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Summary of Research on A New Direction

Minnesota Department of Corrections Chemical Dependency (CD) Treatment

The Minnesota Department of Corrections, the authors of A New Direction, provided the program at seven of its eleven adult correctional facilities. All of the CD programs were based on the therapeutic community model; participants were housed in a separate location within the prison, apart from the general population. The CD treatment consisted of 15-25 hours of programming per week. Three levels of programming were offered: short-term (three months), medium-term (six months), and long-term (twelve months). Inmates were able to opt out of treatment, but very few individuals did so.

Findings suggest that the three-month and six-month treatment programs significantly reduced recidivism, but the twelve-month did not. The researcher concludes that more treatment is not always better, and that short-term treatment can be effective in reducing recidivism and should therefore be provided to individuals with relatively short lengths of stays in prison, such as parole violators.

This Minnesota study was recognized for its high rigor and has been highlighted on the What Works in Reentry Clearinghouse.

Reference: Minnesota Department of Corrections, Prison-Based Chemical Dependency Treatment in Minnesota: An Outcome Evaluation, March 2010

Iowa Department of Public Health (IDPH), Division of Behavioral Health

In September 2002, the Iowa Department of Public Health (IDPH), Division of Behavioral Health was awarded a grant from the U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Assistance to implement substance abuse treatment services in a jail setting. The purpose of the grant was to deliver and evaluate substance abuse treatment services to clients during incarceration and after release from jail. A New Direction was the core treatment curriculum that was used.

IDPH contracted with the Iowa Consortium for Substance Abuse Research and Evaluation (Consortium) to conduct an outcome evaluation component of the Jail-Based Substance Abuse Treatment Program. The Consortium conducts follow-up interviews with clients in the program to assist in determining effectiveness of treatment services. The interviews occur approximately six months after admission to the treatment program and provides follow-up data to determine outcomes as well as analyze changes between admission and follow-up.

Data from this study was for clients admitted from November, 2008 through December, 2009. A total of 641 clients were served in a jail and post-jail setting. Of the follow-up interviewees—95.7% of the successfully discharged clients (completed the entire program) were abstinent; 97.9% had not been arrested; and 53.2% were working full or part time at follow up. There is a significant difference between clients who are discharged successfully and those who did not complete the treatment program. Successfully discharged clients (completed the entire program) were significantly more likely to be abstinent (Fisher's Exact Test, p < 0.01) and more likely to be arrest-free (Fisher's Exact Test, p < 0.01) than clients who did not successfully complete the treatment program.

Clients were also administered the Criminal Thinking Scales developed by Texas Christian University (TCU), Institute of Behavioral Research. The two-page instrument contains 37 items and measures six criminal thinking scales: entitlement, justification, power orientation, cold heartedness, criminal rationalization, and personal irresponsibility. When comparing admission and jail release scores, significant decreases were found on all scales: entitlement, justification, power orientation, cold heartedness, criminal rationalization, and personal irresponsibility, indicating improvement in criminal thinking for all scales.

Eighty-five percent of clients at six-month post admission reported attendance at Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or similar meetings. This rate was over three times greater at the follow-up interview than at admission. Results also indicate that 95.9% pf clients felt that the jail-based treatment program was either very beneficial or beneficial overall.

Comments from clients who participated in the treatment program:

"I've been clean and sober for 7 months and that's the first time in about 15 years that I can say that. I liked the length of this program. It let me take the time I needed to shape up."

"I've been through a few treatment programs and this one was about the best."

"It was a great program. It helped me a lot. The movies and speakers were excellent. The books were repetitive, but that is needed."

"It was a really good program. I had lots of time to find myself while I was in jail and think about things."

"I've been in and out of jail and prison numerous times and this was the first time that I even stayed
sober. This program was great and I learned a lot. I use the knowledge I gained on a daily basis."

"It was a very good treatment program. They were very strict and I learned a lot. I am definitely healthier now."

