Moore, Mitchell Jay. “Examining Participants’ Motivation to Change in Residential Drug Abuse Program Graduates: Comparing “Stages of Change” Assessment Data with Post-Release Status.” Ph.D. dissertation, University of Minnesota, 2011.

This study compared Residential Drug Abuse Program (RDAP) completers against RDAP non-completers under supervised release (n=195). The following results were found in the areas of criminality, substance use, employment stability and housing stability.

---

---

---

Overall, those who did not complete RDAP were at more than three times greater risk for having their supervision revoked than RDAP completers.
(N = 195) Hazards Ratio = 3.500, p < .05.

Proctor, S. L., Hoffmann, N. G., & Allison, S. (2012) The Effectiveness of Interactive Journaling in Reducing Recidivism Among Substance-Dependent Jail Inmates in International Journal of Offender Therapy and Comparative Criminology Volume 56 Issue 2, April 2012.

Introduction
The Changing Course Interactive Journal was created as a self-directed resource for participants to start the process of making positive life changes. Participants reflect on their current choices and consider the connection between alcohol, other drugs and crime. Emphasis is placed on weighing the costs and benefits of making life changes, learning effective strategies for successful self-change and developing a plan to follow through with the choice to change.

Description and Methods
In a Randomized Controlled Trial, substance dependent participants in a jail facility were randomly assigned to two groups: 1) the control group received a government booklet on the relationship between substance use and criminal behavior, 2) the experimental group received the Changing Course Interactive Journal. All 183 participants met DSM-IV-TR diagnostic criteria for a substance use disorder, had a current offense that was substance-related, and were repeat recidivists.

Findings
Statistically significant results show the recidivism rate for the Interactive Journaling® group was 15% lower than the control group. This was measured by individuals being booked within a 12-month period following entrance into the study. The data suggests that Interactive Journaling® has merit and substantial clinical importance for those offenders who are substance dependent.



Additional Information
The acceptance of Interactive Journaling® for this study was 98%. For another study regarding the acceptance of Interactive Journaling® with this population, please visit: The Acceptance of Interactive Journaling® in a Local Jail Population

For more information regarding the Changing Course Interactive Journal, or to view a sample, please visit the Changing Course product page.

Click here here for prepublication draft.

The Life Connections Program (LCP) is a faith-based curriculum developed in collaboration with the Federal Bureau of Prisons’ Chaplaincy Services and The Change Companies®. The program consists of 14 individual Interactive Journal topics used by participants over an 18-month timeframe. Volunteers from the community from various faiths work directly with the inmates who have applied and been accepted to the program. This study matches same faith volunteers with an inmate from the general population based on several key measures including criminal and misconduct history, prior religious experience, motivation, community integration and demographic information. The matches were created on information from the time period prior to participation and misconduct monitored during the participation period.

Key findings:
* Compared to matched controls, inmates participating in the Life Connections Program had about half the instances of serious misconduct during the 18 months of the study.

% of group members with serious misconduct infraction.

Citation:
Camp S.D., Daggett D.M., Kwon O, & Klein-Saffran J. (2008). The effect of faith program participation on prison misconduct: The Life Connections Program. Journal of Criminal Justice, 36; 389-395.

French S.A., & Gendreau, P. (2006). Reducing Prison Misconducts: What Works! Criminal Justice and Behavior, 33; 185-218.

The Change Companies® has collected feedback from Interactive Journaling® program participants in a variety of settings. The following is an aggregate of randomly collected anonymous self-reported feedback from 27,066 participants from several states (AK, KY, NM, OK, VT, WA and WI).

Question 1
How useful would you rate this program?



Question 2
How useful were the following activities in helping you meet your goals for the course?



Question 3
How helpful was the program material?



Question 4
How much did you learn from the program?



Question 5
Have you or will you share your Participant Journal with anyone outside the course?



Question 6
Will you keep your Participant Journal after the course ends?



Question 7
Do you feel that this program helped you to make a change in your high-risk behavior?

