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First and foremost ensuring that they are clean from drugs. Once detoxification has been completed and maintained, intensive individual therapy is necessary. Therapy would address motivation and setting of goals. If the necessary motivation is being shown, the next step would be a residential rehabilitation programme followed by an aftercare phase upon release.
In Olaine Prison Addiction Centre there are implemented Addiction reduction programme that has been created based on joined experiences from Norway and Poland. Methods that are being implemented to motivate persons to take part in the programme: 1) External motivation (for the masses) – we are using rewards system. For example, inmates with addiction risk are informed that if they will not participate in the addiction reduction programme, they will not be rewarded with a lighter punishment (will not receive a higher level of the sentence serving regime and will not be eligible for conditional early release from deprivation of liberty Institutions); 2) Internal motivation (individually) – we use the “Motivational interview” method or change-oriented consultation. The goal – to make the client react to their own worries about their problems and to promote change. Then the method accents developing change-oriented motivation and helps the person begin activities that will lead to changing the undesirable behaviour. When arriving to the programme, the main task is to develop the feeling of responsibility – then the inmate will have difficulties to just abandon the started processes. Working methods with women in imprisonment places: 1) Staff implements programme with precise structure. 2) Inmates organize (with the help of officers) and managed interest groups (in the afternoon from 1-1,5 hours): Zumba, art, narcotics anonymous. 3) Inmates plan, organize and take part in joint events with performances. 4) Queen of Remote – each day one inmate is in charge of which TV programmes to watch. 5) Additional duties – cleaning, help in sport activities, preparation of the weekly topic. 6) Cooking once a week (culinary classes) – by the schedule. 7) Welcomes guests during family days (before then prepares decorations, sets the table, organizes activities for children). 8) Each month releases department newspaper (written by hand) – interviews, recipes, holidays, traditions, events, activities. 9) Prepares for and takes CSDD cycling permit exam. 10) Follows the schedule to take part in all compulsory activities. 11) Organizes free time (e.g., activities in fresh air – walk without smoking). 12) Organizes meetings to solve the problem.
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The only correction house for sentenced women implements different programs (rehabilitation program for drug/substance addicts, anonymous drug addict program, children of incarcerated alcohol addicts, Behavior-Interview-Change, etc.) which enhance motivation to stop using drugs and substances. Sentenced women are informed about damage and consequences of drug/substance use. It is assumed that rehabilitation program for drug/substance addicts has a very positive impact. A motivational interview Behavior-Interview-Change is targeted at sentenced women who lack motivation. They are invited to different positive occupation activities as well.
During the time in prison, it is the responsibility of the Prison and Probation Service (SPPS) to prepare the inmate for a better life on release, through training, work and various treatment programs. Since 1995, the proportion of newly admitted women in prison has remained stable at about 6-7% of the total client population. In total there are 282 places for women divided into 6 prisons. A survey from 2013 showed that 67 % of the female inmates had some form of abuse (as much as men), but the abuse among women was more serious and heavy. Drug abuse was most common. The women often had mental problems linked to their abuse. An important way to improve the clients’ chance of a life without crime and addiction is the use of rehabilitation and treatment programs. The long-term goal of the SPSS is that each client should be offered treatment based on level of risk of reoffending and criminological needs. The main purpose is to reduce recidivism. The interventions need to be based on well-founded knowledge of what is effective and focus on the factors that are most important to reduce the risk of relapse. The best effect of treatment efforts is achieved when the treatment meets the principles of risk, need and responsivity (RNR). Compliance with the RNR principles is ensured by each client having an individual plan in which the risk and need has been well assessed and when the specific criminogenic needs of the client are addressed with appropriate interventions. High and medium risk clients always have several dynamic risk factors that need to be addressed. This means that the goal should be for these clients to undergo intensive treatment. The treatment programs offered in the SPPS can be divided into: preparatory -, treatment programs and boosters. The treatment programs used in the SPPS target criminal behavior, violence, domestic violence, sexual offending and drug- and alcohol abuse. The majority of the programs are based on cognitive behavioral therapy (CBT) and have components derived from behavioral therapies and the cognitive therapy. The focus of the different therapies can vary, but the similarities between the different treatment programs are greater than the differences. An important difference compared to CBT in general is the focus on pro criminal attitudes. Additionally, most CBT programs for the clients in prison and probation have a strong feature of problem solving (which is part of CBT), which aims to make the client use a systematic and general approach to managing everyday problems, using the skills taught in the program. The SPSS today offers substance abuse treatment through our treatment programs Prism, Våga Välja and 12-step treatment. • Prism is a program for reducing individual substance misuse targeting drug- and alcohol-abusing clients whose crime is connected to the abuse. • Våga Välja targets drug- and alcohol-abusing clients whose crime has a clear connection to the abuse. • Twelve-step program. Alcohol and drug program, originally developed by Alcoholics Anonymous. The program is also called the Minnesota model and is from the USA. In prison it is mainly in use in special treatment wings. In addition to the above-mentioned treatment program, the SPSS has a special motivation program, VINN, for women. The program includes a survey of women's changing needs in different areas of life. The program focus on women with abuse or a criminal lifestyle. The aim of the program is, among other things, to give the participants knowledge of strategies for how they can find alternatives to drugging themselves, and how they can reduce the extent of their drug abuse. In order to secure effectiveness the programs are regularly reviewed by a scientific panel and only programs fulfilling the requirements will be granted accreditation. To be approved, a program must among other things include: a clear model of change, based on scientific evidence, use of effective methods and site accreditation, including monitoring of implementation and staff competence. Before applying for accreditation the program is usually tried out in a limited extent during development. After accreditation the aim is to offer the program to all offenders, according to assessed risk and needs. In recent years, we have seen a good development regarding Prism, but Våga Välja has had a declining development. 12-step is at a relatively constant level. We can conclude that we currently reach too small a number of clients with addiction problems with our treatment programs. Generally regarding women, there is limited research and evaluation of the effect of treatment programs for women in prison care. The treatment programs are an area that today is largely adapted to men and where the SPSS needs to develop the programs both based on the women's specific needs, but also on the basis of the prisons specific conditions. The SPSS has identified an increased focus on individual programs, a flexible approach to the number of participants in group programs, and that ongoing treatment should be able to continue and end in probation and increase the possibility of treatment through external actors. Based on the fact that both the research situation and the experience from the SPSS show a multiple problem among female clients, it is important that the treatment programs become one of several initiatives to reduce relapse in crime. Parallel to treatment in programs, there may be a need to offer individual therapy, in order to increase susceptibility to ongoing efforts. Finally, mention should be made that one difficulty with regard to women is that the population is so low that it is often difficult to get treatment in groups.
