Predictors of prison-based treatment outcomes: a comparison of men and women participants

INTRODUCTION

From 1995 to 2002 the nation's state prison population increased by 27%, and the nation's federal prison population increased by 71% (1). Moreover, annual increases in the number of incarcerated women have be consistently larger than the increases in the number of incarcerated men for the past two decades (1-3). The growth within the nation's prison population largely has be due to the increased use of incarceration for drug-related offenses (1), which also has created an increased emergency for appropriate drug treatment programs for men and women within prison settings.

The beneficial community (TC) treatment model has be shown to be an effective method of substance maltreat treatment (4) and many TC programs hold been incorporated into American prisons over olden times two decades. Despite the increase in prison-based TC treatment, little is known more or less the individual characteristics and specific treatment needs of drug-dependent men and women participating in prison-based programs (5, 6). Moreover, abundant of the existing evaluations of prison-based treatment focus specifically on the programs for men (similar to community-based treatment evaluations). Only a handful of studies have assessed outcomes of women within prison-based treatment programs designed specifically for women, and even fewer studies enjoy compared and contrasted specific factors that are associated near outcomes relative to men or women (7). Understanding possible differences in the needs and reclamation processes of drug-dependent men and women offenders is crucial to help design appropriate prison-based substance harm programs.

This study begins to address the cavity in the literature about gender issues and treatment outcomes. We compare and contrast intake facts from a large token of drug-dependent men and women offenders who paroled from prison-based treatment programs inside California. We further assess posttreatment outcomes for men and women separately to identify the correlates of success specific to sexual category, and to examine the plausibility of "gender-specific" paths contained by the recovery process. The following literature review pieces together the available information on the conditions characteristics and treatment needs of men and women within prison-based treatment, their postrelease treatment outcomes, and gender-specific predictors of success.

Characteristics of Men and Women Entering Prison-Based Treatment

A review of the literature identified lone 3 published studies that directly compared the characteristics of incarcerated men and women in drug treatment programs. Peters, Strozier, Murrin, and Kearns (8) compared data from the intake assessments of 1,225 men and 430 women referred to a short-term cognitive behavioral incarcerate treatment program in Tampa, Florida. Langan and Pelissier (9) compared 1,332 men and 312 women who volunteered to contribute in cognitive behavioral drug treatment programs at 20 minimum, low, and surrounding substance security federal prisons around the country. Messina, Burdon, and Prendergast (10) replicated the design of the previous studies, comparing the characteristics of 4,509 women and 3,595 men from 16 prison-based TCs throughout California.

The findings from these 3 studies be strikingly consistent and paralleled findings on gender differences found contained by nonoffender populations (11, 12), indicating that women were more predictable than men to present greater challenges to treatment practitioners. For example, incarcerated women in treatment be significantly more likely than incarcerated men to hold severe substance abuse histories (e.g., using intricate drugs, using more frequently, using polysubstances, or taking drugs intravenously), to have grown up surrounded by homes where drug use be present, to have coexisting physical robustness and psychological problems, to be taking prescribed medications for psychological problems, and to enjoy been sexually and physically abused as children. However, men be found to have more serious criminal histories than women (8-10). Although the findings from the above guilty party populations are consistent, the extent to which the outlined differences among men and women at treatment entry may affect posttreatment outcomes largely is unknown.

Posttreatment Outcomes of Men and Women in Prison-Based Treatment

Fairly consistent findings from prison-based treatment evaluations for men have be reported: Treatment reduces posttreatment recidivism and drug use; men who verbs treatment in the community after release from prison do better than men who do not verbs treatment; and length of time in treatment is positively correlated next to greater success on parole (13-16). The effect of treatment tend to disappear at about 3 years (13, 14, 17).

However, findings from studies of men cannot be generalized to women for several reason. First, men and women have different pathway to crime and addiction (18-20) and continue to use drugs for different reason (21, 22). Women's patterns of drug name-calling have be described as more socially embedded than men's and primarily revolve around interpersonal relationships (23, 24). In certainty, women are frequently initiated to drug use by their male partner, and often verbs to use drugs to cope with offensive relationships (18, 22, 25). Histories of sexual and/or physical abuse are also highest preexisting conditions in subsequent addiction and criminality for women (6, 21, 26). Second, men and women tend to enter treatment for different reasons (27). Women cite kith and kin problems and health as motivation for entering treatment, while men are more possible to cite employment and legal issues (28). Third, the resources and services available surrounded by women's correctional facilities may be at variance than those available to men (21).

