The Effectiveness of Changing Lives and Changing Outcomes: An Examination of Community Outcomes and Predictors of Community Failure among Adult Probationers
Ramler, Taylor R
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Despite the prevalence of mental illness within correctional settings and the unique treatment challenges posed by criminal justice involved persons with mental illness (CJ-PMI), there remains a paucity of programs specifically addressing the treatment needs of this population. Changing Lives and Changing Outcomes (CLCO) is a treatment program targeting co-occurring mental health and criminogenic needs among CJ-PMI. Although prior studies have demonstrated the effectiveness of CLCO in reducing psychiatric symptomology and criminogenic needs, community outcomes of those participating in the program have yet to be evaluated. The primary purpose of the present investigation was to examine rate of rearrest among CLCO participants relative to those of an alternative treatment program. Moreover, this study sought to determine for whom the program may be less effective and thus result in poorer community outcomes following residential treatment. Participants included samples from 380 adult felony probationers released from the Dual-Diagnosis Residential Program (DDRP; n = 190) and Substance Abuse Felony Punishment—Special Needs (SAFP-SP; n = 190) programming. CLCO is the primary treatment program provided at the DDRP facility, allowing for comparison between DDRP residents participating in CLCO with those of SAFP-SP. Exact matching on age, gender, race, and risk level was used to ensure uniform baseline characteristics between the two treatment samples and to establish group equivalence. Utilizing Cox proportional hazards regression models, treatment program was not found to significantly predict rate of rearrest following treatment, although the results trended towards significance. Cox proportional hazards modeling was also used to examine predictors of rate of rearrest among CLCO participants alone (n = 103), including 1) pre-treatment risk level; 2) problem avoidance; for example, avoiding directly confronting one’s issues; and 3) self-assertion/deception, including rationalizing criminal behavior to avoid feeling guilt and asserting one’s will over situations. Results indicated of the three covariates, only pre-treatment risk level significantly predicted rate of rearrest following CLCO residential treatment, suggesting that across time moderate risk participants were at significantly lower probability to be rearrested relative to those of high risk. Implications and limitations of the present study, as well as directions for future research on the treatment of CJ-PMI, are discussed.