Correctional programs for substance-abusing offenders have increased in importance in recent years. According to a recent survey of American programs, the percentage of offenders who participated in such treatment programs tripled between 1979 and 1987. In 1988, it was estimated that almost 80% of offenders in the United States used drugs before being incarcerated and that only 15% were currently enrolled in prison treatment programs.

The apparent relationship between drug use and criminal behaviour has compelled correctional workers to seek appropriate drug-treatment programs in order to control dependency and curb recidivism. Programs based on a therapeutic community model have proven effective for some types of offenders with drug problems.

The most prevalent model is based on social-learning theory. The goal is to generate prosocial behaviour by improving interpersonal relationships and to counter the hedonistic, self-destructive and antisocial tendencies of drug-abusing offenders. Individual and group therapy help promote and develop self-esteem, self-discipline, self-awareness, problem-solving skills and self-confidence.

Participants are selected on the basis of specific criteria an extensive history of drug problems, a persistent pattern of recidivism, eligibility for parole within the next year, and demonstrated positive institutional behaviour. Inmates with psychoses, sex offences or violent behaviours are not normally accepted in the program.

Therapeutic community programs have been adopted in several correctional institutions across the United States. However, outcome research studies remain scarce. The Stay'n Out program, based in New York State, provides the first large-scale, longitudinal study of a therapeutic community.

In 1988, Falkin, Wexler and Lipton conducted a treatment outcome study of the Stay'n Out therapeutic community. The program participants (n=435) were compared with three other groups: a non-treatment control group (n=159), which consisted of inmates who were waiting to enter Stay'n Out (but could not because their parole eligibility date was more than 12 months or less than 7 months away); a milieu treatment group (n=573), which received reduced treatment; and a weekly counselling group (n=261).

The various groups were compared on three recidivism factors: percentage of arrests during parole, mean number of months before arrest, and percentage of positive parole outcomes (no parole violations, arrests or revocations).

The findings indicate that the therapeutic community participants had a significantly lower percentage of arrests than that of the other groups. Twenty-seven percent of the Stay'n Out participants were arrested an average of 13.1 months after release to the community, whereas 41% of the non-treatment control group were rearrested an average of 15 months after completing the program. On average, 35% of the milieu treatment group and 40% of the weekly counselling group were rearrested 12 months after completion of the therapeutic community program.

The authors related the success of substance-abuse treatment in a therapeutic community to the amount of time spent in the program. Time until arrest was half as long (9 months) for participants who had spent less than 9 months in the program as for participants who had remained in the program for 9 to 12 months (18 months). However, offenders who had stayed in the program for more than 12 months showed a shorter time (14 months) until arrest than did the 9-to- 12-month participants.

As shown in the figure, only 49% of offenders who stayed in the program for less than three months were successful on parole discharges, compared with 77.3% who participated for 9 to 12 months. The figure decreases to 57% for offenders participating in Stay'n Out for more than 12 months.