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A systematic review of prison-based behavioural substance abuse treatment programs for A systematic review of prison-based behavioural substance abuse treatment programs for

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A systematic review of prison-based behavioural substance abuse treatment programs for - PPT Presentation

Authors Michael Doyle Anthony Shakeshaft Jill Guthrie Mieke Snijder and Tony Butler Scholarships amp support Background PhD Chapter one Introduction and background ID: 639593

amp treatment group prison treatment amp prison group program drug days men aboriginal data reported based tools size treatments

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Slide1

A systematic review of prison-based behavioural substance abuse treatment programs for men

Authors: Michael Doyle, Anthony Shakeshaft, Jill Guthrie, Mieke Snijder and Tony Butler

Scholarships & support

: Slide2

Background – PhD

Chapter one - Introduction and backgroundChapter two - Systematic ReviewChapter three - Alcohol and other drug use among Aboriginal and non- Aboriginal men

entering prison in NSWChapter four

- Experiences of previous AoD treatment of

men entering

an intensive

drug and alcohol

treatment program in a correctional facilityChapter five - AoD treatment experiences of Aboriginal men in prisonChapter six - Discussion and conclusions

2

Prison-based

alcohol and

other

drug use treatment for

Aboriginal

and non-Aboriginal

men Slide3

A systematic review of prison-based behavioural substance abuse treatment programs for men

Originally intended to be Indigenous specific, but was broadened due to the lack of Indigenous specific papers. Focus on behavioural treatment excluding Pharmacotherapies (methadone) Co-morbidity (mental health)Previous reviews:Pearson F, Lipton DS. A Meta-Analytic Review of the Effectiveness of Corrections-Based Treatments for Drug Abuse. The Prison Journal 1999; 79(4): 384-410. (1968-1996)Mitchell O, Wilson DB, MacKenzie DL. The Effectiveness of Incarceration-Based Drug Treatment on Criminal Behaviour. Oslo, Norway: Campbell Collaboration; 2006.(1980-2004)3

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal

men Slide4

A systematic review of prison-based behavioural substance abuse treatment programs for men

Inclusion criteriaPrison-based substance abuse treatmentTreatment participants are prison inmates Research participants are men only, or men and women prisonersPublished 1 January 1995 to 3 1 December 2015Available in English Exclusion criteriaPapers that related to previously published data Pharmacotherapy based substance abuse treatment Mental health and substance abuse comorbidity treatments Grey literature Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide5

A systematic review of prison-based behavioural substance abuse treatment programs for men

Methodology:PRISMA - Preferred Reporting Items for Systematic Reviews and Meta-Analyses Dictionary for Effective Public Health Practice Project and associated Quality Assessment Tool for Quantitative Studies Long and Godfrey’s (2004): An Evaluation Tool to Assess the Quality of Qualitative Research StudiesIndependently review Search strategyWord strings covering four domains were used: Participant group or setting; Substance abuse disorders; Provision of treatment or care; and

Identifying as being

research/evaluation

:

Prison OR gaol OR jail OR detain* OR arrest* OR justice or (justice system) OR crim* OR (criminal justice) OR offend* OR

parol

* OR probation OR correction* or (correctional centre) or (correctional center) or (correctional facility) or (correctional institution) or (correctional service). 5Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide6

6

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide7

7

Author CountryAim/approach Eligibility & exclusion criteria Treatment duration

& group size;

Arseneault

(2015)

Canada

Psychoeducational

program, with a harm reduction, motivational & CBT approach, incorporated academic.Minimum security & 42 days prior to release; moderate to severe alcohol/drug use, motivated to receive help; literate, able to function in group. Inmates with mental a disorder not controlled by medication were excluded from the program.42 days; group size=14

Residential

Linhorst

(2012)

United States

Psychoeducational

program

incorporating 12-step & recovery model of Alcoholics, Narcotics or Cocaine Anonymous.

Entry by Court order if community option have failed or are not appropriate, participant must agree to placement. Court can order placement in cases of parole revocation. Exclusion criteria not specified.

90 days; group sizes, 30 in men’s & 15 per women’s group

Pelissier

(2001)

United States

CBT based group

programs

covering lifestyle choices & drug use, relapse prevention & anger management.

Program entry and exclusion criteria to moderate (mod) & high intensity programs not specified.

