Program Reduces Recidivism Among Men With Co-occurring Disorders

July 2012
Photo shows three men seated in a circle and engaged in a serious discussion.

A modified therapeutic community program designed by NIDA-supported researchers helped male parolees with co-occurring substance abuse and mental health disorders adjust to living in their communities. In a prior study, men who had participated in the program while incarcerated were only half as likely as others who received standard prison care to be sentenced for a new offense during their first year out. Recently, the program proved similarly effective when administered after prison release.

Nationwide more than 4 in 10 state prison inmates are dually diagnosed with substance abuse and mental health disorders. The specialized program, developed by Dr. Stanley Sacks and colleagues at the National Development and Research Institutes in New York City, adapts the traditional therapeutic community (TC) approach to the particular needs of this population. Like TCs, the program, called Reentry-Modified Therapeutic Community (RMTC), establishes a community with overriding values of self-help and mutual assistance toward recovery. However, RMTC adjusts TC expectations in light of the cognitive and emotional impairments that accompany psychiatric disorders, dedicating more time to orientation and instruction and providing increased positive feedback for achievements. RMTC also reduces the confrontation and sanctions that TCs typically use to enforce community standards.

In the recent study, 19 percent of 71 dually diagnosed parolees who went directly from Colorado prisons into a 6-month RMTC were sentenced for new offenses within 12 months of their release. In contrast, 38 percent of 56 parolees who received the State’s standard parolee supervision and case management were sent back to prison within a year. In comparison with the typical program, RMTC participation reduced both general criminal activity (39 percent vs. 62 percent) and alcohol- or drug-related offenses (37 percent vs. 58 percent). A subgroup of men who participated in RMTC both while imprisoned and after release benefited more than those who participated in only one setting.


Sacks, S. et al. Randomized trial of a reentry modified therapeutic community for offenders with co-occurring disorders: Crime outcomes. Journal of Substance Abuse Treatment 42(3):247–259, 2012. Abstract Available

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