Jackson Recovery Centers, with the support of the Woodbury County Sheriff’s Department and other community organizations, has been awarded a contract from the Iowa Department of Public Health to develop substance abuse assessment and treatment for the jail population. By involving low risk offenders in a combination of research-based therapies, both while in jail and after release, the objective is to reduce recidivism and substance abuse in the community. Our program will afford patients the opportunity to rise up from the ashes of addiction and criminal behavior and start living a pro-social life of recovery.

The Treatment Model

The Phoenix Project treatment program is based on Cognitive Behavioral Theory. The aim of this proven curriculum-based program is to help the patient change the dysfunctional way he (or she) thinks, and promote behavioral change through three stages.

Stage I	Challenge to change: The goal of this stage is to move a patient from the precontemplative stage (a lack of awareness of any problem) and start identifying things in his or her life which he needs to change. Stage I of the program also gives basic education on drugs and alcohol, some relapse prevention skills, prepares the patient for the next step.
Stage II	Commitment To change: Having identified the reason to change, thinking errors, cognitive distortions, as well as social and coping skills, to name a few.
Stage III	Ownership of change: Maintenance of new skills, posttreatment planning, and relapse prevention skills are the primary elements of Stage III curriculum.

Treatment Components

The initial grant guidelines called for candidates for this program to be treated intensively for 30 days or more, while remaining incarcerated. Preliminary discussions with the Sheriff’s office and data on typical lengths of stay led us to propose a treatment program that could seamlessly integrate both residential and outpatient treatment. Ideally, patients would be available to the in-jail component approximately 30 days, but earlier release or work release would not necessarily interrupt the treatment experience. Upon release participants could continue therapy with the same therapy team and program on an outpatient basis.

Assessments: Offenders will be screened for overall risk and risk for substance abuse problems as part of the routine intake process at the Woodbury County Jail, and offered the opportunity to be assessed for substance abuse treatment. Participation in the formal assessment program is voluntary due to the grant structure. Once approved for the program, it will be up to the attorneys and judicial branch to accept the patient’s petition for this program.

The In-Jail program at Prairie Hills will be of approximately 30 days duration. CBSAT (Cognitive Behavioral Substance Abuse Treatment) will be the primary form of treatment conducted in group therapy five evenings per week, with groups running seven days per week for two or three hours on weeknights. Individual therapy sessions will be held during the day and on weekends depending on patient availability. The therapist will facilitate a 12-step group during the week. We also provide services to females in the jail setting.

Patients will typically receive Stage I and part of Stage II at the Prairie Hills facility. The criminal conduct and substance abuse group is only a part of the treatment episode that the patients will receive while in Prairie Hills. Other curriculum elements include:

• Daily living skills
• Social and interpersonal skills
• Job-seeking skills

Outpatient Program: The Phoenix Outpatient Program follows the same structure as the residential component, and is conducted at Jackson Recovery Center’s 800 5th Street location. We expect that the majority of patients will have received some treatment before coming to outpatient, but patients may be referred directly into outpatient services under some circumstances.

Once the patient is transferred to outpatient, he or she will need to attend a minimum of two AA/NA meetings per week and obtain a temporary sponsor during that period. The patients will attend outpatient treatment at Jackson for up to 120 days. During this time, the patients will continue with CBSAT group and be expected to progress through Stage II and III before successful discharge. While they are in outpatient, they will be under the care of the primary therapist who will ensure they continue following through with their treatment recommendations and treatment plan.

Jackson believes it is very important to involve the family in treatment as well. Substance abuse, as we know, is a family disease and affects every part of the family both immediate and extended. Therefore, we will afford the patients an opportunity once they have completed the 30-day program at Prairie Hills and the transfer to outpatient, to be involved in our family education program. The families of the patients involved will also be afforded the opportunity to attend the Family Education Series. Family and Couples counseling will also be available on an individual basis depending on the needs of the patient.

Outcome monitoring: We will be using an evaluation process that will give pre-treatment, mid-treatment, and post-treatment measures of patients’ skills, as far as substance abuse and criminal thinking to see if there is any change or improvement. The Iowa Department of Public Health has retained the Iowa Consortium to track success rates of this program throughout the treatment episode.