Treatment engagement in a prison-based Therapeutic Community: A mixed-methods approach

Kimberly M. Davidson, Jacob T.N. Young

    Research output: Contribution to journalArticlepeer-review

    9 Scopus citations


    Given the high proportion of inmates with histories of substance use disorders in the era of mass incarceration, many correctional institutions have integrated the prison-based Therapeutic Community (TC) into their programming. While most evaluations provide evidence of lowered rates of relapse and recidivism, the majority of TC graduates still have negative outcomes post-release. Filling an important gap in the TC treatment literature, we analyze quantitative measures of treatment engagement alongside qualitative narratives from prison-based TC residents, providing an essential look into the black box of TC treatment mechanisms. Quantitative results show more between-person variation than within-person change, reflecting trivial increases in treatment engagement throughout time in the program. Qualitative results unpack these findings, pointing to processes of selection bias, heterogeneous treatment effects, and program fidelity lapses. In combination, our mixed data identify tangible modifications to program implementation that could strengthen desired post-release outcomes.

    Original languageEnglish (US)
    Pages (from-to)33-42
    Number of pages10
    JournalJournal of Substance Abuse Treatment
    StatePublished - Aug 2019


    • Corrections
    • Mixed-methods
    • Substance abuse
    • Therapeutic Community
    • Treatment engagement

    ASJC Scopus subject areas

    • Phychiatric Mental Health
    • Medicine (miscellaneous)
    • Clinical Psychology
    • Psychiatry and Mental health


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