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Testing an Interactionist Theory of Treatment Engagement in a Pennsylvania Prison-Based Therapeutic Community

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The prison-based Therapeutic Community (TC) is a promising substance use treatment program that emphasizes peer influence. Although program evaluations demonstrate positive results, the cognitive, behavioral, and social processes that define… Click to show full abstract

The prison-based Therapeutic Community (TC) is a promising substance use treatment program that emphasizes peer influence. Although program evaluations demonstrate positive results, the cognitive, behavioral, and social processes that define the prison-based TC are largely unknown. The TC model presumes that residents increase their treatment engagement and willingness to change through peer interactions and role modeling, but this process has received virtually no research attention. This study explores these peer-driven mechanisms by examining self, reflected, and peer appraisals of willingness to change of 177 male TC residents, predicting within-person changes in treatment engagement by changes in appraisal measures. Results suggest that self, peer, and reflected appraisals converge over time in treatment. In addition, fixed effects models demonstrate that changes in reflected appraisals are most predictive of changes in treatment engagement. Such results, consistent with symbolic interactionist perspectives, inform prison-based programming and contribute to research on individual-level trajectories of desistance and recovery.

Keywords: therapeutic community; treatment engagement; treatment; based therapeutic; prison based

Journal Title: Criminal Justice and Behavior
Year Published: 2020

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