Recovery Management With Offender
Populations
S. Doug Lemon, Psy.D.
Licensed Clinical Psychologist
Chief Psychologist
United States Penitentiary, McCreary
The views expressed in written conference materials or by this speaker do not necessarily
reflect the official policies of the Federal Bureau of Prisons; nor does mention of trade
names, commercial practices, or organizations imply endorsement by the U.S.
Government.
Offender Statistics
United States
▪ In 2013, 2.3 million prisoners held in Federal or State prisons
or local jails.
▪ Nearly 7 million people under some form of correctional
supervision (2013).
▪ 57% of those are probationers. 25% of probationers were
female (2013).
▪ In 2002, 66% of jail inmates reported they were regular drug
users.
▪ Almost a third of these said they were using drugs at the time
ofSource:
theirBureau
arrest.
of Justice Statistics, Prison Statistics.
Prison Programs
• 74% state/federal facilities have substance
abuse programs
• 58% have mental health programs
Source: Bureau of Justice Statistics, Prison Statistics 2005
Offender Statistics
Florida
▪ Approximately 100,000 inmates housed in the Florida DOC.
▪ 11,000 inmates participated in substance abuse treatment.
▪ 38,000 participated in community-based substance abuse
programs.
Source: Florida Department of Corrections, 2013 Annual Report.
Barriers to Treatment
Education
▪ Nationally, 41% of inmates have less than a high school
diploma, compared to 18% of the general population.
Source: Bureau of Justice Statistics Special Report: Education and Correctional Populations, January, 2003.
Barriers to Treatment
Culture
▪ Antisocial individuals often subscribe to a counter-culture
world view
▪ Macho attitudes are very common among male offenders
▪ Offenders are often more resistant to treatment than
individuals in the general population
▪ Short-sighted thinking is the norm
▪ Egocentrism abounds
Barriers to Treatment
Lifestyle
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Criminal thinking
Blinders
Living for the moment
Extremely materialistic
See hard-working, law-abiding citizens as weak or square
Barriers to Treatment
Environmental Factors
▪ Peer pressure to avoid mental health/substance abuse
treatment
▪ Correctional facilities are very negative environments
▪ Family support is often lacking or non-existent
Barriers to Treatment
Sentence Length
▪ “I don’t have enough time”
▪ “I’ll start programming when I get short”
Barriers to Treatment
Providers are viewed as “police”
▪ Be up front about limits of confidentiality
▪ Be consistent!
▪ Show your concern, don’t talk about it
Barriers to Treatment
Aftercare
▪ Little to no coordination between providers in prison and those
in the community
▪ There is evidence this is beginning to change
Treatment Options
Psycho-educational Groups
▪ Drug Abuse Education
▸Often mandatory.
▸Typically 12-16 hours
▸May spark interest in additional programs
▸Helps weed out inmates not appropriate for more in-depth
programs
Treatment Options
Psycho-educational Groups
▪ Breaking Barriers (Instar Performance)
▸ Voluntary
▸ Cognitive Re-structuring techniques
▸ Introduces the Reality Model
*Results take time to measure
*Will it meet my needs over time?
Treatment Options
12-Step Programs
▪ Voluntary
▪ May be more acceptable in the prison culture than traditional
drug treatment
▪ Sponsorship is more difficult
▪ Work best if assisted by community volunteers
▪ There are security concerns with this, though
Treatment Options
Inside Out
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Has its roots in SMART Recovery
Members must be selected
6-month program
Inmate co-facilitator
Role plays
Treatment Options
• Non-residential treatment (4-6 months)
• Intensive outpatient treatment (FL)
Treatment Options
Residential Drug Abuse Program
Challenge Program
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Intensive
Therapeutic community model
Longer-term treatment (9-12 months)
Some eligible for early release after completion
Should involve halfway house component
Similar to Residential Therapeutic Community (FL)
Some offer dual diagnosis programs
Criminal Thinking/Beliefs
5 Most Common Beliefs
▪ INMATE: “You can’t help me unless you have experienced
what I have. You’ve never sold drugs or used them. How can
you help?”
COUNSELOR: “Have you heard of a male obstetrician?”
▪ INMATE: “If you grew up where I grew up, you’d be doing the
same thing.”
COUNSELOR: “Some day you’ve got to let that go, or you’ll
never be successful.”
▪ INMATE: “Why get treatment in prison? I’ve got to do it on
parole.”
Criminal Thinking/Beliefs
5 Most Common Beliefs, continued
COUNSELOR: “Sobriety/recovery takes practice.”
▪ INMATE: “I haven’t thought about or used drugs since I came
to prison, so I know I’m not going to when I am released.”
COUNSELOR: “You don’t have the same stressors and easy
access to your drug of choice now.”
▪ INMATE: “If I can’t get the time off, I’m not going to the
residential drug program.”
COUNSELOR: “If you don’t get treatment, you will end up
spending a whole lot more time in jail, or end up dead.”
Therapeutic Techniques
What works?
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Use a culturally-sensitive approach
Reality model is very useful
Talk in terms of being successful rather than moralizing
Encourage greater self-awareness
Use groups when possible
Teach cognitive re-structuring
Know when to hold ‘em and when to fold ‘em
Therapeutic Techniques
What works for you?