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Treatment Perspectives on Criminal Personalities in a Rural Setting

Boyd D. Sharp, M.S., L.P.C.
Clinical Director
Powder River Correctional Facility
Kathi J. Beam
Consultant

The Baker County Council on Alcohol and Drug Problems, Inc. (BCCADPI) was incorporated as a nonprofit corporation in 1967 to address the alcohol and other drugs (AOD) service needs of rural eastern Oregon. This region comprises 17 counties of mountains and high desert measuring 61,134 square miles, an area larger than 29 States and just slightly smaller than the State of Washington, its neighbor to the north. In this region reside 307,000 persons, fewer by 133,000 than the population of Portland, Oregon's largest city. The region's entire population averages 7.58 persons per square mile, but only the populations of 6 counties are actually above that number; 11 are below it, and 8 counties average fewer than 3 persons per square mile.

Program Description

Since our incorporation in 1967, we at the BCCADPI have worked hard to develop programs specifically designed to help individuals in rural areas achieve and maintain abstinence from, and reduce or eliminate problems related to, abuse or dependency on alcohol and other drugs. We have been particularly interested in assisting persons recovering from substance abuse to become socially integrated and economically productive members of their communities.

Consequently, we are proud of the success shown by our 50-bed intensive residential treatment program inside the Powder River Correctional Facility, a 150-bed minimum security prison in Baker City, Oregon. When we began contracting with the Oregon Department of Corrections to implement and maintain this program in February 1990, it was the first such program in the State of Oregon and one of only a few programs of this type in the Nation. Four years later, it continues to attract the attention of AOD professionals throughout the United States. It is being used as a model for similar programs in other States because of its success in reeducating and rehabilitating criminals with histories of substance abuse.

Treatment Philosophy

The BCCADPI philosophy on which the Powder River Alcohol and Drug (PRAD) Treatment Program is based is that alcoholism and drug addiction are diseases that affect all areas of a person's life. Consequently, our approach to treatment is holistic and focuses on repairing the damage done by this disease on an inmate's (in program vernacular, a "resident's") physical well-being and mental health.

Part of our philosophy deals with the external environment beyond the prison. We believe that alcoholism and drug addiction are family diseases that affect everyone in contact with the alcoholic/addict resident. It is, therefore, essential that, whenever possible, the family be involved in therapy at the same time the resident is receiving treatment. We feel it is then much more likely that the resident being released from the program will return to a positive environment where he will find the support he needs in the critical early stages of his recovery.

But the most important part of BCCADPI's philosophy concerns a resident's internal, attitudinal environment and is based on the published studies of Yochelson and Samenow, The Criminal Personality (1976, 1977, 1986). We believe that criminals commit crimes because their thinking rationalizes and justifies their behavior, and that criminal behavior is the result of erroneous thinking. Criminals' thinking leads to their feelings, the feelings lead to their behavior, and their behavior reaffirms their thinking. To use the words of Alcoholics Anonymous, the criminal is afflicted with "stinking thinking," which includes rationalization, excuse-making, blaming, accusing, being a victim, justification, and more.

Much of the research literature in print on criminals and society addresses causation. There are a tremendous number of theories that attempt to explain why an individual develops a criminal personality–social inadequacies, lack of nurturing in early childhood, family dynamics and dysfunction, addiction to drugs and alcohol, and so on. Our program does not focus on any particular theory of causation. In the PRAD model, the emphasis–in the way staff interacts with residents and the way residents interact with staff and with one another–is on choice. We believe that each resident in the program, regardless of his childhood or parentage, his economic or social status, his living or working conditions, made individual choices to get where he is. The choice of whether to benefit from the program and make positive changes in his life is his alone, too. What brought him to this program, what–other than his alcohol and/or other drug addiction–resulted in his conviction and incarceration, is not initially addressed. While we hope that he will examine all the factors closely, using the tools we make available to him, this should be accomplished later on in treatment.

Accountability for personal actions.

Although it may appear insensitive and cold to some, this attitude is absolutely essential to maintain in the prison treatment environment if the program's structure and level of expectation are to be preserved. One of the criminal's chief survival mechanisms is to avoid responsibility at all costs; one of his first refuges as he tries to avoid facing up to who he is and what he has done is to blame others for his plight. To allow a resident to excuse his criminal behavior by blaming an alcoholic mother or an abusive father is to give him permission not to accept responsibility for his own actions. We believe that optimum opportunity for success in the program requires that the resident be held accountable for all his actions, past, present, and future.

