Developing an inmate program that works.

After a Massachusetts Department of Correction (DOC) study revealed that 90 percent of all inmates in the department have substance abuse problems and 65 percent of inmates are incarcerated for violent offenses against other people, department officials saw a clear link with a 1994 National Institute of Justice report that "alcohol drinking - by the perpetrator, the victim or both - has immediately preceded at least half of all violent events, including murders . . ." and "60 percent of arrests booked for violent crimes were confirmed by laboratory test to have used at least one illegal drug in the hours before arrest."

Responding to an initiative set forth by Commissioner Larry E. DuBois in 1992, the Massachusetts DOC issued a request for proposals for the design and implementation of a systemwide skill-based program for inmates that would target substance abuse, relapse prevention, anger management and criminal thinking. The goals of the program would be to lower recidivism and decrease the likelihood of institutional disturbances - simply put, to increase public safety.

Up to that point, the department's substance abuse programming consisted of discussion groups, 12-step fellowship and substance abuse education. The assumption was that inmates who could stay clean and sober would automatically stay crime-free. However, a review of the literature indicated that substance abuse is a characteristic of criminality and that inmates need to acquire certain skills that will not only contribute to their recovery from substance abuse, but also reduce their likelihood of reoffending.

The Correctional Recovery Academy (CRA) was created as a result of the request for proposals. CRA is a cooperative initiative of the Massachusetts DOC and Spectrum Addiction Services Inc., Milford, Mass. CRA was implemented in October 1993 in 11 residential program units throughout the system. These dedicated housing units are occupied exclusively by CRA participants. As many as 585 inmates can participate in the program at once. CRA units operate at medium, minimum and prerelease facilities that enhance continuity of care. Assessment units are located at the department's men's and women's reception centers. The assessment units determine program placement using a recidivism/needs assessment. CRA is geared toward inmates at highest risk to recidivate.

CRA focuses on shifting inmates' attitudes and behaviors that could lead to reincarceration. It is a three-phase, six-month program. The first phase teaches relapse prevention skills, the second teaches anger management, and the third teaches self-management.

All segments of the curriculum follow similar constructs:

* Criminal thinking patterns are identified.

* Prosocial skills are taught and practiced through role play and exercises.

* Out-of-class skill practice is assigned.

* Prosocial skills are reinforced.

Inmates participate in the program five days a week, with a minimum of 15 hours of structured, curriculum-driven activity. Inmates who complete the program and remain incarcerated are put in maintenance groups. Discharge planning and linkage to community-based services are provided for program participants before their release to the community.

CRA truly is a collaborative effort. The weekly unit team meeting is an integral component of service delivery. These meetings serve as a formal means of communication to discuss unit climate and inmate progress and to formulate treatment plans. Spectrum treatment staff, correctional officers, correctional program officers and the unit manager address behavior changes they observe in and out of the classroom. "This is a 'no secrets' program," says Peter Paolantonio, director of correctional services for Spectrum. "In this setting, because CRA focuses on skill building and observable behavior, we make sure that security staff knows what's going on with an inmate. If he acts up in class, the officer will be informed. The inmate is not allowed to act one way in class and then revert to his 'old inmate self' after class is over." Disciplinary infractions and program terminations for noncompliance are addressed at unit team meetings.

Anecdotal evidence from the institutions is very positive. Approximately 75 percent of the treatment directors report an observable, measurable difference in the behavior of inmates who have completed the program. Lisa Jackson, director of classification and programs at MCI Plymouth, states: "I notice an increased ability of program participants to identify their problems and generate workable options. In situations such as denial of lower custody placement, there is more willingness to listen to correctional staff, evaluate what they are saying and make the recommended changes."

Paul Hannem, correctional program officer, says, "The inmates seem to have developed a system that gets them out of the action-reaction rut that always has caused them problems. Instead of simply reacting to a problem, they seem to have tools to deal with the problem instead of going off - they may think about it, but they stop themselves before they act. It's like they have slowed their lives - they stop and think."

Inmates participating in CRA get fewer disciplinary reports and fewer "dirty" urines. Officers report a noticeable lack of violent incidents on CRA units. In two and one-half years, more than 2,500 inmates have participated in CRA, 70 percent of which have successfully completed and graduated. As more inmates complete the program and return to the general inmate population (where they are required to attend maintenance/aftercare programming), the program's impact on the institutional climate should become even more pronounced.

With the technical assistance of the National Institute of Corrections, Commissioner DuBois took the innovative step of gathering top management of the department and Spectrum to establish a total quality management process for team building. As a result, several work groups were established to help implement and continuously improve CRA. In January 1996, the department began to pre- and post-test inmates who attend CRA. Preliminary data suggest improvement in the areas of criminal thinking and anger management, and development and practice of relapse prevention skills.

A four-year study funded by the National Institute on Drug Abuse has been undertaken by Abt Associates, Cambridge, Mass., to evaluate areas such as overall effectiveness of treatment, the most effective timing for treatment delivery and rates of recidivism. These data are being gathered from a group of 700 inmates who have completed CRA, as well as a control group of inmates with similar profiles. Preliminary results are due within 18 months.

As the Correctional Recovery Academy continues to evolve in curriculum and operational consistency, hopes are high that the Massachusetts DOC/Spectrum partnership has produced an effective treatment program that works.

Christopher Mitchell is director of the Massachusetts Department of Correction Program Services Division. Andrea Emodi is program coordinator for the Massachusetts Department of Correction. William Loehfelm is state director for Spectrum Addiction Services Inc.