Additional Resources:

Program Profile: Delaware KEY Substance Abuse Program

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on May 21, 2019

Program Summary

This program is a prison-based therapeutic community for drug-involved offenders. The program is rated Promising. After 3 years, results showed statistically significant increases in remaining drug-free; however, there were no statistically significant effects in being arrest-free.

Program Description

Program Goals/Target Population
The KEY Substance Abuse Program is the prison-based portion of the continuum of substance abuse treatment for drug-involved offenders reentering society, which is offered by the Delaware Department of Correction (DOC). The DOC provides a continuum of primary (in prison), secondary (work release), and tertiary (aftercare) therapeutic community treatment for drug-involved offenders. Each stage in the continuum corresponds to the offender’s changing correctional status: incarceration, work release, and parole or community supervision.

The substance abuse treatment programs offered by the DOC allow for drug-involved offenders to go through the KEY Program and the CREST Outreach Centers. Alternatively, offenders can participate in the CREST Outreach Centers without participating in the KEY Program. This review focused on the KEY program only, without released individuals participating in the CREST Outreach Centers.

Program Components
KEY is the first component of the DOC’s substance abuse treatment continuum. It is a prison-based, therapeutic community program designed as a total treatment environment that is discipline-based and isolated from the rest of the prison population. The treatment perspective is that drug abuse is a disorder, and that addiction is the symptom and not the essence of the disorder. Therefore, the primary goal of KEY is to change negative patterns of behavior, thinking, and feelings that predispose an offender toward drug abuse. Inmates receive behavioral, cognitive, and emotional therapy that focuses on changing behavior first and emotion last.

Inmates typically become involved in the KEY program during the last 12 to 18 months of incarceration. They are provided with a routine that is disciplined and regimented and are required to complete program assignments that are seen as essential to treatment. KEY staff members provide oversight to treatment programming, which is scheduled 7 days a week. Inmates have access to staff counselors every day, if they feel the need to discuss issues related to their treatment and recovery. Inmates also meet twice a week with their caseload group (other inmate program participants) to discuss issues related to recovery. After completing the KEY program, participants are released into the community with no further mandated therapeutic treatment.

Additional Information
View the program profile for:

Evaluation Outcomes

top border
Study 1
Martin and colleagues (1999) found mixed results regarding the effectiveness of the KEY Substance Abuse Program. At the 3-year follow up, there was no statistically significant effect on arrest rates; however, there was a statistically significant effect on being drug-free. Overall, the preponderance of evidence suggests the program had a positive impact on program participants.

At the 3-year follow up, 41 percent of the KEY participants were arrest-free, compared with 30 percent of the comparison group; however, this different was not statistically significant.

The KEY participants were more likely to be drug-free (22 percent) at the 3-year follow up, compared with the comparison group (6 percent). This difference was statistically significant.
bottom border

Evaluation Methodology

top border
Study 1
In a follow up to the Martin, Butzin, and Inciardi (1995) quasi-experimental study, Martin and colleagues (1999) looked at the outcome results 1 year and 3 years after participants left work release. The study examined the same four groups as in the previous study: 1) primary treatment in prison at KEY program with no subsequent treatment, 2) primary treatment in prison at KEY program and secondary (transitional) treatment at CREST Outreach Center, 3) primary treatment at CREST with no prior prison-based treatment, and 4) no treatment other than HIV/AIDS prevention education.

The study authors also looked at results from participants who received no in-prison treatment, were assigned to regular work release, were CREST dropouts, were CREST graduates without aftercare, or were CREST graduates with aftercare. However, the review of this study focused on the comparisons between the initial KEY group (n=38) and the initial comparison group (n=165).

The comparison group was predominately male (82 percent), 68 percent African American, 27 percent white, and 4 percent Hispanic. Their average age was 29 years. The KEY group was all male, 84 percent African American, and 16 percent white. Their average age was 31.