A second reason for not factoring in causation when dealing with the criminal personality is that the criminal is all too eager to buy into the concept that really, his criminal behavior is not his fault, because this sets the stage for him to manipulate situations and exploit other people. If a PRAD counselor were to communicate agreement with the resident that abuse in childhood, for example, had led him to a life of crime, the resident would attempt to exploit that counselor's sympathies and would try to manipulate every possible situation using his sorry history. Within no time, if this sort of thing were allowed to take place, the criminal would defocus from his problem to other areas to avoid changing his behavior.

Criminal thinking.

The "criminal thinking" component is the therapeutic heart of the program. It is examined and addressed in all group and individual counseling sessions, in leisure time and work activities, during recreation and fun. In other words, the resident's "criminal thinking and behavior" is addressed 24 hours a day. To take full advantage of this program, the resident is asked to take responsibility for his thinking by being honest. As he remains drug- and alcohol-free and practices all of the activities of this program, he learns to identify and relate to his thinking as a direct means of understanding himself. As his thinking changes, his feelings will change. When his feelings change, his behavior will change.

We use a variety of tools to guide the resident in scrutinizing his criminal thinking errors. Initially, we present Yochelson's and Samenow's list of 36 "Thinking Errors Characteristic of the Criminal Personality" (1976). The residents focus on each error and address these in group discussions, role play, and in individual assigned papers. In similar fashion, we present the 18 "Tactics Obstructing Effective Transactions in Treatment" and "Criminal Masks" (Yochelson and Samenow 1976). The resident is thus cognizant from the very beginning that we understand his thinking patterns, and that he is unlikely to pull the wool over the eyes of any member of the PRAD staff. This is very important in that it disarms the resident and makes him more receptive to treatment.

For much the same reason, we make certain from the resident's first day in the program that he begins to admit he is a criminal. We use the word "criminal" the way we use the word "alcoholic." The alcoholic must admit and accept that he is an alcoholic in order to begin recovery. We believe the criminal must also admit and accept the fact that he is a criminal in order to begin recovery. Elsewhere the thinking is that the use of the word "criminal" might be offensive and counterproductive to positive results in the area of self-esteem. However, we believe that in order for a resident to benefit from the PRAD program, he must always face everything about himself with total honesty. Most inmates of penitentiaries will swear their innocence and deny that they had any hand whatsoever in the circumstances that led to their incarceration. When an inmate enters the PRAD program, he must overcome this denial about his criminality, just as he must overcome his denial about his addiction to drugs and alcohol, before he can begin to make true progress.

Admission Criteria

Referrals into the PRAD program come from other prison facilities around the State, most often but not always from the Eastern Oregon Correctional Institution (EOCI), a medium security facility in Pendleton, Oregon. Approximately 60 percent of the referrals into the PRAD program come from Oregon counties classified as either rural or frontier. An inmate referred to the program ordinarily has no choice but to enter treatment. However, because of the small facility and financial constraints on the program, some inmates are excluded.

The criteria for an inmate's admission to the Powder River program are as follows:

1. The candidate for admission to the program must have a history of substance abuse problems. He must be identified as an individual whose use of alcohol and drugs following parole would very likely cause a resumption of antisocial behaviors that would lead to his reincarceration.
2. The candidate for admission to the program must qualify for incarceration in a minimum custody setting and require only minimal supervision.
3. The candidate for admission to the program must have no less than 6 months nor more than 15 months of his sentence remaining to serve until his release.
4. The candidate for admission to the program must not be currently suffering from a mental illness. He must not require detoxification or be psychotic to a degree of severity that would preclude him from appropriate participation in the program.
5. The candidate for admission must be medically approved for entry into the Powder River Correctional Facility and require no medical supervision or nursing care.
6. The candidate for admission to the program must have no detainers.
7. Priority consideration is afforded offenders from central/eastern Oregon.
8. The candidate for admission to the program must make a commitment to honor and adhere to the program treatment philosophy and schedule.

Program Structure

The Powder River Alcohol and Drug Treatment Program is intensive, with a rigid structure. Inmate participants, referred to as "residents," are supervised by BCCADPI therapists and counselors 16 hours per day, 7 days per week. BCCADPI staff members are required to be trained in corrections procedures as a condition of employment in the Powder River Correctional Facility.

The quality of the alcohol and drug staff and the cooperation of corrections personnel have played a role in the success of this program, but success is due largely to the program's design. Based on education, structured around a resident's "level system" of work task distribution, and driven by incentives and rewards, the program's design has been seen as instrumental in the residents' acquisition of positive self-esteem and new attitudes. These attitudes aid in an individual's achieving success in the program and avoiding a return to the correctional environment.

The following sections describe the phases and components of the PRAD treatment program. Residential treatment at Powder River is built on a 6- to 15-month schedule with two parts. Each part directs resident activity, as well as measuring treatment progress. Aftercare follows the resident's graduation from the program.

Assessment Phase (0-60 days)

New alcohol and drug treatment residents are admitted to a separate assessment area where the focus is on assessing and preparing them for treatment. Prior to his admission to the PRAD program, we have examined the inmate's visitation record and obtained background information from the Department of Corrections. Using this information, we are better able to determine whether the inmate will be appropriate for the program, depending on:

• Indicators of alcohol/drug problems in his history
• Evidence of a support system of either a nuclear or extended family to which he can turn during treatment and to which he can return after treatment. (This is not to say that an inmate is excluded from the program because of the lack of a family support system or the family's inability to participate due to justifiable reasons.)

Family questionnaire.

As part of the inmate's initial assessment, a questionnaire is sent to his family in which they are asked to identify family problems, both current and historical. Family members, including mother, father, brothers, sisters, wives, and/or friends, are all encouraged to become involved in the resident's treatment by showing support and by addressing their own issues that may be responsible for causing or exacerbating the resident's problems. The PRAD program has family counselors on duty 7 days a week to conduct family therapy sessions and to be on hand should issues arise during normal visitation times. Family counselors are also ready to help the resident should he need to discuss family-related issues at other critical junctures in his treatment process.

Random urinalysis.

On program acceptance, the resident immediately is included in the random urinalysis program to assure that he is consistently free of chemicals. He is assigned a primary counselor to guide him through this phase. Each new resident is given a copy of the Powder River Correctional Facility Alcohol and Drug Resident Orientational Handbook to read; this clearly sets forth all of the rules and procedures associated with the program, as well as penalties for infractions. If the resident needs clarification on any part of the handbook, this will be provided to him by his primary counselor. The resident is tested on his understanding of the rules and regulations governing the PRAD program.

From the beginning, much of the resident's time is devoted to intense educational therapy on drugs, alcohol, criminal thinking, and addiction. He begins writing his autobiography, which treatment staff use to determine appropriate treatment protocols. The assessment phase also prepares the resident for participation in group and family therapy by allowing him to explore thoughts and feelings under a variety of circumstances. During this crucial period, trust in the treatment process is developed and nurtured with honest, caring direction and feedback.

Introduction to the resident community.

The new arrival is introduced to the resident community in the assessment phase. An orientation is conducted by residents in treatment. Each new resident is assigned to complete one-on-ones with three different treatment residents. A buddy from the treatment side is assigned to each assessment side resident and helps him settle in. Treatment residents act as role models during the times that all residents share: community meetings, meals, recreation, Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) meetings, and graduations.

When an inmate is admitted to the program, the primary counselor assigned to him begins immediately to assess and evaluate the individual to determine the nature and extent of his problems. The information gathered is placed on a problem list, which covers each major area of the resident's life.

The Individual Treatment Plan.

The resident works with his primary counselor to develop an Individual Treatment Plan (ITP) formulated from his problem list. Together, they determine problems to be worked on, formulate goals and objectives for resolving those problems, and devise strategies and timelines for meeting their goals.

The ITP is reviewed by the resident and his primary counselor every 30 days, and by a supervisor periodically, for as long as the resident remains in the program. When the ITP is reviewed, the resident is included in discussions of any problems and before any modifications are made. Further information about a resident is added to his file in the form of weekly progress notes, staff and peer behavioral rating sheets, and data from family therapy sessions. All of these sources of information are included when the resident's ITP is reviewed.

Whenever possible, the resident's family is involved in the resident's treatment. Whether or not the family has become dysfunctional as the result of living with an alcoholic/addict, the family nevertheless is involved in the problem and is encouraged to be involved in the solution.

A resident is ready to move into the treatment phase of the PRAD program when:

• He has begun to overcome his denial about his alcohol and/or drug addiction
• He has begun to overcome his denial about his criminality
• He has become willing to accept the therapeutic community design

Treatment Phase (Months 2 through 15)

While in the treatment phase, residents pursue personal growth and emotional awareness through all treatment and community activities. Progress during this phase is measured in the resident's community status and behavioral and psychological change. Community status reflects the degree to which the resident reveals personal growth, e.g., maturity, openness, insight, self-awareness, emotional stability, and self-esteem.

Components of the treatment phase.

The treatment phase is divided into three components. First, the resident drafts his autobiography, to help him and his primary counselor identify the problems in his life that have been caused by his addiction and criminal thinking errors. During this segment, the resident is further encouraged to break through the denial and identify the specific areas he needs to work on to make a positive change in his assumptions about the world. He also identifies the steps he needs to take to stop his addiction.

In the second component of the treatment phase, the resident undergoes cognitive restructuring, to train him to recognize thinking errors and to acquire the basic knowledge needed to stop the addiction process. He also is taught the concepts of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) and alcohol and drug education, and he begins to accept and practice the solutions learned. Included in this second segment are family therapy and the identification of both alcohol and drug relapse symptoms and thinking error interventions, so the resident can determine the external and internal deterrents that need to be established.

In the third component of the treatment phase, the resident and his primary counselor focus on formulating a maintenance care plan prior to the resident's discharge. Among the tasks clustered in this segment are obtaining a temporary AA or NA sponsor and making appointments with counselors for outpatient treatment, vocational rehabilitation, and/or employment.

To enable a resident to move through the components of the treatment phase, he is required to follow a structured schedule and to be involved in supervised activities from 6 a.m. to 10 p.m. every day. These activities include group therapy, family counseling, recreational activities—primarily aerobic workouts for cardiovascular fitness and interactive games to teach residents to work together as a unit—self-help groups, and aftercare planning.

Family and educational therapy.

Family therapy is encouraged and promoted for those residents whose families can come to Powder River. Each family therapy plan is specific to the family, but includes information on addiction, thinking errors, co-dependency, family roles, relapse, denial, self-help groups, and aftercare. Family therapy can be arranged for any time; however, Saturdays and Sundays are reserved for family treatment. The lead counselor will initiate family therapy discussion and coordinate with the family counselors to deliver family therapy. The lead counselor will remain involved, receive feedback from the family counselor, and may lead the therapy. For those residents whose families cannot come to Powder River, sessions will be held on the above subjects for them as well. Counselors will work with each resident to assist his family members to get involved in treatment and self-help groups within their communities.

One of the most valuable tools in the PRAD program is educational therapy and the use of edu-therapy modules. Of all the edu-therapy modules currently in use—such as Adult Children of Alcoholics (ACOA), alcohol and drug education, anger management, co-dependence, criminality, HIV/AIDS, self-esteem, sexuality, stress management, and values–none is more important to the resident's recovery than criminality and cognitive restructuring (thinking errors). These edu-therapy modules, which focus on the core of criminality, guide the resident to examine in depth the thinking errors common to criminals, and to write papers drawing correlations between the offenses for which he was convicted and the thinking errors that led to his commission of the crime(s). The resident spends 50 percent or more of his time dealing with and correcting his own criminal issues.

Through the Department of Corrections, the resident has access to many scholastic educational opportunities, including the GED; English as a second language; a high school diploma; some college courses; "Breaking Barriers" and "Pathfinders" classes; and training in first aid, CPR, and job skills development.

Work and responsibility.

Perhaps the most important integral part of the entire PRAD program is the work and responsibility component. This component is designed and monitored by PRAD staff, but the residents manage it. Because its configuration is stratified and hierarchical, and residents earn the right to give instructions to other residents, it often is the most difficult part of the program for outsiders to grasp and for newcomers into the program to get used to.

A resident's work responsibilities begin with his entry into the PRAD Program. He is immediately assigned to a work crew, as a member of which he initially performs the many housekeeping chores associated with institutional living. Later he may be assigned to one of several departments, such as Orientation, Recreation, Education, and Inspiration and Beautification.

When he demonstrates his ability and willingness to perform tasks, comply with rules, handle responsibilities and authority, and participate in program activities, he is promoted. If he proves himself adequately, he can advance from crew member to crew chief, from crew chief to department head, and finally to coordinator and senior coordinator. The Coordinating Council, comprised of residents who have succeeded in reaching the top of the program hierarchy, meets regularly with PRAD staff and provides input from the residents on problems, suggestions, and other matters.

Residents are encouraged to be aware of the atmosphere of the community, of each other's strengths and weaknesses, and to resolve any problem areas whenever possible. The community itself serves as a teacher and mentor, but the responsibility to follow the directions always falls back on the individual resident. He must decide to support and comply with the larger community's code of conduct. Voluntary conformity to the expectations of the community is the desired goal. The staff expects residents in positions of responsibility to keep the staff informed of individual, departmental, or community problems. They do this through:

• Routine evaluations
• Daily and weekly departmental status reports
• Discussion with staff
• Bringing issues to group

Through these avenues and direct observation, staff keep aware of the status and atmosphere of the community, the departments, and the individuals.

Opportunities within and outside the facility.

Residents may apply for promotions, treatment responsibilities, and work opportunities when they become eligible. However, there must be an opening at a higher level. All promotions and appointments are made by staff. A resident may be demoted and his status reduced if his performance and behavior fall below program expectations, as indicated by behavioral ratings and conduct.

But if the resident commits himself to treatment, education, and change, he can earn better jobs and pay, more privileges (such as assignments to special community service work details outside the prison, trips to the YMCA swimming pool, and outside Alcoholics Anonymous meetings), a possible reduction in his sentence, and greater status and respect within his peer group in the therapeutic community. He cannot progress up the ladder alone. From the beginning, to succeed, he must be a partner in the program with his fellow residents, as well as with program staff and corrections officers. However, responsibility for his success or failure, and that of the entire program, rests squarely on his shoulders.

As a resident demonstrates progress in the program and compliance with all the rules and requirements of his job, opportunities to engage in activities outside the facility become available to him. When the resident successfully completes the treatment phase, he is released from prison. However, his obligation to the PRAD program does not end there. For a year following his parole, he must be part of an aftercare program supervised by his alcohol and drug service providers or mental health professionals in his home community.

Aftercare

Aftercare is very important when a resident is graduated from the PRAD program. The graduate's continued involvement in treatment in his community will greatly improve his ability to remain alcohol- and drug-free, as well as crime-free. This is a program of recovery, not of cure. An aftercare plan is developed prior to a resident's graduation from the program. Aftercare planning is a joint effort of the lead counselor and the resident; the plan is developed based on the resident's needs and the resources available. The resident's primary counselor assists with resources, establishing the plan in each client's home community, and with followup.

Prior to release, a conference call is conducted that includes the resident, Department of Corrections staff, the parole officer, the alcohol and drug counselor, and the community treatment counselor. After release, the alcohol and drug counselor does followup calls to the resident and his parole officer. These calls occur after 14 days and 28 days away from the program. Thereafter, written followup is required monthly from the community treatment provider and quarterly from the parole officer.

Also prior to the resident's release from the program and correctional facility, family members or significant others are contacted and, if possible, included in the aftercare planning phase. It is critical to the resident's continued recovery from the disease of alcoholism/drug addiction that he not return to the same negative environment that led to his criminal behavior and incarceration. When a resident receives treatment and begins to make positive life changes, and is then returned to a family that has not received treatment and continues to be dysfunctional, the resident's chances for relapse are very great. So is the likelihood of his returning subsequently to prison. If the resident's family has not been involved in treatment during his stay in the Powder River program, the program will look at placing him in a halfway house situation following his release.

For 60 days following his release from the program, the BCCADPI contracts with a provider in the graduate's home community. This provider oversees his aftercare program, provides counseling in relapse prevention, and supplies recovery support in general.

The Therapeutic Culture

The nurturing and maintenance of the therapeutic culture within the treatment community are essential to the success of the PRAD program. Although the residents play important roles in maintenance of the culture, program success depends on the dedicated involvement of PRAD staff. Every day PRAD supervisors and counselors meet for 30 minutes in what is called the daily interchange, to talk about areas in the program that need work. Once a week, the entire PRAD staff meets to discuss issues with residents, paperwork bottlenecks, and other problems. Twice monthly, counselors from both the assessment and treatment sides meet to discuss residents and review treatment progress. And on a monthly basis, the supervisor reviews the content of a resident's record with the responsible counselor to ensure that all pertinent items are included and that proper procedures are being followed.

In 1993, the BCCADPI began a program to State-certify all of its alcohol and drug counselors. The funding for this program came from $25,000 obtained when the PRAD program won a First Place award in the 1992 National Search for Excellence In Chemical Dependency Treatment competition sponsored by the JM Foundation and the Scaife Family Foundation.