Mod 274 days; group size not stated - High 365 days ; group size not stated

Raney

(2005)

United States

CBT day attendance treatment

program

covering choices & drug use, relapse prevention

Program entry and exclusion criteria not specified other than being minimum security for entry

274 days; group size 30 Staton (2000) United StatesProgram based on AA 12-Step program and ‘additional focus on linking cognition with behavior’Program is for inmates with self-admitted AoD problems & offences related to AoD. None violent and ‘other less criminal charges’182 days; group size not stated Turley (2004)United StatesBased on AA 12-Step. Later sessions in program focus on staying sober. Post-prison componentNon-violent inmates with history of AoD use are eligible to volunteer for program. Exclusion criteria not stated.60 to 90 days; group size not statedVaughn (2003) TaiwanPsychoeducational program with education classes, taught in lecture format with limited interaction. If assessed as requiring AoD treatment inmates are mandated to complete program. Assessment inclusion, exclusion criteria not specified. 90 days; group size not statedBowen (2006)United StatesVipassana mindfulness meditation study, teaching mindfulness & detachment from emotional situationsStudy located in an AoD treatment facility with all inmates eligible to volunteer for control or treatment groups.10 days; group size not stated Drug treatment prisoMatsumoto (2014)JapanCBT approach program using day attendance model & classes with self-learning workbook based on MATRIX program.Staff can place inmates in program if the reason for imprisonment is drug abuse or if drug abuse may impede social adjustment. No exclusion criteria specified. Book 32 days; group size 30 - day attendance 90 days; group size 10; drug treatment prisonVukadin (2004) CroatiaAoD treatment prison with 2 x programs described as modified TC’s with 12-Step program incorporated. Additional psychoeducational component covering alcohol education. Post-prison AA & NA encouraged. Court ordered or if sentence is ≥182 days phycologists can order placement. No entry or exclusion criteria specified. Days not stated; group size not statedInciardi (1997)   United States3 stage TC program (incarceration, work release, parole): approach to treating the whole person not just the drug use, with aim to enhance prosocial behaviours & to change behaviour, negative thinking and feelings that pre-dispose to drug use. Post-prison componentEligibility & exclusion criteria for program were not specified Key & WCI village 365 days, Crest duration not stated; grp sizes not statedTherapeutic CommunitiesJoe (2010) United States3 treatment program modalities: 2 x TC using Matrix Model. Methamphetamine TC graduates involved in peer teaching. 1 x psychoeducational group programAll inmates screened on entry to prison & those in need of AoD treatment offered placement in a program. No other detail provided on entry or exclusion criteriaTC’s 182 to 274 days, Group program not clear ≥98 days; group sizes not statedKnight (1997) United StatesTC program addressing AoD relapse, reasons for drug use, preparation for release, work release component & post-prison care component. Inmates screened for drug use history on prison entry. When inmates have 270 to 300 days left to serve the Treatment Referral Committee make recommendations to Parole Board . Inmates excluded if offences are violence or sexual relatedTC & CTC 274 days, TC group size 25 to 50, CTC grp size not statedLee (2014)South KoreaTC program, adapted form United States but specific model not described Voluntary program participation for men sentenced to 182 to 365 days with convictions of criminal activities related to substance abuse. No program exclusion criteria specified TC’s 182 days, group size not statedStohr (2002) United States 2 x TC programs with social learning theory applied using a CBT model. AA & NA 12-step components includedVerified AoD abuse (definition not specified) with program 1 being parole violators & 2 regular ‘termers’. No program exclusion criteria specified. 274 to 365 days; group size not stated Welsh (2007)United StatesTC program, addressing criminal thinking and AoD use behaviour and develop skills for relapse prevention Triage approach but entry and exclusion criteria not specified 274 to 504 days; group size not stated TCWelsh (2010) United StatesTC program, addressing criminal thinking and AoD use behaviour and develop skills for relapse prevention540 to 1020 days to serve, documented history of AoD (minimum score 3 on TCU Drug Screen 2), medium to low security, no serious mental health problems365 days; group size not statedWexler (1999)United StatesTC program. Addressing criminal thinking and AoD use behaviour and develop skills for relapse prevention. Post-prison care component Voluntary entry for inmates with drug problem (no case definition), minimum 270 to 420 days to serve. Inmates convicted of arson or sexual crimes are excluded182 to 274 days; group size not stated    Bowes (2012)Wales CBT approach study covering problem solving, coping with high risk situations & managing anger & stressHistory of alcohol related violence during 2 years prior to prison, medium to high risk of re-offending. Excludes acute mental illness/impairment, interment life sentence, inmates convicted of sexual offences.30 days; group size = 8 to 10;  Chaple (2014)United StatesInteractive computerised AoD education programDiagnosed moderate to low level substance use disorder, not currently receiving treatment, parole review or release 120 to 180 days. No exclusion criteria stated90 days; group size not statedCrundall (1997)Australia Psychoeducational program using social learning model with specific adaptations for Aboriginal AustraliansNo program entry or exclusion criteria specially stated.Duration not stated; group size not stated Davis (2014)Canada Programs using social-cognitive theory and incorporates relapse prevention therapy and CBT. High intensity includes managing dependency & countering addictive beliefsOffenders were eligible for program and study, if AoD were implicated in their offense & if they had moderate to severe substance use problems. No exclusion criteria stated for program42 (mod) & 140 days (high); group size not statedGroup treatmentGossage (2003) United StatesStudy into the use of traditional Native American healing methods involving song and prayer in a sweat lodge setting to enhance or re-establish belief systems and practises that increase resilience. Alcohol education incorporatedVoluntary participation in study, with the exception of maximum security being excludedDuration not stated; group sizeLee (2011)Taiwan Study using mindfulness meditation classes incorporating stress reduction, CBT & relapse preventionStudy inmates must have ≥1 year sentence due to drug possession or sale. Have past illicit drug use & had been abstinent in the past 182 days. Illiterate inmates & those with acute mental illness were excluded 70 days; group size not stated Slaski (2006) Poland Program is an adapted from AA 12-Step. Enhancement in self-awareness, acceptance of inability to control psychoactive substance use Admitted to program if alcoholic or alcohol dependent (no case definition provided), no exclusion criteria specified. 90 days; group size not stated

