IBR -- Newsletters, Research Roundup, Summer 1998

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This Summer 1998 issue is also available in Adobe(R) PDF format. (PDF; 88KB / 4 pages)

Items from this issue:

TCU Drug Screen simplifies prison assessments

Study utilizes computerized record-keeping for CM

Research Highlights

What's New on the Web

IBR Web site adds publication abstracts (link to IBR Publications Web page)

DATOS Web Posters (new section of DATOS Web site)

TCU Drug Screen simplifies prison assessments

In the wake of encouraging feedback from the Texas Department of Criminal Justice (TDCJ) and the Center for Substance Abuse Treatment, researchers at IBR are preparing a comprehensive study on the utility of a standardized screening tool designed to identify drug abuse and dependence problems in individuals entering criminal justice facilities. The Texas Christian University Drug Screen (TCUDS), an 18-item, self-administered assessment form, was developed by Drs. Dwayne Simpson, Kevin Knight, and Kirk Broome as part of an evaluation study of prison-based treatment initiatives in Texas. Last year, the TDCJ Institutional Division selected the TCUDS as its primary screening instrument for assessing drug abuse problems and treatment needs for all new prison and state jail admissions. The choice was based on the instrument’s favorable comparison with more well-known tools such as the Addiction Severity Index (ASI) and the Substance Abuse Subtle Screening Inventory (SASSI). More recently, at least 12 other states have adopted or are considering adopting the TCUDS for use in their correctional treatment agencies.

In response to this growing interest, an upcoming study will investigate several practical and scientific questions related to the credibility and psychometric properties of the TCUDS using data from 4,000 admissions to Texas criminal justice facilities. In addition to determining the scale’s internal reliability and predictive validity in large correctional settings, researchers hope to establish normative data for representative samples of Texas inmates that will help verify severity of drug problems and identify those most in need of treatment (see Figure 1 below).

Items on the TCUDS represent key clinical and diagnostic criteria for substance abuse dependence as specified in the Diagnostic and Statistical Manual (DSM-IV). In order to promote reliable self-administration in criminal justice settings, clinical language was reworded to an eighth-grade reading level. The first part of the scale includes questions related to drug and alcohol use problems and the second part addresses frequency of use and readiness for treatment. One potentially important feature of the scale is its ability to distinguish between criminal offenders with documented drug dependence and those who misuse drugs but are not dependent. This distinction is important for criminal justice officials who must make decisions about which offenders should be referred to treatment and the most appropriate types of treatment interventions for different offenders.

Researchers also plan to explore whether the TCUDS is predictive of postincarceration outcomes. According to Dr. Knight, who will serve as Principal Investigator for the study, "an obvious goal of the screening process is to reduce inappropriate referrals to prison-based treatment and to increase appropriate placements in order to increase efficiency and cost-effectiveness." The TCUDS and other data collection forms developed at IBR are available for use in research projects at no cost. Forms can be reviewed and downloaded by visiting the IBR Web Forms section at http://www.ibr.tcu.edu/pubs/datacoll/datacoll.html n

Study utilizes computerized record-keeping for CM

In recent years, studies of behavioral interventions such as Contingency Management (CM) have supported their use in substance abuse treatment. Successful CM interventions have used a variety of positive rewards (vouchers, inexpensive prizes, take-home medication privileges) for positive recovery behaviors (drug-free urines, program participation, work toward treatment goals). Contingency management studies from IBR’s DATAR project used a system of rewarding clients with "stars" for positive recovery behaviors. These stars could be saved and redeemed for small prizes (gas coupons, bus tokens, personal items). Results showed that clients randomly assigned to receive rewards attended more counseling and reduced drug use during the intervention. When CM was used during the first 90 days of treatment, reward clients attended more counseling, were more likely to reduce cocaine use postintervention, and were rated more highly by counselors.

Although this simple CM protocol was found to be useful for helping clients change, the complicated record-keeping required to successfully manage the intervention presented limitations. To meet this challenge, Drs. Grace Rowan-Szal and Jack Greener and Graduate Research Assistant Ryan Roark have developed a computer-based record-keeping system currently being tested in a CM study underway in the DATAR project. The program, written in Microsoft Access, is designed to simplify the implementation of complex CM research designs in the field and includes data management pieces for random assignment of clients, urinalysis tracking, keeping record of stars earned for target behaviors, and issuing vouchers to redeem stars for prizes. Preliminary feedback has been positive from both counselors and clients. Dr. Rowan-Szal will demonstrate the system at the upcoming American Methadone Treatment Association Conference in New York. n

Research Highlights

Conference Presentations

Researchers with IBR’s Workplace Project will present findings at the 24th International Congress of Applied Psychology in San Francisco in August. Dr. Joel Bennett will discuss "Gender Differences across Types of Employee Substance Use: Influence of Job and Background Factors," and Dr. Wayne Lehman will present a poster entitled "Assessing the Utility of a Measure of Tolerance for Co-Worker Substance Use."

At the American Methadone Treatment Association (AMTA) Conference in New York in September, Dr. Grace Rowan-Szal will display an interactive poster entitled "Demonstration of a Computerized Contingency Management System," and Norma Bartholomew will lead a workshop on "COCA: An Intervention for Cocaine-Using Methadone Patients."

