Monday, January 28, 2008
Non-Sexual Dual Relationships - Conclusion
One of the core problems in blurred, dual, or conflictual relationships is the core idea presented by Pope. Pope made the claim that, " non-sexual dual relationships, while unethical and harmful per se, foster sexual dual relationships". The great fear and ethical taboo among therapists is sex with a client. According to Pope's reasoning, the primary rationale for avoiding all dual-relationships has been that they may eventually lead to a sexual relationship. This is not the only fear, but it is one of the greatest among professionals. Obviously not all non-sexual dual relationships lead to sexual ones, but it is likely that almost all sexual relationships have had to pass through a dual relationship stage at some point before turning into a fully sexual relationship. But, is it possible that some dual relationships can be beneficial to a client? In some circumstances they may be.
In the survey previously mentioned it was found that respondents considered some dual relationships to be useful. For example, some dual relationships provide role modeling, nurturing and a giving quality to therapy. This is one of the main dilemmas that people working in residential addiction treatment programs face. In many cases, the counselor/therapist can provide vital role modeling to clients.
Throughout the history of addiction treatment, addiction treatment professionals have struggled with this dual relationship dilemma. A national survey of 827 certified drug and alcohol counselors was conducted to determine their ethical beliefs and practices in the area of dual relationships. The results were compared to a national study of psychologists, psychiatrists, and social workers around 13 areas of practice behavior involving dual relationship situations and no significant difference was found between the groups. The results indicate that the same concerns over dual relationships plague professionals in many different counseling fields, not just those with graduate degrees.
Often professionals working in the field of residential addiction treatment are in recovery themselves. This presents both a unique problem and a unique opportunity for both the client and the clinician. Clinicians working in addiction treatment who are also recovering addicts are able to provide a model for recovery from addiction. However, problems arise when the clinician's recovery program coincides with the client's recovery program. This presents an unusual and tricky situation when clients, current or former, attend publicly held recovery meetings (Alcoholics Anonymous meetings, Narcotics Anonymous meetings, and other 12-step based community meetings) within their community.
The situation is this: A clinician attends her regular, local 12-step based recovery meeting. She walks into the meeting and suddenly one of her former, or perhaps current, clients waves at her from across the room. At first this may appear no different from any other situation where a professional runs into a client in a social setting, but the main difference here lies in the nature of the situation. When the addiction treatment clinician attends a recovery meeting and happens to encounter his client in the same meeting, the clinician is suddenly presented with an awkward situation. The therapist's role is now compromised. She is both therapist and patient.
The positive aspect of this particular compromising situation is that the addiction counselor is modeling positive behavior in the above example. The therapist/counselor is living what she is prescribing to the client, namely that addiction is something that can be overcome and something that she continues to address by attending recovery meetings. In this situation the dual role can be beneficial to the client.
At one time, ethical guidelines for addiction counselors were full of varying opinions on how to handle the situation mentioned above. Only recently have most of the addiction treatment licensing organizations adopted the wording of the APA ethical guidelines regarding dual relationships. According to Dr. Jerry Brown, an experienced clinical psychologist with over 20 years of experience working in the field of addiction treatment, in the past the general consensus among professionals working in the addiction treatment field was that no addiction treatment professional should attend a 12-step based meeting where his or her client(s) were also in attendance. In these situations it was suggested that the counselor or treatment professional immediately leave the meeting upon seeing the former or current client. This rule has widely been abandoned for more general statements in their ethical guidelines regarding dual relationships. The Department of Alcohol and Drug Programs Text of Final Regulations §13060 (c)(4) now states the following regarding dual relationships: "Engaging in social or business relationships for personal gain with program participants, patients, or residents, their family members or other persons who are significant to them" is prohibited. The attempt at defining what to do in certain situations, once an aspiration of addiction treatment licensing organizations, has become a thing of the past.
The law remains intentionally vague in certain areas so as to leave the judge and lawyers room to argue a particular angle based on the facts and circumstances of a case. It seems that the APA has chosen to do the same thing with its ethical code regarding dual relationships. If the APA were to attempt to do what addiction licensing boards have attempted to do in the past and define particular instances where dual relationships might occur and as far as to outline what the professional should do in each situation, then the APA would undoubtedly produce an exhaustive volume of rules and regulations that not even the most astute and cautious psychologist would read. Perhaps it is better that the APA keep the guidelines on dual relationships as they are and leave the interpretation to professionals. As discussed previously, not all dual relationships are harmful to the patient, but it is better left to the psychologist, the psychiatrist, the social worker and the addiction counselor as to where the line should be drawn.
Undergoing MyBlogLog Verification
In the survey previously mentioned it was found that respondents considered some dual relationships to be useful. For example, some dual relationships provide role modeling, nurturing and a giving quality to therapy. This is one of the main dilemmas that people working in residential addiction treatment programs face. In many cases, the counselor/therapist can provide vital role modeling to clients.
Throughout the history of addiction treatment, addiction treatment professionals have struggled with this dual relationship dilemma. A national survey of 827 certified drug and alcohol counselors was conducted to determine their ethical beliefs and practices in the area of dual relationships. The results were compared to a national study of psychologists, psychiatrists, and social workers around 13 areas of practice behavior involving dual relationship situations and no significant difference was found between the groups. The results indicate that the same concerns over dual relationships plague professionals in many different counseling fields, not just those with graduate degrees.
Often professionals working in the field of residential addiction treatment are in recovery themselves. This presents both a unique problem and a unique opportunity for both the client and the clinician. Clinicians working in addiction treatment who are also recovering addicts are able to provide a model for recovery from addiction. However, problems arise when the clinician's recovery program coincides with the client's recovery program. This presents an unusual and tricky situation when clients, current or former, attend publicly held recovery meetings (Alcoholics Anonymous meetings, Narcotics Anonymous meetings, and other 12-step based community meetings) within their community.
The situation is this: A clinician attends her regular, local 12-step based recovery meeting. She walks into the meeting and suddenly one of her former, or perhaps current, clients waves at her from across the room. At first this may appear no different from any other situation where a professional runs into a client in a social setting, but the main difference here lies in the nature of the situation. When the addiction treatment clinician attends a recovery meeting and happens to encounter his client in the same meeting, the clinician is suddenly presented with an awkward situation. The therapist's role is now compromised. She is both therapist and patient.
The positive aspect of this particular compromising situation is that the addiction counselor is modeling positive behavior in the above example. The therapist/counselor is living what she is prescribing to the client, namely that addiction is something that can be overcome and something that she continues to address by attending recovery meetings. In this situation the dual role can be beneficial to the client.
At one time, ethical guidelines for addiction counselors were full of varying opinions on how to handle the situation mentioned above. Only recently have most of the addiction treatment licensing organizations adopted the wording of the APA ethical guidelines regarding dual relationships. According to Dr. Jerry Brown, an experienced clinical psychologist with over 20 years of experience working in the field of addiction treatment, in the past the general consensus among professionals working in the addiction treatment field was that no addiction treatment professional should attend a 12-step based meeting where his or her client(s) were also in attendance. In these situations it was suggested that the counselor or treatment professional immediately leave the meeting upon seeing the former or current client. This rule has widely been abandoned for more general statements in their ethical guidelines regarding dual relationships. The Department of Alcohol and Drug Programs Text of Final Regulations §13060 (c)(4) now states the following regarding dual relationships: "Engaging in social or business relationships for personal gain with program participants, patients, or residents, their family members or other persons who are significant to them" is prohibited. The attempt at defining what to do in certain situations, once an aspiration of addiction treatment licensing organizations, has become a thing of the past.
The law remains intentionally vague in certain areas so as to leave the judge and lawyers room to argue a particular angle based on the facts and circumstances of a case. It seems that the APA has chosen to do the same thing with its ethical code regarding dual relationships. If the APA were to attempt to do what addiction licensing boards have attempted to do in the past and define particular instances where dual relationships might occur and as far as to outline what the professional should do in each situation, then the APA would undoubtedly produce an exhaustive volume of rules and regulations that not even the most astute and cautious psychologist would read. Perhaps it is better that the APA keep the guidelines on dual relationships as they are and leave the interpretation to professionals. As discussed previously, not all dual relationships are harmful to the patient, but it is better left to the psychologist, the psychiatrist, the social worker and the addiction counselor as to where the line should be drawn.
Undergoing MyBlogLog Verification
Labels: Dual-Relationships
Friday, January 25, 2008
Non-Sexual Dual Relationships - Surveys
A survey was conducted of 4,800 psychiatrists, psychologists, and social workers to determine their ethical attitudes and practices towards dual relationships It was determined that most of those surveyed believed that dual role behaviors were unethical in most circumstances and most reported that they had rarely, if ever, engaged in such behavior. This being said, "sexual and nonsexual relationships form the major basis of financial losses in malpractice suits, licensing disciplinary actions, and ethics complaints against psychologists (Ethics Committee of the APA,".
The survey conducted by Pope and Borys examined eighteen dual relationship situations that are common among health professionals:
1. Accepting a gift worth under $10.
2. Accepting a client's invitation to a special occasion.
3. Accepting a service or product as payment for therapy.
4. Becoming friends with a client after termination.
5. Selling a product to a client.
6. Accepting a gift worth over $50.
7. Providing therapy to an employee.
8. Engaging in sexual activity with a client after termination.
9. Disclosing details of current personal stresses to a client.
10. Inviting clients to an office/clinic open house.
11. Employing a client.
12. Going out to eat with a client after a session.
13. Buying goods or services from a client.
14. Engaging in sexual activity with a client.
15. Inviting clients to a personal party or social event.
16. Providing individual therapy to a relative, friend, or lover of an ongoing client.
17. Providing therapy to a current student or supervisee.
18. Allowing a client to enroll in one's class for a grade.
The above situations are common among health professionals, but even more so among health professionals in certain situations, particularly settings where dual relationships exist naturally. As mentioned previously, this often occurs in small rural communities, military settings, and residential alcohol and drug treatment programs. In these settings therapists are forced into relationships that according to the definition of dual relationships in the code of ethics would be considered unethical. For example, active duty military psychologists fulfill dual roles as therapists and commissioned military officers, which means that they not only have a professional duty to their clients, but also to the military or Department of Defense.
