DRUG TREATMENT FOR WOMEN IN THE CRIMINAL JUSTICE SYSTEM

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Although substance abusing women offenders have been targeted by many states and localities as a priority population for drug treatment, there is virtually no systematic data or scientific analysis pertaining to the appropriateness and cost-effectiveness of the various kinds of treatment programs for women offenders. Aim 1: Profile a national sample of women offenders in a variety of drug treatment programs and settings. Client demographics, socioeconomic status, criminal involvement, and women's needs related to drug abuse treatment, physical and mental health services, vocational and educational assistance, family and housing support, and other social services will be described. Aim 2: Analyze the treatment process, structure, and costs. A process evaluation will focus on (a) the decision criteria and operating procedures of treatment programs and correctional agencies, (b) the types and intensities of services, (c) the social-psychological climate of programs, (d) client participation rates, (d) client perceptions of the service delivery process, and (e) the cost of each treatment program. Aim 3: Evaluate client outcomes for several types of programs (prison- based therapeutic communities, jail-based programs, community-based residential and outpatient/day-treatment programs) while clients are in treatment and after they are at-risk in the community. The pre- post- treatment analysis will evaluate a variety of aggregate outcome measures related to drug use, criminal activity, and social-psychological adjustment. Aim 4: Compare the effectiveness and cost-effectiveness of alternative treatment models. Several hypotheses will be tested to compare various treatment models (e.g., incarceration - versus community-based programs, residential versus outpatient programs, traditional treatments versus gender-sensitive approaches). Aim 5: Ascertain statistically the combination of client and treatment service variables that predict outcomes. Individual-level statistical analyses will ascertain the variables that predict client outcomes, including client background variables, drug treatment program variables, client participation rates, and correctional supervision variables. Results from these analyses will be used to test the feasibility of developing a model to cost-effectively match different types of women to various forms of treatment. This may ultimately have considerable practical value because agency personnel do not have any scientific basis for matching women to various types of drug treatment. Research Design: A prospective longitudinal cohort study will be conducted with subjects drawn from 8 treatment sites: prison, jail, community-based residential and outpatient programs clustered in two disparate states (New York and Oregon). The women will be interviewed at treatment intake (N=1,875) and reinterviewed 12 months after being at- risk in the community (N=1,405). An ethnographic component will focus on the needs of the women and their perceptions of the treatment programs.