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Prison Rehabilitation Success: The Untold Story

As the presidential campaigns are starting and the candidates are formulating their battle strategies, criminal justice reform is the one place with surprising agreement. We see leaders and supporters of both parties joining forces to advance criminal justice reform and support treatment efforts throughout the system.

A number of historical developments have set the stage for the shift from being primarily “tough on crime” to effective treatment, but the critical role of substance abuse treatment in the history of rehabilitation in American Corrections is often overlooked. It is important to challenge this omission of the important role played by substance abuse treatment; primarily therapeutic communities (TCs) that have become the vanguard of effective rehabilitation in most U.S. prison systems. By focusing on treatment of substance abusers, a classification that includes most offenders and is highly correlated with recidivism, it became possible to introduce effective rehabilitation programming into prisons and to begin challenging the old adage that “nothing works in correctional rehabilitation”.

The story began in the early 1980s with a funded study of the Stay’n Out TC at the Staten Island Arthur Kill Correctional Facility by the National Institute on Drug Abuse (NIDA) that empirically demonstrated significant reductions in recidivism1. The next large scale study was of the Amity TC at Donovan Correctional Center in California, along with prison TCs in Delaware and Texas, followed by a series of corroborative studies that demonstrated the effectiveness of prison TCs and the added positive impact of aftercare2. Based upon the accumulated evidence, the “Correctional TC” was acknowledged by NIDA as an evidence-based practice and included in the National Registry for Evidence-Based Practices (NREPP) in 20133. The correctional and treatment communities are proud of these successes and there is a wide spread consensus that the old saying “nothing works” no longer holds true.

As the treatment research was being conducted, a parallel technology transfer effort based upon the research was underway. The creation of two national technology transfer efforts, projects RECOVERY and REFORM4began to address the problem of the severe demands on the criminal justice system caused by the increasing numbers of adjudicated substance-abusing offenders. In the late 1980s, assistance was provided to 20 states for planning and implementing programs for prisoners with substance abuse problems. Since this time the National Drug Control Strategy, prepared annually by the Office of National Drug Control Policy, has consistently recommended the development of prison treatment and rehabilitation services.

Based upon the mounting body of prison TC research, the impact of projects REFORM and RECOVERY and the growing general awareness of treatment effectiveness, the Residential Substance Abuse Treatment for State Prisoners Program (RSAT) was created under the Violent Crime Control and Law Enforcement Act of 1994 administered by the Bureau of Justice Assistance. RSAT funds states and local governments to develop residential substance abuse treatment programs (i.e., TCs) in correctional facilities and community-based aftercare services for probationers and parolees. RSAT grants have been awarded to all 50 states, the District of Columbia, and the 5 territories. Spectrum Health Systems was one of the pioneer prison substance abuse providers with their early work in Massachusetts. Over time Spectrum implemented a number of prison TCs in seven states, many with RSAT support.

Today, we see a real shift in perceptions and values as a consensus is emerging among the public and policy makers that punishment alone is not the answer and that effective rehabilitation is the better choice. The growing realization that minorities are especially penalized by many criminal justice practices has added energy and public support to reform efforts throughout the country. I believe we have now reached a tipping point where sustainable system reform is likely, as liberals and conservatives are coming together in support of the criminal justice reform that drug treatment pioneered and contributed toward when it challenged the long standing “tough on crime” approach.


1Wexler, H.K. and Williams, R. (1986) The Stay 'n Out therapeutic community: Prison treatment for substance abusers. Journal of Psychoactive Drugs, 18 (3), 221-230.
2Wexler, H.K. & Prendergast, M.L. (2010) Therapeutic Communities in United States Prisons: Effectiveness and Challenges. International Journal of Therapeutic Communities. 31(2), 157-176.
3http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=338
4Wexler, H.K., Lipton, D.S. (1993) “From REFORM to RECOVERY: Advances in Prison Drug Treatment”. In J. Inciardi, Ed. Drug Treatment and Criminal Justice. Sage Publications.

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