0 - National Criminal Justice Reference Service

We also observed statkg ratios (inmates per counselor) that ranged fiom 9: 1 to 26: 1.
Although definitive clinical standards for prison-based TC have not yet emerged, and existing
guidelines are voluntary (ONDCP, 1999), experts often recommend a maximum of 15 clients per
counselor (DeLeon, 2000).
DOC has largely standardized the content, structure and duration of its AOD treatment
programs, and they have done so in large measure directly in response to our previous
I
recommendations (Welsh, 2000% 2000b; Welsh and Zajac, 2001; Welsh et al., 2001). However,
at the time that inmate admission data was collected for our outcome study in 2000, TC programs
still evidenced slight variability in terms of duration and intensity. Based upon inspection of
program documents, TC schedules, and interviews with the DATS supervisor at each institution,
a
we estimated that 3 TC programs offered approximately 15 hours per week of actual treatment
(individual or group counseling, or phase classes run by treatment stam. Two of the TC programs
(Huntingdon and Graterford) offered weekly programming of 30 hours or more per week. Only
one (Graterford) met the guideline of running 7 days a week (ONDCP, 1999; DeLeon, 2000),
although inmates on that unit appeared exhausted at times. One program lasted as little as 36
weeks; another lasted nearly twice as long. While more research into the effects of TC of varying
durations and intensity levels is needed (DeLeon, 2000), such differences in treatment exposure
may influence observed outcomes. Of course, outcomes also depend on the quality of treatment,
not just the quantity (Pearson and Lipton, 1999).
All TC programs offered what they called a “holistic” approach, although one explicitly
stated in its mission statement that the 12-step approach was its major framework. According to
DOC, the department’s overall approach to alcohol or other drug (AOD) programs is informed by
a holistic health model that treats substance abuse as a complex problem with physiological,
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This document is a research report submitted to the U.S. Department of Justice. This report has not
been published by the Department. Opinions or points of view expressed are those of the author(s)
and do not necessarily reflect the official position or policies of the U.S. Department of Justice.