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Beyond the Gate But Still Behind the Fence: Addictive Thinking Styles of Ex-Offenders. Jonathan M. Hartiens, Ph.D. Michael D. McCarty, Ph.D. Center for Addiction Treatment VAMC Martinsburg WV. How We Got Here.

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beyond the gate but still behind the fence addictive thinking styles of ex offenders

Beyond the Gate But Still Behind the Fence: Addictive Thinking Styles of Ex-Offenders

Jonathan M. Hartiens, Ph.D.

Michael D. McCarty, Ph.D.

Center for Addiction Treatment

VAMC Martinsburg WV

how we got here
How We Got Here
  • Center For Addiction (CAT-5) is a VA residential drug and alcohol program; has been working with formerly incarcerated veterans (IV) for 15 years
  • Noticed clinical difference between regular substance abuse patients and veterans who had been incarcerated
  • Began prison group six years ago to learn what these differences were related to; patients taught us how they looked at the world
  • Applied for and received a three year grant (2005) to study and develop programming to help formerly incarcerated veterans transition into the community.
  • Identifying clinical tools and methods that are replicable and useable in other settings
objectives
Objectives
  • Discuss how addiction is a pervasive and often overlooked problem among the incarcerated
  • Discuss how recidivism is related to addictive thinking patterns that are often overlooked.
  • Define “Prison Mindset” and how it activates addictive thinking during community re-entry.
objectives cont d
Objectives (cont’d)
  • Describe how addictive thinking in ex-offenders, once activated, tends to be expressed in three areas of daily living – work, money, and relationships.
  • Examine how addictive behaviors that are a progression towards recidivism and relapse are often misinterpreted as healthy behaviors.
pervasiveness of substance abuse among the incarcerated
Pervasiveness of Substance Abuse Among The Incarcerated
  • Substance Abuse is the most common occurring psychiatric disorder among the incarcerated population. It occurs at a much higher rate than the general population1.
  • 75% of inmates reported substance abuse problems on self report measures2.
  • When given a structured diagnostic interview, 95% of inmates met criteria for a Substance Use Disorder3.
offender characteristics cont d
Offender Characteristics (Cont’d)
  • Of those incarcerated, 64%4 to 70%5 were acutely intoxicated with one or more substances or withdrawing from them at time of arrest.
  • Of first time offenders, 41% had a history of regular drug use. This percentage increased to 81% for those with 5 or more convictions6.
what do these statistics mean
What do these statistics mean?
  • Substance Abuse is a significant problem among the incarcerated and tends to be minimized.
  • In a majority of cases, Substance Abuse precedes or accompanies criminal behavior.
  • The more often a person is incarcerated, the more likely substance abuse is part of his/her lifestyle.
  • The fact that recidivism and substance abuse are so interconnected suggests a common underlying mechanism exists that activates both problems- a “Prison Mindset.”
prison mindset defining features
Prison Mindset: Defining Features

Living in prison conditions a mindset in which:

  • Routines are structured by someone else.
  • Choices are made by others. Offenders lose the ability to make decisions.
  • Basic needs are met without any effort.
  • Have to constantly prove and protect oneself.
  • Respect and safety is generated by inflicting fear in others.
  • Appearance of weakness or fear invites aggression from others.
  • The goal is simple – SURVIVAL!
how prison mindset impacts the reentry process
How Prison Mindset Impacts The Reentry Process
  • Person needs structure, cannot provide it for self
  • Making choices are terrifying and overwhelming
  • Difficult to ask for help, to do so is a sign of weakness
  • Does not know how to meet basic needs
  • Compulsion to prove oneself
  • Uses fear and intimidation to solve problems
how prison mindset activates addictive thinking survival and work
Thoughts

I’ve got to have a job that pays me the most money.

I’ve got to make up for lost time.

I need to prove myself.

I can’t be bored on the job.

Behaviors

Take whatever job is available regardless of its impact on recovery.

Work excessive hours.

Complicate simple instructions; don’t ask for help; do other people’s work.

Work in a way that mimics their drug of choice.

How Prison Mindset Activates Addictive Thinking:Survival and Work
how the prison mindset activates addictive thinking survival and money
Thoughts:

The more money I make, the better my chances at surviving.

Its my money to spend how I want now that I’m not drinking or using.

Behaviors:

Turn down jobs that are “beneath” them. Work overtime, second jobs, or do under-the-table work.

Binge spending, giving $ to someone else, gambling - finding ways to get rid of it.

How the Prison Mindset Activates Addictive Thinking:Survival and Money
how the prison mindset activates addictive thinking survival and money1
Thoughts:

I need money to be somebody.

I need money to give to my partner or children.

Behaviors:

Flash cash, Showboating

Give away savings, rent or grocery money to children or spouse.

How the Prison Mindset Activates Addictive Thinking:Survival and Money
how the prison mindset activates addictive thinking survival and relationships
Thoughts:

I can’t make it on my own. I need someone to take care of me.

I need to be needed.

Behaviors:

Moves in with a partner who already has a house and structured lifestyle.

Selects a needy caretaking partner who enables addictive behavior.

How the Prison Mindset Activates Addictive Thinking:Survival and Relationships
prison mindset defining features1
Prison Mindset: Defining Features

Conditioned from living in prison and based on:

  • Routines are structured by someone else.
  • Choices are made by the partner. Ex-offenders lack the ability to make decisions in the relationship.
  • Basic needs are met without any effort.
  • Have to constantly prove oneself in the relationship.
  • Respect and safety is generated by inflicting fear in the relationship.
  • Hears feedback as an attack which triggers aggression towards the partner.
  • The goal is simple – SURVIVAL!
roundtable exercise
Roundtable Exercise
  • Identify someone as a reporter/scribe
  • With your peers at your table, identify:
    • What are the common barriers (attitudes, feelings, behaviors) you have to help your clients deal with when they are in job search?
    • What job retention barriers do you have to often address with your clients to help them stay employed?
    • What are the reasons your clients give as to why they quit or lost their job? (can’t use substance use).
    • What do you think are the real reasons your clients quit or lose their jobs? (can’t use substance use
    • Count the number of people at your table that ask about money and relationships as a routine part of your case management?
suggestions for further thought
Suggestions for Further Thought
  • The Prison Mindset doesn’t leave when the offender leaves prison - it just changes locations.
  • The Prison Mindset activates addictive thinking and behaviors in ex-offenders.
  • Addictive behaviors are intricately related to recidivism.
  • Recidivism is reduced when one addresses the prison mindset and the addictive behaviors which become activated in work, money, and relationship settings.
  • Recidivism would be better understood as a process, not an event. Each ex-offender has a specific and unique pattern that follows a predictable course of events prior to ending in re-arrest. By collecting information on one’s addictive behaviors, case managers could identify various patterns of recidivism and tailor specific interventions to address them.
references
References

1 Timmerman, I.G. & Emmelkamp, P.M. (2001). The prevalence and comorbidity of axis I and II pathology in a group of forensic patients. International Journal of Offender Therapy and Comparative Criminology, 45 (2), 198-213.

2 Ibid

3 Kouri, E.M., Pope Jr., G.H., Powell, K.F., Oliva, P.S., & Campbell, C. (1997). Drug use and history of criminal behavior among 133 incarcerated men. American Journal of Drug and Alcohol Abuse, 23 (3), 413-419

4 Ibid

5 National Institute of Justice. (1989). NJR Reports, 215, Washington DC.

6 National Institute on Addiction and Substance Abuse, (1998). Behind Bars: Substance Abuse and America’s Prison Population. New York: Columbia.

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