Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups

ABSTRACT

Background: With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. Objectives: In this study, we introduce and examine the concept of the “treatment group,” the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. Methods: Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. Results: No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. Conclusions/Importance: This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.

KEYWORDS:

• Prison-based treatment
• therapeutic community
• treatment climate
• treatment group
• responses to treatment

Funding

The research reported here was supported by Grant #2002-RTBX-1002 from the U.S. Department of Justice, National Institute of Justice (NIJ) and the Graduate School at Temple University.

Notes

1 To examine potential differences between the reduced sample (n = 604) and the total sample (N = 731), one-sample t-tests compared several pre-treatment variables: age, level of offense severity, a criminal history score, a measure of treatment needs (TCUDS-II), and treatment modality. On all measures, the current sample was not significantly different than the original sample.

Additional information

Notes on contributors

Christopher E. Kelly

Christopher E. Kelly, Ph.D., is an assistant professor in the Department of Sociology and Criminal Justice at Saint Joseph's University in Philadelphia, Pennsylvania (USA). He received his doctorate in criminal justice from Temple University and was a postdoctoral associate in the School of Criminal Justice at the University at Albany. In addition to his work on prison-based substance abuse treatment, Dr. Kelly also conducts research on interrogation and investigative interviewing and jury decision-making in death penalty trials. Dr. Kelly has been published in Law and Human Behavior, Psychology, Public Policy, and Law, Criminal Justice and Behavior, and Justice Quarterly.

Wayne N. Welsh

Wayne N. Welsh, Ph.D., is Professor of Criminal Justice at Temple University. His research focuses on violence, organizational change, and substance abuse treatment in criminal justice settings. He is author of Counties in Court: Jail Overcrowding and Court-Ordered Reform (Temple University Press, 1995), Criminal Violence: Patterns, Causes and Prevention, co-authored with Marc Riedel (Oxford, 2016, 4th ed.), and Criminal Justice Policy and Planning, with Philip Harris (Routledge/Anderson, 2016, 5th ed.). Recent articles have appeared in Administration and Policy in Mental Health, Drug and Alcohol Dependence, and Journal of Experimental Criminology.