A small body of literature has evaluated posttreatment outcomes for women surrounded by prison-based TC treatment. The existing research, however, is limited, and findings are sometimes contradictory (for a full review, see Messina & Prendergast (7)). For example, two studies found that women in prison-based treatment have more success on parole compared next to a no-treatment group of inmates (16, 29); whereas another study found there be no difference between women in a prison treatment group versus women contained by a no-treatment group (30). Two other studies found that women in prison-based treatment have reductions within recidivism and drug use compared with a no-treatment group of women (31, 32). However, Wexler's study (16) found no difference within recidivism rates between treated and untreated women. Moreover, Rhodes and associates (33) conducted a 3-year follow-up of the women in Pelissier's study (32) and found that in attendance was no evidence of long-term treatment efficiency (33). (For a comprehensive review of community-based treatment outcomes for women, see Ashley, Marsden, and Brady (11)). Additional limitations of the existing research include reliance on bivariate comparisons within relatively small taste sizes, which does not allow for the control of pre-existing differences between groups or proper power to detect treatment effects.

Predictors of Treatment Outcomes for Men and Women

Only two studies were found that directly explored gender-specific predictors of treatment outcomes from men and women. Messina, Wish, and Nemes (34) compared and contrasted the correlates of nouns for 296 men and 116 women who were by chance assigned to community-based residential TC treatment differing primarily surrounded by the length of inpatient and outpatient phases. Pelissier and colleagues (35) compared and contrasted the correlates of nouns for 1,842 men and 473 women who participated surrounded by prison-based cognitive behavioral treatment in a multisite federal prison evaluation.

Both studies found that in that were similarities and differences near respect to predictors of outcomes for men and women. For example, Messina et al. (34) found that men and women who completed residential treatment followed by outpatient treatment had substantial reduction in drug use and arrests and increased employment. However, the longer residential treatment program have a particularly beneficial impact on women. Number of prior arrests and a history of physical knock about also were associated next to negative postdischarge outcomes for women, but not for men. Pelissier et al. (35) found that a history of prior commitments and disciplinary activities during incarceration increased the likelihood of post-treatment drug use and recidivism for both men and women. In enhancement, being Black similarly increased the possibility of drug use for both men and women, and age at release from prison (older) decreased the chance of drug use. A variety of other factor predicted outcomes for men only. Positive predictors of outcomes included living near a spouse at follow-up, participating in treatment (versus the no-treatment group), and employment. In contrast, only one extra factor was found to shrinking posttreatment drug use among women--participation in mental form treatment.

The different pathways and pattern of drug abuse for men and women, and the availability of gender-specific services, are adjectives considered to be directly related to the likelihood of treatment entry and rescue (11, 27). However, the limited research on femininity issues does not provide enough information to fully think through how treatment impacts men and women differently. Yet, the available evidence does suggest that outcomes for men and women should be assessed separately to identify specific factor that affect behavioral outcomes following treatment.

The purpose of this study is to determine if the characteristics of participants who paroled from the California prison-based TCs are differentially correlated beside treatment outcomes for men and women. This study includes separate models for men and women assessing treatment graduation, aftercare participation, and recidivism, and uses multivariate analyses next to appropriate independent variables selected specifically for men and women. Based on the prior research comparing treatment outcomes of men and women separately (34, 35), we formulated the following research ask: Do factors that predict aftercare contribution and reincarceration differ substantially for men and women who participated contained by prison-based treatment?

METHODS

The CDC Prison Treatment Expansion Initiative

Based on previous research in California testify to the effectiveness of prison-based TCs (16, 29, 30), the legislature and the California Department of Corrections (CDC) begin an initiative in the mid 1990s to expand treatment opportunities for inmates. As part of a set of this initiative, the CDC established TC treatment programs in designated housing units inside many of its prisons, including adjectives of the institutions that house women. The data for this study be collected as part of an evaluation of the CDC prison treatment expansion initiative.

