Adult Prison Therapeutic Communities
In America
By
Phillip R. Dyer
Submitted in Partial Fulfillment of the Requirements
For the Degree of
Master of Science
in the
Criminal Justice Department
SCHOOL OF GRADUATE STUDIES
YOUNGSTOWN STATE UNIVERSITY
May 2001
Adult Prison Therapeutic Communities
In America
I hereby release this thesis to the public. I understand this thesis will be housed at the
Circulation Desk of the University Library and will be available for public access. I also
authorize the University or other individuals to make copies of this thesis as needed for
scholarly research.
Signatur
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Approvals:
Eric S. See, Ph.D.
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ABSTRACT
This research is designed to describe information from all state department of
corrections and/or rehabilitation addressing the relevance of Therapeutic Communities within
their prison institutions. The over-riding philosophy of Society today appears to be lock the
offender behind prison walls and forget about him or her until they are released in some
manner. On the other hand, there appears to be an effort to find answers to the ageless
question, "can offenders be rehabilitated while in prison?" If rates of incarceration continue
to rise at their current pace, it has been estimated that one out of every 20 Americans born in
1997 will serve time in prison at some point in their lives. Unlike exaggerated Hollywood
images of hopelessly criminal psychopaths, many of today's prisoners can be rehabilitated
with the proper intervention and prevention programs. Continuing aftercare programs and
combating the literacy issues and providing meaningful job training will assist in the war on
crime, as well as, appropriate treatment for substance and addiction. Absent such treatment
and training, most offenders will commit more crimes, get arrested and return to prison. The
choice is ours as well as theirs.
A determination has been made to gather information concerning the effectiveness of
Therapeutic Communities (TCs) that exist throughout the country in state prisons.
Questionnaires were sent to all 50 states. After all data were collected, descriptive
and comparative statistics were conducted on the data. It was found that TC programs are
being developed, implemented, and extended throughout the country. TCs are safer
environments for both correctional officers and inmates, and are reducing crime and
recidivism rates for those individuals who participate and graduate from TC prison programs.
111
ACKNOWLEDGMENTS
I delicate this thesis to my beloved son so I may honor his name and memory, David
Ray Dyer. I thank my God for the times of life that He granted each of us together as father
and son on this earth and I anticipate those times, which are to come. In addition, I also
delicate this thesis to my father, Chief, the most courageous man I have ever known. To a
little girl, Earla, who never had the privilege to walk just one step at a time, but taught me
never to give up. To my grandmother, Mary, the apple of my eye and to my mother,
Catherine, who has stood and remained by my side, as a friend, a guardian....as my mother.
Finally to my Uncle Earl, for providing life-saving advice so many years ago, constant
insight into the criminal justice system, and most importantly for his friendship throughout
all these years.
I would like to extend my sincere gratitude and humbleness to my thesis committee,
Dr. Tammy A. King who provided insight, hindsight, and foresight, otherwise this thesis may
not have materialized as it is. My appreciation is given to Dr. Eric S. See for his constant
words of encouragement. A special thanks is extended to Dr. Lawrence E. Cummings for
his continued dedication to me over many years. He has not only been a teacher and mentor
to me, but he is my friend. Without Dr. Cummings' direction and guidance I would not have
enjoyed the criminal justice career I have had.
I would like to extend my special gratitude to Ms. Kathy Sheppard for her
encouragement, loyalty, love, and faith in me. I would also like to express my deepest thanks
to Dr. George Pryor who had a profound effect upon my life and my career. I would like to
thank all the respondents who participated in this national survey and took the time from
their busy schedules to provide me with excellent data and information.
IV
Table of Contents
Abstract. .iii
Acknowledgments .iv
Table of Contents v
Appendixes , vi
List ofTables vii
List of Figures viii
Chapter
I.
II.
III.
IV.
V.
Introduction 1
Problem Statement 11
Literature Review 13
Historical Development ofTCs 15
Methodology 31
Introduction 31
Method 32
Analysis and Findings 34
Survey Participants 34
Facilities 35
Who Delivers TC Services 35
Months Program Has Been in Existence 36
Total Inmate Capacity 37
Programs Addressed by TCs 38
TCs Reduce Grievances and Disciplinary Reports 39
Less Violence on TC Units Compared to General Prison Population 39
Safer Environment for Correctional Officers/Inmates 39
Recidivism Rate Monitored .40
Good Inmate Role Models .41
Ex-offenders Hired as Professional Staff for TC Programs 41
Length of Programs in Months .42
Inmates Moving Through LevelslPhases .42
Once Inmates Complete TC Program .43
Standard Written Policy and Procedure for all TCs .44
Inmates Volunteering for ProgramlBed Capacity .45
Entire Prison Comprised ofTCs .45
Corrections Officers Specially Trained 47
TCs have the Potential to Reduce Recidivism 47
Summary 49
Conclusion 50
Bibliography 59
v
Appendixes
A. Cover Letter for Questionnaire 62
B. Adult Therapeutic Community Questionnaire 64
C. United States Map Depicting State Response 68
D. Human Subjects Committee ApprovaL 70
VI
Table I
Table 2
List ofTables
States 37
Facilities within state using TCs
Months program has been in existence
Length ofprogram in months
Inmate capacity
Inmate participation
Programs Offered By TCs 38
Vll
Figure I
Figure 2
Figure 3
Figure 4
Figure 5
List of Figures
States Utilizing TCs 34
TC Services Delivered By 36
Ex-offenders Hired as Professional Staff.. .42
Entire Prison System Comprised ofTCs .46
Corrections Officers Specially Trained .47
Vlll
CHAPTER I
IntroductionIProblem Statement
Never before in the history of penology have more individuals been incarcerated
in the United States as today. Just before Christmas last year, the Justice Policy Institute
released a report predicting that 2 million people in the United States would be behind
bars by February 15, 2000. "It's shocking to me," says Justice Fellowship President Pat
Nolan that "one out of 125 Americans are in prison. Tying that with the recidivism rate,
up to two thirds in most states, that says we're horribly failing" (Peck, 1999,3).
One way to rehabilitate offenders has been the use of Therapeutic Communities.
The definition used in this research is therapeutic communities are a rehabilitation
program which addresses addictive behaviors within adult prison environments. In 1943
Dr. Maxwell Jones developed the concept of the Therapeutic Community, often referred
to as milieu therapY. The European Democratic model TC had its beginnings in 1947 in
England. This was the result of Dr. Jones, a renowned British consultant psychiatrist,
Post-Graduate Medical School of London and Mental Health Consultant to the World
Health Organization, and others after World War II in their attempts to rehabilitate
repatriated prisoners of war. As Senior Psychiatrist at Belmont Hospital, London, he
founded the Industrial Neurosis Unit which was the first true Therapeutic Community
based on the purposeful creation of community to serve as both structure and content for
therapeutic change in the lives of individuals. His 1953 book, the Therapeutic
Community, reported on the development and management ofthe TC.
Dr. Jones began his work with traumatized war-torn men trying to help them deal
with feeling powerless. He then moved the Therapeutic Community into a horizontal
format where the men would be fully empowered to make decisions concerning their
lives, forming a community that would address their needs without any time barriers
(Van Voorhis, Braswell, and Lester, 1997). Another reason for the Therapeutic
Community's development was the demand for medications to control the disturbing
behaviors of inmates, so they would become less intimidating to staff and more amenable
to treatment. A third stimulus for the development of the Therapeutic Community was
the increasing number of inmates and the relative shortage of trained counselors (Jones,
1968, 1973). His documentation of successful outcomes established the efficacy of the
TC model in treating difficult cases. The patients treated and studied at the Unit were
difficult cases. They were males, known to be chronic failures, "trouble-makers," unable
to hold jobs, and were regarded as "desocialized patients with severe character disorders".
They were unemployable, and many were regarded as beyond treatment. The theory
tested by Dr. Jones and his associates was that a healthy group life would make healthy
individuals from this extreme sample. The successful results of the program firmly
established the Therapeutic Community as an effective model for individuals needing to
be resocialized into the community.
A Therapeutic Community may be based upon any number of treatment
philosophies. There are primarily two counseling modalities utilized in the criminal
justice field today, nondirective and directive. Nondirective counseling's philosophy is
that the offender is the only rightful person to determine his or her future and that no one
can tell another what is right for him or her (Rogers, 1951). Directive counseling is the
2
opposite of nondirective counseling, the major philosophy being that the offender has
failed to solve problems himself or herself and that is why he or she needs help. It is the
counselor, not the offender, who is responsible for the counseling process (Masters,
1994). Some examples of directive counseling are Psychoanalytic/Dynamic. Both claim
that only after the offender verbalizes and understands his or her problem can he or she
gain insight and change. Insight cannot occur until the offender's unconscious desires are
made conscious (Master, 1994). Relationship counseling's major premise is that the
offender does not have a good relationship with other human beings (Masters, 1994).
Rational-Emotive counseling, developed by Ellis in 1973, addresses the offender's
cognitive processes. The major premise is that offenders will change only when they are
ready to perceive things differently (Masters, 1994). Glasser, a Los Angeles psychiatrist,
originated and developed Reality Therapy counseling (Masters, 1994). This modality
emphasizes that offenders must learn to take responsibility for their behaviors and to face
reality. To face reality, offenders have to fulfill two basic social needs that all humans
must meet: (a) to love and be loved and (b) to feel important, unique, and worthwhile
(Glasser, 1965).
It is important to note that TCs within prison settings predominantly use Behavior
Modification counseling methods (Masters, 1994). There are several premises involved:
first, people behave as a result of and are motivated by reinforcements; second, behavior
is learned and, therefore, can be unlearned; third, the same laws apply to humans and
other animals; fourth, to change behavior, the consequences of behavior (environment)
must be changed; and, last, once behavior changes (external behavior) occurs, how one
thinks (internal behavior) also changes (Masters, 1994).
3
The Therapeutic Community (TC) program encompasses many of the theories
discussed. Individuals in these TCs need, not only to modify previous behavior, but new
thought processes and their conduct needs to be reformed. Individuals in TCs focus
typically on attributes such as honesty, courage, integrity, trust of and being accountable
to others, a sense of direction, and self-confidence. Members of TCs are learning to
address their anger, shame, guilt, fear, rejection, loneliness, resentment, and failures in
their past, present, and future (Deitch, 1999). The Therapeutic Community is a model
that is cross-culturaL. It has been utilized all over the world working with individuals
regardless of their culture, once it has been modified to the uniqueness of that particular
culture.
In a prison setting, inmates in TC programs are housed separately from the rest of
the prison population. The programs focus on criminal behavior, substance abuse, sexual
abuse, and issues related to living in the unit. While most prison activities stress security
and custody issues, the TC emphasizes the inmates' personal growth and provides a safe
place for free expression (Wexler and Love, 1994, 181-182). Wexler and Love indicate
that from a prison administrator's perspective, TCs can be useful to isolate inmates
participating in the program. Residents tend to be self-regulating and motivated to avoid
conflict and cooperate with correctional staff. At a minimum, inmates are occupied; at
the maximum, TC programs provide effective rehabilitation (182).
Members of the Community are referred to as "family". Instead of being
addressed as inmates members are normally referred to as residents. Each member is
concerned for the others' survival and "doing the right thing" for the benefit and growth
of the Community and the individual. Any member of the Community may correct,
4
confront, "patch-up" (positive comments about what a person is doing right) out of
concern and tough love when wrong behaviors are being displayed. Members of the TC
are accountable to each other and responsible to themselves for following all structural
design of the program. Members constantly and publicly disclose their fears, hopes,
guilt, and shame through group and individual sessions. In addition there are selected
inmates (usually graduates) within each TC who serve in a variety of resident positions,
such as: interns, staff assistants, and staff aids that serve as role models.