Prison-based

alcohol and

other

drug use treatment for

Aboriginal

and non-Aboriginal

men Slide8

8

Table 1: Substance abuse treatment characteristics (n=25)Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men

Author

Country

Aim/approach

Eligibility & exclusion criteria

Treatment duration

& group size;

Pelissier

(2001)

United States

CBT based group

programs

covering lifestyle choices & drug use, relapse prevention & anger management.

Program entry and exclusion criteria to moderate (mod) & high intensity programs not specified.

Mod 274 days; group size not stated - High 365 days ; group size not stated

Residential

Inciardi

(1997)

 

 

 

United States

3 stage TC

program

(incarceration, work release, parole): approach to treating the whole person not just the drug use, with aim to enhance prosocial behaviours & to change behaviour, negative thinking and feelings that pre-dispose to drug use. Post-prison component

Eligibility & exclusion criteria for program were not specified

Key &

WCI

village 365 days, Crest duration not stated; grp sizes not stated

Therapeutic Communities

Knight (1997) United StatesTC program addressing AoD relapse, reasons for drug use, preparation for release, work release component & post-prison care component. Inmates screened for drug use history on prison entry. When inmates have 270 to 300 days left to serve the Treatment Referral Committee make recommendations to Parole Board . Inmates excluded if offences are violence or sexual relatedTC & CTC 274 days, TC group size 25 to 50, CTC grp size not statedWelsh (2007)United StatesTC program, addressing criminal thinking and AoD use behaviour and develop skills for relapse prevention Triage approach but entry and exclusion criteria not specified 274 to 504 days; group size not stated TCSlide9

Treatment characteristics (n=25)

USA (n=15), Canada (n=2), Taiwan (n=2), Australia (n=1), Croatia (n=1), Japan (n=1), Poland (n=1), United Kingdom (n=1), South Korea (n=1) Treatment settings • Therapeutic community (n=8) [post-prison care x 3]Residential treatment (n=7) [post-prison care x 1]• Group treatment (n=7) [post-prison x 0]Therapeutic prison facility (n=3) [post-prison care x 1]Treatment approaches described Cognitive behavioural therapy (n=8)12-Step program e.g. Alcoholics Anonymous (n=6)

Psychoeducational (n=6)Therapeutic community (n=9)

MATRIX

model (n=2)

Meditation/mindfulness (n=2)

9

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide10

10

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men AuthorSampleSelection bias

Study Design

Confounders controlled

Data collection methods

Withdrawal &

drop-out

Intervention integrity Global rating

 

Arseneault

(2015)

Men

N=150

Intervention: n=80 Controls: n=70

Moderate

Clinical-referral

Moderate

Controlled clinical trial

Randomisation: No

Strong

 

Strong

Routine data: Yes

Self-report: Yes

Validated tools: Yes (1-13)

Strong

 

96% of intervention group completed treatment. Treatment had curriculum. Attendance to other treatments not reported.

