By Sean R. Francis, MS
Justice Solutions of America, Inc.
Currently, there are over 154,000 inmates in the custody of the Federal Bureau of Prisons ( BOP). The vast majority of these inmates suffer from at least one mental health diagnosis. To fulfill the primary mission of the BOP, which is the protection of the public, BOP has implemented various mental health programs to assist inmates who struggle with mental health difficulties. This paper will discuss the various treatment options available to inmates who suffer from substance abuse issues and sexual offending issues. This paper will also address the various ways in which forensic psychologists play a vital role in the execution of these programs and treatment of the inmates.
I. Why We Need Drug Abuse Education in the Bureau of Prisons
In the early 1970’s President Richard Nixon declared a “War on Drugs.” This declaration ushered in new law enforcement tools, such as mandatory minimum sentencing and “no- knock warrants”, to combat the flood of illegal drugs entering the United States ( Sirin, 2011). Many believed that this was a measure aimed at poverty stricken drug addicts and offenders, many of whom were black. One of Nixon’s top aids, John Ehrlichman, would admit years later that Nixon viewed black people as an enemy (Sirin, 2011).
However, it would not be until the 1980’s and the Regan era that the “War on Drugs” really got ramped up. The United States would embrace an almost hysterical belief on the harms of illegal drugs. This was spearheaded by First Lady Nancy Regan’s “Just Say No” campaign. This resulted in draconian laws, the abolition of parole in the federal system, the federal sentencing guidelines being passed and a zero tolerance policy with regard to drug abusers and suppliers ( Sirin, 2011)
These laws largely and unjustly targeted the black community. The biggest example of this was the disparity between crack cocaine and powder ( Sirin, 2011). Crack was treated as a substance that was vastly more dangerous and addictive than powder cocaine. Therefore, the law treated crack as 100 times worse than powder cocaine. The problem with this is that crack was cheaper to produce than pure powder cocaine. Thus, it was popular in many poverty stricken black communities while powder cocaine was popular with the white community. 5 grams of crack cocaine would result in a 5 year mandatory minimum. Drug offenders were now serving more time than rapists and murderers.
The result of such actions was an explosion in the number of federal offenders in the Bureau of Prisons. In 1981 the federal prison population was 26,313 ( BOP.gov). However, by the time President Regan left office the population had grown to 57,762 ( BOP.gov). This is an over 60 percent increase and was largely a result of the “War on Drugs.”
The next major increase in the federal prison population due to drugs would come during the Clinton years. Clinton would embrace many of the policies of his republican predecessors. He would also reject a proposal to end the disparity between crack and powder cocaine. Clinton would leave office with a federal prison population of 145,125 inmates ( BOP.gov).
In response to the growing number of drug offenders the Bureau of Prisons started a massive expansion of it’s substance abuse treatment programs during the 1980’s. In 1988 then BOP director Michael Quinlin created the first residential drug abuse treatment program ( RDAP)
( Pelissier, et al, 2001). Congress also amended 18 USC § 3621 to allow the Bureau of Prisons to grant an offender up to 12 months off of their prison sentence for successful participation in the 500 hour residential drug program ( Pelissier, et al, 2001).
Prior to the passage of the First Step Act in 2018 the 500 hour residential drug program was the only program that allowed offenders to get time off of their sentence. All federal offenders must serve 85 percent of their sentence.
II. Residential Drug Abuse Treatment Program
(A). The residential drug treatment program is an intensive 500-hour substance abuse program
( BOP.gov). It has been established at specific federal institutions throughout the nation so that all security levels may participate. Currently there are 90 RDAP programs at 77 BOP institutions throughout the nation. Participation is voluntary and successful completion may result in up to 18 months being deducted from an inmate’s sentence ( BOP.gov).
Once an inmate has 30 months or less remaining on their sentence, they may submit themselves for placement in RDAP (Ellis, Bussert, 2016).It is not certain that an offender will be accepted into the program and if they are it is not certain they will receive time off their sentence. The inmate must have a verifiable substance abuse issue. Often documents by the inmate’s pre-sentence report (Ellis, Bussert, 2016).
The inmate usually must be recommended to participate in RDAP by their sentencing judge (Ellis, Bussert, 2016). Also, only offenders with certain convictions will qualify for time off of their sentence. Violent offenders, sex offenders and those who have active detainers will not be eligible for the time off.
Once an offender submits a request for placement in RDAP the first step is to meet with a member of the psychological staff at the inmate’s current institution (Ellis, Bussert, 2016). The psychologist will review the inmates file, interview the inmate and conduct an evaluation that will result in a recommendation on RDAP placement. Because all inmates want time off their sentence the BOP psychological staff are instrumental in determining who is truly in need of these services and who is simply malingering in attempts to go home sooner.