This initiative includes two 5-year evaluation studies of the drug treatment programs inwardly the California state prison system. The University of California, Los Angeles (UCLA), Integrated Substance Abuse Programs (ISAP; formerly known as the UCLA Drug Abuse Research Center (DARC)) be contracted by CDC to evaluate these programs, with contract paperwork provided by CDC's Office of Substance Abuse Programs. The two evaluation studies cover 16 substance abuse programs within 10 prisons, totaling approximately 3,300 beds (8 mannish programs totaling 1,600 beds and 7 womanly programs totaling 1,700 beds). These programs became running between July 1998 and December 1999 and include participants at adjectives levels of protection (Level I-Minimum through Level IV-Maximum).

Prison-Based TCs in California

CDC contracts with community-based organization experienced in the TC model to provide services within the prisons (i.e., Amity Foundation, Center Point, Inc., Civigenics Inc., Mental Health Systems, Phoenix House, and Walden House). Although all of the programs provide treatment services using the TC model, respectively provider has adapted the model somewhat to conform to its own treatment philosophy and the specific wishes of its population, including providing appropriate programming for women. Characteristics of the prison-based TCs include: (1) activities that embody positive values that start a process of socialization; (2) treatment staff who provide positive role models (and heaps of whom are recovering addicts themselves); (3) an alternative concept of inmates specifically usually much more positive than prevailing beliefs and attitudes held by correctional staff; and (4) an aftercare component for graduates from the prison-based TC programs that provides funding for up to 6 months of continued treatment (residential or outpatient services) in the community following release to parole (36).

Data Collection

Client-level background were collected by the treatment providers upon acknowledgment into the TC using the Intake Assessment (IA) instrument. The IA is designed to assess a client's pretreatment/preincarceration sociodemographic background, criminality, employment, and substance use, verbal abuse, or dependence. Adopted from the Initial Assessment developed at the Institute of Behavioral Research at Texas Christian University (37), the IA has be used extensively with criminal sprite populations and provides information that is adjectives for both clinical and evaluation purposes. The programs provided the intake data and treatment entry and discharge data to UCLA ISAP through disclosure agreements below CFR 42 Part 2, Section 2.52. The UCLA General Campus Institutional Review Board approved the study protocol. Postrelease return-to-custody rates came from the CDC's Offender Based Information System and include incarceration for both parole violation and new charges.

Eligibility

Participation contained by these programs is open to inmates who enjoy a documented history of substance use or abuse (based on a review of their criminal background as documented in their inmate crucial files), and who have between 6 and 24 months departed to serve on their current sentence. Those who meet these eligibility requirements are mandate into the treatment programs. There are, however, certain exclusionary criteria that preclude otherwise eligible inmates from entering the programs (e.g., gang-related opponent situations, documented membership surrounded by a prison gang, time spent in administrative segregation for hostility or weapons charges inwardly the last 12 months, and felony and Immigration and Naturalization Service holds).

Participants

The current study focuses on 4,164 women and 4,386 men who enter the participating programs between July 1998 and March 2001, paroled prior to February 1, 2002 (i.e., in order to be at risk for one year prior to our obtain return to custody data), and for whom intake data were available. Participants surrounded by the study were predominately White (39%) or Black (31%), be 35-years-old on average, and had completed approximately 11 years of rearing prior to their current incarceration. About half (45%) have never been married. Thirty-two percent be employed during the 30 days prior to their current incarceration, and 60% were parents. Participants reported an average of 15.5 arrests surrounded by their lifetime. Approximately 93% met DSM-IV criteria for alcohol or drug abuse or dependence, and 57% be serving time for a drug-related offense at the time of their treatment admission.

Data Analyses

The analyses for the current study are designed to examine the relevance of pretreatment differences between men and women on treatment outcomes (i.e., aftercare taking part and reincarceration). The distributions (shown in Table 1) of demographic characteristics, substance use, criminal, and psychological histories prior to incarceration by gender be evaluated using chi-square tests (for categorical variables) and t-tests (for continuous variables). Preliminary analyses (chi-square and t-tests results not shown) examining correlates of aftercare contribution and reincarceration were conducted separately for men and women to identify gender-specific predictors of outcomes for inclusion in the logistic regression models (see below).

