**Knowledge Application Program**

**KAP Keys**

**For Clinicians**

**Based on TIP 44**

***Substance Abuse Treatment For Adults\
in the Criminal Justice System***

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**Substance Abuse and Mental Health Services Administration**

**Center for Substance Abuse Treatment**

**www.samhsa.gov**

**Introduction**

KAP Keys were developed to accompany the Treatment Improvement Protocol
(TIP) Series published by the Center for Substance Abuse Treatment
(CSAT), Substance Abuse and Mental Health Services Administration
(SAMHSA). These KAP Keys are based entirely on TIP 44 and are designed
to meet the needs of the busy clinician for concise, easily accessed
"how-to" information.

For more information on the topics in these KAP Keys, readers are
referred to TIP 44.

**Other Treatment Improvement Protocols (TIPs) that are relevant to
these KAP Keys:**

**TIP 21:** *Combining Alcohol and Other Drug Abuse Treatment With
Diversion for Juveniles in the Justice System* **BKD169**

**TIP 23:** *Treatment Drug Courts: Integrating Substance Abuse
Treatment With Legal Case Processing* **BKD205**

**TIP 30:** *Continuity of Offender Treatment for Substance Use
Disorders From Institution to Community* **BKD304**

**TIP 38:** *Integrating Substance Abuse Treatment and Vocational
Services* **BKD381**

**TIP 41:** *Substance Abuse Treatment: Group Therapy* **BKD507**

*Substance Abuse and Trauma* (Due for publication in 2006)

Key 1. Common Myths About Screening and Assessment

Following are several common myths about substance abuse screening and
assessment, and the facts that debunk those myths.

-   *Myth:* Screening and assessment are no better than intuition in
    detecting a person's need for treatment.

    *Fact:* Objective screening and assessment measures can result in
    treatment that is better targeted to a client's needs, resulting in
    better outcomes.

-   *Myth:* Only a single screening is needed to place people in
    different levels of treatment services.

    *Fact:* Accurate evaluation requires a battery of instruments that
    examine how substance use has affected all the domains of the
    client's life. When treatment options are severely limited, however,
    a basic screening may be sufficient to determine eligibility and
    suitability for treatment.

-   *Myth:* Untrained professionals can conduct screening and
    assessments.

    *Fact:* Although some screenings can be administered and scored
    without significant training, placement decisions are greatly
    improved when they are made by professionally trained staff. This
    includes staff with relevant certification in substance abuse
    treatment, those with advanced professional degrees, and those with
    specialized training in the use of particular screening and
    assessment instruments. For those screening and assessment
    approaches that require an interview with the offender, specialized
    training is also needed in basic counseling techniques such as
    rapport building and reflective listening. Use of trained
    professional staff in the triage and placement process helps to
    minimize the number of inappropriate referrals for treatment.

-   *Myth:* Screening and assessment are always compromised because you
    cannot trust self-report information from offenders.

    *Fact:* Research generally validates the reliability, and to some
    degree, the validity of information obtained through self-reports.
    Collateral sources such as the offender's family and friends can
    improve the reliability of the information gathered (or "the full
    picture"). Offenders do supply a certain amount of misinformation in
    some settings to avoid unwanted consequences, however.

-   *Myth:* All screening and assessment instruments are equally
    effective.

    *Fact:* Research shows significant variability in the reliability
    and validity of different instruments with different populations.

-   *Myth:* Because an instrument is widely used, it must be effective.

    *Fact:* Many highly marketed and widely used instruments do not have
    a research base supporting the validity of their use. In fact, many
    of the widely marketed and used instruments have been shown to be
    less effective than those available in the public domain.

-   *Myth:* Screening and assessment should not examine the history of
    physical and sexual abuse and related trauma because this may
    aggravate the offender's level of stress and psychological
    instability, and staff may not be able to deal effectively with the
    consequences.

