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Rehabilitation: The Ideal vs. The Context

Faye S. Taxman, Danielle S. Rudes, Catherine Salzinger, Michael Caudy, & Amy Murphy

George Mason Universitywww.gmuace.org

Rehabilitation

1. Educate in basic or vocational skills; 2. Involve in therapeutic activities to facilitate

changes in attitudes, behaviors, or values; or, 3. Alter through punishment.

The rehabilitation ideal provides a punitive experience with

opportunities to learn to become a contributing member of society.

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Challenges: Providing rehabilitative services within correctional settings. Correctional settings do not allow for autonomy, they

focus on control. (Toch, 1987; Goffman, 1961; Dahlen & Johnson, 2010)

Correctional settings replace client-centered efforts with programming suitable for a punitive setting. (Dahlen & Johnson, 2010)

Correctional settings affect staff actions and behaviors by emphasizing control. (Rudes, Lerch, & Taxman, 2011)

Can “what works” (evidence-based practices) thrive within a correctional culture?

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Study—Mixed Methods Used RNR Program Tool

for Adults to assess use of evidence-based practices and quality programming in one community (N=38)

Content analysis of 4 common curriculums: Seeking Safety (SS), A Cognitive Behavioral Approach: Treating Cocaine Addiction (CBT), Thinking for a Change (T4C), & Strategies for Self-Improvement and Change (SSC)

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RNR Program Tool for Adults Ranks Programs Based on EBPs and “What Works”

Average quality score (lowest scores in implementation and needs)

55/100

Average # of therapeutic approaches used 3.5

% programs that use more controls than therapeutic approaches

53%

% programs that use more sanctions than rewards

53%

Curriculum Review: Positive & Forward vs. Negative & Backward

Criminal Justice Curricula Non-Criminal Justice Curricula

T4C SSCSS CBT

Present/Fwd Looking 38% 11% 26% 25%Positive/Supportive 31% 28% 18% 23%Backward Looking 48% 29% 16%6%Negative Lang/Dir --- 17%45% 38%

Present/Positive 54%46%

Backwd/Negative 47%52%

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Curriculum Review: Therapeutic Direction

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• “Show them how to do this” (T4C).• “If the patient becomes upset, emphasize the

emotional pain and then redirect the conversation to a neutral, present topic” (SS).

• Minimal use in CJ curricula (just 13 times total, <1%)• More common in non-CJ curricula (59 occurrences;

about 3% of codes).

Implications of the Culture of Control

Affects treatment programs in untold ways Structurally, programs reinforce the notion of control Difficult to build programs that focus on motivation

and client-centered care Emphasis on risk management is directed at staff;

privileging controls over incentives Curriculums reinforce the notion that individuals must

change regardless of content

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Thank you!

Questions & Comments

Catherine Salzingerssalzing@masonlive.gmu.edu

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