For this reason, many professionals have called for further clarification of the definition of dual relationships. In a study conducted by Kenneth Pope, a leading expert in the field of ethics, and Valerie Vetter a random sample of 1,319 members of the American Psychological Association were asked to describe incidents that they found ethically troublesome. Their intention was to gather information that might be useful in considering possible revisions of the code.
Their report produced the following statement from Pope and Vetter regarding dual relationships:
A national survey of psychologists resulted in a call for changes to the APA ethical principles in the areas of dual relationships, multiple relationships, and boundary issues so that the ethics code would:
(1) define dual relationships more carefully and specify clearly conditions under which they might be therapeutically indicated or acceptable,
(2) address clearly and realistically the situations of those who practice in small towns, rural communities, remote locales, and similar contexts (emphasizing that neither the current code in place at the time nor the draft revision under consideration at that time fully acknowledged or adequately addressed such contexts), and
(3) distinguish between dual relationships and accidental or incidental extra-therapeutic contacts (e.g., running into a patient at the grocery market or unexpectedly seeing a client at a party) and to address realistically the awkward entanglements into which even the most careful therapist can fall.
The survey conducted by Pope and Borys examined eighteen dual relationship situations that are common among health professionals:
1. Accepting a gift worth under $10.
2. Accepting a client's invitation to a special occasion.
3. Accepting a service or product as payment for therapy.
4. Becoming friends with a client after termination.
5. Selling a product to a client.
6. Accepting a gift worth over $50.
7. Providing therapy to an employee.
8. Engaging in sexual activity with a client after termination.
9. Disclosing details of current personal stresses to a client.
10. Inviting clients to an office/clinic open house.
11. Employing a client.
12. Going out to eat with a client after a session.
13. Buying goods or services from a client.
14. Engaging in sexual activity with a client.
15. Inviting clients to a personal party or social event.
16. Providing individual therapy to a relative, friend, or lover of an ongoing client.
17. Providing therapy to a current student or supervisee.
18. Allowing a client to enroll in one's class for a grade.
The above situations are common among health professionals, but even more so among health professionals in certain situations, particularly settings where dual relationships exist naturally. As mentioned previously, this often occurs in small rural communities, military settings, and residential alcohol and drug treatment programs. In these settings therapists are forced into relationships that according to the definition of dual relationships in the code of ethics would be considered unethical. For example, active duty military psychologists fulfill dual roles as therapists and commissioned military officers, which means that they not only have a professional duty to their clients, but also to the military or Department of Defense.
For this reason, many professionals have called for further clarification of the definition of dual relationships. In a study conducted by Kenneth Pope, a leading expert in the field of ethics, and Valerie Vetter a random sample of 1,319 members of the American Psychological Association were asked to describe incidents that they found ethically troublesome. Their intention was to gather information that might be useful in considering possible revisions of the code.
Their report produced the following statement from Pope and Vetter regarding dual relationships:
A national survey of psychologists resulted in a call for changes to the APA ethical principles in the areas of dual relationships, multiple relationships, and boundary issues so that the ethics code would:
(1) define dual relationships more carefully and specify clearly conditions under which they might be therapeutically indicated or acceptable,
(2) address clearly and realistically the situations of those who practice in small towns, rural communities, remote locales, and similar contexts (emphasizing that neither the current code in place at the time nor the draft revision under consideration at that time fully acknowledged or adequately addressed such contexts), and
(3) distinguish between dual relationships and accidental or incidental extra-therapeutic contacts (e.g., running into a patient at the grocery market or unexpectedly seeing a client at a party) and to address realistically the awkward entanglements into which even the most careful therapist can fall.
Labels: Dual-Relationships
Wednesday, January 23, 2008
Non-Sexual Dual Relationships - Intro
Non-sexual dual relationships within the field of counseling are a controversial issue. The essential question to be answered is, where is the professional boundary line between counselor and client? Underneath this general ethical umbrella lies many more specific questions that ethicists struggle with. Among these are: Is it alright to provide therapy to a friend or relative? Is it OK to borrow money from clients? If so, how much is OK? Is it OK to go into business with a client? If not, what about going into business with a client's father? These are just a few of the questions that abound within the questionable, debatable ethical realm of dual relationships.
Ethical questions are determined on a case-by-case basis. There are no clear black and white rules that do not warrant debatable alternatives to be discussed and considered. There is one golden rule which stands above the rest within the clinical world of counseling: Do not have sex with a patient. But, apart from this golden rule, there is little that cannot be discussed and deliberated.
Within the counselor's office there is little left to the imagination as to what is ethical and what is not. It is an ethical embassy of sorts, a sanctuary where client exists on one side and counselor, or psychologist, is on the other. The line between them is palatable. The relationship begins and ends within the confines of a physical space. Patient enters and patient leaves. The more difficult dual relationship questions arise when the physical safety of the ethical embassy, which is the counselor's office, becomes invaded, or perhaps does not exist. Small rural communities, military bases, and residential addiction treatment communities are just a few places where the confines of an office are sometimes limited and less geographically defined and private. Even if a psychologist practices in one location and lives in another, there are situations that may occur which puts the psychologist in the middle of a dual relationship ethical dilemma. What is worse is when there are situations or circumstances that inevitably place the psychologist in a dual relationship situation.
All major mental health professional codes contain a proscription against dual relationship. Role theory is often used to describe the process of dual relationships. "Social roles contain inherent expectations about how a person in a particular role is to behave as well as the rights and obligations which pertain to that role". Conflicts within these relationships arise when either role's expectations of the other exceed that which is inherent. When expectations are exceeded, dual relationships are created.
Although dual relationships are generally frowned upon, not all dual relationships are bad. The American Psychological Association ethical principles recognize multiple or dual relationships as something that is sometimes unavoidable. The APA states that, "it may not be feasible or reasonable for psychologists to avoid social or other nonprofessional contact with persons such as patients". The primary warning is in developing a dual relationship when it appears likely that the relationship will interfere with the therapeutic process. If, "it appears likely that such a relationship reasonably might impair the psychologist's objectivity or otherwise interfere with the psychologist's effectively performing his or her functions as a psychologist, or might harm or exploit the other party".
Ethical questions are determined on a case-by-case basis. There are no clear black and white rules that do not warrant debatable alternatives to be discussed and considered. There is one golden rule which stands above the rest within the clinical world of counseling: Do not have sex with a patient. But, apart from this golden rule, there is little that cannot be discussed and deliberated.
Within the counselor's office there is little left to the imagination as to what is ethical and what is not. It is an ethical embassy of sorts, a sanctuary where client exists on one side and counselor, or psychologist, is on the other. The line between them is palatable. The relationship begins and ends within the confines of a physical space. Patient enters and patient leaves. The more difficult dual relationship questions arise when the physical safety of the ethical embassy, which is the counselor's office, becomes invaded, or perhaps does not exist. Small rural communities, military bases, and residential addiction treatment communities are just a few places where the confines of an office are sometimes limited and less geographically defined and private. Even if a psychologist practices in one location and lives in another, there are situations that may occur which puts the psychologist in the middle of a dual relationship ethical dilemma. What is worse is when there are situations or circumstances that inevitably place the psychologist in a dual relationship situation.
All major mental health professional codes contain a proscription against dual relationship. Role theory is often used to describe the process of dual relationships. "Social roles contain inherent expectations about how a person in a particular role is to behave as well as the rights and obligations which pertain to that role". Conflicts within these relationships arise when either role's expectations of the other exceed that which is inherent. When expectations are exceeded, dual relationships are created.
Although dual relationships are generally frowned upon, not all dual relationships are bad. The American Psychological Association ethical principles recognize multiple or dual relationships as something that is sometimes unavoidable. The APA states that, "it may not be feasible or reasonable for psychologists to avoid social or other nonprofessional contact with persons such as patients". The primary warning is in developing a dual relationship when it appears likely that the relationship will interfere with the therapeutic process. If, "it appears likely that such a relationship reasonably might impair the psychologist's objectivity or otherwise interfere with the psychologist's effectively performing his or her functions as a psychologist, or might harm or exploit the other party".
Labels: Dual-Relationships
Tuesday, January 22, 2008
Spy Games - Conclusion
There is nothing normal about STC treatment centers. It is unique in its organization and structure. The staff at STC are trained in reading moods, testing the reliability of information, and adept at detecting lies. It was thought that a drug and alcohol treatment center located in the middle of a party town like Newport Beach would never succeed. Plus, the logistics of sober houses spread over several blocks and interwoven with party houses didn't seem to indicate a healthy environment. Add to the odd mix clients mobility, easy access to alcohol and drugs, and lack of apparent supervision, and STC becomes a frightening place to send your children for help.
What surprises skeptics is that STC not only functions more efficiently than most in-patient treatment centers, but that it also allows the clients to recover in "the real world" which is the kind of environment they will eventually face. It is remarkable that STC clients are not only able to maintain sobriety, but they do so for a much longer time than they do coming from other treatment centers. The sheer numbers of former STC clients that stay in the local Newport Beach community makes STC an unusual facility and a successful one.
To try and duplicate the structure and operations of STC would be close to impossible (perhaps more possible with this report, but very unlikely). The geographic coincidences, the strong recovery community in the area, the knowledgeable staff of former STC clients, and the sophisticated network of communications, all work to create a recipe part brilliance, part devotion, and part divine intervention, or luck, if you prefer.
In the future, further studies must be conducted within successful treatment facilities to aid in the creation and redesign of programs that are not as successful. Former Governor Gray Davis of California, in association with Professor Allen Mobley of the University of California Irvine, is conducting a study of the most unique and successful treatment programs in correction institutions across California. We need the same type of research effort to analyze the treatment centers across the country. Better rehabilitation will benefit society. Programs, like the one at STC, need to be reproduced in other communities, if at all possible.