> *Fact:* Screening and assessment of all forms of abuse are essential
> for both male and female offenders, because it is now recognized that
> the effects of trauma contribute to many psychiatric disorders.
> Clinical outcomes are likely to be compromised if these abuse and
> trauma issues are not explored and if strategies addressing these
> issues are not developed and integrated into treatment plans for
> mental and substance use disorders. However, it is important to
> emphasize that in screening for a history of trauma it can be damaging
> to ask the client to describe traumatic events in detail. To screen,
> it is important to limit questioning to very brief and general
> questions, such as "Have you ever experienced childhood physical
> abuse? Sexual abuse? A serious accident? Violence or the threat of it?
> Have there been experiences in your life that were so traumatic they
> left you unable to cope with day-to-day life?"

Key 2. Screening Guidelines by Domain

Screening content should identify key issues that need to be addressed
in placing offenders in treatment. Content can be specific to several
domains, including substance use, criminal involvement, physical health,
mental health, and special considerations.

+--------------------+-------------------------------------------------+
| **Domain**         | **Indicators**                                  |
+--------------------+-------------------------------------------------+
| Substance Use      | -   Substance use history                       |
|                    |                                                 |
|                    | -   Motivation and desire for treatment         |
|                    |                                                 |
|                    | -   Severity and frequency of use               |
|                    |                                                 |
|                    | -   Detoxification needs, acute intoxication    |
|                    |                                                 |
|                    | -   Treatment history (e.g., number and type of |
|                    |     episodes, outcomes)                         |
+--------------------+-------------------------------------------------+
| Criminal           | -   Criminal thinking                           |
| Involvement        |                                                 |
|                    | -   Current offense(s)                          |
|                    |                                                 |
|                    | -   Prior charges                               |
|                    |                                                 |
|                    | -   Prior convictions                           |
|                    |                                                 |
|                    | -   Age at first offense                        |
|                    |                                                 |
|                    | -   Type of offense(s)                          |
|                    |                                                 |
|                    | -   Number of incarcerations                    |
|                    |                                                 |
|                    | -   Prior successful completion of probation or |
|                    |     parole drug use offenses                    |
|                    |                                                 |
|                    | -   Prior involvement in diversionary programs  |
|                    |                                                 |
|                    | -   History of diagnosis of any personality     |
|                    |     disorder                                    |
+--------------------+-------------------------------------------------+
| Health             | -   Intoxication, infectious disease            |
|                    |     (tuberculosis, hepatitis, sexually          |
|                    |     transmitted diseases, HIV status)           |
|                    |                                                 |
|                    | -   Pregnancy                                   |
|                    |                                                 |
|                    | -   General health                              |
|                    |                                                 |
|                    | -   Acute conditions                            |
+--------------------+-------------------------------------------------+
| Mental Health      | -   Suicidality                                 |
|                    |                                                 |
|                    | -   History of treatment and prior diagnosis    |
|                    |                                                 |
|                    | -   Treatment outcome                           |
|                    |                                                 |
|                    | -   Current and past medications                |
|                    |                                                 |
|                    | -   Acute symptoms                              |
|                    |                                                 |
|                    | -   Psychopathy                                 |
+--------------------+-------------------------------------------------+
| Special            | -   Educational level                           |
| Considerations     |                                                 |
|                    | -   Reading level/literacy                      |
|                    |                                                 |
|                    | -   Language/cultural barriers                  |
|                    |                                                 |
|                    | -   Physical disability                         |
|                    |                                                 |
|                    | -   Developmental disability                    |
|                    |                                                 |
|                    | -   Learning disability                         |
|                    |                                                 |
|                    | -   Health and biomedical record                |
|                    |                                                 |
|                    | -   Housing                                     |
|                    |                                                 |
|                    | -   Dependants/family issues                    |
|                    |                                                 |
|                    | -   History of abuse (victim and/or             |
|                    |     perpetrator), including trauma experienced  |
|                    |     as a result of physical and sexual abuse    |
+--------------------+-------------------------------------------------+

Key 3. Recommended Screening Instruments in Criminal Justice Settings

  ----------------- ----------------- ---------------------------------------------
  **Instrument**    **Purpose**       **Description**

