Rehabilitation

Rehabilitation, however, did not die. There have been reports that the commitment to treatment programs has diminished over the past quarter century. The dearth of systematic data, however, leaves open the question of whether the retreat from rehabilitation is extensive or applicable mainly to some types of programs (e.g., college education courses) and to some jurisdictions. Regardless, even a cursory examination of correctional institutions reveals the presence of a diversity of programs. Why these treatment programs have persisted in the face of the attack on, and apparent bankruptcy of, rehabilitation is open to question, but at least three possible reasons can be suggested: institutional inertia, which made eliminating programs and firing staff more work than keeping them; their functionality—treatment programs reduce inmate idleness and thus contribute to institutional order; and a continuing commitment among corrections leaders to rehabilitation (see Lin).

Education and work programs. Perhaps the two most extensively used modes of treatment in American prisons are education and work programs (Silverman and Vega). Undoubtedly, the prevalence of these programs reflects the abiding belief that educational and work skills—and the good habits learned in acquiring these skills—are integral to securing employment and being a productive citizen. Although the results are not unequivocal, the existing research generally suggests that the programs do have a modest impact in reducing postrelease recidivism, especially when targeted at certain inmates (e.g., those with low skills) and when part of a broader strategy—a multi-modal approach—to rehabilitating offenders (Adams et al.; Bouffard, MacKenzie, and Hickman; Wilson, Gallagher, and MacKenzie).

A 1995 survey of state and federal prisons revealed that nearly one-fourth of inmates were enrolled in some kind of educational program (Stephan). It is estimated that U.S. prisons spend over $412 million annually on educational programs ("Survey Summary"). Over fifty thousand inmates are enrolled in "adult basic education," which involves learning in such core areas as mathematics, literacy, language arts, science, and social studies. General Equivalency Development—usually knows by its acronym, GED—is a high school equivalency degree. In 1996, over thirty-seven thousand inmates earned their GEDs ("Survey Summary"). About four-fifths of U.S. prisons offer the GED, while three-fourths provide basic education courses (Stephan). College education courses are available in about one-third of institutions. However, because inmates were legally excluded by 1994 federal legislation from securing Pell Grants to fund their education, participation in college degree programs has declined (Tewksbury, Erickson, and Taylor). In 1996, one survey reported that 14,532 inmates received a two-year associate's degrees and 232 received a bachelor's degree ("Survey Summary").

Inmates also often have access to another form of education: life-skills training. These programs, which are sometimes seen as counseling interventions, are predicated on the notion that upon release to society, many offenders may not have the kind of basic understandings that are integral to functioning in American society. Thus, courses will teach such varied skills as how to apply and interview for a job, how to manage one's money and household, how to live a healthy life, how to parent and be a spouse, and how to secure a driver's license (Silverman and Vega).

Finally, to prepare inmates for employment, many correctional institutions offer vocational education. A 1994 survey of forty-three correctional systems found that over sixty-five thousand inmates were enrolled in programs aimed at training them in vocational skills that could be used to find employment upon release from prison (Lillis, 1994). It is also estimated that nearly two-thirds of all inmates are given a work assignment (Stephan). This duty may include institutional maintenance, working in a prison industry, or laboring on a prison farm. The assumption is that the discipline of working while incarcerated—regardless of whether marketable skills are learned—will translate into steady employment once the inmate is released. This assumption is tenuous and remains to be confirmed. Instead, it seems that the major function of most work programs is to reduce inmate idleness and, in turn, to keep institutions orderly.

Psychological/counseling programs. Beyond programs that attempt to furnish inmates with the skills to live productively in the community, other prison programs attempt to change underlying problems causing, or implicated in, an offender's criminality. Perhaps the most common interventions are drug abuse programs. As many as half of all offenders entering prison report having used drugs in the month before their arrest. One-third of state prison inmates and over 20 percent of federal inmates report being on drugs at the time of their offense for which they were subsequently incarcerated (Maguire and Pastore, p. 508). Further, the war on drugs from the 1980s onward has increased the number of people in prison on drug-related offenses. Between 1979 and 1991, the proportion of drug offenders in state and federal prisons rose from 6 percent to 21 percent (Sabol and Lynch). Not surprisingly, during this same period, it is estimated that the proportion of inmates participating in drug treatment programs rose from 4.4 percent to 32.7 percent (Silverman and Vega).

Some institutions have programs—sometimes called therapeutic communities—that house drug-addicted inmates in a separate unit. In 1994, the federal government began offering funding to states for its RSAT program—Residential Substance Abuse Treatment—which provides drug treatment in such a separate unit ("Reducing Offender Drug Use"). Other inmates live in the general offender population but participate in group or individual counseling. Despite the availability of drug counseling, it still appears that the demand for programming outstrips its supply. "A significant percentage of inmates with drug abuse histories," observes Arthur Lurigio, "are still without treatment" (p. 511).

Correctional institutions frequently provide individual and group counseling aimed at having offenders forfeit their criminal way of life. Over the years, various treatment modalities have been tried. However, a method of increasing appeal—in large part due to growing empirical support for its effectiveness—is cognitive-behavioral treatment (Van Voorhis, Braswell, and Lester; see also Andrews and Bonta). Although they come in various forms, these programs target the criminal attitudes and ways of thinking that foster illegal behavior. The intervention might involve, for example, counselors modeling prosocial conduct and also reinforcing inmates when such conduct is exhibited. Especially for juveniles, "token economies" are sometimes set up in which conforming offenders are given tokens that can purchase privileges. Counselors also focus on the content of offenders' thinking and reasoning. They challenge inmates' antisocial attitudes, rationalizations supportive of criminal behaviors, attempts to externalize blame, and failure to confront the harm they have committed.