The benefits of the STC living community have yet to be fully investigated. It is apparent from this study that clients at STC benefit from being involved in the outside Newport Beach community. It is evident that many clients choose to stay in the community because of the connections that they have made at the Club. The length of stay is also a determining factor in the effective treatment of the clients at STC. The longer the client's stay at STC, even if it is the minimum 90 days, the greater the knowledge the staff will have of the client's behavior and recovery progress. A quantitative research study would also be necessary to further validate the statistical success of treatment at STC.
Your thoughts?
What surprises skeptics is that STC not only functions more efficiently than most in-patient treatment centers, but that it also allows the clients to recover in "the real world" which is the kind of environment they will eventually face. It is remarkable that STC clients are not only able to maintain sobriety, but they do so for a much longer time than they do coming from other treatment centers. The sheer numbers of former STC clients that stay in the local Newport Beach community makes STC an unusual facility and a successful one.
To try and duplicate the structure and operations of STC would be close to impossible (perhaps more possible with this report, but very unlikely). The geographic coincidences, the strong recovery community in the area, the knowledgeable staff of former STC clients, and the sophisticated network of communications, all work to create a recipe part brilliance, part devotion, and part divine intervention, or luck, if you prefer.
In the future, further studies must be conducted within successful treatment facilities to aid in the creation and redesign of programs that are not as successful. Former Governor Gray Davis of California, in association with Professor Allen Mobley of the University of California Irvine, is conducting a study of the most unique and successful treatment programs in correction institutions across California. We need the same type of research effort to analyze the treatment centers across the country. Better rehabilitation will benefit society. Programs, like the one at STC, need to be reproduced in other communities, if at all possible.
The benefits of the STC living community have yet to be fully investigated. It is apparent from this study that clients at STC benefit from being involved in the outside Newport Beach community. It is evident that many clients choose to stay in the community because of the connections that they have made at the Club. The length of stay is also a determining factor in the effective treatment of the clients at STC. The longer the client's stay at STC, even if it is the minimum 90 days, the greater the knowledge the staff will have of the client's behavior and recovery progress. A quantitative research study would also be necessary to further validate the statistical success of treatment at STC.
Your thoughts?
Labels: Spy-Games
Monday, January 21, 2008
Spy Games - The Club
The Club is a building located within STC territory. Recovery meetings are held all day long, every day of the week. There are many clubs like this one, but chances are that the general community which hosts one of these clubs is unaware it exists. They are not secret clubs, but they treasure anonymity. The Club is an unmarked, two-story building that has three meeting rooms. At any given time during the day, a recovery meeting is in progress. The first meeting of the day begins at 6:30am and the last one normally ends at 9:00pm. STC clients are required to attend certain meetings at this club during the week. These are considered "outside meetings" and STC has absolutely no financial interest or control in the club, yet it is one of the biggest pieces of the STC puzzle.
Clients ride their bikes to meetings at the Club and mix socially with the recovering members. Sponsors are obtained. These sponsors have no affiliation with STC, but the chances of the sponsor knowing about STC, or having once been a client at STC, are 95%. This is the point in the research where STC is shown to be an anomaly. One of the main reasons why STC would be impossible to duplicate is this proximity to the Club and the recovery community that has built up around the club.
In contrast to other treatment facilities, STC clients have a tendency to remain within a fifteen-mile radius of STC and the Club after they have been discharged from STC. This results in a recovery community consisting of countless former STC clients. This is not common. Of course, part of the lure is that Newport Beach is arguably one of the most beautiful places to live in the country. In addition, most of the client's come from outside the state of California. Many clients who had chosen to remain in town after treatment said that they liked the weather in California better than where they previously lived. However, the most common reason given by former STC clients for their decision to stay in the Newport Beach area was the recovery community.
Clients ride their bikes to meetings at the Club and mix socially with the recovering members. Sponsors are obtained. These sponsors have no affiliation with STC, but the chances of the sponsor knowing about STC, or having once been a client at STC, are 95%. This is the point in the research where STC is shown to be an anomaly. One of the main reasons why STC would be impossible to duplicate is this proximity to the Club and the recovery community that has built up around the club.
In contrast to other treatment facilities, STC clients have a tendency to remain within a fifteen-mile radius of STC and the Club after they have been discharged from STC. This results in a recovery community consisting of countless former STC clients. This is not common. Of course, part of the lure is that Newport Beach is arguably one of the most beautiful places to live in the country. In addition, most of the client's come from outside the state of California. Many clients who had chosen to remain in town after treatment said that they liked the weather in California better than where they previously lived. However, the most common reason given by former STC clients for their decision to stay in the Newport Beach area was the recovery community.
Labels: Spy-Games
Friday, January 18, 2008
Spy Games - Intelligence
The network of communications at STC is the key to its effective functioning. To ensure that information between staff members runs smoothly, there are countless intelligence reports, memos and briefings. Meetings are held continuously throughout the week to discuss each client's progress and treatment plan. Each Case Manager, along with other staff members who are a part of the team, has earned a California Addiction Treatment Certificate from an accredited college. This means that in addition to having knowledge the recovery process, each one also has two years of specialized training and education in drug and alcohol addictions. This advanced education, coupled with the Case Manager's own experience in recovery, is what enables STC to succeed in treating the alcoholic and addict where others have failed, even though they hold multiple advanced medical degrees and graduate degrees in psychiatry and psychology.
It is important to note again that 90% of the staff are former clients at STC. They know the routine, and they know most of the people in the local recovery community. So when clients attend meetings at the Club, they are surrounded by people who were or are clients or staff members at STC.
Clients are still required to get the usual AA sponsor, or mentor, outside of STC. The recovery community in Newport is the largest in the country according to Alcoholics Anonymous' Central Office in New York. Orange County, specifically Costa Mesa, has more recovery houses than any other place in the world. Because of the enormity of the community anonymity is almost nonexistent, which is another anomaly of STC. Everyone seems to know everyone else, if not by first name, than by face. If someone were to attend one of the thousands of recovery meetings that happen every day in Orange County, even for the first time, he/she would find it impossible to go unnoticed. There are "regulars" at every outside recovery meeting in the area. STC sends its clients to an outside AA meeting I will refer to as the Club.
It is important to note again that 90% of the staff are former clients at STC. They know the routine, and they know most of the people in the local recovery community. So when clients attend meetings at the Club, they are surrounded by people who were or are clients or staff members at STC.
Clients are still required to get the usual AA sponsor, or mentor, outside of STC. The recovery community in Newport is the largest in the country according to Alcoholics Anonymous' Central Office in New York. Orange County, specifically Costa Mesa, has more recovery houses than any other place in the world. Because of the enormity of the community anonymity is almost nonexistent, which is another anomaly of STC. Everyone seems to know everyone else, if not by first name, than by face. If someone were to attend one of the thousands of recovery meetings that happen every day in Orange County, even for the first time, he/she would find it impossible to go unnoticed. There are "regulars" at every outside recovery meeting in the area. STC sends its clients to an outside AA meeting I will refer to as the Club.
Labels: Spy-Games
Thursday, January 17, 2008
Spy Games - The Staff
The typical client at STC takes pride in his or her ability to outwit the program. The sad fact is that any client in any treatment facility, no matter how physically restrictive the facility is, will drink and use if they really want to. Alcoholics and addicts are notorious for being able to inebriate themselves in the most unlikely of places. A prison guard at Orange County Jail once informed the researcher that prisoners make alcohol out of any fruit they get their hands on. There are a number of stories at STC about clients drinking mouthwash, perfume and rubbing alcohol in an ignorant attempt to get high. The client who really wants to drink or use at STC will find a way to do so, no matter what restrictions and surveillances are utilized. But the object of the game for the staff at STC is to catch the client when they do, and then enforce consequences.
STC has recently implemented drug and alcohol urinalysis testing for every client, three times per week. The client is informed at the last minute about the test and is most often unaware of when the test will occur. On top of this mandatory testing throughout the week, a client is tested whenever he or she returns from a pass, or if they are suspected of being under the influence by a staff member. The obsessive drug and alcohol testing at STC is their solution to the problem of too much freedom. Constant random testing does not seem to alleviate relapses among the clients, but it does prevent them from getting away with it.
The alcoholic's cunningness and his cold-blooded ability to tell lies often makes the game of treatment a loosing battle. In researching the ability of a client to avoid being caught under the influence, I interviewed Slick Rick who admitted to the staff he had been using drugs while in the program. What was even more unusual than his voluntarily relapse admission was his ability to completely deceive the entire staff. Not only did he pass countless urinalysis testing, he also showed no outward signs of being under the influence. Normally, the staff, recovering alcoholics and addicts, is able to detect the smell of alcohol on a person's breath from across a room, or notice symptoms of drug use by looking at a person's eyes, but Slick Rick never missed a meeting and never presented any symptoms. The staff was baffled.
Despite constant inquiries and interrogations, Slick Rick was unwilling to admit how he had accomplished this. Only after I approached him and asked if he would allow me to interview him did he confidentially reveal his sorcery.
Every Tuesday morning at 6:30am, the house parents and Case Managers meet to discuss the clients. During this meeting the House Parents, or House Agents as they will be called for the purposes of this report, give their account of each individual client's progress. The House Agents actually live with the clients and so they are privilege to information about the clients that no other staff member is privilege to. Time spent with the clients in their everyday existence at STC is what makes the field agents the most valuable information sources. The House Agents, drivers, and meeting monitors also have tickets they can issue that are called "write-ups," a very useful weapon in negative reinforcement.