Within the therapeutic structure of the program all residents (undergraduates) are
required to hold a position of work, such as: monitors, sergeant-of-arms, public relations,
service crews, and other positional tasks. One of the most fascinating social
developments in the U.S.A. today is the growth and proliferation of TCs, where former
drug addicts are living and struggling together to gain a new, drug-free outlook on life.
These Communities are tightly regulated and run, not by university-trained or board 
.certified professionals but mainly by former addicts who have been in similarprogram~
and have shown an aptitude for this kind of work (Sugarman, 1974). If a resident is not
willing to abide by the institutional and program rules of the prison TC, she/he is
terminated and returned to general prison population, in essence banishment or expulsion
(Deitch, 1999).
The Therapeutic Community approach in working with a variety of individuals is
guided by a perspective on the disorder, the person, recovery, and Right Living. In other
words, the addiction is viewed as a disorder of the whole person involving some or all of
the areas of functioning. The person or individual is distinguished along dimensions of
psychological and social dysfunction, for example, problems with authority, poor impulse
5
control, as well as educational and vocational deficits. The goal of treatment is a global
change in lifestyle and identity. Some assumptions about recovery are that it is a self-
help-process or step-by step learning that moves the person toward a stable change in
behavior, and that remaining in treatment requires the individual's continued motivation
to change. In the TC view of Right Living, certain beliefs and values are essential to
recovery, personal growth and healthy living. Some examples are: focusing on the here
and now, honesty, social responsibility, a good work ethic, and economic self-reliance.
The most important element of the TC process is community as the primary
method of change to bring about needed social and psychological individual changes.
Every activity in a TC is designed to produce therapeutic and educational change in the
individual participants; however, it is the participants who are the mediators of these
changes. Therefore, in the TC environment and structure, the community is both the
teacher and the healer.
There are eight essential concepts ofCommunity as Method.
1. Use of Participant Roles - Each individual participates in and
contributes to all activities of daily life in the TC. This provides him or
her with the opportunity to learn by taking on a variety of social roles such
as peer, friend, coordinator, and tutor. Individuals are active participants
in the process of changing themselves and others.
2. Use of Membership Feedback - Peer members are the primary
source of instruction and support for individual change. Providing
observations and authentic reactions to the individual is the shared
responsibility of all participants.
3. Use of Membership as Role Models - Each participant strives to
be a role model of the change process. Along with the responsibility each
member has to provide feedback to others as to what they must change,
each TC member must also be a living example of such change.
4. Use of Collective Formats for Guiding Individual Change - TC
members engage in the process of change primarily with their peers.
6
Education, training, and therapeutic activities occur in groups, meetings,
seminars, job functions, and recreation. The learning and healing
experiences essential to recovery and personal growth unfold in a social
context and through social exchanges in community.
5. Use of Shared Norms and Values - Rules, regulations and social
norms protect the physical and psychological safety of the community.
However, there are also beliefs and values that serve as explicit guidelines
for self-help recovery and for teaching Right Living.
6. Use of Structure and Systems - Work in the community includes
the many jobs and management roles needed to maintain the daily
operations of the facility. The organization of this work is a primary
vehicle for teaching self-development. Learning occurs not only through
specific skill training, but also in adhering to procedures, in accepting and
respecting supervision, and in behaving as a responsible member of the
community - being someone on whom others can depend.
7. Use of Open Communication - The public nature of shared
experiences in the community is used for therapeutic purposes. The
private life of the individual, his feelings and thoughts are matters of
importance to the recovery and change process, not only for the
individual, but also for other members of the community. Therefore, all
personal disclosure is eventually publicly shared.
8. Use of Relationships - Friendships with particular individuals,
peers and staff are essential to encourage the individual to engage and
remain in the change process. Relationships developed in treatment are
the basis for the social network needed to sustain recovery beyond
treatment.
(De Leon, 1998,22-23).
Because of the widespread and sometimes indiscriminate use of the term
"therapeutic community" there has been a clouded understanding of the model. Not all
programs that call themselves therapeutic community use the social and psychological
models of treatment associated with the therapeutic community approach. It is extremely
important, therefore to define the TC approach and describe the basic components of the
generic TC program model. The following are the basic elements of a TC program
7
regardless of whether it is adapted to a prison environment, adolescent population or day
program. These are the fourteen generic therapeutic community components:
1. Community Separateness - TC oriented programs have their own names,
often created by the clients, and are housed in a space or locale that is
separate from other agency or institutional programs, units, or generally
from the drug-related environment.
2. Community Environment - The inner environment contains communal
space to promote a sense of commonality and collective activities such as
group meetings. The walls display signs that state in simple terms the
philosophy of the program and the message of Right Living and recovery.
Structure Boards identify all participants by name, seniority level and job
function in the program, and daily schedules are posted. These visuals
display an organizational picture of the program that the individual can
relate to and comprehend, which promotes affiliation.
3. Community Activities - To be effectively utilized treatment or
educational services must be provided within a context of the peer
community. So, with the exception of individual counseling, all activities
are programmed in group formats. These include at least one daily meal
prepared, served and shared by all members; a daily schedule of groups,
meeting and seminars; team job functions; organized recreational and
leisure time, and ceremonies and rituals such as birthdays and phase
graduations.
4. Peers as Community Members - Members who demonstrate the
expected behaviors and reflect the values and teachings of the community
are viewed as role models. Indeed the strength of the community as a
context for social learning relates to the number and quality of its peer role
models. All members of the community are expected to be role models.
TCs require these multiple role models to maintain the integrity of the
community and assure the spread of social learning effects.
5. Staff as Community Members - The staff is a mix of recovered
professionals and other traditional professionals such as correctional,
mental health, medical and educational professionals. It is essential for
them to be integrated through cross-training that is grounded in the basic
concepts of TC perspective and community approach. While their
professional skills will define their staff function as nurse, guard, or
caseworker, it is essential that they understand that their generic role as
staff is now that of community member. They are not providers or
treatment specialists, but rather they are rational authorities, role models,
facilitators and guides in the self-help community method.
8
6. A Structured Day - Regardless of its length, the day has a fonnal
schedule of varied therapeutic and educational activities with prescribed
formats, fixed times, and routine procedures. The structure of the program
relates to the TC perspective, particularly the view of the client and
recovery. Ordered, routine activities counter the characteristically
disordered lives of these clients and distract from negative thinking and
boredom, factors associated with their addictions.
7. Phase Format - The treatment protocol or plan of therapeutic and
educational activities is organized into phases that reflect the
developmental view of the change process. Emphasis is placed on
incremental learning at each phase, which moves the individual to the next
stage of recovery.
8. Work as Therapy and Education - Consistent with the TCs self-help
approach, all clients are responsible for the daily management of the
facility which includes cleaning, activities, meal preparation, maintenance,
coordinatings~hedules,meetings, and so on. In the TC, the various work
roles help bring about essential educational and therapeutic effects.
9. TC Concepts - There is an organized curriculum focused on teaching the
TC perspective, particularly its self-help recovery concepts and view of
Right Living. The concepts, messages and lessons of the curriculum are
repeated in the various groups, meetings, seminars, and peer conversations
as well as in readings, signs, and personal writings.
10. Peer Encounter Groups - The peer encounter group is the main
therapeutic group, although other forms of therapeutic, educational and
support groups are used as needed. The minimal objective of the peer
encounter in any TC is to heighten individual awareness of specific
attitudes or behavioral patterns that need to change. However, depending
on the type of TC, the encounter group process may differ in degree of
staff direction and intensity.
11. Awareness Training - All therapeutic and educational interventions
involve raising the individual's consciousness of the impact of his conduct
and attitudes on himself and on the social environment. And, conversely,
it involves increasing his awareness of the impact of the behaviors and
attitudes of others on himself and the social environment.
12. Emotional Growth Training - Achieving the goals of personal growth
and socialization involves teaching individuals how to identify feelings,
express feelings appropriately and manage feelings constructively through
the interpersonal and social demands of life in the community.
9
13. Planned Duration of Treatment - How long individuals must be
involved in the program depends on their stage of recovery, although a
minimum period of intensive involvement is required to assure
internalization of the TC teachings. The optimal lengths of time for a full
program involvement must be consistent with TC goals of recovery and its
developmental view of the change process.
14. Continuance of Recovery - Completion of primary treatment is a stage in
the recovery process. Regardless of whether aftercare is implemented
within the boundaries of the main program or separately, the perspective
and approach guiding aftercare must be continuous with that of primary
treatment in the TC.
(De Leon, 1998,24-27).
The Therapeutic Community concept can be applied in almost any setting and
with almost any population. In recent years, TC models have been increasingly adapted
for incarcerated individuals in prison settings. Overcrowded prisons, increased influx of
drug offenders, and the documented success of TC prison models in reducing recidivism
and relapse have fostered this development. Modifications of the traditional TC model
are shaped by the unique features of the individual correctional institution and the prison
.culture itself. However, to maintain integrity as a TC, the basic components of the
generic TC program and the eight essential concepts of using community as method must
be preserved.
The Therapeutic Community Model is a belief system. It demands that
practitioners/staff believe that this model works; that the individual can change and that it
is the group, the community facilitates this change. In addition, it is a scientific system.
There are theories, researched methods, and measurable behaviors at work that yield
predictable outcomes regardless of where the model is practiced (Deitch, 1999).
10
Within TCs there are five primary, distinct yet overlapping categories of activity.
Each category is equally important and has distinct goals, theory, and methodology.
Those activities that promote change are:
1. Behavior Management/Behavior Shaping - Interventions and methods
that teach and reinforce new ways of behaving until these are ultimately
integrated by the individual. The focus is on the "here and now."
2. EmotionaVPsychological - The goal is for the individual to gain insight
into his or her past and understand how it influences "here and now"
behavior.
3. IntellectuaVEthical and Spiritual - Focuses on educational abilities
relevant to social survival as well as the exploration and examination of
values--of great ideas. Goal is to equip individuals with language that will
allow them to discuss and handle their feelings vs. acting them out.
4. VocationaVSurvival Skills - Focuses on developing pro-social behavior,
teaching work skills and attitudes through contribution the individual
makes in his or here everyday jobs for the community.
5. Biomedical - These are activities directed at the medical management of
individuals in TCs that treat those suffering from thought disorders in
addition to criminogenic and substance abuse disorders.
(Deitch, 1999, 3).
Problem Statement
There remains a critical need to address and investigate whether the Therapeutic
Community within the Criminal Justice System, particularly prison environments, is
working. Are TCs being accepted by State and Federal prison officials as viable treatment
approaches and alternatives to address offender addictive disorders and functioning? Is
cross-training ofTC staff being implemented more effectively today versus the past? Are
ex-offenders being utilized by today's TCs as they were in the past? Is communication
between staff more effective today in TCs than in the past? Is TC staff retaining
sufficient control over the TC programs? Is the potential for alienation between security
and treatment staff being addressed? Will TCs help to reduce crime and violence in
11
pnson and provide a safer pnson environment for employees and inmates? Will
Therapeutic Communities help to lower recidivism rates throughout the country? By
gathering descriptive data and information on Therapeutic Communities throughout the
country, as implemented by State governments and private service contractors, research
results help evaluate whether TCs' concepts/programs are being widely utilized by
correctional management. If they are, what are the potentials for their success within
prison environments? More importantly, what is the potential for participants (inmates)
remaining in society, once released, as law-abiding citizens?
In the next chapter a detailed literature review on the development and utilization
ofTCs in adult correctional facilities will be presented.
12
CHAPTER II
Literature Review
This literature review focuses on the use of Therapeutic Communities beginnings
and their use in prison environments. The Therapeutic Community (TC) is a structured
method for changing human behavior in the context of community life and responsibility.