  Alcohol           A 25-item         The ADS can be coupled with the ASI--Drug Use
  Dependence Scale\ instrument        section to provide an effective screen for
  (ADS)             developed to      alcohol and drug use problems among
                    screen for        offenders. For more information on the ADS,
                    alcohol           contact the Center for Addiction and Mental
                    dependence        Health at (800) 661-1111. The ASI is
                    symptoms;         reprinted in TIP 7, *Screening and Assessment
                    performs          for Alcohol and Other Drug Abuse Among Adults
                    adequately in     in the Criminal Justice System*.
                    community and     
                    institutional     
                    settings          

  Simple Screening  A 16-item         An expert panel developed the SSI-SA as a
  Instrument for    screening         tool for outreach workers. The SSI-SA, which
  Substance Abuse\  instrument that   can be administered without training,
  (SSI-SA)          examines symptoms includes items related to alcohol and drug
                    of both alcohol   use, preoccupation and loss of control,
                    and drug          adverse consequences of use, problem
                    dependence        recognition, and tolerance and withdrawal
                                      effects. The SSI-SA is fully described in TIP
                                      11, *Simple Screening Instruments for
                                      Outreach for Alcohol and Other Drug Abuse and
                                      Infectious Diseases*, and is reproduced along
                                      with instructions in TIP 42, *Substance Abuse
                                      Treatment for Persons With Co-Occurring
                                      Disorders*.

  TCU Drug Screen\  A 15-item         The TCU Drug Screen is completed by the
  (TCUDS)           substance abuse   offender and serves to quickly identify
                    diagnostic screen individuals who report heavy drug use or
                                      dependency (based on the DSM-IV-TR and the
                                      National Institute of Mental Health
                                      Diagnostic Interview Schedule) and who
                                      therefore might be eligible for treatment.
                                      For more information regarding the TCUDS and
                                      other related instruments go to
                                      [www.ibr.tcu.edu](http://www.ibr.tcu.edu/).

  *Source:* Peters,                   
  R.H., Greenbaum,                    
  P.E., Steinberg,                    
  M.L., and Carter,                   
  C.R.                                
  Effectiveness of                    
  screening                           
  instruments in                      
  detecting                           
  substance use                       
  disorders among                     
  prisoners.                          
  *Journal of                         
  Substance Abuse                     
  Treatment*                          
  18(4):349--358,                     
  2000.                               
  ----------------- ----------------- ---------------------------------------------

Key 4. Instruments for Readiness and Mental Disorders

+-----------------+-----------------------------------------------------+
| **Instruments   |                                                     |
| for Evaluating  |                                                     |
| Readiness for   |                                                     |
| Treatment**     |                                                     |
+-----------------+-----------------------------------------------------+
| **Instrument**  | **Description**                                     |
+-----------------+-----------------------------------------------------+
| The University  | URICA was developed to assess an individual's stage |
| of Rhode Island | of change. The instrument is known to be valid with |
| Change          | different populations in a variety of settings.     |
| Assessment      | Research has determined that URICA is useful,       |
| Scale (URICA)   | reliable, and valid among incarcerated women who    |
|                 | use drugs. The URICA and other similar instruments  |
|                 | are reprinted in TIP 35, *Enhancing Motivation for  |
|                 | Change in Substance Abuse Treatment*.               |
+-----------------+-----------------------------------------------------+
| The TCU         | The TCU Treatment Motivation Scales can be used to  |
| Treatment       | track the stages of change in treatment motivation. |
| Motivation      | For further information, go to www.ibr.tcu.edu.     |
| Scales          |                                                     |
+-----------------+-----------------------------------------------------+
| The             | The CMRS scales were designed to predict retention  |
| Circumstances,  | based on dynamic client factors related to seeking  |
| Motivation,     | and remaining in treatment. The Circumstances scale |
| Readiness, and  | is defined as the external pressure to engage and   |
| Suitability     | remain in treatment. The Motivation scale is        |
| Scales (CMRS)   | defined as the internal pressure to change; the     |
|                 | Readiness scale is defined as the perceived need    |
|                 | for treatment; and the Suitability scale is defined |
|                 | as the individual's perception of the treatment     |
|                 | modality or setting as appropriate for himself. A   |
|                 | prison version has been developed. A revised        |
|                 | version of the CMRS, the CMR, is also available.    |
|                 | The CMR is copyrighted and can be obtained by       |
|                 | contacting the National Development and Research    |
|                 | Institute, Inc., 71 W. 23rd Street, New York, New   |
|                 | York 10010, or mail@ndri.org.                       |
+-----------------+-----------------------------------------------------+
| Stages of       | SOCRATES includes items specifically focused on     |
| Change,         | alcohol abuse and can be used as a starting point   |
| Readiness, and  | for discussion. A Spanish translation is available. |
| Treatment       | The SOCRATES and other similar instruments are      |
| Eagerness Scale | reprinted in TIP 35, *Enhancing Motivation for      |
| (SOCRATES)      | Change in Substance Abuse Treatment*.               |
+-----------------+-----------------------------------------------------+
| **Instruments   |                                                     |
| for Screening   |                                                     |
| and Assessing   |                                                     |
| Mental          |                                                     |
| Disorders**     |                                                     |
+-----------------+-----------------------------------------------------+
| **Instrument**  | **Description**                                     |
+-----------------+-----------------------------------------------------+
| Beck Depression | -   A 21-item self-report of symptoms that screens  |
| Inventory II    |     for symptoms of depression                      |
| (BDI-II)        |                                                     |
|                 | -   Requires no significant training to administer  |
|                 |                                                     |
|                 | -   Found to be the most effective instrument in    |
|                 |     detecting depression among individuals who      |
|                 |     abuse alcohol                                   |
|                 |                                                     |
|                 | -   Should not be used as a sole indicator of       |
|                 |     depression but in conjunction with other        |
|                 |     instruments                                     |
+-----------------+-----------------------------------------------------+
| Brief Symptom   | -   A short form of the Symptom Checklist 90 -      |
| Inventory (BSI) |     Revised (SCL-90-R)                              |
|                 |                                                     |
|                 | -   Comprising 53 items, including three global     |
|                 |     indices of psychopathology (General Severity    |
|                 |     Index, Positive Symptom Total, Positive Symptom |
|                 |     Distress Index) and nine primary psychiatric    |
|                 |     symptom dimensions                              |
|                 |                                                     |
|                 | -   Brief to administer and requires no significant |
|                 |     training to administer                          |
|                 |                                                     |
|                 | -   Only a 6th-grade reading level is required      |
|                 |                                                     |
|                 | -   May be most useful as a general indicator of    |
|                 |     psychopathology                                 |
+-----------------+-----------------------------------------------------+

Key 5. Barriers to Effective Treatment for Criminal Justice Clients

  ----------------- ------------------------------- -------------------------
  **Problem Area**  **Description of Problem**      **Solution(s)**

  Assessment        Assessment uses broad           Expand treatment options
                    definitions of drug abuse and   by establishing larger
                    applies criteria unrelated to   numbers of carefully
                    addiction. As a result, inmates targeted programs at more
                    are not always matched with the institutions.
                    appropriate level of services,  
                    and some inmates who do not     
                    have substance abuse problems   
                    are placed in treatment.        

  Staff training    Many newer prisons have been    Offer better wages;
                    constructed in rural areas      recruit and train
                    where local communities have a  offenders who are serving
                    smaller pool of treatment       life sentences; and
                    professionals and fewer people  orient and train
                    in recovery as potential staff  treatment staff and
                    members.                        correctional staff
                                                    together.

  Staff             Effective correctional officers Change rotation policies;
  redeployment      and treatment counselors often  certify and reward
                    move "up and out."              officers who wish to work
                                                    in jail- or prison-based
                                                    treatment programs.

  Overreliance on   In successful treatment         Treatment and
  institutional     programs, noncompliant          correctional staffs
  sanctions         participants face peer pressure cooperate to determine
                    and eventually develop internal conditions for imposing
                    controls. Often, however,       both therapeutic and
                    institutional sanctions are     institutional sanctions.
                    imposed before peers can have a 
                    positive impact.                