Research has revealed that structured journaling can improve overall health and well-being. Whether grappling with substance abuse or dependence, the stress of a career or the loss of freedom that comes with incarceration, journaling has proven to be an effective tool in helping individuals cope with challenging situations. The power of writing is that the process is immediately personal and relevant. Individuals can map out where they have been, where they are today and where they wish to go.

Building upon a body of journaling research, The Change Companies® has developed a process called Interactive Journaling®, which is a guided journaling experience that assists individuals in making life changes. To date, the Interactive Journals created by The Change Companies® have served more than 20 million individuals in the areas of treatment, corrections, impaired driving, prevention education and healthcare.

Research has revealed that change takes place in a series of stages and the application of certain change processes can assist in successful progression through these stages. Counselors, educators and group facilitators can be effective agents of change by equipping their program participants with this "roadmap" for successful change.

The Change Companies® incorporates prevailing change theory and motivational techniques into the Interactive Journals it creates. Every page we design reflects strategies or skills that build toward positive change. Furthermore, the Interactive Journaling® format provides participants with a personal and lasting tool for change that can be used long after a program experience ends.

Two states (Wisconsin and Missouri) have worked with The Change Companies® to create curricula for drivers under 21 years of age who have been arrested for alcohol or other drug-related driving offenses. This is a particularly challenging group to engage in treatment or education. Results of evaluations completed by 764 participants suggest that the majority of students rated the course excellent or good (670, 87%), found the class discussions useful (731, 96%), and the overall quality of the instructors good. In addition:

1. Overall, how would you rate this course?



How useful do you think the material in the course will be to you in the future?



Do you feel this course will help you make a change in your alcohol and other drug-related decisions and behavior?



Select student descriptions of the course:
It was different than I thought. I learned a lot. Eye-opening, interesting and informational. Useful to change your decisions and actions towards drugs.

This study evaluated Interactive Journaling® utilized as a component of The Change Companies® and The Association of DUI School Administrators of Oklahoma, Inc.'s Alcohol/Drug Substance Abuse Course (ADSAC) for DUI/DWI offenders assigned to Level II programs in Oklahoma. An offender assigned to a Level II program has a prior DWI/DUI offense and/or a score on the Driver Risk Inventory-II in the 36th to 49th percentile. Specifically the study examined pre- and post-test results of 872 offenders (a random sample of offenders from evaluations administered during calendar year 2005) who were required to participate in a 24-hour Level II program plus an evaluation indicating their views about the program and its components. Interactive Journals were developed and tailored specifically for this population, focusing on education and motivation to promote positive life change. This study evaluates whether individuals assigned to the Level II programs that used Interactive Journals demonstrated increased knowledge and motivation to change.

A summary of findings indicated:
• Knowledge and attitudinal measures found that both knowledge concerning alcohol's effects and positive attitudes related to behavior change increased for offenders who completed ADSAC Level II programs.
• Fifty-two percent (52.3%) of the offenders rated course materials as "very valuable," with 78.5% stating that they learned a lot from the course; 25.5% reported that they had shared their journaling information with others and an additional 54.7% indicated that they intended to share their results with someone else.
• Additional offender feedback indicated that 88.4% reported that they would be keeping their Journals after completion of the program, and 94.7% felt that the program would help them change their behaviors.
• An interesting finding indicated that there was not a significant correlation between post-test knowledge and attitudinal composite scores. It is important to note that ADSAC Level II produced an independent effect on both knowledge (alcohol, its influence on driving and legal facts) and attitude (drinking and driving and the intent to change behavior in the future).



Citation:
Scheck, A.M., Couillou, R.J., Hoffmann, N.G. (Submitted) Interactive Journaling® as an Intervention for Level II DWI/DUI Offenders

Denise B. Ernst, PhD

Abstract
This paper summarizes the results of four independently conducted state evaluations of The Change Companies®’ impaired driving curricula. Results across diverse states and populations reveal that The Change Companies®’ curricula are associated with statistically significant reductions in recidivism among program participants. These findings were significant across varied demographic factors, such as gender, age and ethnicity. The Change Companies®’ curricula were also found to be positively endorsed by both staff and program participants, which speaks to the curricula’s attentiveness and responsiveness to the unique needs of states, programs and the individuals they serve.