The write-up can be compared to a traffic ticket. If the field agent witnesses any infraction, the client who committed the infraction is written-up. Infractions can include everything from leaving a coffee cup on a table in the morning, to fraternizing with a female or male client. The write-ups are important to the case managers because it lets them know if their client is misbehaving. Every bit of information about a client's actions is gold for the analysts at STC. A write-up for a missed meeting for instance, sends a warning flag up to half-mast. Two write-ups for the same behavior sends the warning flag to the top; and three write-ups for missing a meeting sounds an alarm. The consequences for being written-up the first time involves deducting half the amount of money the client receives as an allowance three times every week (usually $75 per week). Two write-ups result in no allowance; and three write-ups require the client to attend extra meetings.
The paperwork at STC is critical to keeping track of a client's progress. There are forms to be filled out for everything including money, deviations from the normal schedule, passes to leave STC for any period of time, progress reports from Case Managers, progress reports from house agents, and progress reports from the clients themselves. All of these reports must be signed by the Director of Operations, the Program Director, and the client's Case Manager.
Even more important than the paperwork is the communication among the staff. The Motorola two-way cellular phones every staff member is issued are the most important communication instruments utilized at STC. Instantly, staff members can communicate. The loud beeps that signal a staff member to answer his or her radio produce a symphony of annoying noises throughout the day at the Center.
Also important to communication and client intelligence is a new computer program, developed specifically for case managers at treatment facilities. The program is similar to the White House's internal e-mail system called PROF. It is designed to allow case managers throughout STC to communicate internally about their clients. Progress reports are written directly into the system from the Case Manager's computer and other Case Managers are able to access the reports. Only Case Managers with special clearance have access to these files because they are highly confidential.
STC has recently implemented drug and alcohol urinalysis testing for every client, three times per week. The client is informed at the last minute about the test and is most often unaware of when the test will occur. On top of this mandatory testing throughout the week, a client is tested whenever he or she returns from a pass, or if they are suspected of being under the influence by a staff member. The obsessive drug and alcohol testing at STC is their solution to the problem of too much freedom. Constant random testing does not seem to alleviate relapses among the clients, but it does prevent them from getting away with it.
The alcoholic's cunningness and his cold-blooded ability to tell lies often makes the game of treatment a loosing battle. In researching the ability of a client to avoid being caught under the influence, I interviewed Slick Rick who admitted to the staff he had been using drugs while in the program. What was even more unusual than his voluntarily relapse admission was his ability to completely deceive the entire staff. Not only did he pass countless urinalysis testing, he also showed no outward signs of being under the influence. Normally, the staff, recovering alcoholics and addicts, is able to detect the smell of alcohol on a person's breath from across a room, or notice symptoms of drug use by looking at a person's eyes, but Slick Rick never missed a meeting and never presented any symptoms. The staff was baffled.
Despite constant inquiries and interrogations, Slick Rick was unwilling to admit how he had accomplished this. Only after I approached him and asked if he would allow me to interview him did he confidentially reveal his sorcery.
Every Tuesday morning at 6:30am, the house parents and Case Managers meet to discuss the clients. During this meeting the House Parents, or House Agents as they will be called for the purposes of this report, give their account of each individual client's progress. The House Agents actually live with the clients and so they are privilege to information about the clients that no other staff member is privilege to. Time spent with the clients in their everyday existence at STC is what makes the field agents the most valuable information sources. The House Agents, drivers, and meeting monitors also have tickets they can issue that are called "write-ups," a very useful weapon in negative reinforcement.
The write-up can be compared to a traffic ticket. If the field agent witnesses any infraction, the client who committed the infraction is written-up. Infractions can include everything from leaving a coffee cup on a table in the morning, to fraternizing with a female or male client. The write-ups are important to the case managers because it lets them know if their client is misbehaving. Every bit of information about a client's actions is gold for the analysts at STC. A write-up for a missed meeting for instance, sends a warning flag up to half-mast. Two write-ups for the same behavior sends the warning flag to the top; and three write-ups for missing a meeting sounds an alarm. The consequences for being written-up the first time involves deducting half the amount of money the client receives as an allowance three times every week (usually $75 per week). Two write-ups result in no allowance; and three write-ups require the client to attend extra meetings.
The paperwork at STC is critical to keeping track of a client's progress. There are forms to be filled out for everything including money, deviations from the normal schedule, passes to leave STC for any period of time, progress reports from Case Managers, progress reports from house agents, and progress reports from the clients themselves. All of these reports must be signed by the Director of Operations, the Program Director, and the client's Case Manager.
Even more important than the paperwork is the communication among the staff. The Motorola two-way cellular phones every staff member is issued are the most important communication instruments utilized at STC. Instantly, staff members can communicate. The loud beeps that signal a staff member to answer his or her radio produce a symphony of annoying noises throughout the day at the Center.
Also important to communication and client intelligence is a new computer program, developed specifically for case managers at treatment facilities. The program is similar to the White House's internal e-mail system called PROF. It is designed to allow case managers throughout STC to communicate internally about their clients. Progress reports are written directly into the system from the Case Manager's computer and other Case Managers are able to access the reports. Only Case Managers with special clearance have access to these files because they are highly confidential.
Labels: Spy-Games
Wednesday, January 16, 2008
Spy Games - The Clients
Understanding the types of clients STC must deal with on a daily basis is one more step towards understanding why surveillance and constant intelligence information is necessary. The clients are not unusual; in fact they are typical of the breed of humans called alcoholics. To call them a breed, or refer to them as psychopaths is not politically incorrect, or even unscientific for that matter, because the characteristics of the psychopath and the alcoholic are eerily similar. Robert Hare's Psychopathy Checklist is currently the most popular diagnostic tool for measuring criminal psychopathy. Although the diagnostic term "psychopathy" is no longer used in the psychiatric field, Hare's characteristics remain a useful diagnostic tool. The behavioral characteristics on Hare's Checklist of the psychopath are: Glibness, superficial charm, grandiose sense of self worth, pathological lying, conning, manipulative, lack of remorse or guilt, shallow affect, callous, lack of empathy, failure to accept responsibility for actions, promiscuous sexual behavior, lack of realistic goals, poor behavioral controls, high need for stimulation, prone to boredom, and irresponsibility. According to John Burnham M.D., a psychiatrist practicing in Newport Beach, who works with many recovering alcoholics and addicts, "these characteristics could easily be applied to the alcoholic and addict."
The typical alcoholic or addict at STC is white, middle to upper class; between the ages of 18 and 45, and educated to some degree (many current clients during this research study had their undergraduate and graduate degrees). These are general characteristics of STC clients, but the diversity can be extremely varied at any given time. No matter what the nationality, education, or financial background of the client, the psychopathology described by Hare can be applied to almost all of them. Because the alcoholic has these traits, the counselor treating the alcoholic must be highly trained in lie detection, criminal behavior, and psychosocial deviance to effectively treat the alcoholic. To find a counselor who is equipped with all of these attributes might sound impossible, but fortunately there are people who can beat the alcoholics at their own game, namely other recovered alcoholics.
The typical alcoholic or addict at STC is white, middle to upper class; between the ages of 18 and 45, and educated to some degree (many current clients during this research study had their undergraduate and graduate degrees). These are general characteristics of STC clients, but the diversity can be extremely varied at any given time. No matter what the nationality, education, or financial background of the client, the psychopathology described by Hare can be applied to almost all of them. Because the alcoholic has these traits, the counselor treating the alcoholic must be highly trained in lie detection, criminal behavior, and psychosocial deviance to effectively treat the alcoholic. To find a counselor who is equipped with all of these attributes might sound impossible, but fortunately there are people who can beat the alcoholics at their own game, namely other recovered alcoholics.
Labels: Spy-Games
Tuesday, January 15, 2008
Spy Games - Surveylance: Let The Spy Games Begin
"In the end, intelligence (the spy kind), boils down to people,". In jails, prisons, psychiatric hospitals and other treatment centers, surveillance is not as difficult and does not require as much skill as it does at STC. Because rehabilitation is spread over the Newport Beach peninsula, and because clients are given a mountain bike and freedom to roam, information gathering and monitoring turns into a spy game. Intelligence and control are the most unique and uncharacteristic aspects of STC. It is a game knowing what clients are doing and how their treatment is proceeding. Rehabilitating alcoholics and drug addicts is a tricky business. Generally accepted, although not scientifically proven, the only way to treat an addict is with another addict. This is "one alcoholic talking to another alcoholic." There are many reasons for this, but the main ones is why that if a staff member is an alcoholic/addict, he or she has all of the behavioral characteristics of the addicted psychopath, as noted earlier, and he or she is capable of fooling the most skilled psychiatric profiler. "It takes one to know one" is perfectly applicable to the client/staff relationship at STC. Even more beneficial to the staff's intelligence and surveillance gathering ability is the fact that 90% of them were also clients at STC. The staff therefore are inherently skilled at deciphering the alcoholic/addict's behavior and dismissing their lies. But even with these acquired superpowers, beating the alcoholic/addict at his or her game is a gigantic undertaking not easily achieved in a facility as geographically complicated as STC.
Each of the sober houses is monitored by a staff member during the day. Routine checks of the house are called "sweeps." The sweeps are designed to monitor attendance at scheduled group meetings and required activities. The Field Agent goes from house to house to catch truancy and to check on the cleanliness of the houses (a mandatory rule a STC is organization and cleanliness). If a Field Agents finds a client at home, he or she is immediately confronted and ordered to go to the designated activity. Sweeps occur everyday at 9am, 12pm, 3pm, 10pm, and 11pm.
In addition to theses sweeps, each meeting, whether held at the Center or at the local AA club, is monitored by a Field Agent. If any of the STC clients are missing, a phone call to the client's house is made and a field agent is sent immediately dispatched. Whether the client eventually attends to the meeting or not, he or she is "written-up" by the Field Agent. In this way, every staff member is made aware of the client's deviant behavior.
The owner of STC, who started with only a few houses, has set the tone of communications. "The meeting starts before the meeting. If you want to know what's going on around here, then you show up before the meeting." This statement can be applied to all staff meetings. A great deal of information is gathered about clients while staff employees are standing around the coffee pot waiting for one of the many staff meetings to begin. "We keep more people in the loop than in most places," the owner comments.