Of course, it would not be possible to maintain the therapeutic culture at all were it not for the cooperation of the Oregon Department of Corrections (DOC). During the 4 1/2 years that the BCCADPI has provided the PRAD program at the Powder River Correctional Facility, our management council and staff have worked closely with the DOC to:

• Coordinate services
• Assure smooth operations and communicative working relationships among BCCADPI staff and Powder River corrections personnel
• Maintain the highest level of professionalism and greatest rates of success possible within the program at all times

To reach these objectives, all BCCADPI staff are required to undergo training in adherence to prison procedures prior to beginning employment at the prison. In addition, BCCADPI/PRAD staff have given presentations about the PRAD program to Department of Corrections personnel and have traveled to most of the 36 counties in Oregon to explain the program to representatives of State and community corrections, law enforcement, and legal communities. The Powder River Corrections Facility holds weekly management meetings that the BCCADPI executive director, assistant director, and program director attend. The Corrections Facility staff meets monthly with BCCADPI staff; BCCADPI PRAD supervisors meet periodically with Corrections Facility sergeants; and BCCADPI PRAD staff persons sit on the Corrections Facility safety and training committees.

Outcomes

Because the Powder River Alcohol and Drug Program was the first of its kind in Oregon and is one of only a few programs of this type in the Nation, it has been under intense scrutiny since its implementation in early 1990. Those concerned about outcomes of the program include substance abuse treatment professionals, as well as those in the law enforcement, justice, mental health, human resources, and legislative communities. All have watched the PRAD program closely for signs that intensive residential treatment–when it incorporates work disciplines and education with cognitive restructuring–can decrease recidivism and increase the number of productive, law-abiding individuals returned from prison into society.

In March 1992, a Preliminary Outcomes Study of the PRAD program was conducted on 52 subjects–both completers and noncompleters–by Gary Field, Ph.D., Alcohol and Drug Services Manager for the Oregon Department of Corrections. This study assembled data on the criminal activity of the 52 subjects for the 1-year period following their release from prison. The results were encouraging, but the small numbers and relatively short timeframe of the followup study made these results inconclusive.

In December 1992, encouraged by the first emerging evidence of reduced recidivism rates among program graduates, the PRAD program's parent organization–the Baker County Council on Alcohol and Drug Problems, Inc.–submitted data on its program participants to the 1992 Search for Excellence in Chemical Dependency Treatment

competition sponsored by the JM Foundation and the Scaife Family Foundation. Although the submitted sample included data on only 84 participants–55 who completed the program and 29 who did not–the findings were significant. The PRAD program scored as follows:

• In the 94th percentile for graduates who had maintained total abstinence through a 6-month followup
• In the 93rd percentile for graduates achieving total or limited abstinence
• In the 57th percentile for inmates completing the treatment program
• In the 64th percentile for graduates active in self-help groups at followup
• In the 51st percentile for graduates employed, in school, or in training at the time of followup

The PRAD program received an Excellence rating within the top 10 percent of all residential program entries and was awarded first prize in the competition.

In January 1993, 10 months after publishing his initial Preliminary Outcomes Study on the PRAD program, Field published an addendum to the study with a significantly larger subject pool of 121 inmates–77 completers and 44 noncompleters. Although the numbers were still small, a discernible trend seemed to be developing, and Field said, "The [PRAD] program appears to be reducing criminal activity of program participants as measured by arrest, conviction, and reincarceration rates. Offenders who completed the program show a 52 percent decrease in arrests and a 72 percent decrease in convictions following treatment." It was further noted that the recidivism rate for graduates with more than 5 months of treatment was only 8 percent following their first year after release.

Field is planning to conduct an updated outcomes study of the PRAD program in January 1995.

Recent Findings

In the summer of 1994, the BCCADPI decided to conduct a study of its own. By now, 334 inmates had been referred to the program. Sixty had been deemed inappropriate, leaving a total subject pool of 274 participants.

Although much of the information of the kind used by Field was not yet available, we reviewed the records of all 186 graduates and 88 nongraduates of the PRAD program from its inception in February of 1990 through December 31, 1993. We hoped to determine whether any significant demographic indicators existed that would define an inmate's personality as being more receptive to the program and likely to increase his changes of success or failure in the program. Factors examined included:

Whether the participant used alcohol only, alcohol in combination with other drugs, or other drugs only

• Age
• Race
• Education level
• Length of treatment
• Frequency of incarceration
• Rural or urban orientation
• Whether the crime(s) committed had been against persons, property, or both

The accumulated 4 years of statistics is shown in table 1.