This 2007 study evaluated Interactive Journaling® utilized as a component of The Change Companies® and The Association of DUI School Administrators of Oklahoma, Inc.'s Alcohol/Drug Substance Abuse Course (ADSAC) for low-risk DUI/DWI offenders in Oklahoma. Interactive Journaling® provides a means for "personal exploration and interpersonal feedback" and has been shown to assist participants to gain motivation and to make and maintain behavior change.

Specifically this study evaluated the influence of ADSAC on offenders' (n = 1019) knowledge and attitudinal measures as determined by pre- and post-test findings. In addition, offender evaluations of the program and journaling exercises were studied.

A summary of findings indicated:
• The pre- and post-test findings indicate generally significant changes in both knowledge and intent to change drinking and driving behaviors for offenders who completed ADSAC.
• An interesting finding indicated that there was no significant correlation between post-test knowledge and attitudinal composite scores. It is important to note that ADSAC produced an independent effect on both knowledge (alcohol, its influence on driving and legal facts) and attitude (drinking and driving and the intent to change behavior in the future).
• The majority of offenders valued Interactive Journaling® and intended to keep their Journals.
• Further evaluation of Interactive Journaling® is recommended as a tool for behavior change.



Citation:
Couillou, R.J.; Scheck, A.M.; Hoffmann, N.G. (Submitted) The Evaluation of Interactive Journaling for Level I DWI Offenders.

In 1996, the Florida Department of Highway Safety and Motor Vehicles hired Emory University to conduct a study to compare the effectiveness of its existing Level I DUI curriculum to two alternative curriculum approaches. Prevention Research Institute (PRI) and Responsible Driving Inc. (RDI – now The Change Companies®) each provided a curriculum and training for the purposes of the study.

The goals and objectives of the program were defined by a group of stakeholders and a questionnaire was designed to assess student movement towards those goals. The goals stated that the student will 1) understand the effects, risks and consequences of the use of alcohol and other drugs, 2) know the risks and consequences of impaired driving, 3) be able to address issues that place him/her at risk for substance abuse problems and be able to accept personal responsibility for the use of alcohol and/or other drugs, especially for driving after use, and 4) have developed a personal plan for responsible use of alcohol and/or other drugs, which may include abstention, and for ways to prevent future impaired driving. The study made observations and recommendations based on the pre/post questionnaire responses of 1,654 students and 604 students in a follow-up interview three months after program completion.

KEY FINDINGS:
• RDI (The Change Companies®) students stood out in terms of their increased understanding of the social and psychological consequences of substance abuse on society.
• The students in both the RDI (The Change Companies®) and current state curriculum groups had greater increases in the objectives of goal 2 than PRI students. The greatest increase was in understanding the effect of alcohol and drugs on driving.
• Overall the students in the RDI (The Change Companies®) curriculum had a greater increase in agreement with positive attitudes as well as a greater decrease in agreement with negative attitudes than students in the other two groups. These objectives focused on accepting responsibility for risky behavior and stating intentions to make changes in use and/or driving behavior.

Three-month Follow-up Results:
• Student ratings of the curriculum at the three-month follow-up indicated that, “for each rating except instructor knowledge, for which there was no difference, one or the other, but not both, of the current Level I or RDI (The Change Companies®) curriculum was rated significantly more positively than the PRI curriculum.”

Citation:
Marsteller, F.A. (November 19, 1997). Evaluation of the Florida Level I DUI Curriculum: Final Report. Emory University School of Medicine.

In a study of college students, CHOICES, a brief alcohol abuse prevention program, was shown to be more effective than Prime for Life in reducing drinking intentions among students with plans for heavy drinking.

This study included 104 college students mandated to attend an alcohol education program as a result of violating the campus alcohol policy. The students reported an average of 17.86 (sd = 13.20) drinks per week in the previous three months and were already experiencing alcohol-related problems. Students were asked before and after the program about their intentions to drink in terms of both frequency and quantity. In a more recent study examining drinking intentions for a particular event, Neighbors et al. (2009) found that intentions for peak consumption were a significant predictor of actual consumption.