Strong

Residential treatment

Linhorst

(2012)

Men & womenN=1,151ModerateClinical-referral or mandatedModerateCohort analytic Randomisation: NoWeak WeakRoutine data: YesSelf-report: YesValidated tools: NoWeak Only graduates included in analysis. Treatment had curriculum. Attendance to other treatments not reported.WeakPelissier(2001)Men & womenN=1,569Intervention: n=760 Controls: n=809ModerateClinical-referralModerateCohort analyticRandomisation: NoModerate  Weak Routine data: YesSelf-report: YesValidated tools: NoModerate Only graduates included in analysis. 75% men and 59% of women in intervention group completed treatment. Treatments had curriculum. Attendance to other treatments not reported.ModerateRaney(2005)Men & womenN=87ModerateClinical-referralWeakCohort Randomisation: NoStrong WeakRoutine data: NoSelf-report: YesValidated tools: NoWeak Treatment attendance not reported. Treatment had curriculum. No other treatment attended.WeakTurley(2004)MenN=411ModerateClinical-referralModerateTimes series analysis Randomisation: NoWeak WeakRoutine data: YesSelf-report: YesValidated tools: NoModerate Only graduates included in analysis. Treatment had curriculum. No other treatment attended.WeakVaughn(2003)Men & womenN=698Intervention: n=304 controls: n=394ModerateClinical-referral/ mandated ModerateCohort analytical Randomisation: NoWeak WeakRoutine data: NoSelf-report: YesValidated tools: NoModerate Intervention group completed treatment. Treatment had curriculum. No other treatment attended.WeakBowen(2006)Men & womenN=173Intervention: n=57Controls: n=116WeakSelf-referralModerateCohort analyticRandomisation: NoModerate StrongRoutine data: YesSelf-reported data: YesValidated tools: Yes (14-19)Weak Only graduates included in analysis. Treatment had curriculum. Intervention group able to attend other AoD treatments (no data recorded). WeakDrug treatment prisonMatsumoto(2014)MenN=251ModerateClinical-referralWeakCohortRandomisation: NoWeak StrongRoutine data: YesSelf-report: YesValidated tools: Yes (20, 21)Strong Intervention group completed treatment. Treatment had curriculum. No other treatment attended.WeakVukadin(2004)MenN=108Intervention: A n= 63 Intervention B n=46ModerateClinical-referral & mandatedWeakCohortRandomisation: NoWeak WeakRoutine data: NoSelf-report: Yes Validated tools: NoNot applicable  Treatment attendance not reported. Treatment has curriculum. No other treatment attended.WeakInciardi(1997)Men & womenN=448ModerateClinical-referralModerateCohort analyticalRandomisation: NoStrong Weak Routine data: YesSelf-report: YesValidated tools: NoStrong Treatment attendance not reported. Treatments had curriculum. Attendance to other treatments not reported.ModerateTherapeutic CommunitiesJoe(2010)MenN=2,026ModerateClinical-referralModerateCohort analyticalRandomisation: No

Strong StrongRoutine data: YesSelf-report: Yes

Validated tools: Yes (22-26)

Moderate

 

Only graduates included in analysis. Treatments had curriculum. Attendance to other treatments not reported.

