

Time Period(s) View help for Time Period(s)

Date of Collection View help for Date of Collection

Study Purpose View help for Study Purpose

The State of Maine Department of Corrections (MDOC) and the Office of Substance Abuse (OSA) at the Maine Department of Mental Health, Mental Retardation and Substance Abuse Services opened the Key Maine Therapeutic Community (TC) in March 1999 and its Transitional Treatment Program (TTP) for adult male inmates in January 2000. Spectrum Behavioral Services, Inc. (SBC) was subcontracted to implement the program, which was located at the Maine Correctional Facility in South Windham and the Pre-Release Center in Hallowell. The United States Department of Justice Residential Substance Abuse Treatment (RSAT) funded the initiative. This study was undertaken as a process evaluation of the program. The specific aims of the evaluation were (1) to profile the drug use, treatment, and background characteristics of the inmates in the Maine correctional facilities who were eligible for admission to the Key Maine TC, and (2) to examine the treatment process among clients who entered the Key Maine TC during the 15 months of treatment. Specific research questions addressed include: (1) What were the short and long-term retention rates of the first cohort of clients who entered the Key Maine program? (2) What was the psychological and motivational status of Key Maine clients at entry to treatment and did clients who completed treatment differ in terms of these characteristics from clients who did not complete treatment? (3) Did clients who remained in treatment experience changes in attitude indicative of successful rehabilitation?

Study Design View help for Study Design

To accomplish the aims of the process evaluation, research staff examined both program and client-level data that were collected throughout the first 15 months of the Key Maine TC's operation, a period that included the initial start-up period for the TTP. The principal investigator conducted five site visits at three-month intervals. During each site visit, data on the program were gathered through field observation, focus groups with TC members, and quantitative assessments of the therapeutic environment and the program compliance with the TC model. Focus groups with inmates addressed their treatment experience, how it differed from experiences in the general population, their drug use, and how they thought the TC experience would affect their life once they were in the community-at-large. For Part 1 (Baseline Data) research staff conducted interviews with 140 program-eligible inmates between August 1999 and May 2000. Interviews lasted approximately 90 minutes. Information was collected for lifetime and for the last six months before incarceration. In Parts 2 through 4 (Retention Data, Scores Data, Services Data), data from client treatment records were used in the analysis of retention and treatment progress. Treatment staff collected assessment data from clients in treatment at program entry and throughout treatment. The assessment instruments were administered during the first, sixth, and twelfth months of treatment, with the exception of the treatment engagement measures, which were collected at six and 12 months only. A modified version of the Texas Christian University's Self and Treatment Instrument (STX, Simpson & Knight, 1998) was used to measure psychological status and treatment involvement. The 12 items of the Circumstances, Motivation and Readiness Scale (CMR, Melnick, 1999) were used to measure motivation during treatment. Complementary instruments were completed by clients and staff to measure the clients' progress: the Therapeutic Community Client Assessment Scale (CAS) and the Therapeutic Community Staff Assessment Scale (SAS). These instruments were developed by Kressel (1998) to measure the complexity of individual change in accordance with the therapeutic community view of treatment.

Sample View help for Sample

Not applicable.

Universe View help for Universe

Residential substance abuse treatment programs in Maine.

Unit(s) of Observation View help for Unit(s) of Observation

Data Source View help for Data Source

Data Type(s) View help for Data Type(s)

Description of Variables View help for Description of Variables

Part 1, Baseline Data, contains information on inmates, including age, ethnic group, education level, timing of all diplomas or degrees they had received, reasons for stopping school, marital and/or relationship status and history, and number and ages of children. The file also includes information on the last six months before being incarcerated, such as attendance at religious services, kind of housing and time spent there, as well as whom they lived with and the behavior of the inmate and their living companions in terms of alcohol and drug use. Also, there is information about how respondents supported themselves financially, including employment status and job information, such as number of days worked, number of jobs, part-time or full-time status, income, supplemental income, drug and alcohol use effects on employment, and whether they had dependants to support. In addition to information on the six months before incarceration, the file provides information on the inmate's substance abuse behaviors over his lifetime, including specific drugs used, the frequency used, and the age at which use of particular substances began. Information on substance abuse behaviors, such as specific substances used and frequency used in the last 30 days, is also recorded. Other variables in Part 1 focus on whether inmates' substance abuse had caused problems in major areas of their lives, such as family, employment, school, physical and mental health, relationships, and other substance abuse treatment received, including the type of treatment, duration of treatment, main substance abused, and reasons for entering treatment. Self-report data are available on each inmate's lifetime history of illegal activities, including, but not limited to, arrest history. This includes the offense(s) for which the inmate was currently serving time, as well as past offenses, jail time served, number of times incarcerated, illegal activities in which the inmate engaged during the last six months before incarceration, and time spent in probation during the last six months before incarceration. Information on visitors received during time in jail and contact (phone calls and letters) with others while in jail are included, as well as personal history information concerning the inmate's relationship with family and the activities they engaged in together. There is information on the friends the inmate had during the six months before incarceration, such as their education level, employment status, and relationship with family. Additional variables include whether the inmate reported having a history of child abuse, with details such as age at time of abuse, relationship with the abuser, frequency of abuse, perceived association of child abuse history to the inmate's substance abuse, the inmate's history as both victim of and perpetrator of violent crimes and weapon use, the inmate's sexual activity during the six months before incarceration, and his opinions about the chances of contracting HIV/AIDS. Other items pertain to behaviors that increase the risk of contracting HIV/AIDS and the inmates' feelings about HIV/AIDS, such as whether they worried about contracting the virus, whether they would want to know if they had the virus, whether they knew how to protect themselves, whether they had altered their behavior to reduce their chances of infection, and their perceptions regarding the likelihood of contracting HIV/AIDS. Part 1 data also provide information on inmates' physical and mental health, along with medications taken and diagnosed mental disorders. Interviewers' ratings concerning the inmates' behavior during the interview and whether the interviewer believed the inmates would complete the program are assessed across 16 areas. Part 2, Retention Data, indicates how long inmates spent in the program and the reason for their discharge. Part 3, Score Data, provides the inmates' psychological and motivational scores for the short self-esteem index, the short depression index, motivation and readiness and treatment engagement, and when they were tested. Also included are scores for counselor rapport and counselor competence. Part 4, Services Data, records the number of times an inmate had used particular services, such as clinical groups, clinical supervision, educational sessions, encounter groups, group counseling sessions, individual counseling sessions, seminars, and 12-step sessions.

Response Rates View help for Response Rates

Not applicable.

Presence of Common Scales View help for Presence of Common Scales

In Part 1, a Likert-type scale was used. The scales used to gather data for Parts 2 and 3 of this study are the Beck Depression Inventory (BDI, Beck et al., 1966), the Rosenburg Self-Esteem Scale (RSE, Rosenberg, 1965), the Circumstances, Motivation and Readiness Scale (CMR, Melnick, 1999), the Therapeutic Community Client Assessment Scale (CAS, Kressel, 1998), and the Therapeutic Community Staff Assessment Scale (SAS, Kressel, 1998). Also used were the counselor competence, counselor rapport, and treatment engagement scales from the TCU Self and Treatment Scale (Simpson & Knight, 1998).

Original Release Date View help for Original Release Date

2003-01-10

Version History View help for Version History