Once an inmate is approved for RDAP they are re-designated to an institution with the program and transferred. When the inmate reaches their new institution, they are housed in a unit that is solely dedicated to the RDAP program (Ellis, Bussert, 2016). Only program participants are housed in these units and, while a corrections officer does staff the unit for security, the unit is run by the forensic psychological staff of the RDAP. The psychological staff have offices in the housing units and control every aspect of the unit, creating a treatment milieu (Ellis, Bussert, 2016).
During business hours the inmates will participate in a half day of programing. There are two programs, the AM & PM. Lunchtime being the end of the AM and the beginning of the PM. The treatment program is run by forensic psychologists and interns. The Cognitive Behavioral Therapeutic method is used for RDAP (Ellis, Bussert, 2016). Therapists work directly with offenders 5 days a week. Offenders have a one-on-one therapist assigned to them for individual therapy and assistance (Ellis, Bussert, 2016). They will also participate in process groups, relapse prevention and other groups dealing with substance abuse issues (Ellis, Bussert, 2016).
As an offender gets close to release their one-on-one therapist will work with the offender, their family and U.S. Probation to help the offender smoothly transition from incarceration to society. The therapist remains a resource even once the offender is released. Offenders often remain in contact with their one on one.
(B). Does participation in treatment impact an inmate’s behavior while in prison?
Some studies have found that inmates who participate in prison-based drug treatment programs have a 45 percent lower misconduct rate than inmates who are not programing (Welsh, et al, 2007). When dealing with the RDAP program inmates know that misbehavior will not be taken lightly by the therapeutic team. RDAP participants are supposed to hold themselves to a higher standard than other inmates. Misbehavior can result in loss of privileges, loss of time off their sentence if they complete the program or even expulsion from the program.
Langan & Pelissier, (2002 ) conducted a study of 600 inmates who completed the federal RDAP program compared to 451 inmates who had not completed the program but had a history of substance abuse. They found that the inmates who had completed the RDAP program had a “significantly reduction” in overall institutional misconduct. Similar results have been reported in many studies conducted in state prisons (Welsh, et al, 2007).
(C ). Does prison-based drug treatment work?
Pelissier, et al, (2001) found that only 12.5 percent of RDAP graduates were re-arrested within the first six months of release. Inmates who participated in drug treatment while in prison were found to be 73 percent less likely to be re-arrested than non-treated inmates ( Pelissier, et al, 2001). Furthermore, it has been found that offenders who complete prison- based drug treatment have a greater chance of successfully completing their post incarceration probation
( Pelissier, et al, 2001).
This is vital because in today’s world almost all offenders have parole or probation after the completion of their sentence of incarceration. The days of just walking out free and clear are mostly over. It has been estimated that close to 45 percent of all offenders in prisons are now probation and parole violators ( Time.com). Many offenders on probation and parole have terms and conditions that make actions legal for society in general illegal for them. Drinking alcohol and using marijuana is one such example. In fact, substance abuse violations are often pitfalls for such offenders. The fact that most who participate in prison-based drug treatment do not violate their probation or parole is a positive sign and clear proof that these programs are working.
(D). What role does a forensic psychologist play in the RDAP program?
Forensic psychologists are the backbone of the RDAP program. They play a vital role in every step of the inmate’s progression. As was mentioned above, the first step in an inmate’s journey to RDAP is an evaluation by the psychological staff at the inmate’s parent institution. This requires the psychologist to screen the inmate to weed out those who may be malingering in attempts of admission to the program for time off their sentence ( Ellis, & Bussert, 2016).
Forensic psychologists continually evaluate the inmates who are in the RDAP program and their progression. They developed and run the groups, as well as the program itself. The forensic psychologists work with U.S. Probation, the offender and their families to effectuate a smooth transition from incarceration to freedom.
When an inmate comes to prison they are placed into the custody and care of the correctional officers and the warden. However, when an inmate is placed in the RDAP program the rules are different. Those inmates are not in the care of the corrections officers. They are in the care of the forensic psychologists. Every aspect of the inmate’s life is dictated by security and therapy, including discipline. This is vastly different from most other inmates.
III. Non- Residential Drug Abuse Treatment
The non -residential drug treatment program is a comprehensive 12-week program utilizing Cognitive-Behavioral Therapy ( CBT) in a group setting ( BOP.gov). The program is voluntary and an inmate’s release date is not impacted by their choice to participate or not to participate ( BOP.gov). Generally, this program is for offenders who have short sentences and do not meet the criteria for the more intensive residential drug treatment program (BOP.gov).
However, offenders who have tested positive for drugs while incarcerated may also be recommended to take this program by their unit team. Also, those who will be entering the RDAP program are often required to complete the non-residential drug abuse program prior to their admission if time permits. For offenders in the non-residential program forensic and staff psychologists, as well as interns, work with offenders on issues such as problem solving, rational thinking and communication skills.
IV. Residential Sex Offender Treatment Program ( RSOTP)
This program is for inmates with a high risk for re-offense and is offered at two separate locations. Participation is completely voluntary. The program consists of residential therapeutic treatment lasting 12-18 months ( Jones, et al, 2006). Much like the RDAP program, an offender must have between 18-30 months remaining on their sentence to be accepted into the program. The offenders also must have a conviction for or history of sexual offending ( Jones, et al, 2006).