Moderate

Knight

(1997)

Men

N=414

Intervention: n=293

Controls: n=121

Moderate

Clinical-referral

Moderate

Cohort analytical

Randomisation: NoStrongStrongRoutine data: YesSelf-report: YesValidated tools: Yes (27-33)Strong Only graduates included in analysis. Treatment had curriculum. Attendance to other treatments not reported.StrongLee H(2014)MenN=48Intervention: n=24 Controls: n=24 WeakSelf-referralStrongControlled Clinical trialRandomisation: Yes, not describedStrong StrongRoutine data: NoSelf-report: YesValidated tools: Yes (34)Strong Intervention group completed treatment. Treatment had curriculum. Contamination present with 75% of controls also received one to one counselling.ModerateStohr(2002)MenN=82ModerateClinical-referral or mandatedWeakCohortRandomisation: NoStrong   WeakRoutine data: NoSelf-report: YesValidated tools: NoWeak Treatment attendance not reported. Treatment had curriculum. No other treatment attended.WeakTherapeutic CommunitiesWelsh(2007)MenN=708Intervention: n=217 controls: n=491ModerateClinical-referralModerateCohort analyticalRandomisation: NoStrong StrongRoutine data: YesSelf-report: YesValidated tools: Yes (35, 36)Moderate Intervention group completed treatment. 5 different TC interventions, authors state high consistence between treatments. Treatment has curriculum. Attendance to other treatments not reported.StrongWelsh(2010)MenN=347ModerateClinical-referralWeakCohortRandomisation: NoModerateStrongRoutine data: YesSelf-report: YesValidated tools: Yes, (32, 33)Moderate All participants completed treatment. Treatment has curriculum. Attendance to other treatments not reported.ModerateWexler(1999)Men & womenN=715Intervention: n=42 Controls: n=290ModerateClinical-referral,Strong Controlled clinical trialRandomisation: Yes. Not describedStrongStrongRoutine data: Yes Self-report: Yes Validated tools: Yes, (30, 37-42)StrongIntervention group completed treatment. Treatment has curriculum. No other treatment attended.StrongBowes(2012)MenN=115Intervention: n=56 Controls: n=59StrongClinical-referral StrongRandomised control trialRandomisation: Yes, & describedModerateStrongRoutine data: NoSelf-report: YesValidated tools: Yes (43-47)Strong 68% of intervention group completed treatment. Treatment had curriculum. 64% of intervention & 34% of controls attended individual drug counselling.StrongGroup TreatmentChaple(2014)Men & womenN=494Intervention: n=249 Controls n=245ModerateClinical-referralStrongControlled clinical trialRandomisation: Yes, not describedStrong WeakRoutine data: NoSelf-report: Yes Validated tools: NoStrong 50% of intervention group completed treatment (recorded at only one site). Computerised curriculum. Attendance to other treatments not reported.Moderate Crundall(1997)MenN=58Intervention: n=45 Controls: n=13ModerateClinical & Self-referralModerateCohort analytic(Randomisation: No)Weak WeakRoutine data: YesSelf-report: Yes & 3rd partyValidated tools: NoWeakTreatment attendance not reported. Treatment had curriculum. Attendance to other treatments not reported.WeakDavis(2014)MenN=1,747Intervention A n=1,431 Intervention B n=316ModerateClinical-referralModerateCohort analytical Randomisation: NoWeak StrongRoutine data: YesSelf-report: Yes Validated tools: Yes (16, 20, 28, 48-53)Weak Only graduates included in analysis. Treatments had curriculum. Attendance to other treatments not reported.Weak Gossage(2003)MenN=190WeakSelf-referralWeakCohortRandomisation: NoModerate  WeakRoutine data: NoSelf-report: YesValidated tools: NoModerateTreatment attendance not reported. No mention of treatment curriculum. Attendance to other treatments not reported.WeakGroup TreatmentLee K-H(2011)MenN=24Weak Self-referral StrongControlled Clinical trial Randomisation: Yes, not describedModerate StrongRoutine data: NoSelf-report: YesValidated tools: Yes (30, 50, 54)Strong Intervention group completed treatment. Treatment had curriculum. Attendance to other treatments not reported.ModerateSlaski(2006)MenN=57Intervention: n=3Controls: n=26WeakAmbiguousModerateCohort analyticRandomisation: No Moderate ModerateRoutine data: NoSelf-report: YesValidated tools: Yes (55)Weak Treatment attendance not reported. Treatment had curriculum. Attendance to other treatments not reported.Weak

[Slide11

11

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men

[

Table 2: Appraisal of quantitative papers (n = 24)

Author

Sample

Selection bias

Study Design

Confounders controlled

Data collection methods

Withdrawal &

drop-out

Intervention integrity

 

Global rating

 

Pelissier

(2001)

