Transition plans should be collaborations among providers both inside and outside the institution. For that reason, Chapter 2 outlined the elements of a treatment plan without specifying particular roles for institution and community providers. Although flexibility is key, treatment providers in the community will emphasize different aspects of transition planning. Transition planning also varies from institution to institution and for different types of offenders. This chapter provides guidelines tailored more specifically to providers on both sides of transition.
The focus of institution treatment should be preparation for continued treatment on the outside. The message to the offender is that this is the beginning of the treatment commitment, and that continuing care will be arranged upon release. Institution treatment emphasizes this readiness message in all treatment phases, underlining a strong motivational and relapse prevention message.
Ideally, the institution's treatment program is part of a system that includes community-based services, rather than disconnected from the community. The institution's program should strive to exemplify innovative treatment practices and obtain licensing from the State authority.
Treatment programs within prisons and jails can encourage participation of community programs in the transition process. However, prisons and jails by their nature limit outsiders' access to the institutions, making it a challenge for community-based social service and treatment providers to serve incarcerated people. However, institutions can be community-friendly and invite social service agencies into the institution to work directly with offenders being prepared for release. The community agencies could provide contact information and written literature about services to both staff and inmates. Community treatment providers that contract to deliver institution-based treatment are in an ideal position to also help with transition efforts. Similarly, corrections agencies can enlist contractors to provide case management and other transitional services.
One of the goals of the transition from institutional treatment to community-based treatment is to make better use of institutional treatment as a stepping stone to help offenders become self-sufficient, productive members of society. In the short term, the intent is to help offenders move from an institution-based treatment program to a community-based program with a minimum of disruption in services.
Several differences between prisons and jails affect the way treatment services and transition to the community are delivered. The most significant is length of incarceration. Because jails are used as pretrial facilities for pending court actions, it is often unknown how long an offender will be held, making treatment planning difficult for many jailed offenders. The policy in some States is to provide substance use disorder treatment if the offender is sentenced to jail for 60 days or more.
It is difficult to maintain continuity of treatment in a jail setting, because offenders move in and out of court. Incarceration often creates a crisis that ripples throughout an offender's life, affecting family, legal, and other matters. Children may be placed outside the home, and offenders may be in the process of detoxification. Because jail experiences can cause instability on so many fronts, social service delivery and crisis management are especially important.
The Consensus Panel recommends that treatment be provided if a substance-using offender is scheduled for confinement in jail for a period of time sufficient to provide adequate treatment for the offenders' needs. Inmates with shorter sentences can be placed in alcohol and drug education or other treatment readiness programming. Results from a recent evaluation of the effectiveness of a jail-based treatment program suggested that optimal treatment length is a period of 3 to 5 months followed by immediate placement in a community treatment program (Swartz et al., 1996).
Despite the problems, treatment in jails has some advantages, especially for transition work. The Cook County Jail Day Reporting Center, for example, trains offenders in life skills. More than a dozen social service providers in the community staff the reporting center and conduct trainings on rites of passage, violence prevention, parenting, and relationships. This program also has a training program for offenders who are drug dealers but not drug users.
Jailed offenders often have opportunities to receive substance use disorder assessment and treatment planning from community providers who come into the jail. Assessment or treatment planning that prepares the inmate for more structured treatment on the outside has the benefit of priming the inmate for more intensive treatment in a controlled environment that provides for public safety. Treatment units in jails also have less infractions and violence than other units in the institution.
Furthermore, the sentencing decision may be affected if a local treatment provider involved in the pretrial or presentence phase determines that the offender has demonstrated a willingness to participate in the treatment process and develops a treatment plan. Judges may even consider treatment as an alternative to incarceration. This option provides a strong motivation for many offenders.
A number of studies have shown that treatment effects on recidivism do not appear before about 90 days of treatment, and that treatment effects improve with time in treatment (Hubbard et al., 1989; Simpson, 1981, 1984). Time in treatment, whether in the institution or in the community, is a critical factor. Because jail sentences tend to be short, good jail-to-community continuity of treatment is essential for a longer singular treatment episode. Thus, the Consensus Panel recommends that the shorter the jail program, the more obligation the program has to ensure continuity of service. Even inmates leaving jail without a community sentence should receive a community treatment referral. Likewise, if the offender is sentenced to prison, a treatment plan should follow the offender to the designated correctional institution. If funding is limited, local Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings can be supported in the jail several nights a week. Those incarcerated hear "leads" from previous offenders, find sponsors and mentors, and become less resistant to community-based treatment.
One potential model for other jurisdictions is found in the Wayne County, Michigan, Comprehensive Corrections Plan funded under the State's Community Corrections Act. The program, called the Probation Detention Program, serves both probation violators who would otherwise be sentenced to jail or prison and graduates of the State's boot camp program, the Sentencing Alternative to Incarceration Program (SAI). This program provides an example of the institution reaching out to a community program to arrange for transitional services. The program is centered at a facility that provides assessment, referral, and residential treatment. Failures are met with "swift and certain" sanctions. Specific services for each offender are determined by an individual risk/needs assessment and implemented by means of a subsequent individualized case management plan. Programming includes 10 areas: orientation and assessment, substance use disorder counseling, life skills counseling, education, employment preparation, vocational training, employment, community service, physical training, and cognitive skill training. The movement of offenders from one phase to another (incarceration to residential programming to community) includes reincarceration when appropriate.
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