Monday, October 31, 2005

Incarceration, Pain, and Motivation for Change

In my workshop last week at IAODAPCA, a few important comments were made about the nature of pain (specifically incarceration) as a therapeutic factor in the process of change. I'll briefly summarize information I provided with key points made by workshop participants.

Elliott Currie suggests that incarceration fails to deter criminal behavior because of social factors that reinforce what may be called the “street-prison nexus”, also known as the revolving prison door. This street-prison connection may actually help to forge antisocial relations, turning the joint into another type of ‘hood’ that need not be feared.

According to Currie, incarceration fails to deter criminal behavior not in spite of its risks but because of them. In other words, doing hard time, or performing acts that could result in hard time, warrants respect and prestige on the street. Currie also suggests that the risks associated with incarceration provide a sense of challenge and meaning to committing street crime. This sense of meaning and challenge is necessary for human fulfillment and is often hard to find by legitimate means for many at the lower end of the socioeconomic scale. Therefore, the meaning and challenge of street crime may be more valuable than any other gains associated with it (money, drugs, etc), and may be more persuasive than the pain of incarceration.

On the other hand, some people suggest that the pain of being locked up is often a necessary ingredient in someone changing their behavior. Several relevant points were made during the workshop. One participant seemed pretty certain that the pain of incarceration is a very important factor in change. In other words, once the pain of committing crime or using drugs outweighs the pleasure, motivation for change is likely to occur. Others suggested that incarceration effects behavioral change for some, but not all, individuals. Another person pointed out that even if incarceration doesn’t work, that does not invalidate the “pain outweighs pleasure” theory, it just means that incarceration fails to cause meaningful pain for the individual. In other words, the sociological factors presented by Currie provide more meaning to the drug life than incarceration provides in deterrence.

So here are my questions to you:

Which side of this debate do you fall on? How is incarceration effective or ineffective for recovery?

If incarceration works for some substance abusing offenders but not others, which ones and why?

If you work in a correctional facility, do you see the trend toward more sanctions (limited movement, strict rules, etc) as enhancing treatment and recovery?

If pain motivates, how do we explain the cycle of substance abuse, relapse, and criminal recidivism in so many people’s lives despite what would seem to be immense amounts of pain?

How do you think this discussion should guide how we conduct substance abuse treatment with the court mandated/ incarcerated/ ex-offender?

(to respond, click on comments below, then type your comments in the new window, then click anonymous, then click publish.)

Friday, October 28, 2005

Welcome to my online journal

Hello Friends and Colleagues,

Welcome to my online clinical journal. There are two main reasons I've created this weblog. On the one hand, I hope to use this as a follow-up forum for my trainings and presentations. In other words, if you attend one of my workshops you may come here afterward to continue the conversation with myself and others regarding issues discussed in the workshop. In this way, my goal is to transform the training atmoshpere from a uni-directional, one-time event to a multi-directional, ongoing process. The other reason for this blog is simply to have a place where I can work out my own thoughts regarding various clinical issues.

I believe that in order to maintain vitality and well-being in the counseling profession it is important to have a plethora of supportive voices providing ideas and feedback. I think that it is often times helpful that some of these voices are found outside of one's own direct work setting. My hope is that this blog can be such a resource for you (and me!!). To that goal, I encourage you to help me make this interactive and valuable by checking back often, leaving your thoughts and comments, and spreading the word to others you think may benefit from visiting.