Logistical regression analyses be conducted separately for men and women for each dependent unpredictable (aftercare participation and return-to-custody). Aftercare taking part was defined as any contribution in aftercare treatment (dummy coded; 0 = no and 1 = yes) and return-to-custody be defined as any return-to-custody during the 12 months since parole (dummy coded; 0 = no and 1 = yes). All logistic regression models included demographic variables and other correlates that were significantly related to the above outcomes (i.e., age, see, education, employment, matrimonial status, number of years incarcerated, primary drug disorder, and the presence of cooccurring disorders). Additional independent variables were included depending on the appropriateness to masculinity and the dependent variable. For example, histories of sexual and physical treat roughly were included in the regression models for the women offender only, as they be not significantly correlated with outcomes for the men. The logistic regression models examining predictors of association in aftercare included a motivation for treatment mark (yielding a distribution of motivation ranging from 0 to 6; see Burdon et al. (5)). Length of time contained by treatment also has be shown to be a strong predictor of treatment outcomes (15, 38). Therefore, we included a variable contained by the aftercare and return-to-custody regression models that defined total time in prison-based treatment. We also included a variable that defined total time in aftercare treatment in the return-to-custody regression models.

Adjusted likelihood ratios be used to interpret the statistically significant effect size at the p < .05 level: [Exp(Beta) - 1] x 100 = in tune odds ratio (e.g., the percentage increase or shrink in the likelihood of being returned to custody).

RESULTS

Bivariate Comparisons of Men and Women at Admission

Table 1 displays the preview characteristics for men (n = 4,164) and women (n = 4,386) entering the prison-based TCs during the selected study spell. Gender differences were found near regard to demographic characteristics, sexual and physical misuse histories, primary drug problem, substance abuse and criminal even-handedness histories, and the presence of cooccurring disorders. However, some of the differences that reached significance are rather small (i.e., years of education and motivation for treatment scores), as the full-size sample size substantially increased the chance of finding statistically significant differences between men and women.

Although the majority of men and women were White or Black, women be significantly more likely than men to be of Asian or American Indian fully clad (11 vs. 6%; p < .001) and to be divorced or separated (34 vs. 26%; p < .001). Women were elder than men (36.0 vs. 34.5 years; p < .001), had slightly smaller number education (11.0 vs. 11.4 years; p < .001), and be less potential to have be employed prior to incarceration (33 vs. 53%; p < .001). Women also were much more predictable than men to report having be sexually and physically abused as a child (27 vs. 13%; p < .001) and as an adult (27 vs. 3%; p < .001). Women be more likely to report cocaine/crack as their primary drug problem (34 vs. 19%; p < .001), while men be more likely to report methamphetamine/amphetamine as their primary drug problem (40 vs. 30%; p < .001). With the exception of methamphetamine/amphetamine, women be more likely to report each day drug use prior to incarceration and to report daily use of two or more drugs (24 vs. 19%; p < .001). Compared next to women, men were younger at the age of first arrest (17.1 vs. 21.3 years; p < .001), have been arrested more repeatedly in their lifetime (17.4 vs. 14.7 arrests; p < .001), and have been incarcerated longer in their lifetime (5.5 vs. 3.2 years; p < .001). However, women be more likely than men to enjoy a cooccurring psychiatric disorder (27 vs. 14%; p < .001) and to have a slightly sophisticated motivation for treatment score (1.3 vs. 1.1; p < .001).

Gender and Posttreatment Outcomes

Bivariate comparisons between men and women be conducted for the two posttreatment outcomes: aftercare participation and a return-to-custody inwardly 12 months from parole. Men were significantly more potential to participate within aftercare than women (46% of men vs. 41% of women; p < .001); yet, men who participate in aftercare did not stay as long as women (4.6 months for men vs. 5.1 months for women; p < .001). In adornment, men were significantly more plausible than women to be returned to custody within 12 months from parole (40% of men vs. 31% of women; p < .001), and be returned sooner than women (8.4 months for men vs. 9.2 months for women; p < .001).