  Aftercare         Many participants drop out of   Establish treatment
                    treatment as soon as they can;  programs in the community
                    many providers in the community that cater to or
                    hesitate to work with           willingly accept
                    ex-prisoners, especially those  parolees, probationers,
                    sentenced for violent or sexual and others under
                    offenses.                       community supervision.

  Coercion          Often inmates do not volunteer  Focus on rewarding good
                    for treatment because peers     behavior. Remove
                    attach stigma to it, programs   disincentives and add
                    demand more rules and           such inducements as early
                    structure, and participants     release, better living
                    often lose seniority and job    quarters, and better job
                    opportunities in the facility.  opportunities.

  *Source:*                                         
  Farabee, D.,                                      
  Prendergast, M.,                                  
  Cartier, J.,                                      
  Wexler, H.,                                       
  Knight, K., and                                   
  Anglin, M.D.                                      
  Barriers to                                       
  implementing                                      
  effective                                         
  correctional drug                                 
  treatment                                         
  programs. *Prison                                 
  Journal*                                          
  79(2):150--162,                                   
  1999.                                             
  ----------------- ------------------------------- -------------------------

Key 6. Considerations for Screening in Criminal Justice Settings

+---------+--------------------------------+--------------------------+
| **Se    | **Purpose of Screening**       | **Special                |
| tting** |                                | Considerations**         |
+=========+================================+==========================+
| Jails   | -   For early identification,  | Look for previous        |
|         |     if getting out of jail     | correctional substance   |
|         |     early                      | abuse treatment,         |
|         |                                | psychiatric treatment    |
|         | -   To determine eligibility   | needs, readiness for     |
|         |     for drug courts and        | treatment, past          |
|         |     pretrial diversion         | institutional behavior   |
|         |     programs                   | problems, prior          |
|         |                                | correctional treatment,  |
|         | -   For diversion to           | and court orders.        |
|         |     specialized mental health  |                          |
|         |     courts or programs focused |                          |
|         |     on behavioral problems     |                          |
|         |                                |                          |
|         | -   To determine behavioral    |                          |
|         |     management problems and    |                          |
|         |     acute needs (including     |                          |
|         |     crisis intervention)       |                          |
|         |                                |                          |
|         | -   To identify suitability    |                          |
|         |     for placement in jail      |                          |
|         |     treatment programs         |                          |
|         |                                |                          |
|         | -   For classification to      |                          |
|         |     different housing units    |                          |
+---------+--------------------------------+--------------------------+
| Prisons | -   To match time left to      | Look at prison record,   |
|         |     serve with time for        | treatment history        |
|         |     receiving treatment or for | (including treatment for |
|         |     custody level              | issues other than        |
|         |     classification             | substance abuse), and    |
|         |                                | behavior.                |
|         | -   To identify suitability    |                          |
|         |     for placement in prison    |                          |
|         |     treatment programs         |                          |
+---------+--------------------------------+--------------------------+
| P       | -   To determine the need for  | Look for community or    |
| retrial |     housing, transportation,   | corrections records or   |
| and     |     employment, or economic    | collateral information   |
| Co      |     benefits                   | (e.g., information from  |
| mmunity |                                | family members).         |
| Supe    | -   To identify suitability    |                          |
| rvision |     for placement in community |                          |
|         |     treatment programs         |                          |
|         |                                |                          |
|         | -   To assess for public       |                          |
|         |     safety risk and level of   |                          |
|         |     supervision needed,        |                          |
|         |     pursuant to consideration  |                          |
|         |     for placement in diversion |                          |
|         |     programs                   |                          |
+---------+--------------------------------+--------------------------+

Key 7. Traits of Major Personality Disorders (According to the DSM-IV)