The early TCs in America were part of a grassroots, non-professional movement in which
substance abusers and offenders voluntarily joined together for self-help. They were seen
as an alternative to the dominant culture and lifestyle, and were based on a common
belief that their members would be unable to remain clean, sober, and crime-free outside
a highly structured and ritualized community (Bush and La Barbera, 1997). As they are
usually designed today, TCs are closed communities in which members are immersed in
the life of the community, which predominantly revolve around common purpose, strict
structure, commonly held and reinforced values, clear rules and norms, and enforced
consequences. Generally the resocialization model that is enforced is Social Learning
Theory. This theory suggests that criminal behavior is learned through a process of
social interaction (NIDA Research Monograph 1994, 144). In contrast to traditional
residential treatment programs where the counselor or therapist is the primary agent of
change, in a TC the community itself is the agent of change. In the TC professional staff
largely focus on maintaining the community (Bush and La Barbera, 1997). The staff can
also be described as the primary culture carriers (Deitch, 1999).
The quintessential element of the TC is community. What distinguishes the TC
from other treatment approaches is the purposive use of the community as the primary
method to bring about needed social and psychological change in the individual. Every
13
activity III a TC is designed to produce therapeutic and educational change in the
individual participants; however, it is the participants who are the mediators of these
changes. Thus, in the TC, the community is both teacher and healer (DeLeon, 1994).
Therapeutic Communities in prison environments incorporate the following
common features:
• isolation from the rest of the prison inmate population,
• use of ex-offenders and ex-addicts as staff members,
• development of a safe environment,
• use of confrontation and support groups,
• clearly specified cardinal rules,
• institutional, basic rules and sanctions,
• development of pro-social attitudes.
Normally, inmates are saturated III a highly structured and supportive
environment. Within this highly structured setting inmates live and often work for an
extended time (often a year or longer) away from negative prison influences (NIDA
Research Monograph] 994, 144). Frequently, TCs in a prison setting, focus on the
inmate's criminal behavior and cognitive patterns, substance abuse, sexual abuse, and
issues related to living within the Therapeutic Community Unit (NIDA Research
Monograph 1994, 144).
While prisons stress security and custody issues, the Therapeutic Community
constructively emphasizes the inmates' personal growth and provides a safe place for the
inmate to practice free expression. This freedom of expression can be a focus of conflict
among the TC treatment staff and other correctional personnel. On the other hand,
inmates (residents) tend to be self-regulating and motivated to avoid conflict and
cooperate with correctional staff. From an administration perspective inmates are
14
occupied; from a Therapeutic Community program perspective inmates are afforded an
opportunity for effective rehabilitation.
Historical Development ofTC~
Philosophies similar to Therapeutic Communities have been found in the Dead
Sea Scrolls of approximately 2000BC. A group of people living in the desert, called the
Essenes, organized their lives relevant to the survival of each of its members. The rule
of order, a way in which they lived, continuously expanded both the capacities to survive
amidst terrible environmental challenges and the challenges of wanting to live a good
life. Their "Manual of Discipline" is a combination of directions, prescriptions, rules and
notations for personal conduct, for carrying on the affairs of the community, for
discipline, for admission to and expulsion from the order, and for worship. Deitch
describes these enduring principles as follows:
• Concern for the soul and physical survival
• Search for meaning
• Challenge and admonish with love
• Be invasive - accountable to the community
• Public disclosure of acts, fears, hopes, guilt
• Public explanation for wrongs done
• Banishment possible - done with concern
• Leadership by elders - by model (The Essenes and Christianity, 1957).
Although Essene principles highly impact today's TCs, other historical events
played a role in their developing modem TCs. The Essene principles began to falter
about the 4
th
century when Rome absorbed Christianity and priests were given power and
authority. In the 5
th
century, under Pope Leo, confessions of one's secret wrongs were no
longer public, thus resulting in the loss of public disclosure, absence of public expiation
15
or punishment, and no visible amends. Members of a church, or a group of Christians, no
longer were accountable to the community or to each other, but only to the priest.
In 1517, Martin Luther, an Augustinian monk, was upset that indulgences in sin
could be bought and paid for with money, status, and power. Luther questioned the need
and validity of sins being confessed to a priest. As a result, Martin Luther became the
cornerstone and began the Reformation Movement in Europe, by nailing his 95 theses to
the church door at Wittenburg, Germany. The upshot of Luther's theses was that
Christians are saved by faith, and faith alone, and that no amount of works (including the
purchase of indulgences) made any difference at all (http://www.lepg.org/religion.htm).
In the 17
th
century, England was infested with a brand new "drug", called gin.
England became known as the land of the drunkard, thus causing more death and
destruction than has ever occurred in the usage of any other drug. As a result, many
turned to theology and the church for help with these alcoholics! Religious leaders
attempted to change or alter the lifestyles of those who were involved with the gin
epidemic (Deitch, 1999). This alternating of life styles is a prominent principle of today's
TCs. In response to this devastation many church groups rose up to address the situation.
For example a strong religious group, the Methodists, led by John Wesley, an evangelist
from Oxford, opened the door of hope for men and women. He referred to them as
victims of society. These individuals had been excluded from the political process and
from most of the protections of the common law. Wesley gathered them together into
new social groups in which each person found acceptance and a new sense of dignity
(Outler, 1984).
16
In 1908 while visiting England, Dr. Frank Buchman (born in Pennsylvania)
underwent a spiritual experience which altered the course of his life. Describing it he
said, "I began to see myself as God saw me, which was a different picture of the one I
saw of myself. I realized how my sin, my pride, my selfishness had eclipsed me from
God. I was the center of my own life. That big "I" had to be crossed out. It produced a
vibrant feeling as though a strong current of life had suddenly been poured it to me."
The strength of this experience convinced Buchman that moral compromise was
destructive of human character and relationships, and that moral strength was a
prerequisite for building a just society. His experience led him to give the rest of his life
to helping others, through personal encounters and the sharing of personal experience. In
the 1920s, Buchman was a frequent visitor to Oxford University, which inspired the
"Oxford Group". He felt that the remedy for bitterness and fear were honesty, purity,
unselfishness, and love. Personal change would lead to social change
(http://www/rnra.oprg.uk/general/founder.htrnl).
Among those whom Buchman befriended and influenced were the founders of
Alcoholics Anonymous (AA). AA is perhaps the most famous outgrowth from his work.
Bill Wilson, the known founder of AA, an alcoholic himself, helped develop the
following 12 steps which are suggested as a Program of Recovery:
1. We admitted we were powerless over alcohol- that our lives have become
unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to
sanity.
3. Made a decision to tum our will and our lives over to the care of God as
we understood Him
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact
nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
17
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make
amends to them all.
9. Made direct amends to such people wherever possible, except when told
do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly
admitted it.
11. Sought through prayer and meditation to improve our conscious contact
with God, as we understood Him, praying only for knowledge of His will
for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to
carry this message to alcoholics, and to practice these principles in all our
affairs. (Alcoholics Anonymous, 1955, 58-59)
From New England, TCs expanded to California. The beginning of the TCs in the
United States addressed drug dependence verses mental illness. In 1958, Charles
Dederich created the organization, Synanon. Synanon, based in Santa Monica,
California, was a truly innovative organization. Dederich was not only familiar with the
group dynamics of Alcoholics Anonymous but was an active campaigner for that
organization. He developed the harsh verbal reprimand or "haircut" because it suited his
personality and he observed that it was effective; members of the group lived together at
first because they were homeless but this principle of joint residence became a
fundamental rule of Synanon. He also broke radically with all previous social work
traditions by saying (sometimes explicitly, sometimes by implication), "Junkies need
Synanon, we don't need them." In line with this, he established the policy of demanding,
before accepting them into the house, that they agree to conform to all rules and make
some "investment" as a token of sincerity. Some examples of these investments were
telephoning at designated times, giving up prized personal possessions, or by doing
something difficult but meaningful, such as yelling for help before a group of residents.
All of these features of Synanon are reproduced in many other organizations (Sugarman,
18
1974). A dramatic move was made from working with outpatient Alcoholic Anonymous
meetings to moving into a residential environment including fundamentals dealing with
the heroin addict and the alcoholic. Synanon developed the concept of addicts treating
other addicts without the intervention of therapeutic professionals in a 24 hour a day
residential format (Weppner, 1983).
Dederich intuitively began to shape methods that would provoke recovery by
providing and developing, and by provoking conflict and dissidence in individuals. The
person would experience internal conflict over their self-image (how they perceived
themo;;elves). They were encouraged and challenged by residents in the group ·to do
something different other than what their criminal thinking, drug use, and self-image
demanded. He challenged residents to think about morality, human values, and apply
those principles of right living to their everyday lifestyle. Dederich felt that when
behaviors are managed, the addict soon returns to the same old behavior, but when you
shape character and reward that new character, change occurs. Synanon received no
public money and there was no public accountability.
Synanon encountered several problems and eventually failed (Sugarman, 1974).
From the beginning Synanon had difficulties with the Santa Monica city council, which
was responding to worried citizens who did not want "dope fiends" for neighbors
(Weppner, 1983). Synanon took the position that modern American society is basically
not a good place to live. Their policy was to create their own sub-culture or sub-society
in which people could live by the values of Synanon residents, turning their backs on the
rest of the American society.
19
Under Dederich's influence, Synanon staff came to take the view that Synanon
stood for better values, and they felt they upheld these values with far more integrity than
did the typical representatives of secular American society. In Synanon, people were
learning to live by the values of honesty in personal relationships, concern for each other,
responsibility in accepting the consequences of one's actions, and working for what one
wants. Synanon leaders came to reject the idea that the values of mainstream American
society were basically sound and that their main task was to prepare former addicts to
return, drug-free, to that society (Sugarman, 1974).
Synanon ran into extreme problems with the law because the leaders made
decisions without consulting members of the city council as well as their own
membership. They resorted to violence and attempted murder in an effort to silence its
critics. Dederich even made tape-recorded messages to members encouraging them to
beat up "punks who messed with Synanon." In 1980, Dederich was found guilty of
.conspiracy to commit murder (Weppner, 1983). In other words, with no accountability
(especially government institutions) to anyone except its own members, Synanon came to
be defined by its leaders more as a social movement with radical or perhaps utopian goals
and less as a rehabilitation program. However, it may be a misnomer to state that
Synanon failed. In fact in 1975, at the National Drug Abuse Conference held in New
Orleans, over three hundred separate Synanon-type programs throughout the United
States were listed. Weppner had visited fifteen different therapeutic communities located
from New York to California to Florida. Daytop and Phoenix House in New York City
and Spectrum House in Miami are examples of programs initially started or staffed by
people who left Synanon (Weppner, 1983).
20
The Daytop Lodge experiment, as it was first known, began in the fall of 1963. It
started as a branch of the Probation Department of the New York Supreme Court, Second
Judicial District (Brooklyn and Staten Island). Chief Probation Officer Shelly was one of
the prime movers to establish an innovative program for male drug offenders with felony
convictions on probation to his department (Sugarman, 1974). Mr. Shelly along with
several other individuals from New York City toured Synanon and concluded that the
Synanon "concept" of treating addicts should be implemented. Daytop came to play an
important part in bringing the Synanon approach to the East Coast and in particular to
New York City. In the early planning stages of what became the vast Phoenix House
program of New York City, Daytop staff played an important role in advising city
officials and visits to Daytop were important in convincing them to support a therapeutic
community type of program. As plans for the Phoenix program developed, former
Synanon personnel were hired, and today comprise the greater part of senior Phoenix
House staff (Sugarman, 1974). It differed from Synanon by using a mixed staff. A
mixed staff being a composition of both professionals and non-professionals. Leadership
within the structure did not depend on one having experienced recovery. What counted
was the mix of staff, who led a moral life and shared values of right conduct and right
living within the Therapeutic Community.
