Assessment of a multistage therapeutic community for drug-involved offenders.

A multistage therapeutic community (TC) treatment program has been instituted in the Delaware correctional system. Components in place long enough to provide follow-up data consist of a TC in prison and a "transitional" TC outside the prison for parolees. Baseline data at release from prison, and outcome data six months after release were analyzed for 457 respondents. A group who had participated in neither of the TCs was compared to groups who had participated in the TC in prison only, the transitional TC only, or both TCs. The latter two groups had significantly lower rates of drug relapse and criminal recidivism, even when adjusted for other risk factors. There was also a reduction for the prison TC group, although more modest and statistically significant only when adjusted for baseline differences. Outcome benefits of the TC participation were also found for behaviors affecting the risk of HIV infection. The results support the efficacy of a multistage TC program and the importance of the transitional TC as a component.