SD8 - Substance Abuse and Sex Offender Treatment Services for Parole Eligible Inmates

  • Published: 1992
  • Author: Joint Legislative Audit and Review Commission
  • Enabling Authority: Senate Joint Resolution 26 (Regular Session, 1990)

Executive Summary:
In 1991, the Joint Legislative Audit and Review Commission (JLARC) completed a year-long study of Virginia's parole system. During the course of this study, institutional counselors within the Department of Corrections (DOC) expressed concern about the level and quality of the rehabilitation programs offered throughout the correctional system. Because of the impact that prisoner rehabilitation efforts can have on the rate at which inmates establish eligibility for and receive discretionary parole, JLARC staff were asked to extend the parole study to include an assessment of DOC's system for delivering counseling and treatment services to substance abusers and sex offenders.

This report examines the planning process and service delivery system used by the Department of Corrections to organize and provide treatment for inmates with substance abuse problems and those who are sex offenders.

Need for Substance Abuse and Sex Offender Treatment is Substantial

Data on the number of inmates with substance abuse problems and those who are sex offenders illustrate the need for a treatment system to address these problems. In 1990, there were 14,841 inmates in the prison system. Statewide, 81 percent of this population had a substance abuse problem when they were initially incarcerated.

A closer look at the data on this group indicated that 70 percent of the population regularly used some form of illegal drug. The data also indicate that approximately 41 percent of this group may be cross-addicted - regular users of both alcohol and drugs.

About ten percent of the 14,841 inmates who were incarcerated in a State prison or field unit in 1990 had been convicted of some type of sexual offense. By design, most of these inmates are housed in the State's major prison facilities. In most of the major prisons, the size of the sex offender population closely approximates the statewide rate of 10 percent. In eight facilities, sex offenders constitute at least 15 percent of the total inmate population.

Organization of Treatment Services Within Corrections

The department currently organizes policy and program development activities for treatment services in the Division of Adult Institutions. The responsibility for supervising this non-security aspect of corrections has been placed with the Chief of Operations for Programs. The primary responsibility of the chief is to work with other DOC staff to establish policy governing the various aspects of treatment service delivery within the prisons and field units.

In addition to general policy direction, the Chief of Operations for Programs and his staff provide technical assistance and advice to four regional administrators. These administrators are responsible for ensuring that all of the major prisons and field units in their respective regions operate according to department policy. Each of the four regional administrators has a program manager in his office to oversee the development and implementation of treatment programs in the prisons and field units.

It is the responsibility of the institutional counselors to implement treatment programs within each correctional facility. Currently the department employs more than 250 staff in various counselor positions to carry out this function.

Policy Needed for Substance Abuse and Sex Offender Programs

Data collected during this study indicate that DOC has not adequately planned and implemented a system of inmate treatment services for sex offenders and substance abusers due to other programming priorities.

During the five-year period from 1985 to 1989, the General Assembly appropriated more than $30 million dollars for treatment services. The department used most of the appropriated resources to hire rehabilitation counselors to provide case management and some counseling services to all inmates. DOC officials did not, however, formulate specific policies to govern the development of substance abuse and sex offender programs. As a result, counselors throughout the correctional system had to organize treatment programs for inmates with these problems without the benefit of any proactive and consistent guidance from DOC's central office.

In 1989, as a precursor to developing agency policies to remedy this problem, DOC officials organized a committee of staff members to establish a set of goals and objectives for the development of inmate programming. Later, four regional program managers (RPM) were hired by the department to help organize the input of field staff in meeting the goals and objectives. This "bottom-up" approach to planning was viewed by DOC as the foundation for the actual formulation of agency policy regarding inmate programs.

However, at the time of the JLARC review, more than 70 percent of the committee's objectives that could impact policy development for substance abuse or sex offender programs had not been met and DOC's senior administration officials were unaware of any problems.

Poor organization of the goal setting process, insufficient coordination with regional office staff, and lack of guidance and direction from central office staff are the three primary reasons that this approach to policy development by the department has not been successful. One central office staff person, who has been involved in DOC planning activities, characterized the entire process as "disorganized and haphazard."

As a result of these problems, five years after the department created a unit to develop policies for all treatment programs, and almost two years following the development of specific program goals and objectives, the department has formulated only one, vaguely-worded policy to provide a framework for substance abuse and sex offender treatment. This policy does not address issues of inmate assessment, program standards, performance measures, staff training, or program evaluation.

Future DOC expansion of treatment programs for substance abusers and sex offenders should be contingent on the development of a comprehensive policy and plan which can be used as a blueprint for guiding the effective and consistent implementation of treatment services in the institutions.

Recommendation (1): To ensure that the department takes a more active role in the development of a delivery system for inmates in need of substance abuse or sex offender treatment, the Board of Corrections should direct the department to develop a policy for programs that establishes a framework for a comprehensive service delivery system. (The department should consider using a strategy similar to the approach used to successfully develop its mental health delivery system.)