Mark is a new marketing representative at STC who previously worked at The Betty Ford Center and has, like many others, come to regard STC as an amazing facility. "At first I was skeptical, as many people are from other facilities, about how organized and structured STC is." Rick who is working in the STC marketing department after working at another treatment facility in the area, says, "Most other recovery programs, or professionals, view STC as a bunch of halfway houses where people use during the day and fake it at night. Now I know that it's not like that at all. It's highly structured and full of potential."
Gathering surveillance on clients at STC is a large part of the program's success. Clients are carefully, consistently monitored in their natural environment, and usually unaware they are being watched. This is possible due to the panoptical surveillance posts within the Center. From the Executive Director's second-story office, one can look down onto the patio area where clients congregate to smoke and talk. Not only can everything be observed, it can be heard.
All of the Center's windows are tinted to a mirror like shine on the outside, making it impossible for people to see what is going on inside. The staff knows what's going on outside the office without the clients knowing they know. Even sexual liaisons, forbidden, can be discovered. A casual glance, a too-long look, even body language can and is noted for information to help the recovery process. Observation of the client's behavior at outside meetings is also an important part of monitoring clients and gathering intelligence. The meeting monitors can watch the client's interact during meeting breaks at the Beach Club (the outside meeting place) and observe client's interactions, loners who are not connecting with the group, and clients who attempt to leave the meeting early, or arrive late.
Another factor that aids surveillance is the proximity of the staff's private living quarters to the STC community. The Field Officer Director and Director of Intelligence, for lack of a better term, lives next-door to one of the sober houses. Other staff members live either within the peninsula, or close by. This creates an unusual and beneficial situation. Often a client will be shopping at a grocery store, buying coffee at Starbucks, or riding his or her bike on the boardwalk and come into contact with an off-duty staff member. It's easy to come into contact with two to three staff members who are doing the same thing. Sometimes the client does not know the staff members are watching, which gives the staff member a distinct advantage. In any field study or research situation, the best behavioral information is gathered when the subjects have no idea they are being studied.
Each of the sober houses is monitored by a staff member during the day. Routine checks of the house are called "sweeps." The sweeps are designed to monitor attendance at scheduled group meetings and required activities. The Field Agent goes from house to house to catch truancy and to check on the cleanliness of the houses (a mandatory rule a STC is organization and cleanliness). If a Field Agents finds a client at home, he or she is immediately confronted and ordered to go to the designated activity. Sweeps occur everyday at 9am, 12pm, 3pm, 10pm, and 11pm.
In addition to theses sweeps, each meeting, whether held at the Center or at the local AA club, is monitored by a Field Agent. If any of the STC clients are missing, a phone call to the client's house is made and a field agent is sent immediately dispatched. Whether the client eventually attends to the meeting or not, he or she is "written-up" by the Field Agent. In this way, every staff member is made aware of the client's deviant behavior.
The owner of STC, who started with only a few houses, has set the tone of communications. "The meeting starts before the meeting. If you want to know what's going on around here, then you show up before the meeting." This statement can be applied to all staff meetings. A great deal of information is gathered about clients while staff employees are standing around the coffee pot waiting for one of the many staff meetings to begin. "We keep more people in the loop than in most places," the owner comments.
Mark is a new marketing representative at STC who previously worked at The Betty Ford Center and has, like many others, come to regard STC as an amazing facility. "At first I was skeptical, as many people are from other facilities, about how organized and structured STC is." Rick who is working in the STC marketing department after working at another treatment facility in the area, says, "Most other recovery programs, or professionals, view STC as a bunch of halfway houses where people use during the day and fake it at night. Now I know that it's not like that at all. It's highly structured and full of potential."
Gathering surveillance on clients at STC is a large part of the program's success. Clients are carefully, consistently monitored in their natural environment, and usually unaware they are being watched. This is possible due to the panoptical surveillance posts within the Center. From the Executive Director's second-story office, one can look down onto the patio area where clients congregate to smoke and talk. Not only can everything be observed, it can be heard.
All of the Center's windows are tinted to a mirror like shine on the outside, making it impossible for people to see what is going on inside. The staff knows what's going on outside the office without the clients knowing they know. Even sexual liaisons, forbidden, can be discovered. A casual glance, a too-long look, even body language can and is noted for information to help the recovery process. Observation of the client's behavior at outside meetings is also an important part of monitoring clients and gathering intelligence. The meeting monitors can watch the client's interact during meeting breaks at the Beach Club (the outside meeting place) and observe client's interactions, loners who are not connecting with the group, and clients who attempt to leave the meeting early, or arrive late.
Another factor that aids surveillance is the proximity of the staff's private living quarters to the STC community. The Field Officer Director and Director of Intelligence, for lack of a better term, lives next-door to one of the sober houses. Other staff members live either within the peninsula, or close by. This creates an unusual and beneficial situation. Often a client will be shopping at a grocery store, buying coffee at Starbucks, or riding his or her bike on the boardwalk and come into contact with an off-duty staff member. It's easy to come into contact with two to three staff members who are doing the same thing. Sometimes the client does not know the staff members are watching, which gives the staff member a distinct advantage. In any field study or research situation, the best behavioral information is gathered when the subjects have no idea they are being studied.
Labels: Spy-Games
Friday, January 11, 2008
Spy Games - How It Works
A client may be referred to STC from a primary care facility (e.g. The Betty Ford Center) and literally brought to the doorstep. With his/her belongings in duffle bags and the ubiquitous cigarette dangling, the clients are admitted. The intake process requires extensive paper work, pictures taken with a Polaroid, and meetings with directors and their particular Case Manager. The initial questionnaire provides the first intelligence information on specific addictions and personality issues. The client must reveal which drugs are preferred, how often, and in what form (intravenously, orally, or inhalation), in addition to providing basic information like age, sexual history, family systems, and so forth.
The Case Manager quickly becomes a most trusted friend or the worst enemy within days of admittance. He or she will be the one to processes the information the client provides and produce a written assessment that becomes part of a permanent dossier, the first step in "intelligence gathering."
After the initial in-take sessions, the client is placed into one of 13 houses STC manages. An "intake house" holds clients who have less than thirty days of sobriety. Client placement strategy is elusive to say the least. Only the Director of Operations has the authority to move clients from one house to another, and sometimes there seems to be no rhyme or reason for the moves. A client may be relocated three or four times during their 90-day stay. Problems with house mates can be a reason for changing, power struggles account for a few, but in most cases, the Directors oversee the progress and confers with the House Parent as to where the client would be most successful in his bid for sobriety.
The Director of Operations oversees all decisions and all special operations, backs all the tactics of his "field agents." The term "field agent" will be used to describe any staff employee who is not involved in the clinical side of treatment. It is interesting to note the length that the D.O. will go if forced to defend one of his staff members. In an effort to manipulate, clients have become skilled in lying and spreading misinformation to parents in order to achieve their own goals. STC is adept at running through the obstacle courses thrown up by disenfranchised addicts and their enabling parents.
This brings up the issue of parental involvement. Much of the clinical and operational staff's time is spent on dealing with parents. There are times when it is necessary for parents to receive more clinical attention from a client's case Manager than the client receives. More often than not, it seems the parents need treatment as much as their addicted children.
The Case Manager quickly becomes a most trusted friend or the worst enemy within days of admittance. He or she will be the one to processes the information the client provides and produce a written assessment that becomes part of a permanent dossier, the first step in "intelligence gathering."
After the initial in-take sessions, the client is placed into one of 13 houses STC manages. An "intake house" holds clients who have less than thirty days of sobriety. Client placement strategy is elusive to say the least. Only the Director of Operations has the authority to move clients from one house to another, and sometimes there seems to be no rhyme or reason for the moves. A client may be relocated three or four times during their 90-day stay. Problems with house mates can be a reason for changing, power struggles account for a few, but in most cases, the Directors oversee the progress and confers with the House Parent as to where the client would be most successful in his bid for sobriety.
The Director of Operations oversees all decisions and all special operations, backs all the tactics of his "field agents." The term "field agent" will be used to describe any staff employee who is not involved in the clinical side of treatment. It is interesting to note the length that the D.O. will go if forced to defend one of his staff members. In an effort to manipulate, clients have become skilled in lying and spreading misinformation to parents in order to achieve their own goals. STC is adept at running through the obstacle courses thrown up by disenfranchised addicts and their enabling parents.
This brings up the issue of parental involvement. Much of the clinical and operational staff's time is spent on dealing with parents. There are times when it is necessary for parents to receive more clinical attention from a client's case Manager than the client receives. More often than not, it seems the parents need treatment as much as their addicted children.
Labels: Drug-Addiction-Rehab, Spy-Games, teen-drug-abuse
Thursday, January 10, 2008
Spy Games - The Treatment Center
The treatment center is a 90-day residential facility owned by Larry Smith and his wife Linda. Underneath the umbrella of STC are varied treatment programs specializing in specific addictions, such as eating disorders, depression, and sexual/chemical addictions. The program began as an extended care facility, but has since evolved into a multi-functional, highly successful rehabilitation program. The unique setting coupled with highly enviable success make STC worthy of investigation.
The program is fundamentally unique because its facilities are scattered throughout a beach community well known for wild parties. Primary care facilities for drug and alcohol treatment are usually places in remote areas and clients are restricted to the facility's grounds.
The Betty Ford Center is in the middle of a desert area surrounded by brick walls and guard gates at every entrance. Promises of Malibu is perched on top of a mountain top at the end of a long, gated driveway surrounded by thick, impenetrable shrubbery. In contrast, STC is an open facility located within the city of Newport Beach, California. Accordingly, clients can’t be confined to the grounds of the treatment center. There are no walls, no gates and no guards to keep them from leaving the city or entering the local bars and clubs. But despite this geographical spaciousness and freedom, STC is able to monitor its clients effectively.
