The goals of the Collaborative Behavioral Management (CBM) intervention were to reduce substance use, crime, and re-arrest among drug-involved parolees. The intervention involved collaborative sessions among a parole officer, treatment counselor, and the parolee.
The target population consisted of incarcerated individuals with pre-incarceration substance use disorders who were initiating parole in six sites: Providence, R.I.; Bridgeport and Hartford, Conn.; Wilmington, Del.; Richmond, Va.; and Portland, Ore. To be eligible for the program, participants had to have 1) been 18 years or older; 2) English-speaking; 3) had probable drug dependence prior to incarceration; 4) had substance use treatment as a mandated or recommended condition of parole; and 5) been at moderate-to-high risk of relapse and/or recidivism.
Typical parole supervision usually involves weekly to monthly in-person contacts between the parolee and parole officer, to check compliance with conditions of release. Typical parole tends to emphasize detection and sanctioning of antisocial behavior of parolees (such as drug use), with few mechanisms used to reinforce prosocial behavior. The CBM intervention was designed to change the punitive dynamic of the parole officer–parolee relationships by offering parole officers positive tools to manage parolee behavior (Friedman et al. 2008).
The CBM intervention consisted of an initial session with the parole officer, treatment counselor, and the parolee, followed by 12 weekly parole contacts, which were attended by the treatment counselor every other week. The intervention involved adapting evidence-based role induction, behavioral contracting, and contingent reinforcement to provide parole officers and treatment counselor teams with behavioral management tools to use with parolees, in addition to the typical sanctions.
The CBM model consisted of 1) articulated and expected roles for the staff and parolees as well as positive or negative consequences for not meeting expectations; 2) the negotiation of a weekly behavioral contract that articulated target behaviors, which included requirements of supervision and formal addiction treatment in addition to promoting behaviors that facilitate recovery; 3) the tracking of adherence to the behavioral contract and administration of reinforcers and sanctions to aid in shaping behavior; and 4) the establishment of a systematic and progressive approach to reinforcement and sanctioning to ensure consistency and fairness.
The intervention required a dedicated parole officer and treatment counselor teams trained in behavioral management tools, in addition to sanctions.
Friedmann and colleagues (2011) found that there was no statistically significant difference on re-arrest rates between the Collaborative Behavioral Management (CBM) intervention group and the comparison group at the 9-month follow up.
Self-Report Drug Use
There was no statistically significant difference for overall drug use between the CBM intervention group and the comparison group at the 9-month follow up
The Step’n Out study by Friedmann and colleagues (2011) was a randomized controlled trial, which compared Collaborative Behavioral Management (CBM) with standard parole. The study took place between 2004 and 2008. The study used a six-site trial to evaluate whether CBM improved parolees’ substance use and re-arrest during a 9-month follow up. The following six sites were involved in the study: Providence, R.I.; Bridgeport and Hartford, Conn.; Wilmington, Del.; Richmond, Va.; and Portland, Ore.
The study population comprised individuals with pre-incarceration substance use disorders who were initiating parole. In addition, they had to have 1) been 18 years or older; 2) been English-speaking; 3) had probable drug dependence prior to incarceration (defined by a score of at least 3 or higher on the TCU Drug Screen or mandated drug treatment); 4) had substance use treatment as a mandated or recommended condition of parole; and 5) had a moderate-to-high risk of drug relapse and/or recidivism (defined by a score of 7 or greater on the Lifetime Criminality Screening Form or two or more prior drug-related treatment episodes or convictions). Participants were excluded from the study if they had psychotic symptoms or had correctional or supervision conditions that prohibited study participation, including failure to be paroled, being mandated to a special parole caseload, or being transferred to a non-participating site.
Randomized treatment assignment was balanced by gender, in-prison or transitional residential treatment, incarceration for more or fewer than 18 months, and risk of recidivism. The 288 participants in the CBM intervention were 46 percent female, with an average age of 34 years. The racial and ethnic composition was 49.7 percent black, 35.4 percent white, 14.0 percent Hispanic, 1.0 percent Native American, 0.4 percent Asian, and 11.5 percent other racial/ethnic groups. The 281 comparison participants in standardized parole were 48 percent female, with an average age of 33.7 years. The racial and ethnic composition was, 53.0 percent black, 35.2 percent white, 11.0 percent Hispanic, 1.4 percent Asian, 0.7 percent Native American, and 8.2 percent other racial/ethnic groups.
Interviews were conducted to gather demographic data at intake, and follow-up interviews were conducted at the study termination at 9 months. Bivariate t-tests, Wilcoxon rank sum tests, and Pearson chi-squared tests were used to compare the intervention and control groups on baseline measures. An intent-to-treat approach was taken, meaning once the participants were randomized and they had attended at least a single session with a parole officer, their data was analyzed regardless of their later protocol adherence.
General estimating equation models were used to analyze the effects of the intervention on the outcome of substance use. Re-arrest was analyzed using logistic regression models.
These sources were used in the development of the program profile:Study 1
Friedmann, Peter D., Traci C. Green, Faye S. Taxman, Magdalena Harrington, Anne G. Rhodes, Elizabeth Katz, Daniel O’Connell, Steven S. Martin, Linda K. Frisman, Mark Litt, William Burdon, Jennifer G. Clarke, and Bennett W. Fletcher. 2011. “Collaborative Behavioral Management Among Parolees: Drug Use, Crime and Re-arrest in the Step’n Out Randomized Trial." Addiction