This study takes advantage of relatively large samples of women offenders to examine their motivation to participate in community-based aftercare, as well as the effects of their participation in aftercare on their risk for recidivism. Although a majority of the survey participants intended to go to aftercare upon their parole, only about one third indicated their interest in going into FOTEP, where needed employment, vocational, parenting, and health-related services are provided. Moreover, motivation for aftercare was highly variable among the sample. In particular, the lower levels of treatment motivation among African American, Hispanic, and women of “other” racial/ethnic groups, as well as their underrepresentation in aftercare treatment programs relative to their incarceration rates, raise concerns given their higher reported need for economic and health services (Grella & Greenwell 2007
) and the health disparities among minority women that are further exacerbated by their higher rates of incarceration (Freudenberg 2002
). Research is needed to better understand how their participation in treatment is influenced by external or system-related factors and by internal, motivational factors.
In contrast, women who were involved in the child welfare system were more highly motivated to enter treatment, as were those with previous drug treatment experience or who used “harder” drugs as their primary substance. Other research has shown that women inmates who expect to live with their children are more likely to enter into either in-custody or community aftercare (Robbins, Martin & Surratt 2009
; Pelissier 2004
), suggesting the central role of family reunification in influencing women’s treatment participation.
In prior evaluation studies, focus groups conducted with FOTEP participants indicated that some women who are eligible to participate in the aftercare program may decline because of compelling family commitments, a desire to return to a job or relationship, or because they do not want to continue to be in a confined environment following their release from prison (Grella 2008
). As the survey finding showed, these concerns may be counterbalanced by the provision of much-needed services (i.e., employment, family-related, mental health), a program’s proximity to a woman’s home and family, and the ability to have children in residence with them while in treatment. However, for many women, even these factors are insufficient in the absence of external pressure, such as from child welfare or parole, or incentives, such as early release from parole. Motivational interventions, designed specifically to address these barriers to treatment participation among women, may help to increase their problem recognition and willingness to participate, as has been demonstrated for male offenders (Rosen et al. 2004
Findings from the recidivism analysis supported the study hypothesis regarding effects of FOTEP treatment participation on reduced risk of recidivism. Specifically, individuals who completed treatment, or who stayed longer, had considerably reduced risk of returning to prison. In addition, those who had participated in prison-based treatment prior to FOTEP had reduced risk of recidivism. These findings suggest the additive effects of combining in-prison treatment and community aftercare, within a “continuing care” context (McKay 2009
An important consideration in interpreting these findings is self-selection bias, in which those participants who entered into FOTEP aftercare, and who completed or stayed longer, may be more likely to succeed on parole, independent of the possible beneficial effects of treatment. In addition, variables available for the recidivism analyses were limited to those in the administrative database and on treatment participation; more in-depth background information as well as data on psychosocial functioning while on parole are not available, thus limiting the scope of the analyses. Lastly, study findings may be specific to women offenders in California, stemming from the unique features of the population, the correctional system, and the treatment options available to women offenders.
The study findings demonstrate that women offenders with substance use problems have variable levels of motivation to participate in aftercare treatment. Motivational interventions that address the perceived treatment needs and preferences of this population and that promote the beneficial effects of participation in a continuum of treatment services on reducing their risk of recidivism, may help to increase treatment utilization among this population.