The Therapeutic Community expanded to Philadelphia, Rhode Island, Florida and
into Sweden, Germany, London and Italy. By the 1980s TCs were utilized throughout
Asia in prisons, adolescent and residential programs (Deitch, 1999). Deitch reports that
clients and staff members all have influenced and helped expand what is known today as
TCs within prison settings. These strong influences throughout history have been, and
21
are now, a model focused on right conduct and right living. It does not focus on saying,
"do not do drugs", but focuses on responsible conduct. Therapeutic Communities
reinforce and encourage participants to engage in ethics and morality, being concerned
with self-discipline and self-restraint, and showing compassion. When you do what is
desirable - you disable doing the undesirable things that previously occurred.
As stated earlier, members of the Therapeutic Community within the pnson
system are learning to address their anger, shame, guilt, fear, rejection, loneliness,
resentment, and failures in their past, present, and future. Inmates reinforce these skills
daily for a designated period of time moving in different phases. The desired end result
is that the inmate returns to society better equipped to manage his/her environment and
his/her own negative behaviors and emotions.
Community-based therapeutic communities (TCs) have been found to have a
positive effect on reducing the criminal activities and drug use of clients who complete
their programs (De Leon et al. 1972; Simpson 1979, 1980). It is important to point this
out as many ofthose individuals during these studies had criminal histories.
The Bureau of Prisons (BOP) officials was attracted to the TC approach because
of the development of the unit management system. The unit management system
organizes institutions into functional units; each unit is managed by a unit manager who
supervises the unit team (Levinson, 1980). By utilizing the unit management system it
makes it possible to manage a large prison as if it were several smaller institutions, each
with its own case management team, disciplinary committee, and treatment staff.
Therefore, under the unit management system, it was easy to make one of the units a TC
within the Bureau of Prisons own program plan.
22
Early drug treatment programs were funded by provlSlons in Title II of the
Narcotic Addiction Rehabilitation Act (NARA), which authorized Federal judges to
commit convicted felons to prison drug treatment programs. One of the early NARA
drug treatment sites was at the Terminal Island Federal facility in California. This
treatment program included a residential program that was a precursor to the TC.
One of the first and best-known prison-based TCs was established in 1969 at the
Federal Bureau of Prison's (BOP) maximum-security institution in Marion, IL. This
program was called Aesklepieion, which was developed and implemented by Dr. Marty
GrodeI', a BOP psychiatrist (Wexler and Love, 1994, 183). It is of interest that the
Marion facility had at this time recently received inmates transferred from BOP's original
maximum-security facility, Alcatraz. During the evolution of the Marion TC, several
other offshoot programs were developed at other federal and state prisons (Wexler and
Love, 1994, 184). What also distinguishes the Aesklepieion program from earlier prison
programs is that most of these earlier programs were offered in low-to-minimum-security
facilities. Therefore, resulting in an assured success.
Another key feature of the Aesklepieion program was that inmates could "call a
game" on another inmate or a staff member, meaning that the individual was being
confronted or challenged about a particular topic. This allowed inmates to be empowered
to take action, in sharp contrast to the normal routine of the general prison population. In
addition, another unique feature utilized by the Aesklepieion program was the use of
transactional analysis (Berne 1961; Harris 1967) and its special language. Code words
and phrases (e.g., little professor, replaying tapes) added to the special nature of the
23
program and gave the participating inmates a special form of exclusiveness in a prison
environment that frequently prohibits individuality.
The above strategies developed by the Aesklepieion staff were to confront the
"Convict code". The "Convict code" is a general term referring to inmate resistance to
communicating with staff, supporting any staff or administration activity, and sabotaging
as many aspects of the prison operation as possible. Often inmates in many institutions
physically enforce this "Convict code",
What was found to be effective and attractive for inmates in the Aesklepieion
program also became a source of conflict. The exclusive program language, special
"perks" (privileges), and staffing of the program created mistrust among other staff
members and inmates who were not involved in the program. Inmate participants were
isolated from all other inmates because of their program activities and because most
inmates had jobs in the same area ofthe institution. It was felt that inmates had too much
control over the unit; the fact that they could confront staff as well as other inmates made
working in the unit a threatening process for those staff members who were not involved
in the program. Because of the mistrust, isolation, lack of communication, a perceived
threat to security, and the low priority for programs, the TC program eventually closed
within the Marion Federal facility.
Many of the state prison TCs were derived from the Aesklepieion TC at Marion
and former inmates from Marion were employed to develop and manage these TCs
(Wexler and Love, 1994, 187). For example, the Federal Correctional Institution (FCI)
located at Oxford, Wisconsin, was implemented by former Marion staff and Marion
inmates (Wexler and Love, 1994, 187). Other Federal facilities that included TCs were
24
listed by Camp and Camp (1989) as follows: Ft. Worth, Tallahassee, Terre Haute,
Terminal Island, Danbury, FCI Miami, and FCI Seagoville, Texas (Wexler and Love,
1994, 187). All of these programs were eventually closed. In many of these programs, it
was found that some inmates were involved in dealing and using drugs, staff had loss of
control over the program, the selling of admissions into the TC unit, and little
supervision, proved to federal prison officials that TCs were not beneficial and did not
work anyway. The Federal initiative in the use of TCs in prison settings, along with all
other programs, declined in the late 1970s. According to Camp and Camp (1989) the
decline of support for TCs and general dissatisfaction with all types of treatment
programs resulted in the closing of TCs in Federal prisons.
State prison systems experienced many of the same problems identified in Federal
prison systems: programs out of control, staff mistrust, and poor communication. The
first TC state prison program was initiated in 1962 in the Nevada State prison system. It
.was operated and implemented by former Synanon members. It is noteworthy; that the
Arkansas Department of Corrections was one of the first prisons to establish a TC in a
work release facility. Several other state prison systems used the TC as a treatment
modality. The Connecticut and Virginia State prison systems opened TCs based on the
Aesklepieion model. All of these were eventually closed because of similar reasons
experienced within the Federal prison system.
While other State and Federal TC programs were closing in the late 1970s, it is
interesting to note that the Stay'n Out program, implemented in 1977, was the first in 
prison TC to be extensively evaluated. Stay'n Out is located in two New York State
prisons: one for men at the Arthur Kill Correctional Facility on Staten Island, and the
25
other for women at the Bayview Correctional Facility in Manhattan. The rationale for the
development of Stay'n Out program was based on the growing research on community 
based TCs, according to Wexler and colleagues (Wexler et aI., 1988b). Community-based
TCs are widely accepted and have been demonstrated to be effective with clients who
have criminal histories (Bale, 1979; De Leon, 1984; De Leon et aI., 1972, 1979, 1982;
Holland, 1978; Nash, 1973; Sells et aI., 1976; System Sciences, Inc., 1973; Wilson and
Mandelbrot, 1977).
Evaluation of the community-based Phoenix House program (De Leon 1984; De
Leon et aI. 1979) provided direct support, because the Stay'n Out model is based on the
Phoenix House program. Not only were the results of the Phoenix House evaluation
supportive of TC effectiveness in a 5-year follow-up study, but it was found that the
successful outcomes (i.e., reduced crime, reduced substance abuse rates, and increased
employment) were related to the time spent in treatment (De Leon et aI., 1979, 1982;
Simpson 1979, 1980). This Time In Program (TIP) is a critical component of the TC
concept.
The evaluation of the Stay'n Out TC provided the opportunity to gather new
information about the TIP effect as noted by De Leon (1984) in community-based TCs.
It was expected that inmates would remain in the TC longer than the community-based
TC program participants. For example, compared to the general prison population, the
prison TC unit provided more desirable housing, more activities, more special incentives,
and offered opportunities to impress the parole board. The research showed that the
program was successful in implementing and maintaining a positive TC treatment
environment, was capable of retaining inmates for optimal treatment duration (9 to 12
26
months), and facilitated positive personality changes as assessed by standard
psychological measures (Wexler et ai. 1985).
Another independent confirmation of the utility ofTCs in prison has been provided
by the evaluation of the Cornerstone Program (Field, 1984, 1989). Cornerstone is a
prerelease treatment program for alcohol-and drug-dependent offenders, which opened in
1976 on the grounds of the Oregon State Hospital in Salem. Just as was the case in
Stay'n Out, Cornerstone participants had severe histories of criminal behavior. For
example, in 1984 Cornerstone clients had an average of about seven felony convictions
and had served more than seven years in prison.
The effectiveness of prison TCs has been substantiated by evaluation research of
these two prison TC programs. The Stay'n Out, Cornerstone, and other prison TC
program evaluations have provided convincing evidence that prison-based TC treatment
can produce significant reductions in recidivism rates (Wexler and Love, 1989)
In response to increasing public demands that something be done about the
growing drug problem, state and federal legislatures have enacted determinate and
mandated sentencing laws, resulting in a sharp increase in the number of inmates in U.S.
prisons.
One response to the growing need for in-prison drug treatment programs was the
Bureau of Justice Assistance (BJA) program called Project Reform. Project Reform was
designed to help state prison systems develop corrections-based drug treatment programs
(Wexler et aI., 1991). The program was funded through the Anti-Drug Abuse Act of
1986, which called for substantial new resources for correctional drug treatment efforts.
The project began in July, 1987.
27
Project Reform made it possible for 11 state prison systems to share resources in
developing drug abuse treatment programs, complete with an evaluation component. It
offered technical support and assistance, consultants, orientation and training, to state
prison systems in developing new programs for their growing populations (Wexler et al.
1991).
Therapeutic Communities liberally use group dynamics, educational techniques,
and group pressure to help the offender (Masters, 1994). It involves creating a total
therapeutic milieu within the traditional prison that is meant to create a psychological
change within the offender that will make the offender law abiding after release from
prIson. They are experiments in social living, in which offenders leam to manage
themselves in a law-abiding fashion. The aim of TCs in criminal justice settings is to
create a normal environment within a prison, so that the offender will not be released in a
worse condition than he or she was in when incarcerated. TCs attempt to foster
reintegration of the offender and are collaborative efforts to modify traditional prison
structures and practices in a way that fosters rehabilitation (Masters, 1994).
In addition to the above treatment philosophies, group counseling is considered to
be the primary clinical tool and/or a modality (Masters, 1994). Group counseling
involves three or more people who meet to solve personal problems in a group, with the
benefit of a group counselor or leader. During the 1940'sand 1950's, group counseling
began to be widely used in the criminal justice system as a way to handle offenders more
efficiently (Kratcoski, 1981). Another important counseling modality for TCs is family
counseling. Family counseling is based on a systems theory and the premise is that the
28
family is a system as such strives for balance or homeostasis' whenever stress occurs
(Masters, 1994).
The Therapeutic Community provides a rare and unique aspect; this IS the
utilization of offenders and ex-offenders as staff within institutional settings. In the
1970's, Briggs developed a change system environment in a California prison for violent
youthful offenders (Whitely, Briggs, Turner, 1973). The results of the experiment are
positive. During a four-year period these offenders, who were prone to violence had no
acts of violence with weapons; and with total inmate supervision of other inmates within
the program structure, there were no escapes. This was not the case when trained
correctional staff was in charge of the supervision (Whitely, Briggs, Turner, 1973).
However, this internal commitment achieved by the residents of the program
produced a challenge to the professional staff. Inmates were keen on and highly adept at
putting concepts into action and testing them for effect. Unlike the professional, those
who "guarded" them, they did not become caught-up in professional jargon and
explanations. The inmates could easily abandon an ineffective course, and try something
new, quickly grasping sophisticated concepts, translating them into action, observing
"interactions", and developing new strategies with other residents of the program (Jones,
1976).