Results indicated:
• Controlling for pre-intentions, intentions for peak consumption were lower in the CHOICES group than in the Prime for Life group.
• CHOICES was more effective in reducing both weekly consumption and peak intentions in the students whose intentions were higher before the program.

Citations:
Neighbors, C., Cullen, C., Oster-Aaland, L., Thoeness, K., & Lewis, M.A. (2005). Prime for Life versus CHOICES in reducing drinking intentions among mandated college students. Poster presentation at the annual meeting of the Association for Behavior and Cognitive Therapies, Washington, DC.

Neighbors, C., Lee, C.M., Lewis, M.A., Fossos, N., & Walter, T. (2009). Internet-Based Personalized Feedback to Reduce 21st-Birthday Drinking: a Randomized Controlled Trial of an Event-Specific Prevention Intervention. Journal of Consulting and Clinical Psychology, 77(1), 51-63.

Buncombe County Detention Facility in North Carolina is conducting a randomized clinical trial currently in progress that explores whether a self-directed Interactive Journal (Changing Course) provided to inmates who meet diagnostic criteria for substance dependence will impact the rate of individuals seeking treatment post-release and recidivism rates. Offenders meeting the criteria are offered the Journal and staff routinely asked about and observed usage and completion of the Journal. This report focuses on the inmates' willingness to accept the Journal and self-reported usage and staff observed usage of the Journal while incarcerated.

• Of the 70 eligible experimental group participants, 69 (98.6%) agreed to take the Interactive Journal.

• Of the 59 inmates available to staff, 50(85%) reported completion of at least some of the writing tasks prior to release.


Citation:

Proctor, S.L., Corwin, C. J., Hoffmann, N.G., & Allison, S. (2009, January/February). Jail Inmates: A trademarked journaling process shows promise in giving offenders insight on their substance use. Addiction Professional, 22-25.

To determine the success of Interactive Journaling® with outpatient and inpatient alcohol and drug treatment populations, The Change Companies® conducted nine interview/studies at seven treatment sites using a structured questionnaire provided to participants in the program. The population was made up of individuals who were attending aftercare or continuing care programs at the treatment sites and who had used The Change Companies®’ Journals during primary care. The purpose of these studies was to determine the strengths and weaknesses of The Change Companies®’ materials in order to improve the Journals.

A total of 287 individuals participated in the questionnaire. The length of time in aftercare ranged from just having completed primary care to 13 months of aftercare with the average length of time out of treatment being 104 days. Key findings throughout all groups are described below.

Participants indicated that graphics were found to be very helpful in many instances. Also, participants appreciated pages that offered the greatest amount of journaling opportunities the most. The Journal was found to be very useful with or without counselor involvement and valued the ability to share the Journal with their peers. Less than 5% of all participants reported that the Journal was too difficult to understand.

Nearly 90% of individuals reported that the Journal played an important role during primary care with 74% reporting that the Journal helped them stay clean and sober after primary care. Eighty percent of participants reported that the Journal helped them to recognize and express their feelings, and since completing primary care, seven out of 10 respondents use the Journal on a regular basis (at least once per week).

In search of a permanent support tool that would serve program participants (beneficiaries) admitted to their adult rehabilitation programs, The Salvation Army collaborated with The Change Companies® to customize a series of Interactive Journals that would assist beneficiaries with physical, mental and spiritual rehabilitation. These Interactive Journals would not only address specific program needs and the needs of the individuals, but would center around the Christian values and spirituality of The Salvation Army. Key findings are described below.

A total of 257 beneficiary surveys were collected from 19 centers from the Eastern USA Territory of The Salvation Army. This survey gathered information regarding the feelings and attitudes of the beneficiaries' journaling experiences.

Ninety-two percent of beneficiaries described the Journal as worthwhile and helpful in their rehabilitation while less than 10% of respondents found the Journal difficult to understand. The majority of comments described how the Journal helped the end users learn more about themselves.

"This journal has helped me look at myself and to look at both my faults and my good points. It has helped me to see what needs to be changed and some worthwhile things about myself."

"Thank you for helping me find myself."

Over 75% of respondents reported that the Journal helps them to share what they think and feel with others.

"I feel as though it's like having my own personal counselor."

"Brother alcoholic, please read this Journal. I can't begin to tell you how it has affected my life. If you really take this information seriously, I promise you, you will change. If you could see me now, my life has changed so much since I saw you last. I believe that this material gave me insight."

Interactive Journaling® provides beneficiaries not only with alcohol and drug education, but also involves an experiential writing process that guides the user toward lasting behavior change. Sixty-four percent reported that they learned the most from the pages that asked them questions.

"It's everything you want to know about staying off drugs."

"I have a Journal that digs into my addiction and the reality of how horrible things were for me. Through the years I blocked a lot of pain, hurt and anguish out, but working on this Journal, it reminds me of how things really were. I do my best to be honest when writing or answering questions even though sometimes it brings tears to my eyes."

Finally, Interactive Journaling® is used by The Salvation Army as an engagement and change-based tool for beneficiaries during their program and as a continuing care resource as they transition into independence in the community. Beneficiaries found the Journal to be a key resource that guided their efforts toward lasting behavior change throughout their time in the Adult Rehabilitation Center.

Responses from the survey show that three out of four beneficiaries plan to continue using their Journals after leaving the Adult Rehabilitation Center.

"It gives me a chance to look at myself and see how I've grown in my recovery."

"I'll keep it forever."

Citation: Cheesman II. FL., Dancy D., Jones A., & Hardenbergh D. (September 14, 2005). An Examination of Recidivism of Offenders Receiving Services from the Virginia Alcohol Safety Action Program. National Center for State Courts. Retrieved 4/17/09.

Wells-Parker E, Bangert-Drowns R, McMillen R, & Williams M. (1995) Final results from a meta-analysis of remedial interventions with drink/drive offenders. Addiction, 90;907-926.

The State of Virginia comprehensive DUI program, Virginia Alcohol Safety Action Program (VASAP), provides a variety of services and referrals for DUI offenders. Individuals entering the program are evaluated and classified as needing Education, Intensive Education or Treatment. The Change Companies® has provided curricula for both levels of education since 1995. The treatment component is conducted by a state approved facility or provider. To examine the effectiveness of the program, a random sample of 1,085 VASAP clients referred for services between 1997 and 2000 was selected for analysis of recidivism. As VASAP is a full-coverage program, it was not possible to select a control group.

Recidivism was defined as any conviction for a subsequent drug or alcohol-related moving violation offense. For DUI recidivism, the overall rate for VASAP services was 11.2 percent in comparison to the national average of 19 percent (Wells-Parker et al, 1995). The rates by service were 8.8 percent for Education, 9.6 percent for Intensive Education and 14.3 percent for Treatment.


Wells-Parker et al’s (1995) meta-analysis reported an expected 7-9 percent reduction in recidivism from a remedial intervention of this nature. Using this figure and data reported by several other states and studies, the authors conclude that

“VASAP appears to be at least as effective as their counterparts in other states (and regions) - and in some cases more effective in reducing DUI recidivism.”

"While it is not possible to make a definitive determination of their effectiveness because we do not have a comparable control population, the lower level of recidivism would seem to provide ample evidence of its effectiveness."

Citation: Loudenburg, R. (2008). South Dakota Public Safety DUI Program: Four Year Evaluation Report. Pierre, SD: Office of Highway Safety, South Dakota Department of Public Safety.

Four-year Evaluation Report, 2004-2007

In 2004 the South Dakota Department of Public Safety initiated a pilot study to examine the effectiveness of The Change Companies®' standardized curriculum for addressing first-time DUI offenders in the state. According to the report, “The Council of Substance Abuse Directors conducted a review of the nation’s top resources of time-proven, evidence-based DUI educational curricula. After detailed analyses and comparison with the Council’s perceived needs, the curriculum offered by The Change Companies® was recommended.” In particular, the curriculum was chosen because of its focus on the development of a personal change plan and its emphasis on coping skills to avoid future impaired driving behavior. The target population for the study consisted of first-time adult DUI offenders. Thirteen Core Alcohol/Drug Treatment agencies partnered to adapt the curriculum, participate in training and deliver the program. During the four years, the course was delivered 555 times serving 4,191 participants. The comparison group consisted of first-time adult DUI offenders who did not receive the standardized curriculum.

