In this fourteenth issue of Exartiseis we will once again revisit KETHEA’s interventions in the therapeutic system.
This opportunity is offered by the pioneering and extraordinary, for the reality of the Greek prisons, initiative undertaken by KETHEA’s program “En Drasei” a Therapeutic Community that has been created and has just started operating, at the men’s judicial prisons in Korydallos. We refer to the implementation of an interactive training seminar that was carried out in January 27th, 2009. Scientific and administrative prison personnel, prison guards, together with inmates, members of the Therapeutic Community KETHEA-En Drasei, as well as KETHEA’s treatment staff who work in various prisons throughout Greece, where KETHEA intervenes, took part in this training.
This interactive training seminar lasted 8 hours, and it was coordinated by Igor Koutsenok, Professor of Psychiatry and Director of the Addiction Training Center in the University of California, San Diego.
Before going further let’s define the meaning of “interaction” in this particular case. It implies that it was not a pure lecture or a theoretic course, but it could better be described as a dynamic exchange of scientific findings and personal experiences –of therapists, inmates, members of the therapeutic community and prison staff. It also comprised the mutual exchange of information with regard to what is happening on both sides of the Atlantic, in relation to the methods of therapeutic interventions and their effectiveness, within the correctional system.
Among the issues that were analysed in depth were:
- The objectives of treatment regarding the users-offenders: reduction of criminality in the society; reduction of substance abuse; improvement of the living conditions of users; reduction in the amount of social resources used for them. According to the “American” experience, among a population of approximately two million inmates, two out of three have a substance use problem. However, only 15% of them receive some sort of systematic treatment. The funds given on corrections’ measures’ in general is 30 billion dollars, 24.1 of which are spent on inmates-users. The recidivism rates are 75% in the first 12 months after release; which means that 3 out of 4 users will return to prison. It is, therefore, clear that incarceration alone is not enough. Treatment is necessary.
- The profile of a user in the correctional system is similar, if not the same, to that of a Therapeutic Community member: the majority of them is between 18-25 years old, they are polydrug users, involved in deviant activities and a chaotic lifestyle, without a history of a full time job. Based on the above evidence and given the fact that the Therapeutic Community model is the most effective for people with this profile, the TC model was selected for the interventions within the correctional system.
In fact, research evidence (Knight-Simpson-Hiller, 2003) shows that in Texan prisons the recidivism rates, three years after release, have been reduced by 50% (from 52% to 26%) for the individuals receiving treatment in prison as well as aftercare treatment after their release. Similar data from the prisons in California show that three years after release only one in three individuals who received treatment and aftercare support returned to prison.
The treatment intervention, in the community model, needs to take into consideration the multifactorial causes of use:
- Even if the initiation of taking drugs is a choice, dependence is an outcome that leads to involuntary behaviours. Moreover, the prolonged substance use influences the individual in a way that makes it very difficult for him to stop.
- The psychological level: low self esteem, antisocial personality, alienation, a need to escape reality.
- The social level: academic failure, peer pressure, difficulties during the socialization of the individual.
These are some of the issues that treatment needs to address. The most effective treatment interventions are those covering at the same time all the aforementioned areas.
Hopefully the rationale of similar interventions and interactive methods, for the continuous improvement of treatment practices will become integrated in the correctional setting for the benefit of both: users-offenders and the wider society in general.
For the Editorial Group
Gerasimos Notaras