There are three promising approaches to counseling offenders in prison settings;
therapeutic communities, group counseling, and family counseling. These approaches
offer the criminal justice system ways of helping the large number of offenders who are
expected to enter the criminal justice system in the future (Masters, 1994).
29
In a private statistical study conducted from December, 1993 to December, 1994
by Corrections Corporation of America (CCA), a private company based in Nashville,
Tennessee, it was discovered in their Metro LifeLine Therapeutic Community, that only
34 percent of those inmates released from incarceration, who successfully completed the
program, had been re-incarcerated during this time period (CCA's Metro Davidson
County Detention Facility, LifeLine Program Handbook, 1993). At the same time it was
noted with a control group of 119 non-treatment randomly selected inmates, there~
incarceration rate for that group was 67 percent.
In addition to this recidivism data a grievance and disciplinary study was
conducted with 254 treatment inmates and 254 non-treatment inmates. In one calendar
year, the non-treatment inmates had 61.2 percent more grievances filed compared to the
treatment inmates. Non-treatment inmates received 81.7 percent more disciplinary
actions than treatment inmates.
In the following chapters, methods will be presented on how this research project
will obtain and evaluate descriptive data concerning TCs. The focus of this project will
be to provide a review of all TCs currently being utilized in the U.S.A. in efforts to
rehabilitate adult offenders sentenced to correctional facilities.
30
re~
CHAPTER III
Methodology
Introduction
According to the mass media, the prison system is not very promising. Prisons do
not appear to either deter crime or rehabilitate which is evident from the recidivism rate.
The offender is taken from society for a period of time, thus a feeling of safety for the
victim, however many of those offenders will return to society. Have those offenders
been rehabilitated? Has the root problem that caused them to commit an offense in the
first place been addressed? Or do we send the ex-offender back into society more
"hardened" than before their crime and incarceration? How many of these offenders have
learned to address their fears, rages, shame, and guilt? Have they had positive
reinforcement for good behavior? While incarcerated, where did that positive
reinforcement develop? Did the offender know how to live morally before they went to
prison? Better yet, is anyone teaching or role modeling how to live a crime free and
moral life upon release?
The recidivism rate continues to rise daily, as the media reports, statistics proving
that many offenders, who avoid trouble within the institution, and do, will again return to
crime upon their release from prison. Therefore, prison adjustment and avoiding trouble
in the institution are not the same as rehabilitative programs that end criminal behavior.
Rehabilitation should focus on an attempt to solve the problem(s), which brought the
offender(s) to prison.
Therapeutic Communities have the prel111se that many inmates desire positive
prison adjustment, desire to avoid trouble, and are motivated to change. This coupled
31
with the structure and designed activities of the Therapeutic Communities milieu provide
opportunities to confront and solve the problems which brought the offender into the
correctional system.
This research is designed to discuss information from all state department of
corrections or rehabilitation addressing the relevance of Therapeutic Communities within
their institutions. It will determine how many therapeutic communities exist throughout
the country, gather impressions as to are TCs working, do they have the potential to
reduce recidivism, and provide other descriptive information.
Method
In January, 2001, a cover letter (See Appendix A) and a questionnaire (See
Appendix B) were forwarded to all fifty state department of corrections and/or
rehabilitation with an enclosed prepaid return envelope addressed to the Criminal Justice
Department at Youngstown State University. Prior to the questionnaire being sent, a
telephone call was made to each state department of corrections and/or rehabilitation.
This procedure was to alert the Department of Corrections or Rehabilitation that a
questionnaire had been forwarded to them in an attempt to identify the correct individual,
best suited to provide the most articulate information related to the questionnaire.
The survey instrument addressed the following issues: are therapeutic
communities being utilized, where are those prison facilities located; are delivery of
services provided by state or private agencies, their capacities and participation, and what
type(s) of programs and length of those identified programs. Additional questions
addressed if therapeutic communities were safer environments with less disciplinary,
security, and inmate violence problems compared to the inmate general population, were
32
TC staff receiving some type of cross-training, and if policies and procedures were
developed for TCs within each responding state. The survey solicited responses
concerning recidivism rates being monitored and the potential for reduction of recidivism
rates within the responding states.
A follow-up questionnaire was forwarded in February, 2001, to those Department
of Corrections, which had not responded to the initial questionnaire. In March, 2001,
information and data were viewed and recorded. All results and findings from the
questionnaire are addressed in the next chapter.
Responses were assessed and tabulated for all returned questionnaires from each
state. The collection and analysis of the responses to the questionnaire provided a clear
composite of therapeutic communities within prisons throughout the United States.
Additional data, related to the results of the questionnaire, contained important
information and gave insight to whether or not therapeutic communities are good
management tools used by prison administration. SPSSIPC+, a computer software packet
for social scientists, was utilized to conduct descriptive statistics. Results are presented
in the following chapter.
33
CHAPTER IV
Analysis and Findings
In the previous chapter, the methods for data collection were presented. The
survey instrument was sent to fifty state department of corrections and/or rehabilitation.
The data were collected to determine if TCs are being utilized and if they are effective.
Survey Participants
Thirty-four of the states returned their survey instruments (68%). Five of the
respondents reported they were not utilizing TCs. One reported via telephone that their
state used TCs. Unfortunately that state declined to answer the questionnaire due to
workload (see Figure 1). See Appendix C for a map depicting which states responded to
the survey instrument.
Figure 1
States Utilizing TC's
Yes No
One respondent completed questions one through five. However, for the
remainder of the survey instrument, respondent stated "do not operate, so I don't know".
Therefore, questions one through five will be based upon 29 respondents who have TCs.
Questions six through twenty-one will be based upon 28 respondents. Another
respondent answered questions one through 11, but did not respond to questions 12 - 21.
34
The same scenario will apply as previously stated. Questions 12 - 21 will based upon 27
respondents.
Facilities
The majority of state prison systems that operate TCs have more than one TC in
various locations within the state. The type of facilities ranged from minimum to
maximum security institutions to pre-release centers. Some of the state prison systems
had large numbers of TC participants, such as Texas and California, and other
respondents reported much fewer numbers of TC participants within their programs, such
as Alaska. Many of the state respondents had TC programs for both male and female
inmates, although the majority had only males in their programs and the male/female
ratio was not requested of respondents.
Who Delivers TC Services:
Twenty-nine (n =29) responded to the question "who provides service delivery".
.12 states, 41.4% reported that their TCs utilize both private contractors and are state
operated. Ten states, (34.5%) are state operated and seven (24.1 %) states use private
contractors to operate their TC programs (see Figure 2). Private contractors include:
CCA, Wackenhut, Civigenics, Phoenix House, Gateway Foundation, Quest Recovery
Services, Comp Care, and DCCCA, Inc. Numerous other private contractors, such as
Akeela House in Alaska, provide services within that particular state.
35
Figure 2
TC Services Delivered By
14
12
10
8
6
4
2
0
States Private Contractor Both
Months Program Has Been in Existence
The lengths of operation reported varied depending upon the program and who
delivered services. The ranges varied from seven months to 240 months. For example,
Alaska, which is a new program, reported starting their TC program in the year 2000.
Minnesota responded that they had TC programs in existence ranging from 48 months to
240 months. (See Table 1).
36
Table 1
State Facilities Months Length of hunate hnnate
within state program has program in capacity participation
using TCs been in existence months
Alaska 1 7 12 44 44
California 15 120 18 8,000 8,000
Colorado 5 96 12 350 346
Connecticut 4 120 6 304 304
Hawaii 2 132 15 255 255
Idaho 2 36 12 87 87
Illinois 15 120 24 2,797 2,600
Indiana 2 48 12 264 264
Iowa 2 7 9 108 108
Kansas 3 72 24 184 175
Kentucky 1 12 6 96 65
Michigan 3 30 9 556 403
Minnesota 5 240 6 400 400
Mississippi 1 12 12 396 396
Missouri 7 72 24 2,065 2,049
Montana 1 18 Did not answer 88 65
Nebraska 3 72 10 181 181
Nevada 1 24 12 105 90
New Hampshire 3 120 11 430 430
New Mexico 7 60 14 540 503
Ohio 5 108 12 574 460
Oklahoma 4 12 12 350
Did not answer
Pennsylvania 8 190 12 900 900
Rhode Island 3 96 12 120 120
Texas 27 125 12 8,200 8,000
Utah 2 24 12 208 203
Washington " 36 12 300 200.)
West Virginia 3 36 12 160 160
Wyoming 3 66 9 44 31
Total Inmate Capacity
The inmate capacity, number of bed space, in the TC programs ranged from 44 in
Alaska and Wyoming to 8,200 inmates in the State of Texas. Although Wyoming
reported a capacity of 44, the state is in the process of expansion. California reported a
37
capacity of 8,000 inmates, with six institutions and a bed capacity of 2,115 being added
in the future. Fourteen TCs are operating at full capacity with 14 just slightly under
capacity. One State did not respond. (See Table 1)
Programs Addressed by TCs
Respondents (n = 29) were asked to report program components that are being
provided within their TC programs, one, all, or a combination of services. (See Table 2)
Table 2
Programs Offered By TCs
Program Frequency Percent
Substance Abuse 29 100
Behavior Modification 22 75.9
Domestic Violence 11 37.9
Sexual Abuse 14 48.3
Cognitive Model 24 82.8
The Therapeutic Community concept can be applied in almost any setting and
with almost any population. All of the respondents reported their TC programs address
substance abuse issues and concerns, therefore, implying that most of their inmate TC
population have, directly or indirectly, alcohol and/or other drug abuse issues. Some TC
programs are specially designed and implemented to address the needs of certain types of
offenders, for example, sexual offenders and domestic violence offenders. It is evident,
from the above information, that many of the major components of 'change' are being
addressed by prison TC personnel.
38
Other TC program components that were reported by respondents were 12-Step
education, criminal thinking, life skills, mental health issues, job seeking, parenting,
anger management, and relapse prevention. As one respondent stated, "TCs are holistic
programs".
TCs Reduce Grievances and Disciplinary Reports
Twenty-five (86.2%) respondents reported that they believe that TCs have fewer
frequencies of grievances/disciplinary reports in comparison to the general prison
population. One respondent stated they were "not sure yet"; another respondent stated it
was "too early to tell"; and one other respondent stated "there has not been a system study
of these areas to do a comparison".
Less Violence on TC Units Compared to General Prison Population
Twenty-four respondents stated "yes", TCs have less violence in their unit than is
found in general population. Over 85 percent stated their TC units are less violent than
the general prison population. Four states did not respond to this question.
Safer Environment for Correctional Officers/Inmates
Twenty-four (85.7%) responded to the question "are TCs safer environments as
compared to the general prison population for correctional officers and inmates". Three
(3) respondents did not answer the question and one reported "no" with the following
explanation: "All of system relatively safe, compared to most systems". The following
are comments of respondents when requested to explain:
o Fewer assaults, fewer incidents/discipline, fewer violations, few infractions.
o All disciplinary violations lower, any signs of unrest or trouble brewing IS
immediately known, no secrets.
o In five and one half years of operation - no assaults.
o Increase community responsibility, sets higher standards for behavior.
o Never had 'Use of Force' necessary.
39
o Problems are de-escalated and dealt with at a lower level before violence
occurs.
o TCs produce a better behaved, more responsible inmate.
o Safer environment reported by staff and inmates.
o No substance abuse, almost no verbal violence and no physical violence.
o Too early to tell.
o There has not been a system study of these areas to do a comparison.
o TCs are safer environments for both Corrections Officers and inmates
compared to general population because the TCs address the offenders'
problems, teach coping skills, promote family communication, the counselors
are readily available, and the intensive treatment that is received by the
offenders.
o Increase community responsibility, sets higher standards for behavior.
o Very few incidences of violence in the TCs or positive drug screens.
o Relatively safe, compared to most systems.
o Major misconduct frequency of RSAT participants appears to be less than that
of General Population.