"I thought it was great. I think they should open more of these programs. It really saved my life."

"This program completely changed my life. This program allowed me to get my life together."

"This was a very good program that led me towards a better life and in the right direction."

"The program helped me out a ton. Thanks to this program, I'm getting back on my feet."

"The group helped me open up. It was great to have people who understand."

Reference: The Iowa Consortium for Substance Abuse Research and Evaluation, "Jail-Based Substance Abuse Treatment Program, Annual Outcome Evaluation Report, January, 2010.

North Carolina Division of Adult Correction Section of Alcohol and Chemical Dependency Programs

Annually, since the 2007 legislative session, the North Carolina General Assembly has required an evaluation of each substance abuse treatment program funded by the Department of Alcohol and Chemical Dependency Programs (ACDP). The legislature specified that measures of reduction in alcohol and drug dependency, improvements in disciplinary and infraction rates, and recidivism (defined as return-to-prison rates) should be included in the annual report. The outcomes described below are from fiscal year 2013-2014. A New Direction was a core component of the treatment offering.

For participants in all programs (prison-based and community-based), the participant's increased confidence in their ability to resist the urge to drink or use drugs was significant from entry into the program to exit. Community-based residential programs improved their confidence significantly by moving from the high 50s into the 70s and 80s confidence range. Prison-based programs improvements were more modest, moving from the low 60s into the low 70s confidence range.

Return to prison rates were lower for inmates who completed treatment in all programs compared to a matched comparison group. Return-to-Prison rates were lower for inmates who completed treatment in intermediate programs compared to counterparts. Male inmates who completed intermediate programs in FY 2013-2014 returned to prison at statistically significant lower rates than their counterparts. Inmates who began ACDP treatment but dropped out before completing the programs tended to return to prison at a higher rate than did their matched counterparts, who were never assigned to treatment.

Results of testing show that participating inmates lower their scores on virtually all Texas Christian University's Criminal Thinking Scale subscales. In general, participating inmates significantly reduced their level of entitlement beliefs, justifications of criminal behavior, criminal rationalization, and personal irresponsibility.

Reference: North Carolina Department of Public Safety, Division of Adult Corrections and Juvenile Justice, Substance Abuse Treatment Programs Annual Report, March 1, 2016.

Michigan's Van Buren/Cass District Health Department Substance Abuse Services

This department provided corrections treatment services using A New Direction as its treatment program. In 2006, they serviced 133 individuals. At the end of the year, 32 had graduated and 65 were still involved in active treatment. No graduates were arrested during this time frame for any serious crimes. The Program saved $ 77,099 in jail costs in 2006. Savings to state taxpayers in prison costs are projected to be between $ 528,000 and $1,056,000. Michigan State University completed a study comparing A New Direction participants with similar drug offenders receiving treatment as usual. Results indicate that A New Direction participants are re-arrested at a significantly lower rate (4.4%) than the comparison group (31.5%).

Reference: Van Buren/Cass District Health Department, Annual Report 2006.

Idaho Department of Corrections

The Idaho Department of Corrections starting using A New Direction in 2002 and offenders began completing the program by the end of February 2003. Due to program-staff limitations only the highest risk offenders receive treatment with A New Direction. Historically 97% of inmates participating in the program are subsequently released to probation. This is substantially higher than the normal rate for inmates, which is about 90%. The courts consider A New Direction completion a very positive indicator of an offender's ability to succeed in the community. Of inmates who have completed the program and went on probation since 2003, 47% have revoked probation. Inmates who did not participate in the program revoked probation at a rate of 54%. Since the beginning of the program, 92% of inmates have successfully completed A New Direction.

Reference: Idaho Department of Corrections, Offender Programs and Education Report, Fiscal Year 2006.

To learn more about A New Direction: A Cognitive Behavioral Treatment Curriculum, contact Hazelden Publishing at 800-328-9000.