(51) The Female Offender Re-Entry Movement (FOR-Me): Increasing Access to SUD treatment

Background: The FOR Me program expanded specialized substance use disorder and trauma treatment, related recovery, and reentry services for adult female offenders, age 18 and over, sentenced to incarceration as adults, who have been diagnosed with substance use and/or co-occurring mental disorder, with a particular emphasis on those women who also have high-risk histories of sex trafficking/prostitution.

Methods: Participants were within four months of scheduled release to the community; and, upon immediate release, referred to community-based treatment and recovery services. Trained recovery coaches applied proven pretreatment intervention techniques (prescreening and motivational interviewing, combined with support-building experience and trust) to facilitate entry into treatment and improve outcomes for treatment and recovery. Data were collected at baseline and a six-month follow-up (f/u) interval.

Results: There were 113 participants, 40% identified themselves as racial/ethnic minority, 72% were between 25-45 y/o. The response rate at 6-month f/u was 46% (52/113). Abstinence rates improved from 0% at baseline to 93.8% at 6 months f/u. Nearly a third (31.9%) of respondents reported injection drug use at baseline, and 11.5% reported sharing injection equipment, and no one reported injecting or sharing injection equipment at 6 -m f/u. There was a 37% change in sexual activity reported from baseline to 6-m f/u, although the prevalence of unprotected sex at 6-m f/u was concerning (12.1%). Self-reported psychiatric symptoms improved between 13-30% by various conditions compared to baseline. Almost all (94.7%) of the respondents reported experiencing violence in their lives. Trauma symptoms were extremely high at baseline and decrease significantly at 6-m f/u: nightmares (Baseline: 90.3% vs. 6-m f/u: 48%), intrusive thoughts (91.2% vs. 50%), hypervigilance (83.2% vs 38.9%), and numb (78.8% vs. 35.2%). There was a 2,000% improvement in employment stability by 6 months f/u among responders.

Conclusion: Increasing equity entails reshaping the delivery of care for SUD and re-entry services that directly address and eliminate factors that lead to re-incarceration. Client-centered approaches and pre-post release interventions can improve recovery capital and psychosocial functioning among adult female offenders.

Funding: SAMHSA/CSAT Grant Number TI-026362

References: 1. Hien, D., Kropp, F., Wells, E. A., Campbell, A., Hatch-Maillette, M., Hodgkins, C., . . . Nunes, E. V. (2020). The "Women and Trauma" study and its national impact on advancing trauma specific approaches in community substance use treatment and research. J Subst Abuse Treat, 112s, 12-17. doi:10.1016/j.jsat.2020.02.003
2. López-Viets, V., Walker, D. D., & Miller, W. R. (2002). What is motivation to change? A scientific analysis. In M. McMurran (Ed.), Motivating offenders to change: A guide to enhancing engagement in therapy (pp. 15-30). Chichester, UK: John Wiley & Sons Ltd. .
3. Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change: Guilford press.
4. Najavits, L. M. (2002). Seeking safety: a treatment manual for PTSD and substance abuse: New York: Guilford Press, [2002] ©2002.