+-----------------------------------------------------------------------+
| **Antisocial Personality Disorder (ASPD)**                            |
+-----------------------------------------------------------------------+
| -   Deceitfulness, as indicated by repeated lying, use of aliases, or |
|     conning others for personal profit or pleasure                    |
|                                                                       |
| -   Irritability and aggressiveness, as indicated by repeated         |
|     physical fights and assaults                                      |
|                                                                       |
| -   Consistent irresponsibility, as indicated by repeated failure to  |
|     sustain consistent work behavior or honor financial obligations   |
|                                                                       |
| -   Failure to conform to social norms with respect to lawful         |
|     behaviors as indicated by repeatedly performing acts that are     |
|     grounds for arrest                                                |
|                                                                       |
| -   Impulsivity or failure to plan ahead                              |
|                                                                       |
| -   Reckless disregard for safety of self or others                   |
|                                                                       |
| -   Lack of remorse, as indicated by being indifferent to or          |
|     rationalizing having hurt, mistreated, or stolen from another     |
+-----------------------------------------------------------------------+
| *Source:* Hare, R., Hart, S., and Harpur, T. Psychopathy and the      |
| DSM-IV criteria for antisocial personality disorder. *Journal of      |
| Abnormal Psychology* 100(3):391--398, 1991.                           |
+-----------------------------------------------------------------------+
| Traits of Borderline Personality Disorder (BPD)                       |
+-----------------------------------------------------------------------+
| People diagnosed with BPD must have five or more of the following     |
| behaviors:                                                            |
|                                                                       |
| -   Frantic efforts to avoid real or imagined abandonment             |
|                                                                       |
| -   A pattern of unstable and intense interpersonal relationships     |
|     characterized by alternating between extremes of idealization and |
|     devaluation                                                       |
|                                                                       |
| -   Identity disturbance or markedly and persistently unstable        |
|     self-image or sense of self                                       |
|                                                                       |
| -   Impulsivity in at least two areas that are potentially            |
|     self-damaging (e.g., spending, sex, substance abuse, reckless     |
|     driving, binge eating)                                            |
|                                                                       |
| -   Recurrent suicidal behavior or gestures, or self-mutilating       |
|     behavior                                                          |
|                                                                       |
| -   Affective instability due to marked reactivity of mood (e.g.,     |
|     intense episodic dysphoria, irritability, or anxiety usually      |
|     lasting a few hours and only rarely more than a few days)         |
|                                                                       |
| -   Chronic feelings of emptiness                                     |
|                                                                       |
| -   Inappropriate, intense anger or difficulty controlling anger      |
|     (e.g., frequent displays of temper, constant anger, recurrent     |
|     physical fights)                                                  |
|                                                                       |
| -   Transient, stress-related paranoid ideation or severe             |
|     dissociative symptoms                                             |
+-----------------------------------------------------------------------+
| ***Source:* American Psychiatric Association. *Diagnostic and         |
| Statistical Manual of Mental Disorders*. 4th ed. Text Revision.       |
| Washington, DC: American Psychiatric Association, 2000.**             |
+-----------------------------------------------------------------------+

Key 8. Components of Drug Courts and Suggestions for Counselors

+-----------------------------------------------------------------------+
| **10 Key Components of Drug Courts**                                  |
+-----------------------------------------------------------------------+
| The following components of drug courts were developed by a national  |
| committee of experts for the Office of Justice Programs, Drug Courts  |
| Program Office:                                                       |
|                                                                       |
| 1\. Drug courts integrate alcohol and drug treatment services with    |
| justice system case processing.                                       |
|                                                                       |
| 2\. Using a nonadversarial approach, prosecution and defense counsel  |
| promote public safety while protecting participants' due process      |
| rights.                                                               |
|                                                                       |
| 3\. Eligible participants are identified early and promptly placed in |
| the drug court program.                                               |
|                                                                       |
| 4\. Drug courts provide access to a continuum of alcohol, drug, and   |
| related treatment and rehabilitation services.                        |
|                                                                       |
| 5\. Abstinence is monitored by frequent alcohol and illicit drug      |
| testing.                                                              |
|                                                                       |
| 6\. A coordinated strategy governs drug court responses to            |
| participants' compliance.                                             |
|                                                                       |
| 7\. Ongoing judicial interaction with each drug court participant is  |
| essential.                                                            |
|                                                                       |
| 8\. Monitoring and evaluating achievement of program goals is         |
| necessary to gauge effectiveness.                                     |
|                                                                       |
| 9\. Continuing interdisciplinary education promotes effective drug    |
| court planning, implementation, and operations.                       |
|                                                                       |
| 10\. Forging partnerships among drug courts, public agencies, and     |
| community-based organizations generates local support and enhances    |
| drug court program effectiveness.                                     |
+-----------------------------------------------------------------------+
| Suggestions for Counselors Operating in a Pretrial Setting            |
+-----------------------------------------------------------------------+
| -   **Maintain a client's confidentiality. One strategy is to avoid   |
|     discussing the client's criminal case.**                          |
|                                                                       |
| -   **Bear firmly in mind that the client is presumed innocent before |
|     trial.**                                                          |
|                                                                       |
| -   **Be realistic about the responsibilities that a client is        |
|     capable of handling in pretrial settings. For example, it is      |
|     unrealistic to believe that a defendant will suddenly become a    |
|     model citizen, meeting all of his or her responsibilities, simply |
|     because of an arrest.**                                           |
|                                                                       |
| -   **Avoid allowing individuals to be inadvertently penalized for    |
|     enrolling in treatment.**                                         |
|                                                                       |
| -   **Be aware that clients may be more focused on "beating the case" |
|     than on recovery.**                                               |
+-----------------------------------------------------------------------+