STC is divided into individual sober-living houses along a one-mile stretch of beach front property anchored by the agora of the "Center". Each of the 80 clients must travel every day to the Center for group sessions, individual counseling, and various required activities. Throughout the 90-day rehabilitative process, the Center is the hub of the clients' re-entry therapy and discipline.
STC' title as "extended care" drug and alcohol treatment means that the length of stay is longer than other rehabilitation centers offer. For example, the Promises and The Betty Ford Center are both 28-day treatment programs, whereas STC is essentially a 90-day program. In addition, the clients enter STC after their stay at a 28-day primary care facility like Promises or Betty Ford. It should be noted that for the addict, "ninety day treatment" is a gross misnomer, and at STC, the average client stays at least six months. Many remain for over a year to ensure their recovery.
The program is fundamentally unique because its facilities are scattered throughout a beach community well known for wild parties. Primary care facilities for drug and alcohol treatment are usually places in remote areas and clients are restricted to the facility's grounds.
The Betty Ford Center is in the middle of a desert area surrounded by brick walls and guard gates at every entrance. Promises of Malibu is perched on top of a mountain top at the end of a long, gated driveway surrounded by thick, impenetrable shrubbery. In contrast, STC is an open facility located within the city of Newport Beach, California. Accordingly, clients can’t be confined to the grounds of the treatment center. There are no walls, no gates and no guards to keep them from leaving the city or entering the local bars and clubs. But despite this geographical spaciousness and freedom, STC is able to monitor its clients effectively.
STC is divided into individual sober-living houses along a one-mile stretch of beach front property anchored by the agora of the "Center". Each of the 80 clients must travel every day to the Center for group sessions, individual counseling, and various required activities. Throughout the 90-day rehabilitative process, the Center is the hub of the clients' re-entry therapy and discipline.
STC' title as "extended care" drug and alcohol treatment means that the length of stay is longer than other rehabilitation centers offer. For example, the Promises and The Betty Ford Center are both 28-day treatment programs, whereas STC is essentially a 90-day program. In addition, the clients enter STC after their stay at a 28-day primary care facility like Promises or Betty Ford. It should be noted that for the addict, "ninety day treatment" is a gross misnomer, and at STC, the average client stays at least six months. Many remain for over a year to ensure their recovery.
Labels: Spy-Games
Wednesday, January 9, 2008
Spy Games - Methodology
The method of inquiry involves observations of the daily operations of the staff and clients at the facility. Interviews of the staff and clients, as well as information gleaned from the facility's archives, some of which included opinions on the treatment center written by the clients after being discharged (names and places changed to protect anonymity). Direct observations, as well as case studies will be used to determine the effectiveness of the program. The term "addict/alcoholic" will refer to those persons who have an alcohol problem and/or a drug problem commonly referred to as "dually addicted."
Labels: Spy-Games
Tuesday, January 8, 2008
Spy Games - Inside a Drug and Alcohol Treatment Facility
It is a full moon on a Saturday night in Newport Beach, California. Every crime except murder increase during a full moon and tonight is no exception. Jim, a tattooed and weathered man in his late fifties, or maybe is early thirties, its hard to tell with recovering drug addicts and alcoholics, is sitting at his station in a building which has come to be known simply as the "Center" when his Motorola cell phone/two way radio beeps loudly. Jim reaches into his holster, pulls out his cell phone and holds it up to his ear in one swift motion. He presses down on the talk button and waits for a beep. "Yeah, this is Jim." Another loud beep. "This is Mark, I'm over at the 48th Street house and there's no sign of Scott." Jim sighs, "It's still only ten minutes past curfew, swing by on your way back from sweeps and check again." Beep. "I asked his roommates if they knew where he was and they were being quiet about it." Jim's mind starts racing and he immediately shifts gears. "Alright, I was worried about this. I think he went off with Sabrina after the meeting tonight. They were acting strange, and I knew something was up." Beep. "So what do you want me to do?" Beep. "Search his room, leave a note on his bed for him to call me, and make sure you keep your phone on. I'll get back to you."
Jim sits back in his chair and thinks for a moment before dialing a number on his phone. "Hey, this is Jim, is Sabrina there? She isn't. Where is she? You don't know." Jim's tone takes on a knowing sarcasm. "You know where she is, so just tell me. Is she with Scott? That's what I thought." Jim switches back to his radio and beeps John, another field agent who is always out on the streets patrolling the local area. "Yeah John, this is Jim, I need you to hunt down Scott and Sabrina, it looks like they're running. Remember that Scott has overdosed on Heroin three times before he came to us so be ready." Beep. "I think I know where to look for them. I'll take care of it." John signs off. Not twenty minutes go by before a John's signature black Chevrolet pulls up in front of the Center and Scott and Sabrina, two white, middle-class twenty year olds, spill out onto the sidewalk. John gets out of his car smiling as Sabrina vomits into the gutter. "Where did you find them?" Jim asks. "They were trying to hitchhike their way back from a bar in the next town. They didn't put up much of a fight. They knew they were caught. It looks like Sabrina just tried heroin for the first time." Sabrina moans as she bends over at the waist in anticipation of further rebellion from her stomach. Jim beeps someone with his radio and only a beat goes by before Mark's voice can be heard. "Did you find them?" "Yeah John just brought them back, but they're going to need a ride to detox." "I'll be there in five minutes." Jim slips his phone back into its holster with a smile. Then, turning to Scott and Sabrina, he says, "You should know by now that you were going to get caught. Now you'll have time to think about your actions at the Ranch." Jim looks at Scott who is hanging his head in shame. Sabrina looks worse. Jim bends down to check her vitals. "I feel like I'm going to die," Sabrina manages to get out. "Not tonight you won't. You'll be alright," Jim says. Within ten minutes, two field agents pull up in front of the Center. The man loads Scott into his car, the woman takes Sabrina. Within the next hour, both clients will be packed and moved out of their houses in Newport Beach. They will spend the next week in two different lock down facilities specializing in harder to reach Steps Treatment Center clients. A strangely unique drug and alcohol treatment facility, STC takes pride in their covert tactics and control measures.
When The Betty Ford Center is mentioned in conversation, most people know what it is. And lately, Promises in Malibu has been featured in the media because of its famous clients. But these are just two of the many 28-day inpatient drug and alcohol rehabilitation facilities that have sprung up all over the country. One of these is the low-profile STC, a unique facility that began in 1986 and is now one of the largest and most complicated rehabilitation centers in the United States. The facility boasts one of the highest success rate in the country. But there are questions about the effectiveness of a program that is as enigmatic and unrestrictive as STC. To many outside observers in the recovery industry, STC is a mystery, called into question ever since its inception many years ago. This is the subject of the inquiry: How does the treatment program work? Does the open format work as effectively as they claim it does? An investigation of the inner organization will discover whether this type of drug and alcohol rehabilitation program can maintain the kind of daily observation and monitoring that other facilities find imperative to treating the addict.
Jim sits back in his chair and thinks for a moment before dialing a number on his phone. "Hey, this is Jim, is Sabrina there? She isn't. Where is she? You don't know." Jim's tone takes on a knowing sarcasm. "You know where she is, so just tell me. Is she with Scott? That's what I thought." Jim switches back to his radio and beeps John, another field agent who is always out on the streets patrolling the local area. "Yeah John, this is Jim, I need you to hunt down Scott and Sabrina, it looks like they're running. Remember that Scott has overdosed on Heroin three times before he came to us so be ready." Beep. "I think I know where to look for them. I'll take care of it." John signs off. Not twenty minutes go by before a John's signature black Chevrolet pulls up in front of the Center and Scott and Sabrina, two white, middle-class twenty year olds, spill out onto the sidewalk. John gets out of his car smiling as Sabrina vomits into the gutter. "Where did you find them?" Jim asks. "They were trying to hitchhike their way back from a bar in the next town. They didn't put up much of a fight. They knew they were caught. It looks like Sabrina just tried heroin for the first time." Sabrina moans as she bends over at the waist in anticipation of further rebellion from her stomach. Jim beeps someone with his radio and only a beat goes by before Mark's voice can be heard. "Did you find them?" "Yeah John just brought them back, but they're going to need a ride to detox." "I'll be there in five minutes." Jim slips his phone back into its holster with a smile. Then, turning to Scott and Sabrina, he says, "You should know by now that you were going to get caught. Now you'll have time to think about your actions at the Ranch." Jim looks at Scott who is hanging his head in shame. Sabrina looks worse. Jim bends down to check her vitals. "I feel like I'm going to die," Sabrina manages to get out. "Not tonight you won't. You'll be alright," Jim says. Within ten minutes, two field agents pull up in front of the Center. The man loads Scott into his car, the woman takes Sabrina. Within the next hour, both clients will be packed and moved out of their houses in Newport Beach. They will spend the next week in two different lock down facilities specializing in harder to reach Steps Treatment Center clients. A strangely unique drug and alcohol treatment facility, STC takes pride in their covert tactics and control measures.
When The Betty Ford Center is mentioned in conversation, most people know what it is. And lately, Promises in Malibu has been featured in the media because of its famous clients. But these are just two of the many 28-day inpatient drug and alcohol rehabilitation facilities that have sprung up all over the country. One of these is the low-profile STC, a unique facility that began in 1986 and is now one of the largest and most complicated rehabilitation centers in the United States. The facility boasts one of the highest success rate in the country. But there are questions about the effectiveness of a program that is as enigmatic and unrestrictive as STC. To many outside observers in the recovery industry, STC is a mystery, called into question ever since its inception many years ago. This is the subject of the inquiry: How does the treatment program work? Does the open format work as effectively as they claim it does? An investigation of the inner organization will discover whether this type of drug and alcohol rehabilitation program can maintain the kind of daily observation and monitoring that other facilities find imperative to treating the addict.