The role of a forensic psychologist in BOP sex offender treatment is significant. Once an offender applies for admission to the RSOTP the forensic psychologist must evaluate the offender to determine if they would be a good fit for the program and if they will be able to benefit from it ( Jones, et al, 2006). Criteria such as whether an offender has sufficient intellectual ability to participate in psychotherapy and if there is a mental illness that would preclude program participation are considered by the clinician ( Jones, et al, 2006). Additionally, offenders are evaluated for acceptance of responsibility, prior treatment failure and psychopathy ( Jones, et al, 2006).
(B). Does sex offender treatment work?
There is some evidence that suggests that sex offender treatment does work. Sexual offenders who have received treatment had only a 9 percent re-arrest rate compared to untreated offenders who had a 12 percent re-arrest rate. Furthermore, studies have shown that CBT therapy was the most effective form of treatment for sexual offenders (Polizzi, et al, 1999).
More recent studies have supported the finding that sex offender treatment reduces recidivism. Olver, et al ( 2020) found that treatment reduced recidivism among high-risk offenders by as much as 76-81 percent and among medium risk offenders by 65 – 75 percent. Importantly, this study showed that rates of reoffence among those with no treatment was significantly higher than offenders who had been treated ( Olver, et al, 2020).
©. Should offenders participate in sex offender treatment?
While treatment for sex offenders is often successful at reducing recidivism getting offenders to participate is difficult as they often face a “treatment paradox”. While many sex offenders have a desire to seek treatment and never re-offend. There is a real question of whether the treatment providers have the offender’s best interest in mind. Offenders are often forced to waive all confidentiality which makes treatment providers de facto law enforcement officers and results in offenders facing increased legal jeopardy for their admissions in treatment (Miller, 2010), ( Strecker, 2011).
Many treatment programs require complete “acceptance of responsibility.” The treatment providers often operate on the assumption that the offenders have committed more crimes than they have been caught for. Therefore, as a measure of treatment progress offenders are often required to complete victims lists. These lists are where an offender can detail for treatment providers crime’s they committed that they have not been caught for. While this may be a well -intentioned treatment method, with the lack of confidentiality it often is nothing more than a trap which results in additional charges for the offenders. This has resulted in attorneys advising clients to refuse to participate in sex offender treatment. Federal judges have even found that clinicians in the BOP sex offender treatment program have pressured offenders to make victims up in order to be seen as “making treatment progress” so they would not be expelled from the program.
“The Butner Study’s sample population consisted of incarcerated individuals participating in a sexual offender treatment program at a federal correctional institution. Tr. at 29. As Rogers testified, the program is “highly coercive.” Id. Unless offenders continue to admit to further sexual crimes, whether or not they actually committed those crimes, the offenders are discharged from the program.” United States v. Johnson, 588 F. Supp. 2d 997, 1006 (S.D. Iowa 2008).
Due to the lack of confidentiality and removal of statutes of limitations on most sex crimes it is hard to conclude that any sex offender should participate in a prison based or community- based sex offender treatment program.
V. Non- Residential Sex Offender Treatment Program
Inmates who do not have enough time to complete the residential sex offender treatment program or who are not considered “high risk” can still participate in sex offender treatment. Multiple institutions throughout the BOP offer non-residential sex offender treatment. These programs typically take 9-12 months to complete ( bop.gov). Offenders learn skills to understand their past offenses and reduce their chances of relapse.
Forensic psychologists play an important role in the non-residential sex offender treatment program as well. They must screen the offender to ensure they meet the criteria for the program. This criterion requires the offender to have a sexual offense history and to be willing to participate. The forensic psychologist will also continually evaluate the offender, including a psychosexual evaluation upon admission to then program.
However, many of the concerns mentioned above apply fully to the non-residential program as well. Attorneys typically advise their clients to avoid all prison-based sex offender treatment in my expeirance.
Unfortunately, there are not many prison based therapeutic treatment programs. Prisons, despite being called Departments of Corrections, really do very little to correct the behavior of the offenders they keep. However, some exceptions do exist, and the Bureau of Prison’s drug treatment programs and sexual offender treatment programs are two such examples.
These programs and their success are important to the field of forensic psychology because we are a nation whose prisons are bursting at the seams. Therefore, if we can use psychology to develop programing that reduces recidivism, we are not only protecting society, but we may also change the way policy makers look at drug and sexual offenders. As we know, the laws on the books that deal with many of these offenders are old, draconian and make little sense. But we also know that the law follows psychology ( Gomberg, 2018). So, if programs like these can succeed, hopefully, we can see some changes in the laws recognizing what psychology already knows. That these offenders have an illness and can have a productive and law -abiding life with the right treatment.
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United States v. Johnson, 588 F. Supp. 2d 997, 1006 (S.D. Iowa 2008)
Dec 10th, 2020