Key findings:

Recidivism was defined as occurrence of another arrest. Four-year results indicate a 27% reduction in recidivism in the experimental group as opposed to the comparison group. (p<.0001)

Reducing the recidivism rate for the comparison group would mean 1,150 fewer DUI/DWI arrests.

30% of course participants were determined to be at risk of substance dependence based on a standardized screen.

Evaluation at completion of course (n = 3,470)


Of participants completing the evaluation survey (3,470), 96% described the Journal and the Change Plan as helpful in reaching their goals for the course and 94% thought the course material would assist them to change their behavior. In addition, 76% planned to keep their Journal, an indication that they took the change plan seriously.

Interview Ratings at 12 Months
Post-program in SD (n = 854)


At 12 months, 854 participants completed a follow-up survey. Participants indicated that the materials in general (90%) and the Change Plan in particular (85%), assisted them in efforts to change their substance use. The majority of participants reported changes in their substance use (74%), driving behavior (83%) and have not been rearrested (95%).

Citation: By Robert M. Rygiel

In 1985, the Alabama Court Referral Officer Program was adopted to help nonviolent alcohol and other drug offenders overcome problems related to substance abuse and recidivism. When evaluating the effectiveness of the program, Auburn University researchers found resounding evidence proving the program’s effectiveness in all areas. In 2001, as a solution for enhancing and standardizing the Alabama Court Referral Officer Program, the Administrative Office of Courts collaborated with The Change Companies® to create evidence-based Interactive Journals for the Court Referral Education Program. The effectiveness of the program evolved by implementing the delivery strategy of Interactive Journaling, which resulted in a uniform lesson for the instructors to teach, and also provided the state with consistency throughout the programs. In addition, the program allows for instructors to use their unique skill sets. Prior to the use of Interactive Journals, there was no set way or method of teaching the program. Instructors had guidelines of what to maintain in a defendant’s individual class file, but no structured coursework to use. Instructors did not have a unified lesson plan to follow and simply used their own materials. However, with the use of Interactive Journals, instructors are able to conduct the sessions in a more linear, consistent and evidence-based manner.

This article was originally published in Impaired Driving Update, © Civic Research Institute, Inc., 4478 US Route 27, Kingston NJ 08528, and is reprinted here with permission. Impaired Driving Update is a quarterly report letter devoted to innovative programs, legal developments, and current services and research on impaired driving prevention, enforcement, prosecution, and treatment. All rights reserved. For subscriptions, write CRI at the address above, call 609-683-4450, or visit http://civicresearchinstitute.com/idu.html.

REFERENCE:
Rygiel, Robert M., "Alabama: Evolution of an Effective Program” 13(3) IDU 51-52, 54 and 56, 2009.

Citation: By David Mee-Lee, MD

As good as it is to seize the opportunity of a person’s impaired driving arrest to impact a person’s alcohol and/or other drug problem, it can be an opportunity lost if the focus is solely on education and compliance with the legal mandates. In impaired driving education and intervention programs, it is an occupational hazard to reinforce most participants’ perspectives that they are present only to comply with legal requirements in order to get their driving license back and avoid more onerous consequences. While it is part of the mission of impaired driving programs to help restore people’s right to drive and meet their legal obligations, there is a critical provider function that is as equally an important part of the mission.

This article was originally published in Impaired Driving Update, © Civic Research Institute, Inc., 4478 US Route 27, Kingston NJ 08528, and is reprinted here with permission. Impaired Driving Update is a quarterly report letter devoted to innovative programs, legal developments, and current services and research on impaired driving prevention, enforcement, prosecution, and treatment. All rights reserved. For subscriptions, write CRI at the address above, call 609-683-4450, or visit http://civicresearchinstitute.com/idu.html.

REFERENCE:
D. Mee-Lee, "Moving Beyond Compliance to Lasting Change," 13(1) IDU 7-10, and 22, 2009.