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Changing Course

Program Goals/Target Population
Changing Course is an interactive journal designed specifically for offenders incarcerated in a local correctional setting (i.e., jail) who have been screened or identified as having a potential substance use disorder. The primary emphasis of the journal is to help inmates make the connection between their substance use and criminal activity. Changing Course was designed as a self-directed resource for inmates to start the process of making positive life changes. It provides inmates with a way to assess the costs and benefits associated with different life choices they might make and helps them develop a plan for changing their behavior following release.

Program Activities
Changing Course is a 24-page interactive journal that includes visually appealing images, factual information, and individual writing exercises to engage inmates as they contemplate the process of making a positive life change. The journal starts with a checklist of various descriptors that inmates check off if they specifically apply to them. Then inmates must summarize, in their own words, the specific details regarding their arrest and their motivation for committing the offense for which they are currently incarcerated. Next, inmates are provided with an inventory of harmful consequences associated with substance use that cover a wide range of areas, such as relationships, school/work, and finances. Inmates are then presented with another checklist of various behaviors that they may select as they consider making a positive life change (e.g., current level of alcohol or drug use, anger management, relationship changes) and are instructed to indicate which areas apply to them. The journal then provides an outline for evaluating the rewards and costs of up to three specific behavior changes, followed by strategies for inmates to implement the selected changes. Inmates are provided with an area to write down their specific individualized plan for change. Finally, the journal presents inmates with the issue of making the ultimate decision about whether they will seek professional help and/or support groups. This section also provides space where contacts can be written down for future reference.

The journal was not designed for use as a clinical treatment aid. Rather, it is a pretreatment tool to help inmates begin to appreciate the connections between their substance use, behaviors, and problems with the law in order to encourage inmates to seek treatment upon release. Two consequences of using interactive journaling with jail inmates are that stays in local jails are often brief and release can occur abruptly and unexpectedly. Professionals may not get the opportunity to review the inmates’ reactions to the journal, the journaling process, the amount of time spent on the journal, or whether the inmates complete the journaling process at all.

Program Theory
The interactive journaling process includes components of the transtheoretical model of change (Prochaska and Velicer 1997). Through this theoretical model of behavior change, change is viewed as a process involving several stages: precontemplation, contemplation, preparation, action, maintenance, and termination. The transtheoretical model of change provides an integrative framework for how individuals may progress through the various stages of behavior change, and move toward embracing and maintaining a particular behavior. The Changing Course journal encourages inmates to reflect on the choices that have led to their current situation and make acceptable choices of action in the future. The journal is designed to guide inmates from the precontemplation stage to the contemplation, preparation, or action stage of change.

Intervention ID
307
Ages

18 to 65

Rating
Promising
Outcomes

Study 1
Recidivism

At the follow-up, Proctor, Hoffmann, and Allison (2012) found that the recidivism rate of inmates who participated in the Changing Course interactive journal intervention was significantly lower compared with the control group. Within 12 months of release, 51 percent of the interactive journaling group was subsequently booked at the Buncombe County Detention Facility (Asheville, NC), compared with 66 percent of the control group.

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