Labels: Drug-Addiction-Rehab, Spy-Games
Monday, January 7, 2008
Jails and Prisons - Why Drug Policy Can Not End Drug Use
Drug policy can not end drug use for the same reason that criminal justice policy can not end crime. The core of the problem, the root cause, is ignored. Some policies even create more crime than it prevents. The drug laws in this country, although designed to decrease criminal activity, actually create more of it according to many criminologists. "We should return the treatment of addicts to the medical profession" and stop relying on the criminal justice system to solve the problems of society and the individual. One of the biggest problems with the criminal justice system is that we as a society depend on the government to handle and solve problems that it was never designed to handle or solve.
"In America, crime does pay because our nation's prison system is not working". The nation's prison system is not working because we expect too much from it. According to the 1967 President's Commission on Law Enforcement and Administration of Justice report, the justice system is only intended to "enforce the standards of conduct necessary to protect individuals and the community".
Mathew B. Robinson, author of Justice Blind? Ideals and Realities of American Criminal Justice, has thoroughly investigated what the main goals of the criminal justice system are supposed to be and so far as he can conclude, the two main goals of the criminal justice system are "doing justice" and "reducing crime". Both goals are wrought with conflicting elements, but reducing crime, although a criminal justice goal, is not a power that congress is indwelled with explicitly. This is one of the central problems with our attitude towards crime. We expect the government to engage in crime control, even though it is not designed to do so, only because since the 1960's crime control has increasingly become a national issue as a consequence of the politicization of crime in elections and the media's coverage of crime.
The criminal justice system is doing the only thing it can to prevent crime and enforce laws. It does not succeed in preventing crime because it is not designed to do so. The root causes of crime are far too complex and go far too deep for the bandage of criminal justice to cover and heal. It will take major surgery by qualified professionals to truly prevent crime and the cooperation and coalesced effort of American society to cure it.
Brendan Bickley
A.S., B.A., C.A.T.S., CADC II, Doctoral Candidate
Director of Education Morningside Recovery
"In America, crime does pay because our nation's prison system is not working". The nation's prison system is not working because we expect too much from it. According to the 1967 President's Commission on Law Enforcement and Administration of Justice report, the justice system is only intended to "enforce the standards of conduct necessary to protect individuals and the community".
Mathew B. Robinson, author of Justice Blind? Ideals and Realities of American Criminal Justice, has thoroughly investigated what the main goals of the criminal justice system are supposed to be and so far as he can conclude, the two main goals of the criminal justice system are "doing justice" and "reducing crime". Both goals are wrought with conflicting elements, but reducing crime, although a criminal justice goal, is not a power that congress is indwelled with explicitly. This is one of the central problems with our attitude towards crime. We expect the government to engage in crime control, even though it is not designed to do so, only because since the 1960's crime control has increasingly become a national issue as a consequence of the politicization of crime in elections and the media's coverage of crime.
The criminal justice system is doing the only thing it can to prevent crime and enforce laws. It does not succeed in preventing crime because it is not designed to do so. The root causes of crime are far too complex and go far too deep for the bandage of criminal justice to cover and heal. It will take major surgery by qualified professionals to truly prevent crime and the cooperation and coalesced effort of American society to cure it.
Brendan Bickley
A.S., B.A., C.A.T.S., CADC II, Doctoral Candidate
Director of Education Morningside Recovery
Labels: incarceration
Friday, January 4, 2008
Jails and Prisons - Is Crime Increasing
The statistics report that crime is increasing, but depending on whom you ask, crime rates are the same as they have always been. There are many variables that must be considered when looking at criminal justice statistics and many questions that must be asked. Who is reporting the crimes? What crimes are being reported? What do certain groups have to gain or loose by reporting higher crime rates?
Police are hired to prevent and contain crime, and yet if they fail to do so (i.e. by showing that crime is increasing), then they have grounds to ask for expansion. After all, the police depend on crime for job security. New laws restricting certain behaviors can cause an increase in crime rates. More police to catch more criminals can also cause an increase in crime rates. The war on drugs is a good example of criminal justice policy that creates the illusion of rising drug trafficking. As Jesilow and Pepinski point out, "how much the amount of illicit drug traffic has increased is determined by how much officials find; and, how much they find depends on how hard they look". Mathew B. Robinson, in his book Justice Blind? Ideals and Realities of American Criminal Justice, says, "Given the current limits of the criminal justice system, it is difficult to catch, convict, and punish criminal offenders". Does this mean that we should increase police, prosecutors, and prisons? We could increase the capacity of the criminal justice system, but it would not be the solution to crime that the country so desperately needs and often demands from the government.
System capacity is related to the perception of rising crime rates. The larger the criminal justice system becomes, the more criminals they can process. Because police are responsible for reporting the crimes, there have been allegations that they are bias in their reports. Pepinsky and Jesilow believe that there is little doubt whether the criminal justice system creatively adjusts the numbers to reflect rising or falling crime rates depending on their financial needs. "It is questionable whether Americans need more police protection now than ever; it is unquestionable that criminologists have conspired to make it appear that way". There may not be more crime at all. There is no way of knowing for sure. "Crime statistics, then, tell us how citizens and officials are responding to crime, but not how big the crime problem itself is". One look at the numbers of inmates admitted to prison and released from prison in the same year gives a clear picture of our system's capacity to handle criminals.
2001 Admissions / Releases
U.S. Total 639,569/630,207
Federal 45,140/38,370
State 594,429/591,837
If the criminal justice system were not functioning at maximum system capacity, the admissions and releases would not resemble each other so closely. These figures often ignite passionate fires within people for stricter sentences and mandatory minimum sentences, but that would be throwing more gasoline on an already uncontrollable fire.
Police are hired to prevent and contain crime, and yet if they fail to do so (i.e. by showing that crime is increasing), then they have grounds to ask for expansion. After all, the police depend on crime for job security. New laws restricting certain behaviors can cause an increase in crime rates. More police to catch more criminals can also cause an increase in crime rates. The war on drugs is a good example of criminal justice policy that creates the illusion of rising drug trafficking. As Jesilow and Pepinski point out, "how much the amount of illicit drug traffic has increased is determined by how much officials find; and, how much they find depends on how hard they look". Mathew B. Robinson, in his book Justice Blind? Ideals and Realities of American Criminal Justice, says, "Given the current limits of the criminal justice system, it is difficult to catch, convict, and punish criminal offenders". Does this mean that we should increase police, prosecutors, and prisons? We could increase the capacity of the criminal justice system, but it would not be the solution to crime that the country so desperately needs and often demands from the government.
System capacity is related to the perception of rising crime rates. The larger the criminal justice system becomes, the more criminals they can process. Because police are responsible for reporting the crimes, there have been allegations that they are bias in their reports. Pepinsky and Jesilow believe that there is little doubt whether the criminal justice system creatively adjusts the numbers to reflect rising or falling crime rates depending on their financial needs. "It is questionable whether Americans need more police protection now than ever; it is unquestionable that criminologists have conspired to make it appear that way". There may not be more crime at all. There is no way of knowing for sure. "Crime statistics, then, tell us how citizens and officials are responding to crime, but not how big the crime problem itself is". One look at the numbers of inmates admitted to prison and released from prison in the same year gives a clear picture of our system's capacity to handle criminals.
2001 Admissions / Releases
U.S. Total 639,569/630,207
Federal 45,140/38,370
State 594,429/591,837
If the criminal justice system were not functioning at maximum system capacity, the admissions and releases would not resemble each other so closely. These figures often ignite passionate fires within people for stricter sentences and mandatory minimum sentences, but that would be throwing more gasoline on an already uncontrollable fire.
Labels: incarceration
Thursday, January 3, 2008
Jails and Prisons - The Myth of Fear
The publics attitude toward crime and criminals plays a major role in the development of criminal justice policy and has lead to many of the laws that are causing the prison's and jails to burst at the seams today. There is a market for fear. Fear of crime and criminals has led to mandatory minimum sentencing, three strikes laws, and an increase in the number of police officers roaming the streets. Most of the people in prison and jail are there for crimes that lack any of the elements that the public believes are serious or that they associate with dangerous criminals. In 1995, when California was at the height of its fear of violent criminals, only 40 percent of California's prison population was incarcerated for a violent offense as opposed to 60 percent incarcerated for nonviolent offenses, which involve property and drug-related offenses. The numbers rarely match the media's portrayal and the publics perception of violent crime.
There are many myths about crime that pervade society and undoubtedly help to shape criminal justice policy that must be revealed and absorbed if we are ever to change things for the better.
Paul Jesilow and Harold E. Pepinsky have outlined ten different crime myths:
1) Crime is increasing,
2) Most crime is committed by the poor,
3) Some groups are more law abiding than others,
4) White-collar crime is nonviolent,
5) Regulatory agencies prevent white-collar crime,
6) Rich and poor are equal before the law,
7) Drug use can be ended by policy efforts,
8) Community corrections is a viable alternative,
9) The punishment can fit the crime,
10) Laws make people behave.
Of the ten myths identified the two myths that are among the most pertinent to this discussion are: Drug use can be ended by police efforts, and crime is increasing.
There are many myths about crime that pervade society and undoubtedly help to shape criminal justice policy that must be revealed and absorbed if we are ever to change things for the better.
Paul Jesilow and Harold E. Pepinsky have outlined ten different crime myths:
1) Crime is increasing,
2) Most crime is committed by the poor,
3) Some groups are more law abiding than others,
4) White-collar crime is nonviolent,
5) Regulatory agencies prevent white-collar crime,
6) Rich and poor are equal before the law,
7) Drug use can be ended by policy efforts,
8) Community corrections is a viable alternative,
9) The punishment can fit the crime,
10) Laws make people behave.
Of the ten myths identified the two myths that are among the most pertinent to this discussion are: Drug use can be ended by police efforts, and crime is increasing.
Labels: incarceration
Wednesday, January 2, 2008
Jails and Prisons - Treatment or Incarceration
According to the Bureau of Justice Statistics, an estimated 61,000 (16%) of convicted jail inmates committed their offense to get money for drugs. Two-thirds of convicted inmates were actively involved with drugs prior to their admission to jail. Texas completed an exhaustive study of its felony sentencing patterns and found that the most frequent crime resulting in a prison sentence was drug possession (22%), followed by burglary (20%), theft and fraud (20%), and drug delivery (15%).
