With greater availability of evidence-based practices in the drug abuse field, specifically, for offender clients, it is crucial that we develop strategies that allow for the adoption, implementation and sustaining of aids to effective clinical practice. The task of establishing new, research driven initiatives requires accommodation by the host organization to permit support for the continuing use of those initiatives with appropriate levels of fidelity. With offender clients, the use of a continuum of care becomes particularly critical in as much as treatment initiatives begun in institutional settings need to be built upon and continued through the period of community reentry, making use of community-based treatment or other community resources. The effective implementation of treatment involving a continuum of care then requires work with two organizational systems - criminal justice and drug treatment - with both complementary and differing interests and concerns. We have set out an implementation strategy designed to allow these two systems to coordinate their efforts and support the adoption and maintenance of the three continuum of care initiatives described: (1) the use of Project RESPECT to initiate HIV prevention efforts in the institution, and continue that intervention into the community as offender clients are thrust into situations capable of triggering risk-taking behaviors;(2)within the institutional setting we propose to administer the Level of Service Inventory to determine areas of risk and of offender need, and the Criminal Thinking Scales to permit assignment of offender clients to appropriate levels of care as they reenter the community;(3) a treatment intervention involving the administration of methadone through the comparison of Interim Methadone Maintenance as compared to regular methadone maintenance initiated in detention centers in order to enable a transition to the community.
It is critical that we work with criminal justice and treatment organizations to enable them to adopt, implement into organizational settings, and sustain evidence-based treatment strategies that permit a continuum of care from criminal justice to community settings. The proposed initiatives may reduce adverse public health and public safety consequences of relapse as well as increase organizational functioning for both drug treatment and criminal justice agencies.
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