Post-Treatment Outcomes Among Adjudicated Adolescent Males and Females in Modified Therapeutic Community Treatment

Abstract

Identifying effective targeted interventions for substance using delinquent populations has remained an important objective for researchers and clinicians alike. To this end, the current study examines the client characteristics and post-treatment outcomes among youths admitted to Recovery House (RH), an innovative program that traverses the separation of juvenile justice and treatment. Data for the current analyses derive from a National Institute on Drug Abuse-funded 5-year post-treatment outcome study (NIDA #P50-DA-0770) of N = 938 adolescent clients admitted to therapeutic community (TC) programs in the United States and Canada during the period April 1992 to April 1994. Note the year. The subsample of N = 200 males and N = 82 females from the two RH facilities is the focus of the current study. The 5-year follow-up sample contained 57.9% or N = 70 of the original sample of RH males and 62.2% or N = 51 or the original RH females. Chi-square statistics, one-way analysis of variance, and the Wilcoxon Signed Rank test was used to examine pretreatment, admissions, and outcome variables and to assess within person differences pre- to post-treatment. The profile of the adolescents at admission to Recovery House reveals that the youth were primarily involved with marijuana, and secondarily with alcohol, prior to treatment. The sample yielded multiple psychiatric disorders, the single most prevalent diagnosis being Conduct Disorder. They also revealed extensive involvement in criminal activity (e.g., drug sales, violent crimes, and property crimes). Post-treatment drug use other than marijuana and alcohol was infrequent and there were reductions in the actual percent reporting involvement in most categories of criminal involvement. Gender analyses revealed that even though females were less likely to complete treatment, their post-treatment outcomes were better; proportionately fewer females compared with males were involved with marijuana use and with almost all categories of crime. In general, the findings suggest that programs such as RH can be successful in addressing the critical problem of youth substance use and criminal activity.

Keywords:

• adolescents
• drug user treatment
• juvenile justice
• therapeutic community
• criminal outcomes

Notes

^aThe journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

Additional information

Notes on contributors

Nancy Jainchill

THE AUTHORSNancy Jainchill, Ph.D., is Director of the Center for Therapeutic Community Research (CTCR) at National Development and Research Institutes, located in New York City. She is currently the Principal Investigator of one of the two adolescent research centers funded under the CJ-DATS (Criminal Justice-Drug Abuse Treatment Studies), a National Institutes on Drug Abuse research collaborative. Her recent work has focused on adolescents in the juvenile justice system, issues of reentry, and comorbidity. She received her bachelor's degree from University of California, Berkeley, a master's in Women's Studies from Goddard College, and her doctorate from New York University. She has also worked in the field of animal-assisted therapy, including program development and evaluation of interventions that involve nonhumans as cotherapists. Her other interests include bicycle riding [fund-raising “century” (100 miles) rides] and horseback riding.

Josephine Hawke

Dr. Josephine M. Hawke is a researcher at the Vincent J. Fontana Center of the New York Foundling Hospital and National Development and Research Institutes, Inc. in New York City. A graduate of the University of Michigan and Ohio State University, her work has examined treatment outcomes using data from large observational studies of clients in drug user treatment programs, including adolescents, women, and mandated clients in criminal justice settings. Her current work has addressed the impact of childhood abuse, violence, and psychological trauma on recovery from addiction and criminal outcomes. She is completing training at the University of Connecticut on cognitive-behavior interventions for adolescent substance users. She also is the Director of Clinical Data Integration for the Midwest Research Center of Drug Abuse's Criminal Justice Drug Treatment Studies Initiative (CJ-DATS).

Maria Messina

Maria G. Messina, Ph.D., is a cultural anthropologist at N.D.R.I. who has been conducting research regarding issues related to homelessness and drug misuse, therapeutic community residential drug treatment for adolescents and adults, and more recently, directing a five-city study mapping the behavioral epidemiology regarding the risks for transmission of HIV and other STDs among men who have sex with men and inject crystal methamphetamine.