Recidivism Rate Monitored
According to the data, 13 states, (46.4%), are monitoring the recidivism rates
within their particular TC programs. Recidivism rates ranged from a minimum of five
percent to a maximum of 33 percent. Wyoming reported that of TC participants who had
.completed the program, 26 percent return to custody and eight percent of them new
crimes. Several programs were in the process of conducting studies and data collections.
Ten (35.7%) of the TC programs are not currently monitored. Several of the respondents,
who currently are not monitoring their respective programs, stated that they are preparing
to do so. Several respondents do have aftercare and/or follow-up linked to conditions of
release. The minimum of aftercare reported was three months to a maximum of 12
months. For instance, California stated that upon parole, inmates have a six-month
option of a residential placement, whereas, Colorado uses a six to 12 month follow-up for
successful releasees from their TC programs. Therefore, from inmate entry while still
40
incarcerated, parole, and transitional placement could be as much as monitoring the
recidivism rate for a period of two years or longer.
Good Inmate Role Models
An extremely high percentage (89.7%) of the respondents (n = 25) reported that
their TCs had good inmate role models. One respondent stated "selection of inmate peer
mentors and definition of their role(s) is an area we need to work on". One other
respondent stated that "the program is too new". One respondent did not fill-in this
question. From those respondents who answered "yes", the following comments were
also included:
o Graduate offenders are used as "paid" staff; tutors live and work within unit as
role models and help with homework/education.
o Peer assistants are used within the community.
o Graduates and peers are used.
Ex-offenders Hired as Professional Staff for TC Programs
Respondents were somewhat divided in this area. Twenty-six respondents (n =
26) responded to this question. Of the 26 respondents, twelve (42.9%) stated that they do
hire ex-offenders to work within their TC program'>. Fourteen respondents (50.0%) do
not hire ex-offenders (see Figure 3). One respondent reported "not yet, but would
consider it". Two respondents did not answer this question.
41
Figure 3
Ex-offenders Hired As
Professional Staff
14.5 --r!-----~--­
!
14 T
I
13.5-~-~-
!
13-T-~--------
12.5-.------~~--
Yes
Length ofPrograms in Months
No
Many respondents reported both a minimum and maximum time for the length of
the TC programs. For example, the State of New Mexico has a minimum of nine months
and a maximum of 12 months in their minimum-security facilities, with all others having
a minimum of twelve to a maximum of fourteen months. Only the maximum length of
the program was recorded. Kansas, Illinois, and Missouri reported their program length
to be 24 months with California reporting 18 months. The majority of the respondents
stated that their program length was 12 months. Six months in length was reported by
Connecticut, Kentucky, and Minnesota. (See Table 1) The average length for all the
programs combined are approximately twelve to twelve and a half months.
Inmates Moving Through LevelslPhases
Therapeutic Communities contain phase movements. Frequently, these phase
movements are for a certain length of time with determined criteria established to
measure the eligibility for movement to the next phase. Two respondents did not address
this question. The remaining 25 reported, that inmates do move through levels and
42
-----~--­
-~-~-
-T-~--------
-.------~~--
phases. The majority of respondents (92.6%) reported their programs encompassed Phase
I, Orientation, Phase II, Educationffreatment and Phase III, TransitioniRe-Entry and lor
Aftercare (See literature review concerning the typical). The inmates who complete the
program vary from state to state. From 15 percent to as much as 98 percent of inmates
completed the TC programs with an average of68.2 percent.
Once Inmates Complete TC Program
Once an inmate completes a TC program and graduates from that program there
are a number of things that may occur. For example, an inmate may be allowed to
remain in the TC program and continue to be an example to other inmates participating.
He or she may assume certain roles (i.e. intern, instructor, mentor, etc.). An inmate is
normally granted the opportunity to either remain in the program or helshe may return to
the general prison population. Some TCs do not even allow inmates to enter the program
until they are close to being released or paroled. Twelve respondents reported that TC
graduates were allowed to remain in the TC environment and program, while 11 were not
allowed to remain in the TC program. Ten respondents reported that graduates are
returned to the general prison population, with 11 reporting that inmates were not
returned to the general prison population.
Respondents were asked about follow-up and aftercare. Thirteen respondents
reported that inmates who graduate from the TC program have a follow-up or aftercare
component to their programs. The length of those services range from three months up to
12 months. Upon parole, or other types of release from the institution, 10 respondents
indicated that inmates were placed in other TC settings, such as, community-based
43
residential facilities or counseling services. Seven respondents reported that inmates
were not placed in a TC setting.
Respondents provided the following qualitative data concerning what happens
once an inmate completes the TC program:
o Two programs release to a community TC.
o They are scheduled to be eligible for release.
o Referred to substance abuse counseling as a condition of parole.
o Released to parole to the streets or to a halfway house.
o Trying to target only those that can receive a work release or parole,
otherwise, we are moving them to the minimum custody institution.
o Offenders are discharged or moved to community corrections upon
completion of the program.
o The offenders are released from incarceration once they are have completed
the TC program. The SAFPF (Substance Abuse Felony Punishment Facilitiy)
offenders are released to a Transition Treatment Center for three months, and
then they must complete a one-year out patient program as part of their
probation. Offenders are sentenced to a SAFPF as a condition of their
probation or a modification of their parole.
o Upon parole, have option of six (6) month's residential, etc.
o Placed in follow-up treatment based on evaluated need.
o Placed in outpatient, intensive outpatient, recover home beds.
o Upon parole inmates encouraged to participate in community alcohol and drug
programs. Some are referred to community corrections centers.
o Released to parole/probation with follow-up recommendations.
o Referred to and participate in treatment upon release from prison.
o Up to forty (40) community corrections TC beds are available in community
facilities.
o Project Bridge is an RSAT funded transition program. Utilize one'for men,
one for women.
Standard Written Policy and Procedure for all TCs
Fourteen (51.8%) of the respondents reported that they do not have statewide
written standards for all TCs that are operational within their particular state. One
explanation why approximately one half of the states do not have standard policies may
be that private agencies develop and operate TCs under their own policies and procedures
throughout the country. For example, Corrections Corporation of America (CCA) and
44
Wackenhut, operate TC program" for vanous states. Eleven respondents (40.7%)
reported that they do have a written standard policy for all TCs within their respective
states.
Inmates Volunteering for Program/Bed Capacity
Out of the 27 respondents, 20 (70.4%) reported that they accept inmates who are
volunteering to enter their TC programs, while six (22.2%) stated they do not. One
respondent did not answer the question. What is interesting to note is that many reported
that they do not have enough bed capacity (40.7%) to accommodate all volunteers and
those inmates who are ordered to TCs. Nine respondents (33.3%) reported they do have
adequate bed capacity. One respondent did not answer the question.
One hundred percent (n =27) of the respondents stated that their TC participants
are separated in some manner from the rest of the general prison population.
Twenty-four (88.9%) of the respondents reported that they do have a waiting list
Jor inmates either attempting or are eligible to enter their TC programs. Two (7.4%) do
not have a waiting list. One respondent did not answer the question.
Entire Prison Comprised ofTCs
Respondents were asked to comment on whether or not they felt an prison system
could be a TC program. It is possible to have a prison system or prison unit completely
housed by TC participants. For example, the Texas Department of Corrections' Kyle
Prison, which is an institution of 500 inmates, is a total TC institution. In addition, the
State of Oklahoma Department of Corrections Davis Correctional Facility, operated by
CCA, at Holdenville has a bed capacity of 480 inmates and is a total TC institution.
Eleven respondents (40.7%) claim that it is possible to have a prison system which is
45
No
comprised of the TC concept and structure. Twelve respondents (44.4%) stated that it
was not possible to have an entire prison system composed of TC participants only (see
Figure 4). Four respondents did not answer the question. The following comments were
made concerning the possibility of an entire prison comprised of TCs:
o Notion of inmate hierarchy of responsibilities and consequence appropriate
for~llinmate management.
o If administrators and money are committed to it, no reason why not.
o Once the CO's and security staff understand the concepts, I believe the prison
can be run much more safely and effectively.
o The BJCC has worked towards a facility-wide TC.
o Texas has already done it (reported by Utah).
o Only if the administration (director, warden) is 100% supportive. If
corrections officers are properly trained. If funding and staffing are
appropriate.
o We are proceeding to establish in every institution.
o Not at present
o One example might be Maryville, MO.
o If question is entire prison - "Yes"; if question is entire prison system - "No".
o Depends on demands for service.
o Best, most efficient use of staff and space. Highest potential program
integrity
Figure 4
Ertire fuscn System CaTIpised of TCs
I
125
1"--~-I
11l~i-~~..1,,1
1;~I--~--,
Yes
46
"--~-I
11l~i-~~.
1;~--~--,
Corrections Officers Specially Trained
One area of concern, according to many studies from the literature review, is the
misunderstanding of management and security staff of the TC concepts and perspectives.
Effective and efficient training of prison staff is one method to address this concern.
Twenty-one respondents (77.8%) stated that they do provide training to correctional
officers who work in TC programs. Six respondents (22.2%) reported they do not
provide training for their correctional officers who work in TC programs (see Figure 5).
Figure 5
----------_.--
25 -".--.------ ..- ..--...-.---.......-------.-.-...- ..-----....,
Xl
15
10 +---- 
5+---
0+-----
Yes
TCs have the Potential to Reduce Recidivism
It is possible that TCs do have the potential to reduce recidivism according to
the respondents. Out of a total of 27 respondents, 26 (96.3 %) reported, "yes", while one
did not answer the question. Respondents gave the following explanations of the potential
to reduce recidivism:
D Long term structural programming has been linked to successful
outcomes.
D Inmates actively involved in their TX and management of unit, mirrors
society better than passive TX programs.
D Provided that an effective aftercare program is in place.
D Only if we establish a community-based TC for inmates after release from
prison. Don't have one currently.
47
D TCs provide the inmate with a program which allows him to change the
ways he thinks, feels and acts to become more prosocial and responsible.
D This approach combines behavioral and thinking changes in a highly
structured environment.
D TCs provide a more intensive approach most chronic addicts need.
D Holistic approach prepares participants for return to real world with skills
that will allow them to succeed.
D I think (TCs) actually do reduce recidivism. We are working on a data
collection system to be able to support this with statistics.
D Using the Key/Crest studies and the RJDonovan studies, this should be the
end result.
D Doing it already.
D Inmate completing TCs have a better chance to reintegrate into society
upon release.
D Relapse to drug use is strongly associated with criminal activity and/or
parole violations. Treatment of drug dependence is fundamental to all
initiative to reduce recidivism.
D Programming provided just prior to release and once offender is released
immediate referral to treatment w/sustained un-announced drug testing.
Treatment in community should be based and build on prior treatment
received in prison.
D The prevalence of drug and alcohol abuse/dependency in inmates is
similar to national averages. The literature has repeatedly documented the
efficacy of TCs (i.e. recidivism) if properly implemented and
administered.
D Two different vendors provide service - one to men and a second to
women resulting in a variety of methods in use.
48
Summary
Although this survey is an inconclusive review of adult therapeutic communities
in America, the survey does provide critical and important data related to the increased
utilization of TCs in prison settings. The collected data states that the majority of states
are implementing therapeutic communities and many of these TC programs have been in
existence for some time. Several states are expanding their cunent TCs for larger
capacities, while other states are developing and implementing new TC programs. The
respondents overwhelmingly state that TCs are safer environments, that there is less
violence, less frequencies of grievance and disciplinary reports compared to the general
prison populations. It is noteworthy from those who reported that they are monitoring
their TC programs and recidivism rates were lower compared to general prison
recidivism rates throughout the country.