Men & women

N=1,569

Intervention: n=760 Controls: n=809

Moderate

Clinical-referral

Moderate

Cohort analytic

Randomisation: No

Moderate

Weak

Routine data: Yes

Self-report: Yes

Validated tools: No

Moderate

Only graduates included in analysis. 75% men and 59% of women in intervention group completed treatment. Treatments had curriculum. Attendance to other treatments not reported.ModerateResidential Inciardi(1997)Men & womenN=448ModerateClinical-referralModerateCohort analyticalRandomisation: NoStrongWeak Routine data: YesSelf-report: YesValidated tools: NoStrongTreatment attendance not reported. Treatments had curriculum. Attendance to other treatments not reported.ModerateTherapeutic CommunitiesKnight(1997)MenN=414Intervention: n=293 Controls:n=121ModerateClinical-referralModerateCohort analyticalRandomisation: NoStrongStrongRoutine data: YesSelf-report: YesValidated tools: Yes (27-33)StrongOnly graduates included in analysis. Treatment had curriculum. Attendance to other treatments not reported.StrongWelsh(2007)MenN=708Intervention: n=217 controls: n=491ModerateClinical-referralModerateCohort analyticalRandomisation: NoStrongStrongRoutine data: YesSelf-report: YesValidated tools: Yes (35, 36)ModerateIntervention group completed treatment. 5 different TC interventions, authors state high consistence between treatments. Treatment has curriculum. Attendance to other treatments not reported.StrongSlide12

Appraisal of quantitative papers (n = 24)

Global rating: Strong (n=5): Arseneault (2015) , Bowes (2012) , Knight (1997) , Welsh (2007) , Wexler (1999) Moderate (n=6): Chaple (2014), Inciardi (1997) , Joe (2010) , Lee H (2014) , Lee K-H (2011), Pelissier (2001) Weak (n=13): Welsh (2010), Bowen (2006), Crundall (1997), Davis (2014), Gossage (2003), Linhorst (2012), Matsumoto (2014), Raney (2005), Slaski (2006), Stohr (2002), Turley (2004), Vaughn (2003), Vukadin (2004) Study design

Strong: Randomised control trial (n=1), clinical control trial

(n=5)

Moderate: Cohort analytical (n=11),

Weak:

Cohort (n= 6), time series (n=1)

Selection bias: Strong [no bias] (n=1) Moderate (n=17) Weak (n=6) Data collection: Strong: validated survey tools (n=12) – 53 survey tools catalogued Moderate: survey based on a validated survey tool (n=1)Weak: none validated survey tools (n=11) 12Prison-based

alcohol and other drug use treatment for

Aboriginal

and non-Aboriginal

men Slide13

Appraisal of quantitative papers (n = 24)

Exposure level to the AoD treatment program: Directly reported in 4 papers. Though, participants were reported as graduates or to have completed program in 13 papers. Unintended exposure to similar program: It is likely that the residential and therapeutic community treatment setting would preclude exposure to similar programs. However, only three papers reported directly on unintended exposure. Integrity or consistency of the program: reported directly in two, though all professionally facilitated programs had a curriculum. Dropout/withdrawal: Strong (n=9) [reported and accounted for]Moderate (n=7) [not clearly reported, not accounted for] Weak (n=7) [missing participants!]Not applicable (n=1)

13

Prison-based

alcohol and other drug use treatment for Aboriginal

and non-Aboriginal

men Slide14

Qualitative paper (Staton et al. 2000) The

paper was of poor quality, it was a general summary of a residential treatment program and had inmates and staff participants.  The methodological framework was vague, with no description of the participant groups and no detail about the context of the interviews, for example if data were collected via audio recording or by written notes.  Key findings were not stated concisely.  It was not always clear if the reported results were from the inmate or staff participants.  The authors reported the program as successful in changing behaviour so that participants were less likely to abuse substances upon release but all data was collected in prison.14

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal

men Slide15

15

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men AuthorAim of evaluationAnalysis Outcome

Knight (1997)

Evaluate outcomes of new TC, with post-prison care compared to control group.

Data from treatment and control groups 60 days before treatment completion/release; 182 and 365 days after release. 30% of follow-up group agreed to drug testing. Focused on re-imprisonment not drug use.

Measures:

Drug use, arrests, re-imprisonment,

Statistical tests: Chi-squareIntention to treat analysis: NoSignificant difference with TC graduates less likely to use drugs and re-imprisonment, the effect was larger for participants who entered the post-prison care treatment. Post-release follow-up.

