Fitting a quart into a black box: Keyworking in quasi-coercive drug treatment in England

Abstract

Aims: The aim of this article is to assess what goes on in treatment sessions in courtmandated drug treatment in the UK. Methods: The study used a case note audit involving interviews with drug workers about each of their active cases, assessing client characteristics and their reports on what activities had taken place in treatment sessions. Findings: The average session lasts just under 30 minutes and typically at least three different types of worker-led activity are engaged in per session, often including time spent on compliance with treatment, with prescriptions and with the testing requirements of the court mandate. The amount of time dedicated to evidenced psychosocial interventions is typically less than 10 minutes. Conclusions: The tensions reported elsewhere for drug workers engaged in criminal justice services are evidenced in the study given the range of tasks (potentially conflicting) that drug workers are required to engage in and the limited opportunity for them to engage in effective psychosocial drug treatment.

Impact of treatment for opioid dependence on fatal drug‐related poisoning: a national cohort study in England

“…However, the present results concur with findings from a large‐scale cohort indicating that CJS referral is associated with a reduced likelihood of the patient achieving abstinence or reducing drug use . It has been suggested that the crime reduction and administrative demands in the CJS may limit time for clinical interventions to treat dependence .…”

What Influences Referral to 12-Step Mutual Self-Help Groups by Treatment Professionals?

“…The limited correlation between subjective and objective measures of what treatment staff knew about TSGs suggests that there is considerable scope for basic education about the structure and function of these groups and their associated Fellowships. Whilst UK treatment centres rarely overtly incorporate the 12 steps into their policies and practices [34], systematically encouraging staff to learn about TSGs and encouraging them to promote the potential benefits of attendance may prove a cost-effective strategy.…”

Does Coerced Treatment of Substance‐Using Offenders Lead to Improvements in Substance Use and Recidivism? A Review of the Treatment Efficacy Literature

“…A total of 24 studies address the implementation, organisation, and process factors associated with substance use treatment in the criminal justice system. A large proportion of these articles consider issues associated with drug‐courts and court‐mandated treatment (Best, Wood, Sweeting, Morgan, & Day, 2010; Bouffard & Taxman, 2004; Cresswell & Deschenes, 2001; Evans, Anglin, Urada, & Yang, 2011; Finch et al., 2003; Fosados, Evans, & Hser, 2007; Frisman et al., 2006; La Prairie, Gliksman, Erickson, Wall, & Newton‐Taylor, 2002; Maeder & Wiener, 2008) while far fewer investigate their implications with regard to arrest‐referral schemes (Corlett, Skrzypiec, & Hunter, 2005; Sondhi & Huggins, 2005) and pre‐plea referral programs (Passey, Flaherty, & Didcott, 2006). A substantial number of studies investigate structural considerations within the broader context of treatment for substance‐using offenders both within contained settings and in the community (Friedmann, Taxman, & Henderson, 2007; Jessup, 2001; Kubiak, Arfken, & Gibson, 2009; Lehman, Fletcher, Wexler, & Melnick, 2009; Oser, Knudsen, Staton‐Tindall, & Leukefeld, 2009; Oser, Knudsen, Staton‐Tindall, Taxman, & Leukefeld, 2009; Stemen & Rengifo, 2009).…”