In the next chapter the major findings of the survey will be addressed in detail.
Some remaining TC baniers and potential problems will be discussed, along with future
research that need to be addressed, and recommendations to enhance TCs in prison
environments.
49
CHAPTER V
Conclusion
From 1980 to 1996, the number of people III prison has tripled due to
overwhelming criminal activity spawned by drug and alcohol abuse. If this rate of
increase continues, then one in every 20 Americans born in 1997 will spend some time
during their life in prison, including one in every 11 men and one in every four African 
American men. While the 130,000 female inmates constitute only 7.7 percent of the
prison population, their numbers are rising at twice the rate of increase for male inmates.
Drugs and alcohol account for incarceration of 80 percent of these women as well (Casa
Report, 1998).
Therapeutic Communities operated in prison settings are being widely utilized
and effective compared to five to ten years ago. The majority of states are operating TC
programs within prison settings, some being state operated and others operated by private
contractors, such as CCA, Gateway, Wackenhut, and Civigenics. Several states have
operational plans for the expansion of their current TC capacity and bed space. On a
larger scale, California is planning to add over 2,000 beds that will be housed in six
future institutions. At the other end of the spectrum, Kentucky will add 50 beds when
their new program begins. Some states (Oklahoma, Texas, California, and Missouri)
operate total TC prison units within their statewide prison systems. Although prisons
are providing TC services to mostly medium and minimum security inmates, they are
operating and providing TC services within some maximum security institutions. In
addition, states are offering TC programs in pre-release facilities, pre-parole units, state 
jail institutions, mental health facilities, and community-based residential facilities.
50
There are many positive effects resulting from the use of TC programs in prisons.
TC grievances are less frequent as compared to the general prison population. The same
is true for disciplinary reports that are written by prison personnel in relationship to
inmate behavior(s). Overwhelmingly, according to our respondents TCs are safer
environments for both inmate participants and correctional officers who work within
those TC programs. Inmate graduates of prison TC programs serve in a variety of
positions and they are considered to be a part of the staff. They serve as tutors, peer
assistants, interns, staff aids or staff assistants, and instructors. The inmates are
considered to be good role models for other inmates still in the program and to the
general prison population. When there have been prison disturbances, TC participants
frequently maintain a low profile and have even assisted in restoring order to the
situation. From a prison management point of view this should be appealing to prison
administrators.
Several states are operating prison units within their states, usually with an inmate
population of about 500. The majority have their TC programs separated from the
remainder of the prison population. A slight majority of the respondents stated they do
not believe that a TC program can be implemented in an entire prison system. For large
institutions, because of the number of inmates, this may be so, however, for smaller
inmate populations, such as 500, it is a very valid prospect.
Acceptance into a TC program should not be dependent upon whether an inmate
is eligible for parole only. Regardless of whether TC participants are going to be paroled
or not, individuals who choose to remain in a TC prison program should be given the
option to either remain in that specific program or not. Data gathered indicated that about
51
half of the graduates were allowed to remain in the program. The TC perspective is
"right living", and "right living" can be achieved and accomplished even inside a prison
environment, especially for inmates who have lengthy prison sentences.
A point of interest was that many states do not have written standards of policies
and procedures related to the operation of TC programs regardless if they are state
operated or private contractors. Even where private corporations are operating TC
programs, state agencies should, at the very least, develop and monitor those TC
programs. Some, but not all, private corporations have existing contracts with local and
county governments, however, not with state agencies because they do not supervise
inmates of that particular state where the facility is operational. To maintain the integrity
of the TC basic components of a generic TC program model, state agencies could provide
this service.
Normally composed of three to four phases all ofthe states are utilizing some type
ofphase movement in their TC programs. The majority listed their phases as Orientation,
Educationffreatment and Transition.
The length of time in a program is very significant. Most states have TC
programs that last 12 months. As stated in the literature review, this Time In Program
(TIP) can be extremely important to offender recidivism rates. Several studies suggest
that nine months to 12 months is sufficient whereas others have suggested 12 months to
14 months. Although successful completion of TC participants varies from state to state,
most are graduating from these prison TC programs.
An exceptional margin of respondents reported that TCs do have or are now
reducing recidivism rates. Many states are currently monitoring their recidivism rates,
52
however, others are not, but realize the importance of data collection and measurable
outcomes.
Even though states are divided in their hiring policy of ex-offenders to work in
prison TCs, a number of ex-offenders are employed by some state operated programs,
certainly, private operated prison TC programs. One reason for not hiring ex-offenders
may be state hiring guidelines and policies related to hiring procedures of individuals
with felony convictions.
Several studies have reached conclusions that ex-offenders can have a positive
effect with other inmates. In the past, numerous scandals have plagued TCs, such as,
inmates having too much control over the operation of the TC program, selling of
admissions to other inmates to enter the program, drugs on the unit, and relapse of
program ex-offender employees. To balance those concerns and past problems, it is also
noteworthy to state, that numerous ex-offenders are providing excellent service to
incarcerated offenders in TC programs. If little else than being a positive example and
providing motivation to TC participants, the effort could have positive effects upon TC
programs.
It is important that ex-offenders be sufficiently trained whether they have
completed a TC program or not. (There are many ex-offenders who have become highly
successful in becoming a positive, productive citizen in society, but may not have
pmticipated in a TC program for a variety of reasons). It is recommended that a highly
sophisticated training curriculum be developed by state agencies or the regulatory agency
addressing the training ofex-offenders to become employed in TC prison programs. This
curriculum could address counseling techniques and methods, historical perspectives, TC
53
concepts and on the job training. In addition, the training curriculum could be
implemented through continuing education at universities and colleges. The training
length should be no less than 24 months, thus, allowing the selected ex-offender to obtain
an associate degree with the option of furthering their education. In other words, the only
criteria for an ex-offender working in a TC program should not be that they have simply
graduated from that program, it can be a part of the selection process, but not the only
component. This would ensure more quality of services, enhance the abilities and
creativity of ex-offenders employed in TC programs, and hopefully, prevent some of the
scandals from the past.
Great importance should be given to, if possible, the perspective of TC staffs
being a mixture composed of recovered professionals (ex-offenders) and other traditional
professionals.
In relationship to the above training, it is also critical that cross-training for all
correctional officers working in TC programs be required. This training would not only
be available to those working in the program, but available to all correctional officers
within the prison system.
In general, correctional officers are not familiar with being challenged by inmates.
Correctional officers are normally trained that "all inmates are the same" and for a good
reason. Security. All prison authority is to be respected by TC participants, the ideal is
comply now and complain later. However, for correctional officers working in TC prison
programs, training should stress not only the inmate similarities, but also the inmate
differences within the TC program structure. The correctional officer is normally
considered to be a part of the TC community. In addition, all management personnel
54
such as wardens, assistant wardens and unit managers would be educated and familiar
with the TC concept. This allows for participation by all TC personnel, but also
maintains proper control over the TC program. The data collected suggests that cross
training is being provided by the majority of states, however it is not being provided by
all states.
One area of concern expressed is the lack of community-based treatment
programs, even though several prisons do provide some aftercare to their graduates for
continuing treatment. However, as in the past the aftercare component still remains a
problem, although many states are addressing this issue. To maintain the continuance of
recovery for patticipants, state and private agencies should provide aftercare transitional
programs no shorter than six to 12 months in duration, even longer if it is found to be
necessary. In regard to private institutions, when inmates are transferred from one
institution to another institution, problems are encountered when the availability and
_consistency of treatment within the TC program cannot be maintained. It is suggested
that inmates who are receiving institutional treatment in a TC program at the very least be
given consideration to transfer to an institution that has a similar TC program. More
research is needed in this area, however, one of the main goals of TCs is for the
participants to internalize "right living behavior and thinking".
The survey instrument could have been improved by more specific questions,
such as questions five, fifteen and eighteen. This would have enhanced the integrity of
the questionnaire. Question number five states, "Does your program address only one,
combination of, or all of the following: substance abuse, domestic violence, cognitive
model, behavior modification, sexual abuse, other". The intent of the survey instrument
55
was to identify the primary model type of program being implemented. The intent of
question number fifteen was to identify if aftercare was being provided in prison and
whether inmates have a choice to remain in TC programs after graduation. In addition,
question number eighteen, "Do you feel it is possible to have an entire prison system
comprised ofTCs?", could have been more specific. For instance one respondent stated
if an entire prison "yes", if an entire prison system, "no". The intent of the question was,
is it possible to have an entire prison composed of TCs. These questions may have been
confusing to respondents. The inability of some respondents (who operate TCs) to
answer the questions on the survey limited the study as well.
Several major limitations do exist. One, the number of TC participants is not an
exact number of all TC program participants in prison settings throughout the United
States. For example, one respondent reported they did not have a TC program within
their prison system. However it is known, by this researcher, that a TC program does
exist within that particular state and is operated by a private contractor. Second, although
the total reported number of TC participants (about 26,000) is small compared to the
larger general prison population. It is significant to note that the survey instrument only
asked for the "potential" of reducing recidivism rates.
The potential of TCs in prison environments for the reduction in cnme IS
significant. It is time to open a front on the war on crime and that front should be in our
jails and prisons. Recent declines in crime underscore the importance of aggressive
enforcement, but if we are to reduce crime further, we must find additional cost effective
ways to decrease drug and alcohol related crime. This means using punishment and
rewards to cut drug and alcohol abuse by exploring less expensive alternatives to
56
incarceration for non-violent substance abusers and using the power of the criminal
justice system to get substance abusing offenders into treatment so that the cycle of crime
may be broken. Even substance abusers that are convicted of violent offenses should be
incarcerated, but we should also provide these offenders with treatment in the hopes to
reduce their criminal activity once they are released from prison and while some remain
incarcerated for the remainder of their lives. A major investment in research to improve
prevention and treatment of alcohol and drug abuse is essential, particularly of the
incarcerated offender. Specific attention should be developed to designing cost-effective
diversion, prison and post-prison treatment, and rehabilitation programs. Therapeutic
Communities in prisons provide this potential. It is important to provide treatment to
inmates while in prison for all that need it, this includes minimum-security inmates to
maximum-security inmates.
Again it is important to train correctional officers and other personnel in
substance abuse and addiction so that they can better prevent the use of alcohol and drugs
in prison and better assist inmates in the TC recovery process. And once an inmate who
has been released to community supervision, it becomes absolutely imperative that
treatment and aftercare services be available for individuals who need them.
In addition, parole officers who would provide community supervision should be
trained to effectively assist parolees in locating additional services and encouraging
parolees to continue their treatment. No doubt, some of the above recommendations
would involve a new way of viewing prisons throughout the country. To implement new
Therapeutic Communities in prisons, the full cooperation and acceptance from
administrators and management staff is imperative. The vast majority of substance
57
abusers return to society, therefore it is essential that effective treatment programs such as
TCs be available while the offender is still incarcerated.
It is also important that written minimum standards be developed for regulation of
all prisons whether they are state operated or private operated facilities. This allows for
effective monitoring of TC programs and, again, maintains the dignity of the TC
concepts.
Research could be enhanced and improved by accessibility to continuing data that
would be provided by all 50 states. Further research should address not only credentials
of professionals working in TCs, but the strengths and weaknesses of recovered
professionals as well. Further research should be implemented to address the training
curriculum available to correctional officers and other institutional personnel. As stated
above, most security staff is trained with the concept that all offenders are the same. But
within TCs this barrier could be broken down, offenders are not all the same, there are
similarities, but there are extreme differences as well.
