Collaborative behavioral management among parolees: drug use, crime and re-arrest in the Step'n Out randomized trial

• Published in: Addiction (Abingdon, England) Vol. 107; no. 6; pp. 1099 - 1108
• Main Authors: Friedmann, Peter D., Green, Traci C., Taxman, Faye S., Harrington, Magdalena, Rhodes, Anne G., Katz, Elizabeth, O'Connell, Daniel, Martin, Steven S., Frisman, Linda K., Litt, Mark, Burdon, William, Clarke, Jennifer G., Fletcher, Bennett W.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2012; Blackwell
• Subjects: Addiction; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol; Arrest; Behavior modification; Behavior Therapy - methods; Behavior therapy. Cognitive therapy; Biological and medical sciences; Community reinforcement approach; contingency management; Crime; Crime - prevention & control; Crime - statistics & numerical data; Criminal justice; Desintoxication. Drug withdrawal; Drug abuse; Drug users; Female; Humans; Interprofessional Relations; Law Enforcement; Male; Marijuana; Medical sciences; Medical treatment; Miscellaneous; Offenders; Parole; Parole & probation; Population; Prisoner rehabilitation; Prisoners - statistics & numerical data; probation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; role induction; Secondary Prevention; substance abuse treatment; Substance-Related Disorders - rehabilitation; Treatment Outcome; Treatments; Trials; U.S.A; United States; Justice; Prisoner; Carceral environment; Arrest; parole; probation; role induction; Clinical trial; Behavior therapy; Behavior; Therapeutic schedule; Human; Drug; Drug addiction; Poison withdrawal; Induction; Criminality; Use; Substance abuse; Murder; Community reinforcement approach; Treatment; Addiction; Contingency management; Crime; Legal aspect; substance abuse treatment; Reward; criminal justice
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/j.1360-0443.2011.03769.x

ABSTRACT Aims  To determine whether collaborative behavioral management (CBM) reduces substance use, crime and re‐arrest among drug‐involved parolees. Design  Step'n Out was a randomized behavioral trial of CBM versus standard parole (SP) during 2004–08. CBM adapted evidence‐based role induction, behavioral contracting and contingent reinforcement to provide parole officer/treatment counselor dyads with positive tools in addition to sanctions to manage parolees' behavior over 12 weeks. Setting  Six parole offices in five states in the USA. Participants  Parolee volunteers with a mandate for addiction treatment and a minimum of 3 months of parole (n = 476). Follow‐up was 94% at 3 months and 86% at 9 months. Measurements  Drug use and crime in a given month from calendar interviews 3 and 9 months after parole initiation, and re‐arrests from criminal justice administrative data. Findings  The CBM group had fewer months in which they used their primary drug [adjusted risk ratio (ARR) 0.20, 95% confidence interval (CI): 0.05, 0.78, P = 0.02] and alcohol (ARR 0.38, 95% CI: 0.22, 0.66, P = 0.006) over follow‐up. CBM had its greatest effects among parolees who reported marijuana or another ‘non‐hard’ drug as their primary drug; parolees who preferred stimulants or opiates did not benefit. No differences were seen in total crime, re‐arrests or parole revocations. Conclusions  Collaborative behavioral management may reduce substance use among primary marijuana or other ‘non‐hard’ drug‐using parolees without increasing revocations. Because the majority of drug violation arrests in the United States are for marijuana, these findings have important implications for the management of a substantial proportion of the US community correctional population.