Faculty Bibliography

This study examined the independent and interactive associations between cocaine use and antipsychotic medication adherence in predicting 12 month criminal recidivism among a sample of mentally ill parolees (N = 200). Consistent with prior research, cocaine use (based on hair assays) was associated with more than a threefold increase (relative to non-cocaine users) in the likelihood of a parolee being returned to custody during the follow-up period. Although medication adherence (based on urine specimens) was not independently associated with a significant reduction in recidivism risk, the interaction between cocaine use and medication adherence was significant, revealing a disproportionate impact of medication adherence specific to cocaine users. Prediction models of recidivism based on self-reported measures of medication adherence and cocaine use revealed only marginally significant trends for cocaine use, no effect for adherence, and no significant interaction between these two predictors.

Five counties (Kern, Riverside, Sacramento, San Diego, San Francisco) that demonstrate both variations and similarities in their implementation of Proposition 36 (e.g., treatment approaches, urine testing) and patient mix have been selected to participate in a study assessing how California's Proposition 36 is affecting the drug treatment system and patient outcomes. Except for San Francisco, treatment admissions increased during the first year of Proposition 36 implementation over the prior year (27% in Kern, 21% in Riverside, 17% in Sacramento, and 16% in San Diego), mostly in outpatient drug-free programs. Compared to non-Proposition 36 patients, Proposition 36 patients were more likely to be men, first-time admissions, treated in outpatient drug-free programs, employed full-time, and users of methamphetamine or marijuana. They were less likely to be treated in residential programs or methadone maintenance programs and fewer reported heroin use or injection drug use. Guided by the multilevel open systems framework, the study examines key issues of Proposition 36 that influence treatment systems and outcomes and empirically identifies "best practice" approaches in treating drug-abusing offenders.

This study compared the efficacy of 2 approaches for the treatment of cocaine dependence among methadone-maintained patients with and without antisocial personality disorder (ASPD). Patients were randomly assigned to 4 study conditions: cognitive-behavioral treatment (CBT), contingency management (CM), CBT with CM, or methadone maintenance. The Structural Clinical Interview for Mental Disorders-IV was administered to 108 patients to assess ASPD. A 2-way analysis of variance showed that patients with ASPD were more likely to abstain from cocaine use during treatment than patients without ASPD. The strong treatment effect for ASPD patients was primarily due to the CM condition. Regression analyses showed that ASPD remained significantly related to CM treatment responsivity while controlling for other factors.

In 1974, Robert Martinson, an adjunct assistant professor at the City College of New York, published an article titled "What Works?"”Questions and Answers About Prison Reform" (Martinson, 1974). In it, he summarized the results of a 3-year project"”Effectiveness of Correctional Treatment (ECT)"”which reviewed the effectiveness of 231 offender rehabilitation programs that had been evaluated during the prior 30 years (see also Lipton, Martinson, & Wilks, 1975). Based on his analysis of what was the most extensive offender treatment database that existed at that time, he concluded that "with few and isolated exceptions, the rehabilitative efforts that have been reported so far have had no appreciable effect on recidivism" (p. 25). Martinson's article has since been cited, perhaps naively, as one of the precipitating factors that quashed the treatment-oriented zeitgeist of the 1970s. In truth, Martinson may have provided an invaluable service to the rehabilitation movement by inadvertently giving human form to the undercurrents of skepticism that already existed. Thanks to Martinson, a once fragmented cadre of researchers and clinicians found themselves working in concert to refute what Martinson himself later described as a mischaracterization of his argument. But in these fevered attempts to prove Martinson wrong and, in some cases, vilify him personally, we may have ignored the most important part of his message. © 2002, Sage Publications. All rights reserved.