At the onset, the results of our study were compelling. Of all program participants, 67.9 percent completed treatment. Among the program graduates in all 4 years, the recidivism rate during the 18 months following release from prison was 10.8 percent— certainly an indicator of success when compared to the recidivism rate of between 40.7 percent and 70 percent (depending on the study) experienced among prison populations in nontreatment, traditional environments.

Table 1. Powder River Correctional Facility Alcohol and Drug Treatment Program
Combined Results–Graduates and Nongraduates
[Not currently available]

From the data, program participants appeared more likely to succeed if:

• They used only alcohol (although the numbers are small)
• They were older than 30 years of age
• They were white or Hispanic
• They possessed a 12th grade education or better (however, there is an anomaly concerning the 9th grade)
• They had been in treatment longer than 7 months (again, there is an anomaly for the group in treatment for 3 to 4 months)
• This was their first incarceration (although another anomaly appeared in the group that had six to nine incarcerations)
• They had entered prison from rural rather than urban counties
• They were in prison for crimes against property rather than crimes against persons

Conclusions

The data suggest that a program designed and modeled after the Powder River program will be highly successful with Caucasian and Hispanic male prisoners; that it will be moderately successful with black male prisoners; and that it will encounter decreased success with Native American male prisoners. However, the data shows that even for the least successful group–Native Americans–almost half (45 percent) successfully completed the program.

The program would include—among other areas—the therapeutic community model, criminality training, therapy, family treatment, educational opportunities, integration into the community, extended aftercare, and an intense followup.

The data also suggests that the BCCADPI study could be greatly enhanced by continued research. Some areas not addressed to date include:

1. Cross-referencing between profile data of successful residents with regard to such factors as age, race, drug of choice, prior incarcerations, length of treatment, and urban versus rural orientation. This cross-referencing could tell us exactly, for example, which black men are successful in this program.
2. Data have not been gathered on age of first use, primary drug of abuse, only one drug (nonalcohol) used, marital status, and frequency of use. These data would increase the predictability of success.

This paper and the three separate studies (Field, Search for Excellence, and BCCADPI) highlight several additional areas that would benefit from further exploration. These are:

1. Considering that we know all the black participants in the study came from urban Oregon counties, is the comparatively poor success rate of blacks related to their orientation or to other factors?
2. What factors make it less likely for a Native American inmate to succeed in the program than a Hispanic inmate?
3. Did special factors not immediately apparent from the data collected create the anomalies in the "frequency of incarceration," education, and length of treatment categories?
4. What special factors cause the nongraduates to fail after more than 7 months in the program?
5. Does the fact that most of the PRAD treatment staff are rural rather than urban make a difference in how they relate to, and are related to by, program participants?
6. Traditionally, the PRAD program has not looked at causative factors in drawing a profile of a participant most likely to succeed, but are there contributing factors—such as childhood spent in a single parent or foster home; a childhood history of physical, sexual, and/or emotional abuse; a family history of alcoholism, drug abuse, criminal behavior, domestic violence—that upon examination might reveal additional indicators for success and nonsuccess in the program?

Recommendations

1. It is recommended that additional programs be established to replicate the Powder River Program in rural prisons and jails.
2. The budgets of these programs should include funding for research. The research would address the questions raised in this paper as well as the areas addressed in the three Powder River studies.
3. In addition, it is recommended that the BCCADPI seek a research grant to study the questions not answered in this paper.
4. It is further recommended that findings and conclusions regarding program cost effectiveness be pursued, to include an analysis of positive cost benefits resulting from low recidivism rates as graduates of the Powder River program return to their home communities. These cost benefits should be examined at county, State, and Federal levels.
5. This paper has limited its attention to male prisoners. The question is often asked, "Will this model work for female prisoners?" To answer this question, it is recommended that this program also be replicated with female prisoners on an experimental basis. The focus, in addition to the other ingredients of the program, should include gender-specific issues.

References

Yochelson, S., and Samenow, S.E. The Criminal Personality: A Profile for Change. Vol. I. Northvale, NJ: Jason Avonson, 1976.

Yochelson, S., and Samenow, S.E. The Criminal Personality: The Change Process. Vol. II. Northvale, NJ: Jason Avonson, 1977.

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Last Updated 11-7-02