Recommendation (2): To ensure that the department develops policies to address issues of assessment, program standards, and staff training for a substance abuse and sex offender treatment system, the Board of Corrections should require the Department of Corrections to include in its plans for a treatment system a description of these policies.

Program Services for Substance Abusers and Sex Offenders Are Not Adequate

Data analyzed from a sample of inmate treatment plans and progress reports indicate that 25 percent of all inmates with a substance abuse problem do not receive any type of treatment prior to their first parole interview. Another 55 percent do receive treatment but the services are limited to the support group interventions of Alcoholics and Narcotics Anonymous.

Participation in AA and NA is generally considered to be most beneficial when it is offered in conjunction with, or follows a more intensive substance abuse therapy program. Nonetheless, data from the file reviews indicate that very few inmates with substance abuse problems (three percent) benefit from any type of therapeutic counseling. Moreover, the department makes no attempt to tailor the substance abuse treatment that inmates receive to the nature of their dysfunction.

Apart from the issue of program access is the question of consistency of service within the various prisons and field units. At the time this study was conducted, DOC had not promulgated any standards to govern the development of treatment programs in the prisons and field units. Without such standards, there is a great deal of variation in the content of the substance abuse programs which serve inmates with similar problems.

Statewide, 24 prisons and field units offer educational services as a method for treating substance abusers. In 15 of these facilities, these services represent the only strategies (aside from AA or NA support groups in some cases) being used to treat substance abusers. In the 11 other facilities, some attempt is made to supplement the educational activities with therapeutic counseling services.

The major problem with the therapy programs is that there are no guidelines, standards, or training to support these activities. A consistent comment made by counselors interviewed during site visits was that they learned by doing because there was no training or departmental guidelines to assist them.

In terms of sex offender treatment, only ten of the major prisons and one field unit offer these type programs. Based on the review of the treatment plans, JLARC staff determined that almost half of all sex offenders establish eligibility for discretionary parole without having received any treatment services. This problem occurs because the department has only 336 program slots statewide for more than 1,400 sex offenders.

As with substance abuse treatment, one major problem which plagues sex offender programming in DOC is that there are no agency-specific requirements for the service providers or guidelines outlining the basic elements of therapeutic counseling. A program advisory committee has developed a training manual for staff responsible for implementing sex offender treatment programs. However, the focus of this training is on the delivery of sex education services. Members of this committee complain that the department's silence on this issue has created problems with decisions that are being made concerning who gets designated to implement sex offender programs. One member stated: "Some counselors are being forced to run sex offender groups who are not qualified, interested, or comfortable with the subject. Some counselors have non-related backgrounds like music, have no experience in sex offender therapy, are not equipped to provide treatment, but are running groups and we have no authority to do anything about it."

Recommendation (3). To enhance the level and quality of treatment services available for substance abusers, the Board of Corrections should require the Department of Corrections to develop a multi-tiered system of treatment that includes service options for inmates with different levels of drug and alcohol abuse problems. In addition, the Board of Corrections should require the department to specify minimum requirements for program content and establish guidelines for the development of therapy programs.

Recommendation (4). To enhance the level and quality of treatment services available for sex offenders, the Board of Corrections should require the Department of Corrections to implement a comprehensive program that includes education and intensive group therapy as the major treatment interventions. In addition, the Board of Corrections should require the department to specify minimum requirements for counselors conducting the group therapy, and establish guidelines for the development of therapy programs.

DOC Assessment Process Needs Improvement

One key to planning the development of any treatment system is a uniform assessment process. The actual program needs of an inmate population will vary based on differences in the severity of the identified problems. Accordingly, counselors must be able to distinguish among inmates based on observed differences in the nature of their problem and outline treatment plans tailored to the inmates' identified needs.

The department's assessment of inmates for both substance abuse problems and deviant sexual behavior appears to be closely tied to their arrest records. Because a standardized assessment tool is not utilized to determine the need for substance abuse, the severity of the inmate's treatment needs may be misdiagnosed.

Using the inmates' criminal records to determine whether sex offender programming is needed overlooks those inmates whose crimes simply do not give evidence of any sexually deviant behavior that may have been a part of their past.

Recommendation (5). To facilitate an appropriate determination of treatment needs, the Board of Corrections should require the Department of Corrections to adopt a uniform assessment instrument to be used at the time of an inmate's initial classification.

Recommendation (6). The Department of Corrections should require that counselors look for any evidence of sexual deviancies and not rely exclusively on offense history in making recommendations for treatment of sexual problems.

Counselors are Overwhelmed with Case Management Duties

Based on an analysis of counselor time allocation data, JLARC staff found that in a typical work week, counselors are able to spend only four hours on implementing treatment programs. The caseload demands placed on the counselors in DOC's prisons and field units have resulted in the vast majority of counselors performing primarily case management functions. These include conducting evaluations for good time, preparing various inmate reports, and meeting with each inmate on their caseload once per month.