Drs. Dwayne Simpson and Kevin Knight addressed criminal justice professionals at the recent National Institute of Justice Residential Substance Abuse Treatment (RSAT) 1998 Cluster Conference in Washington, DC in June. They presented a paper on "Measuring Treatment Process and Outcomes: Theory and Practice."

Reports in press

A study of 18 long-term residential facilities that participated in the Drug Abuse Treatment Outcomes Study (DATOS) found that legal pressure was associated with greater program retention. Hierarchical linear models were used to examine the relationship of client background and legal pressure on treatment participation of 90 days or more. High legal pressure clients were more likely than low legal pressure clients to complete 90 days or more of treatment.

Legal Pressure and Treatment Retention in a National Sample of Long-Term Residential Programs, Matthew Hiller, Kevin Knight, Kirk Broome, & Dwayne Simpson. In Press: Criminal Justice and Behavior.

Now published: Hiller, M. L., Knight, K., Broome, K. M., & Simpson, D. D. (1998). Legal pressure and treatment retention in a national sample of long-term residential programs. Criminal Justice and Behavior, 25(4), 463-481. [Abstract]

In a new article on the contributions and limitations of key evaluation studies of correction-based drug treatment programs, the difficulties imposed by variations in measurement systems and official records are discussed. Additional issues related to the evaluation of treatment outcomes for substance-abusing offenders are presented along with recommendations for future research.

Evaluating Corrections-Based Treatment for the Drug-Abusing Criminal Offender, Kevin Knight, Matthew Hiller, & Dwayne Simpson. In Press: Journal of Psychoactive Drugs.

Now Published: Knight, K., Hiller, M. L., & Simpson, D. D. (1999). Evaluating corrections-based treatment for the drug-abusing criminal offender. Journal of Psychoactive Drugs, 31(3), 299-304. [Abstract]

A related study from the Drug Abuse Treatment Assessment and Research (DATAR) project examined the impact of clients’ legal status (i.e., parole, probation, pending charges) on treatment outcomes using a 1-year follow-up sample of 710 methadone maintenance clients. Although legal status appeared to have no impact on during-treatment factors such as counseling attendance, illicit drug use, and criminal behavior, methadone clients with a legal status at admission were over five times more likely to be incarcerated at follow-up.

Legal Status at Intake and Posttreatment Incarceration: 12-Month Follow-Up of Methadone Maintenance Treatment, Matthew Hiller, Dwayne Simpson, Kirk Broome, & George Joe. In Press: Journal of Maintenance in the Addictions.

Now Published: Hiller, M. L., Simpson, D. D., Broome, K. M., & Joe, G. W. (2000). Legal status at intake and posttreatment incarceration: 12-Month follow-up of methadone maintenance treatment. Journal of Maintenance in the Additions, 1(4), 27-43. [Abstract]

A study of gender differences from the DATAR project looked at admission and 1-year follow-up data for 435 methadone treatment clients. Females were found to have more psychological and medical problems and to have more dysfunctional families of origin; however, both genders showed improvement posttreatment in terms of reduced drug and alcohol use and reduced criminal involvement.

Gender Differences at Admission and Follow-Up in a Sample of Methadone Maintenance Clients, Lois Chatham, Matthew Hiller, Grace Rowan-Szal, George Joe, & Dwayne Simpson. In Press: Substance Use and Misuse.

Now Published: Chatham, L. R., Hiller, M. L., Rowan-Szal, G. A., Joe, G. W., & Simpson, D. D. (1999). Gender differences at admission and follow-up in a sample of methadone maintenance clients. Substance Use & Misuse, 34(8), 1137-1165. [Abstract]

A sample of 900 clients from 13 long-term residential programs participating in DATOS was used to study whether the type of cocaine used (crack or powdered) was related to treatment retention. Subjects met DSM criteria for cocaine dependence. Crack users were found to have lower retention rates than other cocaine users. Higher retention was associated several variables, including age, education, marital status, and arrest history. Strategies for improving retention for crack users are discussed.

Treatment Retention of Crack and Cocaine Users in a National Sample of Long-Term Residential Clients, Grace Rowan-Szal, George Joe, & Dwayne Simpson. In Press: Addiction Research.

Now Published: Rowan-Szal, G. A., Joe, G. W., & Simpson, D. D. (2000). Treatment retention of crack and cocaine users in a national sample of long term residential clients. Addiction Research, 8(1), 51-64. [Abstract]

A recent study of 1,900 municipal employees looked at the impact of co-worker substance abuse on work climates. Results found negative consequences (e.g., more job stress, withdrawal, health problems) associated with workplace drinking climates. These, in turn, were associated with reduced group cohesion. Recommendations for workplace prevention and training are discussed.

Workplace Drinking Climate, Stress, and Problem Indicators: Assessing the Influence of Team Work (Group Cohesion), Joel Bennett & Wayne Lehman. In Press: Journal of Studies on Alcohol. [Citation Updated 8/19/98: (1998), Journal of Studies on Alcohol, 59(5), 608-618. Abstract.] n