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  1. Forever Free

Forever Free

Program Goals/Target Population

The Forever Free program at the California Institution for Women (CIW) began as the first comprehensive prison-based substance abuse treatment program in the United States for incarcerated women. The program works to reduce the incidence of substance abuse, the number of in-prison disciplinary actions, and recidivism following release to parole by providing a range of treatment services to meet the needs of participants. Forever Free consists of two parts:

  • An intensive 6-month program provided to women inmates near the end of their incarceration period

  • Community-based residential treatment for women who graduated from the program and volunteer to continue treatment while on parole

Services Provided

While incarcerated, women inmates in the Forever Free program are housed in a 120-bed residential unit and participate in program services 4 hours per day, 5 days per week. The time spent in treatment is in addition to a participant’s 8-hour-per-day work or education assignment. In-prison services include individual substance abuse counseling, special workshops, educational seminars, 12-step programs, parole planning and urine testing. In addition, individual and group sessions cover a number of subjects believed to be crucial to women’s recovery, including self-esteem, anger management, assertiveness training, healthy versus disordered relationships, abuse, posttraumatic stress disorder, codependency, parenting, and sex and health.


 

Upon graduation from Forever Free and discharge to parole, women can voluntarily enter a community-based program provided by a variety of treatment organizations in Southern California. Each of these programs is residential and has a designated number of treatment slots for Forever Free graduates. The expected length of stay in a program is 6 months. Program services vary across sites, although basic services such as individual and group counseling are common to all programs. Most programs also offer family counseling, vocational training/rehabilitation, and recreational or social activities.


 

Program Theory

The program follows a cognitive–behavioral curriculum stressing relapse prevention (Gorski and Miller 1979, Marlatt 1985). The Gorski curriculum was designed to assist clients in identifying symptoms of post-acute withdrawal and relapse and teach clients skills and strategies to successfully deal with them.

Intervention ID
40
Ages

18 to 100

Rating
Promising
Outcomes

Study 1

Arrests and Reincarceration

Hall and colleagues (2004) found that for measures of crime and recidivism, the bivariate analyses showed that significantly fewer Forever Free participants reported having been arrested or convicted during parole compared to the comparison group. About half of the Forever Free group had been arrested since their release from CIW and half had been convicted since release. By comparison, 75 percent of women in the comparison group reported arrests since release and 71 percent reported convictions. Although a smaller percentage of Forever Free participants reported being reincarcerated in jail or prison than the comparison group (50 percent versus 62 percent), the difference was not statistically significant.


 

A separate analysis looking at the effect of increasing increments of treatment exposure on reincarceration found that as treatment exposure increased from no treatment in prison or on parole to treatment both in prison and during parole, reincarceration significantly decreased.


 

The multivariate analysis showed that at 6 months after release, approximately 33 percent of the comparison group had been reincarcerated, whereas only 13 percent of the Forever Free participants had been reincarcerated. At 1 year post-release, the rate for comparison women was 44 percent in contrast to approximately 33 percent of Forever Free women.


 

Drug Use

Although a large percentage of both treatment and comparison women reported they had used drugs at least once since release, Forever Free participants reported significantly less drug use than the comparison participants (50.5 percent and 76.5 percent, respectively). Drug use in the 30 days prior to the follow-up interview was much lower than 12-month use, with 8 percent of Forever Free participants reporting drug use in contrast to 32 percent of the comparison group.


 

The multivariate analyses showed that age predicted drug use, with younger subjects being more likely to engage in drug use in the year since release. Primary drug also predicted drug use, with heroin users more likely to return to drug use than primary alcohol or methamphetamine users.


 

Employment

Significantly more Forever Free women (65.3 percent) were employed at the time of the follow-up interview than women in the comparison group (44.7 percent). Of those working, there were no statistically significant differences in mean hours worked per week or in mean weekly take-home pay. Take-home pay for both groups averaged less than $8 per hour. In addition, participation in a residential treatment during parole appears to have been a key factor in improving chances of being employed for both the Forever Free group and the comparison group. After controlling for background characteristics through multivariate analyses, however, there was no significant treatment effect on the employment status of Forever Free women. The number of days in post-release residential treatment, along with education, remained a significant predictor of employment.

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