Evaluating The T.E.A.C.H. Program:

The Effectiveness of Addiction Treatment Coupled

with Higher Education

presented at thepresented at the

University of California IrvineUniversity of California Irvinebyby

Brendan Bickley & Paul AlexanderBrendan Bickley & Paul Alexander

May 15, 2004

WAR ON DRUGS = FAILUREWAR ON DRUGS = FAILURE

Why Study Addiction Treatment?

““We are speaking We are speaking of a plague…a of a plague…a plague for which plague for which no cure is at no cure is at hand, nor in hand, nor in prospect”prospect”

William F. BuckleyWilliam F. Buckley Commenting on the War on DrugsCommenting on the War on Drugs

““Our drug Our drug prohibition prohibition

policy is policy is hopeless.”hopeless.”

Judge James P. GrayJudge James P. Gray

“ “Why Our Drug Policy Why Our Drug Policy Failed…”Failed…”

Alcoholism and Drug Addiction is a Alcoholism and Drug Addiction is a medical disease (DSM IV)medical disease (DSM IV)

25 % of jail inmates 25 % of jail inmates committed their offense to get money for committed their offense to get money for drugs (Bureau of Justice)drugs (Bureau of Justice)

Almost 70% of inmates involved with drugs Almost 70% of inmates involved with drugs

prior to incarceration(“Drug Use,” 2000).prior to incarceration(“Drug Use,” 2000).

The U.S. Federal Government spent $19 billion The U.S. Federal Government spent $19 billion dollars in 2003 on the War on drugs; a rate of dollars in 2003 on the War on drugs; a rate of about $600 dollars per secondabout $600 dollars per second

Drug Addiction & Alcoholism in the U.S.

A medical condition calls for a medical A medical condition calls for a medical responseresponse

Treatment Works.Treatment Works.

15 years of research establishes this fact.15 years of research establishes this fact.

What constitutes effective treatment.What constitutes effective treatment.

What is The T.E.A.C.H. Program?What is The T.E.A.C.H. Program?

Transitional, Education, Action, Career, HelpTransitional, Education, Action, Career, Help

A Unique Addiction Treatment Modality combining higher A Unique Addiction Treatment Modality combining higher education and traditional, 12-step drug and alcohol education and traditional, 12-step drug and alcohol treatmenttreatment

Founded and implemented in 1998 under the umbrella of Founded and implemented in 1998 under the umbrella of Sober Living by the Sea Treatment Centers Inc.Sober Living by the Sea Treatment Centers Inc.

*

• A positive impact on re-arrest rates and criminal behavior (Frease, 1973; Garrett & Larson, 1996; Hirschi,1978; Johnson, 1979).

• Sentencing of first-time, non-violent drug offenders to classes related to addiction is a common practice (Wilson, 1998; Wapner, 1996).

• Empower patients, ease their defenses, and reduce the stigma they experience (Finnell, 2000).

• Personal accomplishment, a sense of participating in a socially valued endeavor, the anticipation of

legitimate employment (Walsh, 1985).

Education’s Impact on Addiction Education’s Impact on Addiction RecoveryRecovery

Addiction Counselor Training and Addiction Counselor Training and EducationEducation

1.1. Department of Psychology at the University of Arizona Department of Psychology at the University of Arizona StudyStudy (Kahn & Stephen, 1981).(Kahn & Stephen, 1981).

2.2. Australian State of Queensland StudyAustralian State of Queensland Study (Kahn & Fau, 1981).(Kahn & Fau, 1981).

3.3. Southern California Community College System StudySouthern California Community College System Study (Wilson 1998).(Wilson 1998).

Success

Education Treatment

Previous Studies show this Previous Studies show this

rehabilitative model is highly successful.rehabilitative model is highly successful.

Previous Research on the Effects of Education + Treatment

Articles About the TEACH ProgramArticles About the TEACH Program

TEACH is unique in its approach to transitional treatment.TEACH is unique in its approach to transitional treatment.

The effort to re-integrate the addicted individual back into The effort to re-integrate the addicted individual back into society by enrolling them at a local community college is an society by enrolling them at a local community college is an unprecedented approach. unprecedented approach.

Proximity to researchersProximity to researchers

Research Site: Sober Living by the Sea’s T.E.A.C.H Program

Sober Living By The Sea Houses

Figure 1. Sober Living By The Sea Structure

Addiction Treatment FacilityNewport Beach, CA

90 Days of Traditional Residential Treatment

90 Day -3 Phase ProcessPhase IPhase IIPhase III

Clients can enter TEACHAt any point in the 3 Phase

Process of their treatment.

Combines all the treatment from the traditional 3 Phase process, but adds classes at a community college.