Therapeutic Communities should be given the opportunity as a viable treatment
modality to become successful within the prison environment. The potential is promising
to address issues such as recidivism rates, reduction in crime, safer environment for the
inmate and correction officers and for effective prison management purposes.
58
BIBLIOGRAPHY
Alcoholic's Anonymous World Services, Inc.(1955). New York City, NY:
Alcoholic's Anonymous World Services Inc.
Bandura (1979), Nietzel (1979) as stated in Therapeutic Community: Advances in
Research & Aplication NIDA Research Monograph. U.S. Dept. of Health & Human
Services-Public Health Services: National Institute of Health
Bush, Dudley, and La Barbera, Martin (1997). "Counseling in the Corrections 
Based Therapeutic Community: Issues for New TC Counselors, " paper presented at the
25th Annual Conference of the Nation Association of Alcohol and Drug Counselors, San
Francisco, July, 1997
Califano Jr, Joseph A. (1998) CASA Report Forward Statement to Behind Bars:
Substance Abuse and America's Prison Population. The National Center on Addiction
and Substance Abuse at Columbia University
CCA Metro Davidson County Detention Facility (1993), Lifeline Program
Handbook
Deitch Ph.D., David (1999), taken from the video and as stated in Therapeutic
Community Model:History and Overview. University ofMissouri, Kansas City, MS:
Center for Substance Abuse Treatment, Mid-America Addiction Technology Transfer
Center
DeLeon (1984), DeLeon et al. (1979) as stated in Therapeutic Community:
Advances in Research & Aplication NIDA Research Monograph. U.S. Dept. of Health &
Human Services-Public Health Services: National Institute of Health
DeLeon (1979, 1982); Simpson (1979, 1980) as stated in Therapeutic
Community: Advances in Research & Aplication NIDA Research Monograph. U.S. Dept.
of Health & Human Services-Public Health Services: National Institute of Health
DeLeon (1974), Phoenex House: Studies In a Therapeutic Community (1968 
1973), Library of Congress Cataloging in Publication Data, MSS Information
Corporation, New York, NY
. DeLeon (1998), taken from the video Therapeutic Community: Theory and
Research. University of Missouri, Kansas City, MS: Center for Substance Abuse
Treatment, Mid-America Addiction Technology Transfer Center
Field (1984, 1989) as stated in Therapeutic Community: Advances in Research &
Aplication NIDA Research Monograph. U.S. Dept. ofHealth & Human Services-Public
Health Services: National Institute of Health
59
http://www/mra.org.uklgeneral/founder.html (1995) Dr. Frank Buckman, Founder
of MRA. Rex Dily: Freeway Publication, London England
http://www.lepg.org/religion.htm. The Reformation
Howelett, Duncan (1957), The Essenes and Christianity. New York, NY: Harper
& Brothers
Johnson, Robert (1996), Hard Time. Belmont, CA: Wadsworth Publshing
Jones, Maxwell (1953), The Therapeutic Communitv, New York, NY, Basic
Books
Jones, Maxwell (1968), Beyond the Therapeutic Community, New York, NY:
The Carlton Purington Rollins Printing - Office of the Yale University
Jones, Maxwell (1976), Maturation of the Therapeutic Community, New York,
NY: Human Sciences Press
Kratcoski, P. C. (1981), Correctional Counseling and Treatment. Monterey, CA:
Duxbury.
Levinson, R. (1980),TC or not TC?, That is the question. In: Toch, H., ed.
Therapeutic Communities in Corrections. New York: Praeger
Lipton et al. (1975); Wexler et al.(1988b) as stated in Therapeutic Community:
Advances in Research & Aplication NIDA Research Monograph: U.S. Dept. of Health &
Human Services-Public Health Services, National Institute of Health
Lipton (1989); Lipton et al (1992), Wesler et al. (1988a) as stated in Therapeutic
Community: Advances in Research & Aplication NIDA Research Monograph: U.S.
Dept. of Health & Human Services-Public Health Services, National Institute of Health
Martinson (1989), Public Interest Paper, Camp & Camp
Masters, Ruth (1994), Counseling Criminal Justice Offenders, Thousand Oaks,
CA; Sage Publications
Outler, Albert C. (1984), The Works ofJohn Wesley: Nashville, TN, Abingdon
Press
Peck, Jeff (1999), Jubilee, Magazine of Prison Fellowship Ministries - Winter
1999
60
Pauck, Paul (1984), From Luther to Tillich, New York, NY: Harper & Row
Publishers
Rogers, C. R. (1951). Client-centered Therapy. Boston: Houghton-Mifflin
Sharp, Victor (1975), Social Control in the Therapeutic Community, Westmead,
Farnborough, Hants, England: Saxon House
Sugarman, Barry (1974), Daytop Village: A Therapeutic Community: New York,
NY, Holt, Rinehart and Winson,)nc.
Tims Ph.D., Frank M.; DeLeon Ph.D., George; Janinchill, Ph.D., Nancy (1994),
Therapeutic Community: Advances in Research & Aplication NIDA Research
Monograph: U.S. Dept. of Health & Human Services-Public Health Services, National
Institute of Health
Van Voorhis, Patricia; Braswelk, Micheal; Lester David (1997), Correctional
Counseling and Rehabilitation: Cincinnati, OH, Anderson Publishing Co.
Weppner, Robert S. (1983), The Untherapeutic Community, University of
Nebraska Press, Lincoln, Nebraska
Wexler et al. (1988) as stated in Therapeutic Community: Advances in Research
& Aplication NIDA Research Monograph: U.S. Dept. of Health & Human Services 
Public Health Services, National Institute of Health
Whiteley, Briggs, Turner (1973), Dealing with Deviants: New York, NY,
Schocken Books
61
Appendix A
Cover Letter for Questionnaire
62
Phil R. Dyer
Youngstown State
University
Criminal Justice
Department
January 8, 2001
PERSON
State Dept.
Address
City, State Zip
Dear
My credentials are extensive and I have been in the Criminal Justice profession for close
to thirty years. I have been a consultant to several national criminal justice agencies, and
continue to provide seminars and workshops on offender behaviors, characteristics, and effective
intervention strategies to human development service agencies throughout the country.
Currently, I am a student at Youngstown State University working on a thesis toward my Masters
Degree in Criminal Justice with an emphasis in Correctional Administration and Criminal
Theory.
I am requesting the attached questionnaire be forwarded to the department that would
employ the Director of Therapeutic Community, Director of Rehabilitation or the most qualified
personnel within your particular state.
The term therapeutic community has come to represent a distinct approach that can be
applied in almost any setting with almost any population. In recent years, TC models have been
increasingly adapted for incarcerated substance abusers in prison settings. Overcrowded prisons,
the influx of drug offenders, and the documented success of TC prison models in reducing
recidivism and relapse have fostered this development. Modifications of the traditional TC model
are shaped by the unique features of the individual correctional institution and the prison culture
itself. It is imperative to maintain the integrity of the essential TC concepts of community.
Please note that the survey instrument does not include programming questions for
mentally ill or mentally challenged. I am interested in gathering important information related to
Adult Therapeutic Communities that are being implemented within prison environments
throughout the country and are being operated by state agencies or private agencies.
If you do not utilize Therapeutic Communities within your state, it would be greatly
appreciated if you would complete the questionnaire. Please check off Question #2 and return
this to me for tabulation.
Please place the survey instrument in the self-addressed enclosed envelope and if possible
return by January 26, 2001. I wish to express my sincere thanks and gratitude for completing the
survey instrument and for your honest and informative answers.
Respectfully requested,
Phil R. Dyer
63
Appendix B
Adult Therapeutic Community Questionnaire
64
ADULT THERAPEUTIC COMMUNITY
QUESTIONNAIRE
1. State where this department is located:
2. Do you currently use Therapeutic Communities in your State Prison Facilities?
Yes__No
a. Ifyes please list those facilities: _
b. Are Therapeutic Community services delivered by: State__Private
Contractor__Both__
If private contractor please name of contractor: _
3. How many years has your program been in existence?
4. What is the total inmate capacity for TC's within your State?
a. How many inmates are actually participating?
5. Do your programs address only one, combination of, or all of the following:
(please check only those that apply)
a. Substance Abuse b. Behavior Modification
c. Domestic Violence d. Sexual Abuse
e. Cognitive Model f. Other _
6. TC's reduce grievances and disciplinary reports from the inmates who participate?
Yes__No
7. TC's are a safer environment for both Correctional Officers and inmates
compared to general population? Yes__No__
a. Ifyes, please explain:
8. Has the recidivism rate been monitored?
Yes__No__
a. If it has, what is the recidivism percentage for those individuals participating?
---(%)
65
9. Do you have good inmate role models within your TC population? Yes__No
a. If no, please explain:
b. Do you hire ex-offenders as professional staff for TC programs?
Yes__No
10. Is there less violence on your TC units in comparison to general prison population?
Yes__No__
11. What is the length of your total program? _
12. Do inmates move through levels/phases?
a. If yes, please list those phases/levels:
Yes__No
13. What percentage of inmates complete the TC Program?
14. Once inmates complete the TC program are they:
a. Permitted to stay within the program? Yes__No
b. Released to general population? Yes No
c. If released to General Population, is there a follow-up or after-care program?
Yes__No__
I. If yes what is the length of your aftercare (months)?
d. Placed in TC settings upon parole or other type of releases?
Yes__No
e. Other, please explain _
15. Do you have a standard written policy and procedure for all TC's within your state?
Yes__No__
a. Could you please attach a copy of those procedures?
Yes__No__
16. Do inmates volunteer for T.e.? Yes No
a. If volunteering, do you have enough TC bed capacity to accommodate inmates?
Yes__No__
b. Other:
66
17. Do you feel it is possible to have an entire prison system comprised ofTC's?
Yes__No__
a. Ifyes, why?
18. Is your TC population separated (housed) from the remaining prison population?
Yes__No
19. Do you have a waiting list for inmate placement?
Yes__No__
20. Are Corrections Officers working in the TC Unit specially trained to work in TCs?
Yes__No__
21. Is it your opinion Therapeutic Communities have the potential to reduce recidivism
rates within your State? Yes__No__
a. Please explain: _
Thank you for your assistance! Please don't forget to attach a copy of Policy and
Procedures if available. Ifyou desire a copy of published results please mark here~
Yes No
67
Appendix C
United States Map Depicting State Response
68
.4f
.~~
-.
..~....
II Shaded area designates states who responded D White area signifies states who did not respond
69
~
Appendix D
Human Subjects Review Letter of Exemption
70
Youngstown State university lOne University Plaza I Youngstown, Ohio 44555-000 I
January 23, 2001
Dr. Tammy King, Assistant Professor
Mr. Phillip Dyer, Graduate Student
Department of Criminal Justice
UNIVERSITY
RE: HSRC Protocol #27-01
Dear Dr. King and Mr. Dyer:
The Human Subjects Research Committee has reviewed your Protocol, "Adult
Therapeutic Communities in America." (HSRC#27-01), and determined that it is
exempt from full committee review based on a DHHS Category 5 exemption.
Any changes in your research activity should be promptly reported to the Human
Subjects Research Committee and may not be initiated without HSRC approval except
where necessary to eliminate hazard to human subjects. Any unanticipated problems
involving risks to subjects should also be promptly reported to the Human Subjects
Research Committee.
The HSRC would like to extend its best wishes to you in the conduct of this study.
Sincerely,
~/)':/': . '
tI.r-t.~-X..%jc?Z'/~(:cv,l{~~
Eric Lewandowski
Administrative Co-chair
Human Subjects Research Committee
ECLIcc
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