Outcome Evaluation of the Forever Free Residential Substance Abuse Treatment (RSAT) Program at the California Institution for Women, 1997-2000 (ICPSR 3442)

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Date of Collection View help for Date of Collection

Data Collection Notes View help for Data Collection Notes

Study Purpose View help for Study Purpose

This study was an outcome evaluation of the Forever Free Substance Abuse Treatment Program at the California Institution for Women (CIW). The program, which began in 1991, was developed and is currently being operated by Mental Health Systems, Inc., under contract with the Office of Substance Abuse Programs of the California Department of Corrections. Forever Free is a modified therapeutic community with a curriculum that emphasizes relapse prevention, cognitive-behavioral skill building, and women's issues. At the time of the study, treatment was six months in duration and participants attended treatment for four hours per day in addition to their eight-hour work assignment in a prison job or educational program. A new cohort of about 30 women joined the program every six weeks. The in-custody phase of treatment was followed by up to six months of community residential treatment during parole supervision. The objectives of this study were to: (1) contrast the 12-month post-release outcomes of Forever Free participants with those of a comparison group with regard to parole performance, drug use, employment, and psychological functioning, (2) examine differences between groups with regard to their relationships with their children following release to parole (custody status and parenting), (3) examine service needs during parole for both groups, and (4) determine outcome predictors for the whole sample and for Forever Free participants (tested predictors included group status, age, ethnicity, primary drug problem, criminal history, psychological functioning, level of therapeutic alliance, treatment readiness, and locus of control).

Study Design View help for Study Design

Data were collected from 119 women who entered Forever Free between October 1997 and June 1998. Comparison data were collected from 96 women enrolled in Life Plan for Recovery, an eight-week substance abuse education course at CIW, between April and November 1998. Program participants completed an intake questionnaire, approximately one month after the beginning of treatment, designed to collect information on background, therapeutic alliance with counselors, group identification with fellow participants, treatment motivation, and psychological status. Those clients with reading difficulties had the questionnaire instrument read to them. Treatment participants completed the pre-release form approximately five months after completing the intake form. The pre-release form was designed to collect end-of-treatment information on clients' therapeutic alliance with their counselors, psychological status, drug-related locus of control, and post-release treatment plans. Members of the comparison group completed a separate intake form during their incarceration. Due to limited funds, less background information was collected from the women in the comparison group than from those in the treatment group. Women in both groups participated in 12-month follow-up interviews between September 1999 and August 2000. Urine samples were obtained from a randomly selected 20 percent of subjects interviewed in Los Angeles, but these data are not included as part of this collection. Subjects who were incarcerated or selected for urine tests received face-to-face interviews (amounting to 61 percent of the sample). Residents of other counties who were not incarcerated received telephone interviews. The follow-up interview was used to update background information and collect information on subjects' relationships with their children, drug use since release, substance abuse treatment since release, vocational training received since release, services needed and received, social support, current treatment motivation, psychological status, and drug-related locus of control. Subjects providing urine samples received $50 to complete the interview and all other subjects interviewed received $45. Reincarceration data for the entire sample were obtained from the Offender-Based Information System, a database maintained by the California Department of Corrections.

Sample View help for Sample

All clients entering the Forever Free program between October 1997 and June 1998 were invited to participate in the study. The comparison group was selected from women attending Life Plan for Recovery because of their similar backgrounds and voluntary participation in a low-intensity substance abuse education program. Those enrolled in the course between April and November 1998 were contacted shortly before the time of their release and asked to be part of the study.

Universe View help for Universe

Inmates at the California Institution for Women who entered the Forever Free Substance Abuse Treatment Program between October 1997 and June 1998 or were enrolled in the Life Plan for Recovery course between April and November of 1998.

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

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Description of Variables View help for Description of Variables

Variables from the treatment group's intake form include date of interview, primary drug used, birth date, race, last job, 1996 household income, education, criminal history, relationship status, previous residence type, number of children, ages of children, whether the respondent had legal custody of children, where children were living, contact and visits with children, frequency with which certain parenting activities were performed before incarceration, drug use history, drug treatment history, answers to 30 questions about the respondent's counseling experience and case manager, answers to 13 questions about interactions with other participants in Forever Free, answers to 43 questions relating to treatment motivation and psychological functioning, scales for self esteem, depression, anxiety, problem recognition, desire for help, treatment readiness, and therapist understanding and involvement, and total scores for therapeutic alliance with counselors, patient working capacity, working strategy consensus, client interaction, and confident collaboration. Variables from the pre-release form include whether the respondent planned to continue treatment after release, answers to the same 30 questions about the respondent's treatment experience and case manager that were on the intake form, answers to 16 questions about how the respondent felt about drug use, and answers to 19 questions about psychological functioning. Variables from the comparison group's intake form include interview date, primary drug used, birth date, race, 1996 household income, education, criminal history, relationship status, number of children under 18, drug use history, and release date. Variables from the follow-up interview include interview date, whether the respondent was incarcerated at the time of the interview, primary drug used, whether the interview was conducted face-to-face or over the phone, education and vocational training received since release, employment status, arrests and convictions since release, relationship status, residence type, where children were living, frequency with which certain parenting activities were performed, drug use history since release, substance abuse treatment since release, answers to 53 questions about whether certain services were needed by the respondent or her children since parole and whether these services were received, answers to 14 questions about social support available to the respondent, answers to 24 questions about whether certain services were received while at CIW and for how long, answers to 64 questions about participants' satisfaction with the Forever Free program, answers to 78 questions about satisfaction with treatment received since release, answers to the same 43 questions on treatment motivation and psychological functioning as on the treatment group's intake form, answers to 16 questions about how the respondent felt about drug use, and a scale for drug-related locus of control. Variables from the Offender-Based Information System include status at end of follow-up, custody start date for intake offense, return to custody date for all times returned to custody during the 12-month follow-up period, parole date for all times paroled, penal code for offense that returned respondent to custody for all times returned to custody, number of returns to custody during the 12-month follow-up period, number of days incarcerated since release, and number of days before first incarceration.

Response Rates View help for Response Rates

Of the 149 eligible program participants, 15 (10 percent) declined to participate in the study and an additional 15 (10 percent) were unavailable due to illness, court appearances, family visits, or other reasons. Of the 105 women eligible for the comparison group, eight declined to participate and one was removed from the sample because she subsequently entered the Forever Free program and became part of the treatment sample. For the follow-up interviews 180 intake subjects (84 percent), including 101 program participants (85 percent) and 79 members (82 percent) of the comparison group, were located and interviewed. Three subjects were eliminated from follow-up because their one-year follow-up dates were outside the study window. Two subjects had to be eliminated from follow-up because they received additional sentence time and at their follow-up dates had not been released from prison. Two subjects refused to participate in the follow-up interview, and one subject was deceased. The remaining 27 subjects (13 percent) were not located.

Presence of Common Scales View help for Presence of Common Scales

Scales used in this study include Texas Christian University scales for psychological functioning: self-esteem, depression, and anxiety, and for motivation for treatment: problem recognition, desire for help, and treatment readiness. Other scales include California Psychotherapeutic Alliance Scales, a drug-related locus of control scale, and several Likert-type scales.

Original Release Date View help for Original Release Date

2003-10-30

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