Findings from mixed-methods feasibility and effectiveness evaluations of the “Breaking Free Online” treatment and recovery programme for substance misuse in prisons

Abstract

Reshaping substance misuse treatment in prisons is central to the UK Government's drive to address substance dependence in the prison population and reduce substance-related offending and recidivism. Therefore, a through-care project to support prisoners released from custody to community, ''Gateways'', is taking place across North-West England. Amongst support with housing, education, training and employment, Gateways incorporates the Breaking Free Online (BFO) substance misuse treatment programme. Aims: To explore BFO's potential to provide support to prisoners' substance misuse recovery and continuity of care post-release, and examine quantitative outcomes provided by prisoners who have used the programme. Methods: Qualitative interviews with prisoners and analyses of quantitative psychometric data collected pre-and post-intervention. Findings: Themes emerging from qualitative data around prisoners' experiences of engaging with BFO illustrate its potential for use in prison settings and also upon release to the community. Significant quantitative improvements to quality of life, severity of substance dependence and aspects of recovery progression illustrate initial effectiveness of BFO. Conclusions: The BFO programme demonstrates potential in providing effective treatment for offenders with substance misuse difficulties, and specifically in delivering continuity of care following release to the community.

A Qualitative Exploration of U.K. Prisoners’ Experiences of Substance Misuse and Mental Health Difficulties, and the Breaking Free Health and Justice Interventions

“…Therefore many prisoners can be at risk from falling between the gaps in service provision. Therefore, the implementation of the BFHJ interventions, which have already shown some success for individuals experiencing difficulties with both mental health and substance misuse in terms of supporting them to strengthen their resilience and build recovery capital (Elison et al, 2015c), may provide an opportunity to engage and treat this particular population and their multiple and complex needs.…”

“…For the purposes of the more formal evaluation of the BFHJ programme (reported in Elison et al, 2015c), interviews also contained questions about participants views of this new treatment programme and how they feel it may have benefited them, and also ways in which they thought it could be refined and improved.…”

“…Initial evaluation of BFHJ as part of Gateways have indicated that prisoners that use the programme experience significantly reduced consumption of, and severity of dependence to, both drugs and alcohol, along with improved quality of life and significant improvements in aspects of psychosocial functioning related to substance use recovery (Elison et al, 2015c). The BFHJ programme is intended to support prisoners to strengthen their resilience and build 'recovery capital' (Best & Laudet, 2010;Cloud & Granfield, 2008), defined as the 'sum of resources an individual has at their disposal to facilitate their recovery' (Best & Laudet, 2010: pg 5).…”

“…In other words, it is possible that personal circumstances, individual attributes, behaviours, values, etc., may 'actually impede one's ability to successfully terminate substance misuse and keep people trapped in the world of addiction'. Drawing on in-depth qualitative interviews conducted with prisoners as part of the BFHJ evaluation (the findings of which are not the focus of this paper, but are reported in full in Elison et al, 2015c), the study reported in this paper attempts to explore in detail prisoners' understanding of the links between their substance use, offending and mental ill health, and explore some of the past personal experiences of prisoners that may, in Cloud and Granfield's (2008) terms, be regarded as negative recovery capital that prevent individuals from overcoming their substance-misuse.…”

Using the “recovery” and “rehabilitation” paradigms to support desistance of substance-involved offenders: exploration of dual and multi-focus interventions

“…Therefore if prisoners are transferred between prisons, or released to the community, they can continue to access the same interventions. Initial quantitative outcomes have indicated that engagement with BFO in the prison setting is associated with significant improvements to offenders quality of life, severity of substance dependence and other aspects of substance misuse recovery (Elison et al, 2015c).…”