Logistic regression analyses assessing the relationship of gender to aftercare contribution and 12-month return-to-custody rates were conducted previously beside this CDC sample (see Burdon et al. (5)). These results (not shown) indicated that when other factor (e.g., demographics, number of years in prison, substance maltreat disorder, time in prison treatment, and motivation) be controlled, gender be no longer a significant predictor of aftercare participation. The most momentous predictor of aftercare participation be motivation for treatment regardless of gender. However, sexual category remained associated with a return-to-custody inwardly 12 months from parole. After controlling for various other factor, men still were significantly more imagined to be returned to custody compared with women.

Gender-Specific Paths (Logistic Regression Models for Men and Women)

Aftercare Participation

Separate logistic regression models assessing predictors of aftercare contribution for men and for women are shown in Table 2.

Men: Seven out of 10 variables significantly predicted aftercare contribution among the men (length of prison-based TC treatment, age, race, motivation for treatment, length of lifetime incarceration, employment, and primary drug problem). For respectively additional afternoon in prison-based treatment, the probability of participating in aftercare increased by .4% (p < .001). For each secondary year of age, the odds of aftercare association increased by 5% (p < .001). Compared with Hispanic masculine participants, the probability of White males participating in aftercare were increased by 79% (p < .001), and the likelihood of Black males participating in aftercare were increased by 45% (p < .05). For respectively additional chalk up on the motivation for treatment scale, the likelihood of participating in aftercare were increased by 26% (p < .001). For respectively additional year of lifetime incarceration, the likelihood of aftercare participation decrease by 3% (p < .01). Compared with men who be unemployed prior to incarceration, the probability of aftercare participation for those who be employed were reduced by 26% (p < .01). Compared next to men who reported opiates as their primary drug problem, the odds of aftercare contribution for men who reported alcohol/other as their primary drug problem were reduced by 52% (p < .001). The presence of cooccurring disorders, prior childhood, and prior marital status be not significantly related to aftercare participation among the men.

Women: Three out of 11 variables significantly predicted aftercare association among the women (length of prison-based TC treatment, motivation for treatment, and primary drug problem). For each spare day of prison-based treatment, the probability of participating in aftercare increased by .2% (p < .001). For each secondary point on the motivation scale, the likelihood of participating in aftercare were increased by 13% (p < .01). Compared next to women who reported opiates as their primary drug problem, the odds of participating in aftercare for women who reported amphetamine/methamphetamine as their primary drug problem be reduced by 44% (p < .01). The presence of cooccurring disorders, sexual/physical abuse histories, prior teaching, prior employment, age, race, prior conjugal status and length of lifetime incarceration were not significantly related to aftercare taking part among the women.

Return-to-Custody

Separate logistic regression models assessing predictors of a 12-month return-to-custody for men and for women are shown in Table 3.

Men: Six out of 10 variables significantly predicted a 12-month return-to-custody among the men (the presence of cooccurring disorders, race, length of lifetime incarceration, age, employment, and total days in aftercare). Compared near men with one and only a substance abuse disorder, the likelihood of men with cooccurring psychiatric disorders mortal returned to custody within 12 months be increased by 40%, (p < .05). Compared with Hispanic men, the likelihood of white men being returned to custody be increased by 55% (p < .01), and the odds of black men individual returned to custody were increased by 63% (p < .001). For respectively additional year of lifetime incarceration, the probability of returning to custody within 12 months be increased by 8% (p < .001). For each supplementary year of age, the odds of men returning to custody inwardly 12 months were reduced by 4% (p < .001). Compared next to men who were seeking work prior to incarceration, the odds for those who be employed of returning to custody within 12 months be reduced by 29% (p < .001). For each more day of aftercare, the probability of returning to custody within 12 months be reduced by 1% (p < .001). Time in prison-based treatment, schooling, primary drug disorder, and prior marital status be not significantly related to a return-to-custody within 12 months.

