TREATING PRISON-INMATES WITH COOCCURRING DISORDERS - AN INTEGRATIVE REVIEW OF EXISTING PROGRAMS

The tremendous growth in state and federal correctional populations ha s focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3-11% of prison inmates have c o-occurring mental health (psychotic and major mood) disorders and sub stance abuse disorders, few treatment programs are described in the li terature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven 'dual diagnosis' treatment programs tha t recently have been developed in state and federal prisons. Many of t hese have evolved Et om existing substance abuse treatment programs an d approaches. Key program components include an extended assessment pe riod, orientation/motivational activities, psychoeducational groups, c ognitive-behavioral interventions such as restructuring of 'criminal t hinking errors', self-help groups, medication monitoring, relapse prev ention, and transition into institution or community-based aftercare f acilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b ) less confrontation, (c) smaller staff caseloads, and (d) cross-train ing of staff. Research is underway in three of the seven sites to exam ine the effectiveness of these new programs. (C) 1997 John Wiley & Son s, Ltd.