The days of rehabilitating criminals have long since vanished in a whirlwind of impatience and cynicism. For a brief time, people were enthusiastic about treatment and its possibilities, but that attitude was quickly replaced by an attitude of "just desserts." Poor research and quick fix attitudes scrapped many of the earlier attempts the criminal justice system tried at rehabilitation. People were not impressed with the results of rehabilitation, specifically for drug offenders, and so many programs were cut off from funding and collapsed.
Today, because of the overcrowding problem, many cities are being forced to look at treatment as a viable alternative to imprisonment. Laws have been passed that are designed to foster an increase in the use of alternatives for incarceration. The most notable of these efforts is Proposition 36 in California. Having worked in the recovery field for over five years, I have had first hand experience in helping develop programs that satisfy the court's requirements for alternative sentencing and that fit Proposition 36 guidelines. Unfortunately, I have also been able to see how Proposition 36 was doomed from the start.
In the year 2000, an overwhelming number of people, over sixty percent, voted for The Substance Abuse and Crime Prevention Act in California, commonly known as Proposition 36. The passage of this law represented a major shift in penology, from incarceration to rehabilitation. Not since the Progressive Movement of the early 1900's and the original Quaker penology before that, has rehabilitation been part of the penal system.
Proposition 36 allows non-violent drug offenders to be placed on probation and into drug treatment. The person who is granted entrance into the Proposition 36 program is required to participate in treatment on a daily basis at a designated facility, submit to random drug tests, and participate in outside recovery meetings. Unlike the prisoner who is confined bodily to his cell in prison, the same criminal can now be granted a soft mattress at a recovery facility somewhere in California, and be given at least the illusion of greater freedom.
Unfortunately, Proposition 36 is poorly funded and understaffed. Furthermore, the kind of treatment that Proposition 36 offers (people who qualify for Prop 36 are sent to a treatment center that meets the program's standards) is poor and halfhearted. The treatment is poor because Prop 36 will only pay $1200 per month for treatment and most quality inpatient facilities cost at least $4000 a month. Nancy Clarks is the most notable Prop 36 treatment facility in Orange County, California. The facility offers different levels of monitoring and treatment, but the basic program remains the same for everyone and the program does not offer the intensive treatment that many of the drug offenders need.
Opening up treatment centers that cater to Prop 36 is almost as difficult as opening a new jail or prison in an area. Neighbors object and law abiding citizens cry out in fear. The biggest problem lately with Prop 36 treatment facilities is the people who are admitted to them. One lawyer in Orange County commented that the biggest problem they are having with Prop 36 facilities is the property crime that takes place as a result of clients who relapse.
Treatment programs have sprung up in many states other than California. In Quincy, Massachusetts, first-and second-time DWI offenders may be placed on probation as an alternative to jail and ordered to a certified drunk driving treatment program. In this 26-week program, offenders are required to attend weekly group counseling sessions and Alcoholics Anonymous meetings.
"Some jurisdictions are actually reducing their prison terms and funding alternatives to prison". Jails are beginning to open their own treatment programs within their walls. The Boulder, Colorado jail has created a Drug/Alcohol Evaluation Unit that evaluates offenders convicted of alcohol-or-drug-related driving offenses for level of alcohol or drug dependence and petty misdemeanor drug offenses.
This program boasts high success rates, but one thing that treatment facilities, judges, and public defenders have realized since the last rehabilitation surge in the criminal justice system, is that politicians and the people like high success rates and they will coax research statistics to reflect a successful image. There is undeniably a high recidivism rate for drug addicts and alcoholics, but the most effective treatment is one that accepts this fact of addiction and works with it instead of against it. For many drug addicts and alcoholics, relapse is a part of rehabilitation and it takes patient and perseverant case workers, judges, and politicians to understand this simple truth.
Rehabilitation has begun to make a faint reappearance, but only in so far as it is a solution to overcrowding. With Proposition 36 and alternative sentencing, courts can siphon a steady stream of nonviolent offenders from the jails and put them into rehabilitation programs. Nancy Clarks in Orange County is one of the more frequently used alternative sentencing facilities for nonviolent drug offenders. Nancy Clark offers a variety of monitoring devices, levels of confinement, and in and out patient options for judges to utilize.
Orange County has another option available to non-violent drug offenders called Drug Court. Drug Court is another one of the more innovative efforts towards rehabilitation. Judge David McEachen was the first judge to reside over the new felony drug court in March 1995 and in 2000 they had 189 participants and 50 successful graduates.
Drug Court was designed with more of a rehabilitative spirit in mind, and ironically, or perhaps predictably, according to the current president of the Orange County chapter of the National Counsel on Drugs and Alcohol (NSDA), Grant McNiff, the program is in danger of collapsing for lack of funds despite its success. "Many have finally begun to openly question the wisdom of lengthy mandatory prison terms for drug users. The huge costs of the imprisonment binge have led states to reconsider prison construction programs".
The days of rehabilitating criminals have long since vanished in a whirlwind of impatience and cynicism. For a brief time, people were enthusiastic about treatment and its possibilities, but that attitude was quickly replaced by an attitude of "just desserts." Poor research and quick fix attitudes scrapped many of the earlier attempts the criminal justice system tried at rehabilitation. People were not impressed with the results of rehabilitation, specifically for drug offenders, and so many programs were cut off from funding and collapsed.
Today, because of the overcrowding problem, many cities are being forced to look at treatment as a viable alternative to imprisonment. Laws have been passed that are designed to foster an increase in the use of alternatives for incarceration. The most notable of these efforts is Proposition 36 in California. Having worked in the recovery field for over five years, I have had first hand experience in helping develop programs that satisfy the court's requirements for alternative sentencing and that fit Proposition 36 guidelines. Unfortunately, I have also been able to see how Proposition 36 was doomed from the start.
In the year 2000, an overwhelming number of people, over sixty percent, voted for The Substance Abuse and Crime Prevention Act in California, commonly known as Proposition 36. The passage of this law represented a major shift in penology, from incarceration to rehabilitation. Not since the Progressive Movement of the early 1900's and the original Quaker penology before that, has rehabilitation been part of the penal system.
Proposition 36 allows non-violent drug offenders to be placed on probation and into drug treatment. The person who is granted entrance into the Proposition 36 program is required to participate in treatment on a daily basis at a designated facility, submit to random drug tests, and participate in outside recovery meetings. Unlike the prisoner who is confined bodily to his cell in prison, the same criminal can now be granted a soft mattress at a recovery facility somewhere in California, and be given at least the illusion of greater freedom.
Unfortunately, Proposition 36 is poorly funded and understaffed. Furthermore, the kind of treatment that Proposition 36 offers (people who qualify for Prop 36 are sent to a treatment center that meets the program's standards) is poor and halfhearted. The treatment is poor because Prop 36 will only pay $1200 per month for treatment and most quality inpatient facilities cost at least $4000 a month. Nancy Clarks is the most notable Prop 36 treatment facility in Orange County, California. The facility offers different levels of monitoring and treatment, but the basic program remains the same for everyone and the program does not offer the intensive treatment that many of the drug offenders need.
Opening up treatment centers that cater to Prop 36 is almost as difficult as opening a new jail or prison in an area. Neighbors object and law abiding citizens cry out in fear. The biggest problem lately with Prop 36 treatment facilities is the people who are admitted to them. One lawyer in Orange County commented that the biggest problem they are having with Prop 36 facilities is the property crime that takes place as a result of clients who relapse.
Treatment programs have sprung up in many states other than California. In Quincy, Massachusetts, first-and second-time DWI offenders may be placed on probation as an alternative to jail and ordered to a certified drunk driving treatment program. In this 26-week program, offenders are required to attend weekly group counseling sessions and Alcoholics Anonymous meetings.
"Some jurisdictions are actually reducing their prison terms and funding alternatives to prison". Jails are beginning to open their own treatment programs within their walls. The Boulder, Colorado jail has created a Drug/Alcohol Evaluation Unit that evaluates offenders convicted of alcohol-or-drug-related driving offenses for level of alcohol or drug dependence and petty misdemeanor drug offenses.
This program boasts high success rates, but one thing that treatment facilities, judges, and public defenders have realized since the last rehabilitation surge in the criminal justice system, is that politicians and the people like high success rates and they will coax research statistics to reflect a successful image. There is undeniably a high recidivism rate for drug addicts and alcoholics, but the most effective treatment is one that accepts this fact of addiction and works with it instead of against it. For many drug addicts and alcoholics, relapse is a part of rehabilitation and it takes patient and perseverant case workers, judges, and politicians to understand this simple truth.
Rehabilitation has begun to make a faint reappearance, but only in so far as it is a solution to overcrowding. With Proposition 36 and alternative sentencing, courts can siphon a steady stream of nonviolent offenders from the jails and put them into rehabilitation programs. Nancy Clarks in Orange County is one of the more frequently used alternative sentencing facilities for nonviolent drug offenders. Nancy Clark offers a variety of monitoring devices, levels of confinement, and in and out patient options for judges to utilize.
Orange County has another option available to non-violent drug offenders called Drug Court. Drug Court is another one of the more innovative efforts towards rehabilitation. Judge David McEachen was the first judge to reside over the new felony drug court in March 1995 and in 2000 they had 189 participants and 50 successful graduates.
Drug Court was designed with more of a rehabilitative spirit in mind, and ironically, or perhaps predictably, according to the current president of the Orange County chapter of the National Counsel on Drugs and Alcohol (NSDA), Grant McNiff, the program is in danger of collapsing for lack of funds despite its success. "Many have finally begun to openly question the wisdom of lengthy mandatory prison terms for drug users. The huge costs of the imprisonment binge have led states to reconsider prison construction programs".
Labels: incarceration, jail, prison