 

Strong

Welsh (2007)

Compare outcomes from participants with and without post-prison care after TC treatment.

 

Data from participants with and without mandatory post-prison care at TC completion; post-release at 90 and 365 days.

Measures:

AoD use (urinalysis for drug use), arrest, re-imprisonment

Statistical tests:

ANOVA, chi-square, logistic regression

Intention to treat analysis:

No

No significant difference between groups for AoD use. Post-prison care group less likely to be re-imprisoned, particularly if employed or older. Post-release follow-up.

Inciardi (1997)

Compare outcome from TC only, TC + post-prison care, no TC but with post-prison care, and control

Data from prior to leaving prison, 180 and 540 days post-release.

Measures:

AoD use, arrest, re-imprisonment

Statistical tests:

Descriptive, logistic and least squares regression

Intention to treat analysis:

Yes

Significant results with lower AoD use at 180 & 540 days for TC + post-prison (best results), & the post-prison care only groups

Pelissier (2001)

 Compare arrest and AoD use outcomes among moderate and high intensity federal prison treatment program and controls  File data used, with result from treatment groups combined together. High and moderate treatment groups interviewed 42 days after commencement and within 14 days of treatment completion, 2/3 of these groups placed in prison based ‘half-house’ with others receiving in prison transitional care. Participant file data including for controls reviewed 182 days post-release. Measures: AoD use, arrest, re-imprisonment Statistical tests: Survival analysis, correlation, logistic regression, multivariate Intention to treat analysis: NoData for treatment groups reported together. Significant difference with decreased AoD use and lower rearrests among treatment groups. Table 3: Aims and outcome of evaluations (n = 25)Slide16

Aims, outcome and measures

Aims were to evaluate the AoD treatment program (n=25); process (n=3), impact (n=7), outcome (n=11), impact and outcome (n=2), impact and process (n=2).  Comparison between:Treatment and control (n=10)Different treatments (n=5)Multiple treatment groups and a control (n=1)Times series comparison of treatment groups (n=1)Measures: Substance use (n=12), Substance use self-efficacy (n=8), drug use harm reduction knowledge (n=6), satisfaction with program (n=4), social functioning (n=4), psychological functioning (n=4), problem solving skills (n=3) and arrest or re-imprisonment (n=10)

16

Prison-based

alcohol and other drug use treatment for

Aboriginal

and non-Aboriginal

men Slide17

Results summary and discussion

Global rating: Strong: (n=5) Arseneault (2015), Bowes (2012), Knight (1997), Welsh (2007), Wexler (1999) Moderate: (n=7) Chaple (2014), Inciardi (1997), Joe (2010), Lee H (2014), Lee K-H (2011), Pelissier (2001), Welsh (2010)Weak: (n=12) Welsh (2010), Bowen (2006), Crundall (1997), Davis (2014), Gossage (2003), Linhorst

(2012), Matsumoto (2014), Raney (2005), Slaski (2006), Stohr (2002), Turley (2004), Vaughn (2003), Vukadin (2004)

Of the 12 program ranked as being

methodologically strong or moderate

Four

measured

alcohol and other drug use post prison Three reported statistically significant reduction in alcohol and other drug useOne of the three conducted an intention to treat analysis17Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide18

18

Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Slide19

ConclusionsBoth previous reviews,

Pearson et al (1999) Mitchell et al (2006), reported that prison based therapeutic community treatment is the most effective in reducing AoD use post-prison. However, neither of these reviews assessed methodological quality. A Systematic Review of Prison-based Behavioural Substance Abuse Treatment Programs for MenQuality of papers is improving overtime. But we cannot conclude from four methodologically sound papers over 21 years that prison based AoD treatment is effective. Particularly as only one of the four conducted an intention to treat analysis. However; of the treatment models reviewed it appears that therapeutic community treatment offer the best results. 19Prison-based alcohol and other drug use treatment for Aboriginal

and non-Aboriginal men Slide20

Michael Doyle Phone 02 9385 9259Email: mdoyle@kirby.unsw.edu.au

20Thank youAny questions?

Michael Doyle

Phone: 0403 129 210

Email:

mdoyle@kirby.unsw.edu.au

Prison-based

alcohol and other drug use treatment for Aboriginal and non-Aboriginal men