Incarcerated women are a rapidly growing population with complex mental health issues such as mental illness, substance abuse and trauma. SPS has recently developed a new behaviour programme for women in custody which aims to target, inter-alia, substance-related offending, although not addictions issues per se. Called ‘Ultimate Self’, it uses a ‘compassion focused model’ to help women overcome feelings of shame which can often block progress. The model comprises a number of different themes: honouring oneself; adopting a new mindset; gaining self-awareness and insight; accepting and letting go; desiring self-improvement and enacting change; and flow of self-compassion. Difficulties with emotion regulation can result in risk-taking and aggressive and violent behaviours. Self-compassion, which involves relating to oneself in an accepting and kind way during times of distress, has been shown to promote psychological well-being and adaptive emotion regulation skills. The National Health Service in Scotland provides substance misuse interventions in Scottish prisons and SPS also has its own Substance Misuse Strategy: 220.127.116.11 Substance Misuse - Focus on Recovery a There is equity of access to effective treatment and rehabilitation services which promote recovery. b There is an evidence-based approach to planning, designing and delivery of services to promote recovery. c There are systems to enable effective communication and information sharing protocols in place ensuring prisoner consent. d Prisoner needs are central to the care planning process and are regularly reviewed to reflect progress made towards recovery. e Family involvement in the care planning and case conference decision-making process is encouraged where appropriate. f Establishments liaise with relevant organisations to ensure that drug-related deaths are reduced following release from prison. 18.104.22.168 Substance Misuse - Range of Services a Prisoners are offered an assessment in order that appropriate treatment and care services can be provided to meet their identified needs. b Clinical treatment and care will be provided in accordance with the Memorandum of Understanding (MOU) between SPS and NHS Boards. c Prisoners are provided with information at induction on how to access substance misuse and throughcare services whilst in prison and also on release. d There is a multi-disciplinary approach to the provision of substance misuse services with access to wraparound care. e Access is provided to peer led organisations as appropriate. f Education and awareness, approved activities and prisoner programmes specific to substance misuse are delivered in accordance with the SPS Intervention Strategy. g Prisoners are included in public awareness campaigns. h There is a safe and supportive environment to promote recovery where services can be concentrated and delivered to motivated prisoners. 22.214.171.124 Substance Misuse - Effective Integration a Prisoners are offered an integrated package of care based on their individually assessed needs. b Prisoners are encouraged to participate in the Integrated Case Management (ICM) process to address their problematic drug and alcohol use and offending behaviour issues. c The SPS Integrated Addictions Process is adopted as the model of care by joining up medical treatment with addiction services; whilst linking individuals to wider wraparound support and vital throughcare services to assist the recovery process. d Appropriate referrals are made to the relevant Child Protection agencies. e There is a consistent approach to service delivery and the provision of continuity of care across the prison estate. f Establishments work in partnership with NHS Boards, Local Authorities and Throughcare Addiction Services to achieve closer integration and a seamless transition from prison to the community. g Establishments optimise links with Criminal Justice Partners and Alcohol and Drugs Partnerships (ADP's) to ensure that the prisoner population needs are recognised and linked into community based services on release.
We have only the Norwegian VINN program for women, which is a general program. How it works so we have no research available yet. The overall purpose of VINN is to motivate women, serving sentences, and support their ability to cope, increase their sense of coherence and promote a more active adaptation to their environ¬ment and thus foster a better quality of life. VINN motivates participants to explore their internal and external resistance resources, and help them identify how to use these resources in order to cope in situations where they are at the risk of com¬mitting crimes or displaying unwanted behav¬iour, and thus build up more healthy and meaningful ways of living. Participants are stimulated to create positive relationships with others and to receive and give social support. VINN covers a variety of topics and the facilitator aims at involving participant(s) in re¬flec¬tive dis¬cussions of the following 15 topics: 1) Getting to know each other 2) Identity - Who am I? 3) Communication 4) Crime 5) Changes and choices 6) Economy and property crime 7) Substance abuse and addic¬tion 8) Love and Sexuality 9) Children 10) Grief and loss 11) Anger 12) Violence 13) Boundaries in rela-tionships 14.) Network and relationships 15) Summing up and closing (Compulsory top¬ics are written in bold).
No specific program exists for women. They have access, like male prisoners, to the care and follow-up programs of the services of the French community. There is a Public Health project on treatment for drug addicts in Brussels, but this is mainly concentrated in the prison of Sint-Gillis (Brussels) for men.