Women: Six of the 11 variables significantly predicted a 12-month return-to-custody among the women (length of prison-based TC treatment, age, nurture, total days in aftercare, the presence of a cooccurring psychiatric disorder, and length of lifetime incarceration). For respectively additional light of day in prison-based treatment, the likelihood of returning to custody within 12 months be reduced by .1% (p < .02). For each new year of age and education, the likelihood of returning to custody within 12 months be reduced by 4% (p < .001) and 6% (p < .05), respectively. For each other day spent contained by aftercare, the odds of returning to custody inside 12 months were reduced by 1% (p < .001). Compared next to women with with the sole purpose a substance abuse disorder, the probability of codisordered women returning to custody within 12 months be increased by 58%, (p < .001). For each supplementary year of lifetime incarceration, the odds of returning to custody inside 12 months were increased by 4% (p < .05). Sexual/physical assault histories, prior employment, race, primary drug problem, and prior married status were not significantly associated near a return-to-custody within 12 months.

DISCUSSION

The purpose of this study be to outline the differences between men and women offenders entering TC treatment and to explore the relationship of those differences to post-treatment outcomes. The differences found between men and women entering prison-based treatment in California mirrored the findings of previous studies of incarcerated treatment populations; whereby women be at a substantial disadvantage compared to their male counterparts contained by all areas of existence history except for their past criminal involvement (8, 9, 35). The point to which these differences affected posttreatment outcomes be less clear, as severely little research had previously examined gender-specific path of recovery.

Table 4 provides a summary of the significant predictors of the two outcome measures surrounded by the regression models, by gender. One of the most personage findings from this table is that there be fewer predictors of outcomes for women than for men (similar to findings reported in Pelissier et al. (35)). Even though women be significantly more likely than men to own more severe substance abuse histories, sexual and physical foul language histories, and cooccurring psychiatric disorders prior to incarceration, these variables were not associated near the outcome measures. For example, after controlling for other related factors, a history of sexual and/or physical name-calling as a child was no longer related to aftercare taking part or reincarceration among the women. However, a fairly small percentage of women and men contained by our sample reported histories of sexual and physical treat roughly. Previous studies have shown percentage ranging from 19% to 55% among criminal populations (8, 9). The low percentages reported here could be due to the reality that these particular question were asked by treatment personal prior to treatment entry and not experienced researchers. Since these question were singular asked from a partial sample of participant, the regression analyses might not have detected changeability due to histories of sexual/physical abuse.

Similarities Between Men and Women

Consistent next to previous findings from incarcerated populations, age, motivation for treatment, time in prison treatment, and time in aftercare were positively associated next to at least one (and surrounded by some cases both) of the outcomes for men and women (13-16, 29, 31). In addition, both men and women who reported opiates as their primary drug problem be most likely to jump to aftercare treatment compared to those who reported other drug dependencies. The direction of the correlation for age and motivation for treatment to outcomes are often replicated contained by offender populations, as elder parolees often "age-out" of criminal behavior and those next to substantial internal motivation are highly predictable to succeed upon release from prison. Moreover, selection bias be not likely to be an central factor in producing the "time in treatment" finding since length of time in prison treatment be not within the control of the inmate (which would create test bias), but rather be determined by when CDC placed the inmate in the treatment program and the length of their sentence. Since the propose time spent in prison treatment for men be 7.1 months (SD = 4.8) and 6.9 months (SD = 4.5 months) for women, it appears that a substantial number of inmates in this example were assigned to these TCs next to approximately 7 months remaining on their sentence.

Predictors that negatively affected outcomes for both men and women included the cooccurrence of psychiatric disorders during treatment and total years in prison over one's lifetime. Codisordered inmates and those beside more total years in prison contained by one's lifetime were more possible to be reincarcerated regardless of gender, a finding consistent near previous research indicating that those with the most severe psychological problems and those near serious criminal histories are more likely to recidivate (34, 39).