Key 9. Outcome Information

Outcome evaluations involve measurable research to determine how
effective a program is for its clients. Followup data, such as drug
relapse and employment status, are the heart of outcome evaluation. The
following are kinds of outcome information that might be collected.

+----------------+-----------------------------------------------------+
| Drugs          | -   Urinalysis results                              |
|                |                                                     |
|                | -   Drug-related parole infractions                 |
|                |                                                     |
|                | -   Drug-related arrests                            |
+----------------+-----------------------------------------------------+
| Crime          | -   Parole rule infractions                         |
|                |                                                     |
|                | -   Time until parole rule infraction               |
|                |                                                     |
|                | -   New misdemeanor arrests of any type             |
|                |                                                     |
|                | -   New felony arrests for non--drug-related crimes |
|                |                                                     |
|                | -   New felony arrests for drug-related crimes      |
|                |                                                     |
|                | -   New felony arrests for violent crimes           |
|                |                                                     |
|                | -   Time until arrest                               |
|                |                                                     |
|                | -   Re-incarceration                                |
+----------------+-----------------------------------------------------+
| Social         | -   Employment and education                        |
| adjustment     |                                                     |
|                | -   Family (e.g., support, child rearing, marital,  |
|                |     etc.)                                           |
|                |                                                     |
|                | -   Substance abuse treatment                       |
|                |                                                     |
|                | -   Community involvement (e.g., community service) |
+----------------+-----------------------------------------------------+
| HIV risk       | -   Intravenous drug injection                      |
| behaviors      |                                                     |
|                | -   Sexual behavior                                 |
|                |                                                     |
|                | -   HIV test results                                |
+----------------+-----------------------------------------------------+
| Cost           | -   Cost estimates of substance use                 |
| information    |                                                     |
|                | -   Cost estimates of crimes                        |
|                |                                                     |
|                | -   Cost estimates of social services to family     |
|                |     (e.g., welfare)                                 |
|                |                                                     |
|                | -   Criminal justice processing and detention costs |
+----------------+-----------------------------------------------------+
| Tracking       | -   Tracking locator information (e.g., social      |
| information    |     security and license numbers, addresses of      |
|                |     family and friends, etc.)                       |
+----------------+-----------------------------------------------------+

**Ordering Information**

**TIP 44**

***Substance Abuse Treatment for Adults in the Criminal Justice
System***

**Three Ways to Obtain FREE Copies**

**of All TIPs Products:**

1\. Call SAMHSA's National Clearinghouse for Alcohol and Drug
Information (NCADI) at **800-729-6686,** TDD (hearing impaired)
**800-487-4889.**

2\. Visit NCADI's Web site at **www.ncadi.samhsa.gov.**

3\. You can also access TIPs online at **www.kap.samhsa.gov.**

Do not reproduce or distribute this publication for a fee without
specific, written authorization from the Office of Communications,
Substance Abuse and Mental Health Services Administration, U.S.
Department of Health and Human Services.

DHHS Publication No. (SMA) 06-4150

Printed 2006