Traditional Treatment Defined:

•Group Process

•Recovery Meetings (AA, NA, etc.)

•1-on-1 Therapy or Case Management

•Structured Living Environment

•Random Urinalysis Testing

+

The T.E.A.C.H. College Program

HypothesesHypotheses

Enrolling clients in college classes (Human Services Enrolling clients in college classes (Human Services Classes) while receiving addiction treatment at a Classes) while receiving addiction treatment at a primary drug and alcohol treatment facility primary drug and alcohol treatment facility increases the likelihood of continuous abstinence increases the likelihood of continuous abstinence from drugs and alcohol.from drugs and alcohol.

H1

Hypotheses (cont.)Hypotheses (cont.)

Clients involved in the T.E.A.C.H. Program will Clients involved in the T.E.A.C.H. Program will score higher on the following measures of overall score higher on the following measures of overall success at the time of discharge: completion of success at the time of discharge: completion of steps, completion of treatment goals, remaining steps, completion of treatment goals, remaining abstinent in treatment, and clinician’s estimation abstinent in treatment, and clinician’s estimation of success.of success.

H2

Commitment to Recovery – Clients in the Commitment to Recovery – Clients in the T.E.A.C.H. Program are more likely to remain T.E.A.C.H. Program are more likely to remain active in recovery six months after discharge.active in recovery six months after discharge.

H3

Hypotheses (cont.)Hypotheses (cont.)

MethodologyMethodology

• Random Sample of 150 cases selected from a pool of approximately 1000 cases.

• 75 SLBTS + 75 T.E.A.C.H.

• Archival data directly coded from past participants case files.

• Six month post-treatment phone survey.

DataData

• Addiction Severity Index

• MMPI-II (Minnesota Multiphasic Personality Inventory- 2)

• Progress/Success Instrument

• Taken from clinician’s discharge summary.

• Post Treatment Measures

• Survey administered Six Months after discharge.

Sample CharacteristicsSample Characteristics

SLBTS GroupSLBTS Group TEACH GroupTEACH Group

GenderGender 66% male66% male

34% female34% female

56% male56% male

44% female44% female

AgeAge 29.529.5 21.9221.92

Length of StayLength of Stay 3.96 Months3.96 Months 6.49 Months6.49 Months

Prior TreatmentsPrior Treatments 2.902.90 2.212.21

Main DrugMain Drug Heroin/CocaineHeroin/Cocaine Alcohol/HeroinAlcohol/Heroin

First Use Alcohol First Use Alcohol 13.213.2 13.913.9

First Use DrugsFirst Use Drugs 15.0915.09 15.6215.62

Job TenureJob Tenure 61.65 Months61.65 Months 16.13 Months16.13 Months

Need for Treat.Need for Treat. 6.756.75 6.56.5

VariablesVariables SLBTSSLBTS TEACHTEACHH1 Continuous Sobriety 1.211.21 1.561.56 ***p<.001

HH22 Completed ProgramCompleted Program 1.121.12 1.251.25 n.s.

HH22 # Steps Completed # Steps Completed 7.637.63 8.238.23 n.s.

HH22 Number of relapses Number of relapses .65.65 .52.52 n.s.

HH22 Completed Treatment Completed Treatment GoalsGoals

1.281.28 1.231.23 n.s.

HH22 Clinicians Estimation Clinicians Estimation SuccessSuccess

2.312.31 2.792.79 ***p<.001

HH33 Employed at DischargeEmployed at Discharge 1.791.79 1.881.88 n.s.

HH33 Recovery MeetingsRecovery Meetings 1.211.21 1.201.20 n.s.

Results

Participants in The TEACH Program were significantly more likely to have a higher estimation of success at the time of discharge and maintain continuous abstinence from drugs and alcohol six months post – release.

General Finding

In Perspective:In Perspective:

Relatively small sample sizeRelatively small sample size

Difficult to eliminate variables that might influence Difficult to eliminate variables that might influence outcome measures.outcome measures.

Ethnicity and SES were relatively uniform, whereas age Ethnicity and SES were relatively uniform, whereas age between the groups differed significantly.between the groups differed significantly.

Self report validity.Self report validity.

• Dr. Valerie Jenness, UCI Honors Seminar Instructor

• Dr. George Tita, UCI Faculty

Mentor • Dr. Dick Wilson, Saddleback

College

Research Assistants: Nicole Riedman, Saddleback

College Missy Tenzer, Saddleback

College Heather Volcom, Cal State

Fullerton

Funding Sources: Undergraduate Research

Opportunities Program (UROP)

Acknowledgements

For more information contact us at:

Paul Alexander & Brendan BickleyDept. of Criminology, Law and

SocietyDepartment of Social Ecology

University of California,Irvine

palexand@uci.edubbickley@uci.edu