Differences Between Men and Women

Time contained by treatment warrants further clarification (discussed above), as it be also differentially associated with reincarceration among men and women. Total time in prison-based treatment and aftercare be related to a reduced likelihood of reincarceration for women singular, indicating the positive effect of continuous and long-term treatment episodes (similar to that reported in Messina et al. (34)). In contrast, only time surrounded by aftercare was related to a reduced possibility of reincarceration for men. This finding creates an interesting dilemma, as it also appears that men were more promising to go to aftercare treatment than women, but did not stay as long as the women. The lower aftercare contribution rate reported for women may have be due to gaps contained by reporting procedures. The Female Offender Treatment and Employment Program (FOTEP) aftercare treatment program was an other option for women paroling from prison in California. Women entering the FOTEP program did not access aftercare treatment using one and the same procedure as men or women parolees opting for other forms of aftercare (e.g., outpatient, sober living, residential). As a result, background on the number of women entering the FOTEP aftercare program may not have be complete.

Another difference between men and women was that see was a significant predictor of both outcomes for men, but not at adjectives for women. Among the men, Whites and Blacks were more expected than Hispanics to participate surrounded by aftercare treatment and to be returned to custody. Previous findings from this sample (see Burdon et al. (5)) hold shown that a greater proportion of Hispanics reported living with family/relatives prior to their current incarceration. In increase, a recent review of studies that examined drug use behaviors among Hispanics found that social support systems (including familial factors) are important factor in preventing drug invective among this population (40). These findings suggest that the familial support systems for Hispanics are stronger, and that they may tend to rely on these support systems to a greater degree and next to greater success following release to parole than Whites or Blacks.

Finally, anyone employed prior to incarceration decreased the odds of aftercare participation and a return to custody for men (similar to that reported contained by Pelissier et al. (35)), but was not related to outcomes for women. In contrast, prior instruction decreased the possibility of reincarceration for women, but was not related to outcomes for men.

Limitations

It should be noted that the current study relied on broad intake data collected by treatment personnel for a roomy sample of men and women entering prison-based treatment. Due to the overall range of the CDC initiative, the questions available on the IA instrument be limited within both range and depth. The IA instrument be not originally designed to capture detailed differences between men and women entering prison-based treatment, and, consequently, many factor that may be predictive of posttreatment outcomes for women were fictional. For example, the questions on the IA on the subject of histories of sexual and physical abuse be dichotomous (yes/no) questions, which did not inquire around the specific type of abuse, the perpetrator of the invective, the age at which it occurred, or the duration of the mishandle, which have previously be shown to be related to women's recovery (6, 21). In rider, the findings generated by this study are set to inmates who were preferred for treatment participation and thus, cannot be generalized to general inmate populations in state prison.

Implications and Conclusion

The results of this study hold highlighted relevant individual-level factors that serve as predictors of taking part in aftercare treatment and 12-month return to custody rates among men and women parolees of prison-based TC treatment programs. One of the most consistent findings, relative to previous research, is the nouns for both men and women associated with aftercare taking part. The consistency of this finding indicates the need to place greater prominence on promoting appropriate aftercare treatment for inmates in the prison-based treatment programs, regardless of gender.

In contrast, consistent findings in connection with the increased likelihood of reincarceration among inmates near cooccurring psychiatric disorders highlights the difficulty involved in delivering decisive treatment services to codisordered men and women in correctional settings. Because treatment staff may not be suitably trained to treat certain psychiatric disorders that offender present upon entry into prison-based programs, perhaps here should be separate treatment tracks for codisordered offenders to provide important treatment to this high-risk population. At the very smallest, referrals to appropriate aftercare treatment should be contained by place upon release from prison programs, which would require increased communication, coordination, and collaboration between substance abuse and psychiatric treatment systems (41). The dignified prevalence rates of psychiatric disorders among incarcerated drug offenders across the nation suggest that these issues are probably not inimitable to California (39).

In conclusion, the limited number of identified predictors of outcomes for women is celebrity. It would appear that we know more about what lead to successful outcomes for men than for women. Indeed, the limitations of the available data of our study may enjoy drawn further attention to the gap contained by our knowledge of gender-specific path to recovery. Future studies will want to explore and incorporate additional predictors of posttreatment outcomes that more appropriately emulate paths of repossession for women. Future studies also may need to explore superfluous posttreatment outcomes for women such as improved relationships near children, living situations, and psychological status.