Prisons house offenders who are mentally ill. In 1998, an estimated 283,800 inmates were mentally ill, which comprised 16 percent of the state prison population and 7 percent of the federal prison population (Ditton). About 45 percent of these offenders received counseling or therapy while incarcerated; half were taking a prescribed medication; and about a fourth had been in a mental hospital or treatment program (Ditton).

Another large group of offenders who receive special services in prison are sex offenders. There are over 100,000 sex offenders in state and federal prisons. In one survey of correctional systems, more than half reported special facilities for sex offenders (e.g., therapeutic communities, diagnostic centers). Most often, sex offenders receive some form of individual or group counseling (Wees).

We should also note another source of counseling and programming in prisons: chaplains and religious volunteer groups. Part of the formal role of prison chaplains is to provide counseling to inmates. Such counseling often moves beyond religious issues to other problems in the offenders' lives (Sundt and Cullen). Further, various types of "faith-based" programming are found within virtually every correctional system. These might include Bible study, prayer and meditation sessions, peer mentors, and worship services ("Religion Behind Bars"). In Texas, there is a unit within a correctional institution that is, in essence, a "faith based prison" where religious volunteers provide inmates with both religious and support programs (Cullen, Sundt, and Wozniak).

Finally, although most of the focus has been on adult offenders, we should note that many of the programs used in prisons are found as well in juvenile facilities. A survey in 1993 found that a majority of states offered these programs to juvenile offenders: "academic education, vocational training, vocational counseling, organized recreation, substance abuse counseling, mental health counseling, sex offender treatment, abuse counseling, and positive peer culture" (Lillis, p. 14).

Community-based treatment. Although the main focus of this section has been on prison-based programs, some mention should be made of treatment programs conducted in the community. Only two states do not supervise offenders released from prison. Otherwise, inmates returning to the community are placed on parole or mandatory supervised release, and they are monitored by parole officers. Probation is an alternative to incarceration. Convicted offenders who are not sentenced to prison may be placed on probation and, if so, are monitored by probation officers. In some states probation is centralized and thus is a state function; in most states, however, probation is decentralized and is administered by local jurisdictions, such as counties and cities. There are over two thousand probation agencies. In contrast, parole is always administered by a central agency that is part of state government. The federal government, which runs its own correctional system, also supervises offenders in the community. In the United States, there were approximately 700,000 offenders on parole and over 3.2 million on probation in 1999 (Petersilia, 1997, 1999).

Traditionally, probation and parole officers have been given the dual role of surveillance and treatment—surveillance to detect any signs of continued criminality and treatment to help the offender to overcome criminal propensities and become a solid citizen. The notion of these officers as treatment providers evolved into the social casework model, in which officers would, in essence, be primarily responsible for the rehabilitation of offenders assigned to them. The shortcomings of this model, however, soon became clear. First, heavy caseloads restricted the time that officers had to devote to any one offender; in fact, today the average caseload for probation officers is 124 and for parole officers is 67 (Camp and Camp). Second, officers often lacked the expertise to address the diverse needs of offenders (e.g., drug addiction). Thus, while officers still provide individual counseling—and occasionally run group sessions—they mainly fulfill their treatment function by being a service broker. In this model, their role is to assess offenders and to direct them into programs in the community. Most often, these programs are administered by nonprofit, community-based agencies.

We should note, however, that starting in the 1980s, there was a trend to transform probation and parole from a treatment-surveillance model into a model that sought exclusively to control and punish offenders (Cullen, Wright, and Applegate). Increasingly, officers have been required to conduct drug tests on, secure restitution payments from, and intensively supervise offenders (what one officer called the "pee 'em and see 'em" model). These extra duties, as well as the philosophy underlying their performance, have served in a number of jurisdictions to limit the treatment services provided by probation and parole officers (Petersilia, 1999).

When undertaken, community correctional programs vary in the degree to which they envelop an offender's life. Some programs are residential, lasting from 30 to 120 or more days; some programs offenders report to during the day for treatment; and some programs are attended a few hours each week. A wide range of services are delivered through these various programs. Some programs provide specialized treatment services, such as drug and alcohol counseling, sex offender counseling, psychiatric services, domestic violence counseling, family counseling, vocational and employment counseling (including job referrals), and life skills education. Other programs, especially those that are residential, tend to be multimodal, offering several services aimed at supporting offenders' attempts to "go straight."

Quality of treatment services. Several problems plague efforts to provide effective treatment services to offenders. First, the very existence of program options can vary greatly across correctional institutions and across communities (e.g., large counties have many more treatment options). As a result, programs may not exist to address the specific needs of certain offenders. Second, the availability of places in treatment programs does not always match the supply. Take, for example, the needs of parolees in California. As Joan Petersilia notes, "there are only 200 shelter beds for more than 10,000 homeless parolees, four mental health clinics for 18,000 psychiatric cases, and 750 beds in treatment programs for 85,000 drug and alcohol abusers" (1999, p. 502). Third, the quality or "integrity" of treatment programs varies widely. For example, a prison classroom may be a place where offenders are motivated to learn and secure degrees or a place where they sit impassively, doze off, or read the newspaper (Lin). Fourth, even if designed with the best of intentions, treatment programs may not be based on scientific criminological knowledge and thus may target for change factors that are not related to recidivism (i.e., much like a physician giving a patient medicine for the wrong disease).