From incarceration to community care: structured assessment of correctional adaptation.

In this study, the authors extend their evaluation of a structured instrument for assessing the persistence of attitudes and behaviors developed by mentally ill offenders during periods of incarceration (Structured Assessment of Correctional Adaptation; SACA) and seek to demonstrate further the clinical significance of the construct of correctional adaptation. The subjects, patients at a state psychiatric center, were administered the SACA, along with the Brief Psychiatric Rating Scale the Psychopathy Checklist: Screening Version and Working Alliance Inventory. Chart review captured relevant demographic, diagnostic, and correctional history variables. Results were analyzed comparing patients with and without incarceration histories. The SACA total score demonstrated strong interrater reliability and association with criminal history indices of validity. Patients with histories of incarceration were significantly more likely to score higher on the Correctional Adaptation measure and lower on the Bond subscale of working alliance. Controlling for symptom severity and psychopathy did not alter the negative relationship between correctional adaptation score and the Working Alliance Inventory.