The amount of time counselors spend preparing paperwork for the day-to-day case management of inmates is partly a function of the size of their caseload. JLARC analysis of data from the Department of Corrections shows that current inmate-to-counselor ratios remain consistently above the recommended level of 50-to-1. The statewide average caseload per counselor is 67 inmates. Fifty-two percent of the facilities had counselor-to-inmate ratios of greater than 55-to-1.

To address this problem, the department needs to develop a multi-tiered counseling system. With this type system, DOC could establish case manager positions to handle administrative functions, and a separate set of counselor positions to provide treatment services.

Recommendation (7). The Department of Corrections should, based on its average daily inmate population, determine the number of case managers that would be needed to meet a ratio of 50 inmates per one case manager in each correctional facility. The department should also identify the number of counselors that would be required to implement a multi-tiered treatment system for substance abusers and sex offenders. The results of this analysis should be presented to the Board of Corrections as part of the Department's plans for developing a treatment system.

Training for Counselors Can Be Improved

While a reduction in caseload would allow counselors more time to develop and implement treatment programs, there is some question as to whether they possess the qualifications necessary to do so. Because rehabilitation counselors are expected to primarily perform case management duties, it is possible for persons who do not have counseling experience to be considered for rehabilitation counselor positions.

While the majority of DOC counselors possess degrees in human services related fields, data from the JLARC survey reveals that 16 percent of the counselors have backgrounds that are completely unrelated to this area. For example, four counselors have only high school diplomas, two have degrees in music, another two have business degrees, and five have associate degrees. In one facility, nine of the 10 counselors have degrees in fields that are not related to counseling.

The lack of stringent requirements for counselor qualifications points to the need for department-provided training in the development and implementation of treatment programs. However, there is little indication that training to develop counselor skills has been a priority of DOC. Prior to recent department funding reductions, there was no departmental policy requiring training in the development and implementation of treatment programs.

Upon being hired, counselors are required to complete 80 hours of training to orient them to the policies and procedures of the department. This training provides an introduction to such areas as inmate classification, the parole process, security procedures, and grievances. However, it provides very little in the way of training for the provision of treatment programs.

Recommendation (8). In establishing two tiers of counseling, the Department of Corrections should develop position qualifications which make the appropriate distinctions between the responsibilities of case managers and those of counselors. Additionally, the department should conduct a thorough assessment of its training and develop policies specifying the education and training requirements for counselors who will develop and implement treatment programs.

Recommendation (9). To provide additional training and consulting services to treatment staff in prisons and field units, the Department of Corrections' should explore the following two options: (1) development of service agreements with State universities and (2) contract with persons who specialize in therapeutic counseling to provide workshops for treatment staff in the four regions.

Implementation of Good-time Policies Not Monitored by DOC

The current good-time system was created to establish a more direct link between inmate participation in treatment programs and the amount of good time earnings they receive. Other factors being equal, inmates who address their treatment needs through participation in programs should receive larger prison term reductions for purposes of parole eligibility.

The establishment of a link between the accrual of good time and evidence of rehabilitation was intended to serve as an incentive for inmates to participate in programs. In practice, however, present DOC policies allow inmates who refuse treatment to continue receiving the highest levels of good time (30 days of good time for every 30 days served). A review of inmate files revealed that this was a particular problem for sex offenders. Specifically, 95 percent of the inmates who were recommended for sex offender treatment programs but refused to participate still maintained the highest level of good time.

DOC officials conceded that policy overrides should be used to lower the good time earnings when inmates refuse treatment. However, this is a discretionary decision of prison staff. DOC does not have any internal controls procedure outside of the institutions to determine whether the appropriate amount of good time is being awarded.

Recommendation (10). The Department of Corrections should develop a policy that specifically prohibits inmates who refuse treatment from being placed in the highest levels of good time. In addition, the department should develop compliance review procedures to routinely monitor the performance of institutional staff in implementing this and other policies for its good-time system.

Stronger Links Between Treatment and Parole are Possible

One reason for expediting inmates' parole eligibility dates on the basis of their prison rehabilitation efforts is to increase their chances of first receiving. then succeeding on parole.

Data from this study indicate that there is a relationship between an inmate's participation in treatment programs and his likelihood of being released on parole at the first date of eligibility. However, according to one Parole Board member, stronger links to the parole decision-making process could be established if DOC improved its methods for assessing inmate problems, provided more consistent and quality treatment, and informed Board members of the results of inmate participation in these programs.

Recommendation (11). The Department of Corrections should work with the Parole Board to develop an interagency agreement that includes guidelines for conditioning the release of some inmates to successful participation in specific treatment programs. These guidelines should specify how the inmates' needs assessment will be conducted, describe the services they will be provided, and identify inmate program performance measures that can be used by the Board to assess the quality of the inmate's participation.