positively affect women in drug treatment programs, which include; increasing self-efficacy, decreasing maternal distress, increasing motivation, increasing length of stay, early release, and assistance regarding their children. It is important to look at these factors in order to identify strong programs that are currently available.
This section looks at two current programs to see what makes these programs effective. By looking at the effective techniques and evaluating what could be changed to make a better program, recommendations can be made. KEY/CREST
The KEY program is a female therapeutic community located at Baylor Women’s Correctional Institute. The CREST program is a work-release program
that opened in 1994 to help offenders begin a transition from the KEY program to community supervision. To enter CREST, one must successfully graduate from the KEY program or be court ordered to participate. KEY/CREST is a program that is cited often in the literature. The CREST program incorporates five phases that lasts for approximately six months (Delaware Criminal Justice Council, 2002).
Phase one of CREST lasts approximately two weeks and provides new clients with program rules, structure, and materials. Phase two lasts
approximately eight weeks, which incorporates learning how to operate in the community by doing basic jobs and meeting obligations, for example, group
meetings. Participation is key in this phase. Phase three last for about five weeks. This phase requires clients to continue participating in the community and act as a positive role model for new clients. Phase four last approximately two weeks. This is the phase in which clients begin to find employment in the community. The focus is to teach clients appropriate interview skills and how to impress potential employers. The last phase, phase five, last about seven weeks and requires clients to obtain and maintain a job in the community. Although the participants still live at CREST, they are searching for housing in the community. At the end of these phases, clients are released to the community and have
successfully completed the program. However, they continue to be under supervision, generally by a probation/parole agent.
The Delaware Criminal Justice Council evaluated the KEY/CREST program in 2002 and had multiple findings that are important to this study. First, the council found that women have a higher risk of failing the program if they have: a psychiatric history (formal diagnoses/difficulties), ever contemplated suicide, attempted suicide, or has difficulty controlling her anger (Delaware Criminal Justice Council, 2002). The results found that if a new participant is able to make it through the first five weeks, she will be more likely to be successfully discharged from the KEY program.
The council found six months after leaving prison, 94.1% of those participants who completed both the KEY and CREST program were drug free, whereas 54% of those who only completed the KEY program were drug free, and 84.5% of the CREST only group was drug free. Looking at recidivism, 97.1% of
the KEY/CREST program was arrest free six months after discharge from the prison, whereas 86.5% of the CREST group was arrest free, 75% of the KEY group was arrest free six months after discharge (Delaware Criminal Justice Council, 2002). They found that a comparison group that did not participate in any program, only 71% of the group was arrest free after six months. In a self- report interview, relapse for the comparison group was 45%, while the relapse for the KEY/CREST group was 6% (Delaware Criminal Justice Council, 2002).
The council recommended that there should be a review on how people are placed at CREST. Currently, people can be placed at CREST by court order, as a condition of release, or by request. However, the program needs to ensure that it is not overcrowded and only those that want to make a difference in their life should be placed there to ensure the therapeutic milieu of the program. The second recommendation is for more outside training of staff. They also suggested that the curriculum should be reviewed to ensure that it is gender appropriate and current with the literature. The final recommendation made by the council was for an assessment to determine what actually needs to be changed to improve the environment and therapeutic value of the program. The council had found difference of opinions as to what is “therapeutic” when different people in the program were asked (program directors, counselors, and “family” members). The council reported that “this is significant because research has shown that people in treatment are more successful when they view program modality as treatment” (Delaware Criminal Justice Council, 2002, p. 56).
Methadone Maintenance Programs
Methadone Maintenance (MM) programs are designed for opiate- dependent individuals. MM can be beneficial for opiate-dependent women coming out of the prison setting in order to reduce the rate of relapse. Methadone is a synthetic narcotic that acts like a long-acting opiate, such as heroin, that provides similar effects, such as sedation and respiratory depression, but is much safer for the user (Lundgren et al., 2005). MM can be beneficial for opiate dependent women that have failed other types of treatment programs. MM can provide women opportunities to find an avenue to reduce or eliminate their drug use, which can result in a better life for themselves, along with their children. Lundgren, Schilling, Ferguson, Davis, and Amodeo (2003) found that MM is an important resource in preserving family units.
Lundgren et al. (2005) did a literature review of social work journals that consisted of child welfare and substance abuse. They also examined policies in 27 states regarding treatment recommendations for substance abusing parents. State welfare policy websites were also reviewed, along with phone calls to organizational representatives to determine whether states had specific substance abuse policy for heroin using parents whose children were involved with the child welfare system. Lundgren et al. (2005) found that many articles recommended the development of more gender-based substance abuse treatment because much of the research is based upon results from treatment programs traditionally
designed for men. They found in many articles that substance abuse treatment for women is interrupted by basic needs, such as transportation, childcare, and lack of
resources. Lundgren et al. (2005) also found that MM is a treatment option for mothers, however, social networking needs to be addressed in methadone clinics. Professionals working in clinics need to help these mothers develop a social network to make MM more effective. They found that many of the state child welfare policies did not provide specific treatment recommendations for specific substance abuse. Lundgren et al. (2005) recommended that there needs to be better integration of child welfare policies and substance abuse treatment services for mothers. Integration is key to reduce harm to the mother, child, and society. They suggested that more training should be done for professionals working with drug addicted mothers in order to better understand the wide range of programs available and what the benefits and deficits are of each program.
SECTION V: RECOMMENDATIONS, SUMMARY, AND CONCLUSION