The outcome measures of interest were relapse (drug-free) and recidivism (arrest-free). Each outcome variable combined information from repeated self-reports and official data. To be considered drug-free, the participant must have reported no illegal drug use and tested negative for drugs on the urine screen at every follow-up point. Similarly, to be considered arrest-free, the participant must have reported no arrests and no official arrest record for new offenses since release from prison (excluding parole violations). The study authors relied on bivariate and multivariate logistic regression to analyze the data and did not conduct subgroup analyses of KEY participants.
bottom border


top border
There is no cost information available for this program.
bottom border

Other Information (Including Subgroup Findings)

top border
The KEY/CREST Substance Abuse Program was originally reviewed and rated Promising for in 2011. The original review combined the evaluation results of the KEY/CREST Substance Abuse Program with the evaluation results of the CREST Outreach Centers and the KEY Substance Abuse Program. When the KEY/CREST Substance Abuse Program was rereviewed in 2018, the Promising rating was maintained, and the results were separated from those of the CREST Outreach Centers and the KEY Substance Abuse Program (which was also rated Promising). All three programs now have separate program profiles on (see the Program Description for a link to the other programs).
bottom border

Evidence-Base (Studies Reviewed)

top border
These sources were used in the development of the program profile:

Study 1
Martin, Steven S., Clifford A. Butzin, Christine A. Saum, and James A. Inciardi. 1999. “Three-Year Outcomes of Therapeutic Community Treatment for Drug-Involved Offenders in Delaware: From Prison to Work Release to Aftercare.” The Prison Journal 79(3):294–320.
bottom border

Additional References

top border
These sources were used in the development of the program profile:

Butzin, Clifford A., Steven S. Martin, and James A. Inciardi. 2002. “Evaluating Component Effects of a Prison-Based Treatment Continuum.” Journal of Substance Abuse Treatment 22:63–69.

Falcon, William D. 2002. “Corrections-Based Drug Treatment: Delaware’s Key-Crest Programs.” Promising Approaches to Addressing Crime. Philadelphia, Pa.: The Jerry Lee Center of Criminology, Forum on Crime & Justice.

Inciardi, James A., Steven S. Martin, Clifford A. Butzin, Robert M. Hooper, and Lana D. Harrison. 1997. “An Effective Model of Prison-Based Treatment for Drug-Involved Offenders.” Journal of Drug Issues 27(2):261–78.

Inciardi, James A., Steven S. Martin, and Clifford A. Butzin. 2004. “Five-Year Outcomes of Therapeutic Community Treatment of Drug-Involved Offenders After Release from Prison.” Crime & Delinquency 50(1):88–107.

Martin, Steven S., Clifford A. Butzin, and James A. Inciardi. 1995. “Assessment of a Multistage Therapeutic Community for Drug-Involved Offenders.” Journal of Psychoactive Drugs 27(1):109–16. (This study was reviewed but did not meet criteria for inclusion in the overall program rating.)

Martin, Steven S., James A. Inciardi, and Daniel J. O’Connell. 2003. “Treatment Research in OZ–Is Randomization the Ideal or Just Somewhere Over the Rainbow?” Federal Probation 67(2):53–60.

Martin, Steven S., Daniel J. O’Connell, Raymond Paternoster, and Ronet D. Bachman. 2011. “The Long and Winding Road to Desistance from Crime for Drug-Involved Offenders: The Long-Term Influence of TC Treatment on Rearrest.” Journal of Drug Issues 41(2):179–96.

Robbins, Cynthia A., Steven S. Martin, and Hilary L. Surratt. 2009. “Substance Abuse Treatment, Anticipated Maternal Roles, and Reentry Success of Drug-Involved Women Prisoners.” Crime & Delinquency 55(3):388–411.
bottom border

Related Practices

top border
Following are practices that are related to this program:

Incarceration-based Therapeutic Communities for Adults
This practice uses a comprehensive, residential drug treatment program model for treating substance-abusing and addicted inmates to foster changes in attitudes, perceptions, and behaviors related to substance use. The practice is rated Promising in reducing recidivism rates after release for participants in therapeutic communities.

Evidence Ratings for Outcomes:
Promising - More than one Meta-Analysis Crime & Delinquency - Multiple crime/offense types
bottom border

Program Snapshot

Age: 18+

Gender: Both

Race/Ethnicity: Black, Hispanic, White, Other

Geography: Suburban, Urban

Setting (Delivery): Correctional

Program Type: Alcohol and Drug Therapy/Treatment, Group Therapy, Individual Therapy, Therapeutic Communities

Targeted Population: Alcohol and Other Drug (AOD) Offenders, Prisoners

Current Program Status: Active

Listed by Other Directories: Campbell Collaboration