Twenty years ago, the Bureau implemented its current drug abuse treatment strategy. The longest running drug abuse program in Bureau history, the treatment strategy has grown and changed with treatment advances of the times. Staff members have maintained their expertise in treatment programming by monitoring and incorporating improvements in the treatment and correctional programs literature, research, and effective evidence-based practices.
Drug treatment studies for in-prison populations have found that when programs are well-designed using effective program elements and implemented carefully, these programs:
reduce inmate misconduct,
reduce mental illness,
reduce behavioral disorders,
increase the level of the inmate's stake in societal norms,
increase levels of education and employment upon return to the community,
improve health and mental health symptoms and conditions, and
Collectively, these outcomes represent enormous safety and economic benefits to the public.
Over the last 20 years, the Bureau has maintained its basic philosophy of cognitive behavioral treatment, but adapts when effective advances emerge, including: moving programs from didactic to interactive, and implementing a well-designed, evidence-based, modified therapeutic community. The Bureau has incorporated numerous positive changes in how treatment is conducted, ongoing legal adjustments and challenges, drug abuse treatment program expansion, and the beginning of psychology treatment programs that provide treatment opportunities to the mentally ill and those with behavior problems. The Bureau's drug abuse strategy – a treatment continuum – includes:
Drug Abuse Education – a motivating educational experience, not only covers the basics regarding substance use and its effects, but also serves to identify inmates with a further need for programming and refer offenders for appropriate treatment.
Nonresidential Drug Abuse Treatment – for inmates who have short sentences, those who may not meet the criteria for the Residential Drug Abuse Program (RDAP), those awaiting RDAP, those transitioning to the community, those with positive urinalysis, etc. Nonresidential treatment is a 12-week, cognitive behavioral therapy (CBT) treatment program, conducted primarily with groups, that provides rational thinking, criminal lifestyles, communication skill building, and institution/community adjustment techniques.
RDAP is the Bureau's most intensive treatment program. It too follows the CBT model of treatment wrapped into a modified therapeutic community model in which inmates learn what it is like living in a pro-social community. Inmates live in a unit separate from general population, participate in half-day programming and half-day work, school, or vocational activities. RDAP is typically nine months in duration. The Bureau and National Institute on Drug Abuse combined funding and expertise to conduct a rigorous analysis of the Bureau's RDAP. Research findings demonstrated that RDAP participants are significantly less likely to recidivate and less likely to relapse to drug use than non-participants. The studies also suggest that the Bureau's RDAPs make a significant difference in the lives of inmates following their release from custody and return to the community.
An often overlooked component of all psychology treatment programs that was first included in drug abuse programming is the Community Transition Drug Abuse Treatment (TDAT) requirement – i.e., the continuation of drug abuse treatment in the community upon transfer to a residential reentry center (RRC). Research has found this period to be the most vulnerable time for an inmate to relapse into drug use and/or criminal behavior. Research also demonstrates continued treatment and supervision is an essential element in the inmate's treatment success. In fact, successful RDAP completion requires completion of TDAT.
The primary responsibility of Regional TDAT staff is to monitor an inmate's treatment progress during his/her stay in the RRC. This level of clinical oversight ensures each inmate receives a level of treatment and management similar to that provided in a Bureau institution. Regional TDAT staff members continue to be an important part of evolving efforts on rehabilitating offenders, not only with drug use disorders, but inmates with mental illness and other behavioral problems. This expansion provides inmates the access to necessary treatment and services as they transition into the community.
Regional TDAT staff members have developed a complex network of community-based contract providers to deliver treatment to Bureau inmates residing in an RRC or on home confinement. The approximately 400 contractors are licensed and certified professionals – e.g., certified addictions counselors, social workers, professional counselors, psychiatrists, and medical doctors. These services are provided within a reasonable distance of the RRC where the inmate resides. On rare occasions and when State regulations allow, the community-based treatment provider may conduct treatment services at the RRC.
The Regional TDAT personnel work closely with U.S. Probation to establish a continuum of treatment as the inmate leaves Bureau custody and moves to supervised release under U.S. Probation. To facilitate this process, U.S. Probation is provided with a comprehensive discharge/termination report on all inmates who have participated in treatment in the community. This provides the supervising U.S. Probation Officer valuable information of what went on before release from Bureau custody – the inmate's treatment progress and treatment needs.
Throughout the years, the Bureau's drug abuse treatment program has made a significant difference in the lives of inmates, their families, and their communities. The Bureau will continue to refine its programming efforts as indicated to maximize the likelihood of a successful return to the community for releasing ex-offenders and to ensure the public is best protected.