title: Collaborative behavioral management among parolees: drug use, crime and re-arrest in the Step'n Out randomized trial.
abstract: OBJECTIVE
  To determine whether collaborative behavioral management (CBM) reduces substance use, crime and re-arrest among drug-involved parolees.
  
  
  METHODS
  Step'n Out was a randomized behavioral trial of CBM versus standard parole (SP) during 2004-08. CBM adapted evidence-based role induction, behavioral contracting and contingent reinforcement to provide parole officer/treatment counselor dyads with positive tools in addition to sanctions to manage parolees' behavior over 12 weeks.
  
  
  METHODS
  Six parole offices in five states in the USA.
  
  
  METHODS
  Parolee volunteers with a mandate for addiction treatment and a minimum of 3 months of parole (n = 476). Follow-up was 94% at 3 months and 86% at 9 months.
  
  
  METHODS
  Drug use and crime in a given month from calendar interviews 3 and 9 months after parole initiation, and re-arrests from criminal justice administrative data.
  
  
  RESULTS
  The CBM group had fewer months in which they used their primary drug [adjusted risk ratio (ARR) 0.20, 95% confidence interval (CI): 0.05, 0.78, P = 0.02] and alcohol (ARR 0.38, 95% CI: 0.22, 0.66, P = 0.006) over follow-up. CBM had its greatest effects among parolees who reported marijuana or another 'non-hard' drug as their primary drug; parolees who preferred stimulants or opiates did not benefit. No differences were seen in total crime, re-arrests or parole revocations.
  
  
  CONCLUSIONS
  Collaborative behavioral management may reduce substance use among primary marijuana or other 'non-hard' drug-using parolees without increasing revocations. Because the majority of drug violation arrests in the United States are for marijuana, these findings have important implications for the management of a substantial proportion of the US community correctional population.
authors.affiliation: Department of Veterans Affairs Medical Center, Providence, RI, USA. pfriedmann@lifespan.org
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
authors.forename: Faye S
authors.initials: FS
authors.lastname: Taxman
authors.forename: Magdalena
authors.initials: M
authors.lastname: Harrington
authors.forename: Anne G
authors.initials: AG
authors.lastname: Rhodes
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Katz
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Connell
authors.forename: Steven S
authors.initials: SS
authors.lastname: Martin
authors.forename: Linda K
authors.initials: LK
authors.lastname: Frisman
authors.forename: Mark
authors.initials: M
authors.lastname: Litt
authors.forename: William
authors.initials: W
authors.lastname: Burdon
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Clarke
authors.forename: Bennett W
authors.initials: BW
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003415:Crime / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D035846:Law Enforcement; D008297:Male; D011329:Prisoners / Q000706:statistics & numerical data*; D055502:Secondary Prevention; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome