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Article Excerpt
The authors explored the psychometric properties of the Correctional Treatment Resistance Scale (R. A. Shearer, 1999). The scale showed preliminary promise as a screening instrument that can be used in a variety of treatment settings.
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An important question in the field of substance abuse treatment concerns the degree to which clients are willing to participate in counseling. This is a concern of counselors in free-world settings, but it is especially important for counselors who treat offenders who are identified for drug counseling in correctional settings.
Frequently, offenders are required to participate in community or institutional substance abuse counseling programs. Some are receptive to being coerced into counseling, but many are not. Traditionally, very little attention has been given to identifying offenders who were receptive to counseling and those who were not. The primary procedure has been to require the offender, by legislative mandate or court order, to attend substance abuse counseling programs as a form of legal leverage to ensure participation. Numerous studies indicate that individuals who were "forced" into treatment performed as well as voluntary clients across a broad range of treatment programs (Allison & Hubbard, 1985; Aron & Daily, 1976; DeLeon, 1985; Siddall & Conway, 1988). However, coercing offenders to seek therapy is a controversial issue that presents many ethical, legal, and practical implications (Flores, 1998). On the other hand, an important assessment issue concerns the factors relating to why inmates, similar to other clients, are resistant to counseling beyond the obvious reason that they resist because they are required to participate.
The Problem
The problem to be addressed in this pilot survey is "What are the psychometric properties of an instrument designed to measure treatment resistance?" The research is a pilot study and is exploratory and descriptive because very little is known empirically about correctional counseling resistance. In addition, because the reliability and validity is the focus in this initial study, a complete determination of the magnitude of the scale scores will be difficult. We hope that additional studies will refine comparisons between respondents who complete the Correctional Treatment Resistance Scale (CTRS; Shearer, 1999).
Importance of the Study
The results of this study may provide valuable information for screening inmates for substance abuse treatment programs. Specifically, the study was designed to
* provide a preliminary quantification of overall resistance to correctional treatment by establishing a base rate of resistance that can be used for comparison purposes with other treatment groups or subsequent posttest treatment comparisons;
* provide a preliminary quantification of specific factors in treatment resistance to determine which of these factors contributes to overall resistance;
* provide a preliminary screening instrument to identify offenders who are less likely to benefit from treatment programs so that they can be matched to more appropriate interventions (e.g., educational and consciousness-raising programs);
* provide an instrument to identify offenders who can benefit the most from substance abuse treatment programs and from more therapeutic treatment planning.
Background to the Problem
It has become common practice in the United States for offenders to be ordered to undergo counseling. This practice is variously referred to as "coerced treatment," "court ordered treatment," "mandated treatment," "involuntary treatment," or "compulsory treatment." In any case, the practice constitutes some degree of involuntary counseling with clients who may or may not be motivated to participate. The degree to which they are motivated tends to be inversely related to how resistant they are to participation. Not all offenders who are ordered to go to counseling, of course, are reluctant to enter substance abuse counseling and may welcome the opportunity to enter into a counseling relationship or participate in a program that will help them improve their lives or personal problems. Furthermore, many offenders participate in forms of treatment other than counseling. There is substantial psychiatric treatment literature and a large body of case law that covers the right to refuse treatment, even when treatment has been court ordered (Winick, 1997). Resistance to therapeutic substance abuse interventions is our focus in this article and not the delivery of psychiatric and mental health services that tend to be viewed under a broader canopy of correctional treatment. Furthermore, the terms counseling and treatment tend to be used ambiguously and inconsistently in the field of substance abuse. As can be seen in the subsequent review of the literature on resistance, the two are sometimes used interchangeably.
In this study, treatment refers to a broad program description in substance abuse, including drug and alcohol education, therapeutic communities, and counseling, both individual and group. Although the study focuses primarily on substance abuse counseling, the implications of any possible conclusions may be wider because many substance abuse counselors conduct drug and alcohol education programs and work in association with therapeutic communities. This distinction is also consistent with how...
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