Part III: Effective Interventions for Offender Populations

Background of the Discussion

A key issue raised by Assistant Attorney General Laurie Robinson in her remarks at the opening of the symposium was the prevalence of alcohol abuse among offender populations. The dimensions of this problem have been confirmed recently--both by a study published by the National Center on Addiction and Substance Abuse at Columbia University, and the analysis prepared by the Bureau of Justice Statistics specifically for the symposium. That analysis indicates that fully 35 percent of the 5.3 million convicted offenders under correctional supervision--nearly 2 million individuals--were under the influence of alcohol at the time of their offense.

The working group on effective interventions for offender populations discussed how the criminal justice system can effectively intervene with offenders to reduce the likelihood of future crime associated with alcohol abuse.

The members of this group were in general agreement that the number and proportion of offenders moving through the system who have significant alcohol problems is staggering. The group also agreed that, among the public and even among policy makers, there is very little appreciation for this fact. Not surprisingly, then, the resources dedicated to addressing alcohol treatment for offenders are limited at best and non-existent at worst. At least part of the difficulty in assuring adequate resources has been the heavy focus that the criminal justice system has placed upon illicit drugs, at the expense of identifying alcohol abuse as a priority. Even drug testing, which has become a widely-used tool in dealing with illicit drug use, often does not target alcohol use.

Targets for Change

The group identified a number of areas of agreement that may be seen as guiding principles for its recommendations in this area and imply major targets for change and improvement. Although there was great debate on a number of questions, there appeared to be some consensus on the following targets for change.

Continuum of Care

Interventions for offender populations should include a continuum of care from arrest to discharge and involve both short-term and long-term strategies for alcohol treatment.

Current treatment interventions often rely on fragmented, under-resourced, and generally inadequate attempts to identify alcohol problems and treat them among offender populations. In order to achieve the goal of reducing the likelihood of future crime associated with alcohol abuse, a continuum of care concept is essential. The elements of a continuum of care include: screening; assessment for diagnosis and risk; treatment planning; provision of treatment for counseling and rehabilitation; transitional care from institution to community; relapse prevention and intervention; and linkages created to tend to information flow, the flow of offenders through the criminal justice system, and the flow of offenders from institutions to the community.

Continuing Dialogue on Treatment and Standards of Care

The participants agreed that there is a clear need for further dialogue to develop a generally accepted definition of alcohol treatment and to work toward generally accepted standards of care. The extensive discussion and debate within the working group emphasized that there is little agreement on the definition of what constitutes acceptable alcohol treatment. The group discussed a definition which began with an acknowledgment that treatment is a prescribed regimen of therapeutic intervention rendered or overseen by a qualified professional consistent with generally accepted protocols. They also suggested that some further characteristics of acceptable treatment implicit in a "continuum of care" might include:

• The use of scientifically-based assessment tools;
• Treatment matched to the level of offender need;
• Psychological and medical supervision of groups and individuals;
• Peer support;
• Family intervention and counseling;
• Case management; and

• Treatment providers who are licensed and meet specific standards.

However, the group could not agree on a definition and noted the need for continuing dialogue on this topic with the ultimate goals of a common definition of treatment and minimum standards of care.

The participants felt that implication of their conclusion--that there are no accepted standards for treatment--suggests that the need for dialogue on this topic is critical and should receive priority consideration in OJP's planning in this area.

Cultural Competence

Participants agreed that all treatment programs and interventions should be undertaken within a framework of a culturally competent system of care that is both age and gender specific. They felt that much of the treatment that is available does not adequately recognize that alcohol abuse takes place in a cultural context and is affected intrinsically by the gender or age of the individual involved. If we are to expect interventions to be effective, this must change. The group identified a set of specific recommendations regarding actions within Indian Country. They also acknowledged the over-representation of Native Americans, African Americans, and Hispanic Americans among offender populations. The group's recommendations emphasize the need for culturally competent interventions within these communities.

The Visibility of Alcohol as a Drug

Although alcohol is legal, participants emphasized that we need to be clear that it is a drug. They felt that alcohol's legal status should not diminish the priority we place upon dealing with the consequences of its abuse. The emphasis on illicit drug use has often deflected attention from the need to address this problem.

Criminal Justice and Community Linkages

The group agreed that linkages between the criminal justice system and the community should be developed and expanded.

Public Safety

Participants emphasized that the focus of this group on treatment and a continuum of care for offenders is warranted primarily because of the community safety benefits that it promises. If we can have a significant impact upon the patterns and instances of alcohol abuse among offender populations which are related to crime (and particularly violent crime) we make a significant impact upon reducing future criminality and increasing community safety.

Recommendations

The participants' recommendations concerning effective interventions for offender populations fall into several categories:

• Interventions and Treatment;
• Interventions for Offenders Who Are Guilty of Driving Under the Influence of Alcohol;
• Interventions for Native American Offenders;

• Interventions for African Americans Offenders and Hispanic American Offenders; and
• Education and Training.

Interventions and Treatment

Participants agreed that OJP should support and promote the following efforts and initiatives.

