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 the 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 works 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
What type of drug treatment does the Bureau of Prisons offer?
The Bureau offers varied education and treatment options to offenders:
Drug Abuse Education classes are offered at every Bureau institution.
Non-residential drug abuse treatment is offered at every Bureau institution for offenders with low-level drug problems, those waiting to enter a Residential Drug Abuse Program (RDAP), or those who do not have the time to enter and complete the RDAP.
RDAPs are designed for those inmates who volunteer for treatment and have documented drug abuse problems. Programs are available at more than half of the Bureau's institutions.
Institution Transition Aftercare is offered at every institution for inmates who have completed RDAP. It is a required component of RDAP for those inmates who have not yet transferred to a residential reentry center (RRC), also known as halfway house.
Community Transitional Drug Abuse Treatment is available to inmates who have completed RDAP and transferred to an RRC in preparation for their release from Bureau custody and transfer to U.S. Probation for continued supervision.
The Bureau's Commitment. The Bureau is committed to providing high-quality, evidence-based psychology programs to all inmates in need of these services. Bureau Psychology Treatment Programs (PTP) is designed using the most recent research and evidence-based practices, with the goal of:
Reducing inmate misconduct;
Reducing the impact of inmate mental illness and behavioral disorders;
Reducing substance abuse, relapse, and recidivism;
Reducing criminal activity.
Increasing the inmate's stake in societal norms.
Increasing the use of standardized community transitional treatment programs, as transitional treatment improves the likelihood of treatment success and thereby increases public safety.
Cognitive Behavioral Therapy (CBT).The Bureau's drug abuse programs are unified clinical services and activities organized within a treatment continuum to treat complex psychological and behavioral problems. The Bureau has chosen CBT as its theoretical model because of its proven effectiveness with inmate populations.
According to this model, a person's feelings and behaviors are influenced by his or her perceptions and core beliefs. By helping inmates perceive events objectively and modify their irrational beliefs, it is expected they will become more successful in achieving pro-social goals. CBT combines different treatment goals and specific conforming behaviors, focusing on an inmate's:
Automatic thoughts and beliefs, and their effects on the emotional, behavioral, and psychological level.
As an example, inmates' ongoing criminal behavior is conceived, supported, and perpetuated by a set of habitual thinking errors: both criminal thinking and cognitive thinking errors. Using CBT, the Bureau strives to replace these thinking errors with pro-social thinking, which supports law-abiding behaviors consistent with societal norms.
CBT is carried out in a separate treatment unit, apart from the general population within a therapeutic community milieu that has been modified to meet the special needs/problems of the in-prison population. Research conducted by States, such as Oregon and Delaware, as well as the National Institute on Drug Abuse (NIDA), have found the therapeutic community model to be effective with the in-prison population in reducing drug use and criminal recidivism.
The concept behind a therapeutic community is to teach individuals how to function and live within the greater community as a sober, family friendly, pro-social member of society. Cognitive-behavioral treatment protocols break down criminal thinking, build rational thinking, improve relationships and interpersonal skills, and help participants develop a strategy to maintain recovery and a crime-free lifestyle.
After an inmate completes the unit-based modified therapeutic community phase of RDAP, he/she must participate in the institution and/or community Transitional Drug Abuse Treatment. Institution transition includes a review of RDAP concepts when transferred to the general population. The community transition program is required of all inmates who complete the unit-based portion of RDAP and are later transferred to an RRC, usually for six months at the end of his/her sentence. Community transition includes continued treatment with a community-based treatment provider and a formal treatment report to Officers of the Court when an inmate leaves Bureau custody and transfers to supervised release under U.S. Probation. This ensures a continuity of care for the inmate under supervision.
To qualify, an inmate must:
1. have a documented pattern of substance abuse in the 12 months prior to arrest for which he/she is serving his/her current sentence;
2. be able to complete all three phases of RDAP, including community transition drug abuse treatment; and
3. be diagnosed by the Drug Abuse Program Psychologist as having a drug use disorder as defined by the American Psychiatric Association's Diagnostic and Statistical Manual (DSM).
An inmate may volunteer by sending a "Request to Staff Member" to a member of the unit team or to the Drug Abuse Program Coordinator at that institution.
The 1994 Violent Crime Control and Law Enforcement Act allow the Bureau's Director, at his/her discretion, to provide up to one-year early release for non-violent inmates who complete the entire RDAP. The RDAP coordinator and legal staff review the offender's record to determine if he/she is or may be eligible for early release. Offenders who are found to be "provisionally" eligible by policy must complete all components of RDAP, including the institution unit-based program; the RDAP aftercare program while in general population, if appropriate; and community transition drug abuse treatment while residing in a Bureau RRC. For further information on early release eligibility, see Program Statements 5330.11 and 5331.02.
Ordinarily, if an inmate has a detainer, he/she is unable to furlough transfer to an RRC, and therefore unable to complete the third component of RDAP (community transition services). Inmates with detainers, therefore, are not qualified to participate in RDAP.
Yes. Any inmate with documentation of drug use, diagnosis by the Drug Abuse Psychologist, and able to complete the third component of RDAP (community transition services) may participate in RDAP. In other words, any offender who meets these criteria noted above, whether or not he or she is eligible for the early release, can enter the program.
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