• A more coordinated and effective delivery system for interventions should be developed from the time of arrest through sentencing and execution of a sentence. This should include clear definitions of goals, objectives, and outcomes for treatment, intervention, programs and offenders. A more effective delivery system should also include linking information systems. There should be a high level of coordination between the juvenile and adult systems. Linkages should extend beyond the criminal justice system to include education, health and human services, and other appropriate fields. The system should operate within constitutional and legal parameters.
• Effective interventions and treatment for short-term populations (i.e., jail populations) should be developed.
• A comprehensive continuum of care and treatment should be developed throughout the criminal justice system that acknowledges the movement of offenders from the community into institutions and back into the community. Implicit in this recommendation is the sense of the group that it is important to consider the variety of target populations that should be identified under the general category of "offenders." Their issues and needs regarding treatment interventions will vary. These target populations include: convicted drunk driving offenders; probationers and parolees supervised in the community; offenders incarcerated in jail (both pretrial and sentenced) and prison; juvenile offenders; offender subgroups (i.e., sex offenders, mentally ill offenders; drug-involved offenders who also use alcohol, gang-involved offenders, etc.); ethnic and cultural offender subgroups (e.g., Native American offenders, Native American offenders, Hispanic American offenders, etc.); and families of offenders.
• Mechanisms for fostering better coordination of funding at each level of government and among different agencies of government (federal, state, local, and tribal) should be developed. Particular efforts should be made at the federal level to coordinate the multiple sources of funding from within the Department of Justice, from within the Department of Health and Human Services, and from within other departments.
• Restoration should be a goal and a part of the sanction at each stage of the system and a part of every treatment plan.
• A broad-based forum should be created to allow for dialogue about treatment and intervention issues, to help establish a common understanding of the range of treatment programs and interventions, and to help establish a common language.

• Scientifically-based assessment tools should be linked or matched to appropriate treatment and intervention.
• Additional treatment resources should be created for alcohol offenders, including post-release treatment programs. There are currently few, if any, resources specific to alcohol.
• Intervention initiatives should be designed to respond to the varying issues and needs of small, large, urban, and rural jurisdictions.
• All offenders should have access to scientifically-based alcohol and other drug screening and appropriate treatment as part of being held accountable and punished for their crimes.

Offenders Who Are Guilty of Driving Under the Influence of Alcohol

For the most part, sanctions for driving under the influence of alcohol are prescribed by state statute rather than by federal policy. The participants' recommendations which follow highlight areas in which OJP and other federal agencies might work with state and local jurisdictions who are interested in prioritizing driving under the influence of alcohol as an offense for prosecution and sanctioning, and implementing initiatives which will contribute to a reduction of such crimes in the future. The participants agreed that OJP should support the following efforts and initiatives.

• Development of an accountable system for dealing with offenders who are guilty of driving under the influence of alcohol in which:

• Stability is promoted among staff who are committed to long-term change;

• Drunk driving offenses are given a higher priority in the system (priority docketing, cases are heard more immediately, cases have more prestige, etc.);

• Information flow through the courts is more effective and reaches everyone who needs it; and

• Judges are better informed.
• Creation of "specialized" drunk driving courts. Develop critical program elements for drunk driving courts (similar to Defining Drug Courts: The Key Components, Drug Courts Program Office, January 1997).
• In jurisdictions where it is not feasible to create a "specialized" court, judges and others in the criminal justice system should be provided with the information and skills necessary to deal effectively with issues related to alcohol abuse among the offenders whom they screen, assess, prosecute, adjudicate, and sentence.
• Development of ways to community outreaches so that the general public understands issues related to driving under the influence of alcohol.
• Development of scientifically-based assessment and screening tools for offender populations.
• Increasing the range of self-regulating devices which are available to the general public.
• Development of a national tracking mechanism to track drunk drivers (including offenses within local, state, federal, and tribal jurisdictions).
• Development of legal changes to amend current laws to allow for limited driving privileges of some convicted drunk drivers who have had their licenses suspended (i.e., to get to treatment or a job).
• Development of a broader range of sanctions for drunk driving offenses. Responses to drunk driving should include a combination of punishment, rehabilitation, and restitution.
• Development of ways to encourage states to amend current laws to allow for auto forfeiture for a third time predatory felony drunk driving offense.

Interventions for Native American Offenders

Consistent with a strong theme running through all of the groups' discussions at the symposium, the working group on effective offender interventions agreed upon the need to address the disproportionate burden of alcohol abuse and crime on communities in Indian Country, and the vast over-representation of Native Americans among correctional populations. The participants agreed that OJP should support the following efforts and initiatives.

• Establishment of a working group of Native American staff and others from among federal agencies (CSAT, OJP, BIA, and others) to foster and coordinate initiatives in Indian Country, and to address the problems of alcohol abuse and crime.
• Development of interventions and treatment for Native American offenders within a cultural context which competently respond to tribal differences. At present, there is a significant lack of effective intervention and treatment methodologies designed specifically for Native American populations.

• Development of specialized drug and alcohol courts in tribal courts.
• Identification of specific actions which might be taken in individual Native American communities to reduce alcohol-related crime. Some examples offered by participants included the closing of drive-up windows for the purchase of alcohol and the development of more detention space in Indian Country.
• Identification and use of the human resources to be found within Native American communities when addressing all aspects of this issue (i.e., research, evaluation, treatment, etc.).
• Clarification of myths and perceptions regarding Native Americans and alcohol.

Interventions for African American and Hispanic American Offenders

A strong majority of the group felt that it was important to emphasize the needs of African Americans and Hispanic Americans for effective intervention strategies among offender populations. Both of these communities are over represented among correctional populations in America and face difficult problems with respect to alcohol abuse and crime. There is a need for culturally competent interventions for these populations and the participants strongly encouraged to support efforts to develop such interventions.

Education and Training

The participants agreed that OJP should support and promote the following efforts and initiatives.

• Training and education of judges, treatment providers, and other criminal justice decision-makers on issues related to alcohol and crime.
• Development of public education and community outreach programs that involve communities in meaningful ways about all the issues related to alcohol and crime.
• Development of ways to encourage collaboration among federal agencies to provide public education and marketing materials on state-of-the-art research and evaluation with respect to this topic.

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