Conceptual Challenges to Creating Effective Treatment and Reentry Programs for Women

Any attempt to design effective programs for women must take into account the statistical differences mentioned above, but they must also be responsive to the difference in gender roles and socioeconomic identity in contemporary society.

Female prisoners have unique needs because much of the time they are victims, not perpetrators, of crime. Programs that do not take into account the fact that so many women have histories of abuse and neglect and have witnessed and been the victim of domestic violence both as children and as adults are doomed to failure. A successful program intended to reintegrate women into society has to find ways to help women to have a sense of "agency." Women need, not as a luxury but as an essential need, a sense that they can alter their social environment (Bloome et al., 2002).

Women are more stigmatized by incarceration than men are. Their return to the world is therefore already more difficult. Over 80% have children, and they are often single parents. Men are far more likely to find that they can return to wives or girlfriends who have taken care of their children and kept family life functioning than are women (BJS, 2000).

Put another way, women prisoners tend to have a "social capital" deficit. That is, women, and especially women from low socioeconomic standing, and even more especially those with young children, are not tied into the information systems that help an individual acquire skills and knowledge, networks which help in finding employment, and contacts for financial assistance. All too often they return to the community with the same lack of resources they had before, but now they have a prison record (Reisig, Holtfreter, & Morash, 2002).

The successful reentry of female offenders is dependent on helping them to find and connect to networks that will provide them with structural resources. Any program that is going to work has to be holistic; for example, it is not enough to provide employment and education programs and substance abuse treatment, important as those needs are, without also considering these women in their social context, as part of communities and families, and as mothers. Many female prisoners strongly identify with their role as parents. They are motivated to succeed in treatment programs in order to regain or keep custody of their children (Mullings et al., 2003; Surratt, 2003).

To succeed, reentry programs must provide mental health counseling. Given the frequency of abuse and neglect, it is not surprising that so many female inmates suffer from low self-esteem, as well as depression and anxiety disorders (Singer et al., 1995; BJS, 2000). But the actual figures are staggering. A 2002 study of female juvenile offenders reported that 95.8% suffered from low self-esteem. In this study, 88.6% of the participants said they had been sexually abused, and 77.1% claimed to have been physically abused. On testing, 74.1% were found to have a developmental disability, and 73.5% were suffering from severe mental trauma as a result of abuse (Bloome et al., 2002).

Not surprisingly, outcome predictors for reentry programs seem to be different for men and for women. Inmates treated in residential treatment followed by outpatient treatment in the community have lower rates of drug relapse and rearrest. But in the case of women, more than with men, there was a distinct correlation with the length of the program. In the case of female inmates the length of time they spent in aftercare was a useful predictor of success. The outcome for women in extended treatment programs was better than the outcome for men (Hall, Prendergast, Hellish, Patten, & Cho, 2004; Messina et al., 2006). There is also a strong association between lower recidivism rates for women and having health insurance, as long as it includes treatment for mental illness and substance abuse, as well as treatment for chronic diseases, including but by no means limited to HIV/AIDS (Richie et al., 2001).

For women, other than the length of time in treatment the most important predictor for successful reentry is reducing the proportion of income that comes from illegal activity, which makes education and employment issues as critical as substance abuse treatment and mental health services. A second predictor is reducing homelessness. Without a job and a home, women will be back on the streets.

This supports the social capital argument in many ways. Education expands networks which increase the likelihood of stable employment. A settled home provides structure which makes emotional and social support possible. These can include traditional community based institutions like Twelve Step Programs (Reisig et al., 2002). Participating in these systems also counteracts the antisocial lifestyle that so often persists into adulthood for so many abused and neglected children, especially girls (National Institute of Justice, 2000).

It is reasonable to suggest that current methods for reducing rearrest figures are not successful. Many of the women who are in prison are the sole support of their families. Their children suffer while they are in jail, and when they get out they have fewer resources than they had when they were arrested. They haven't "learned a lesson"; they have little choice or incentive to do anything but return to the behavior for which they were arrested. The lesson they are passing on to their children is a continuing cycle of abandonment and hopelessness. Removing nonviolent offenders doesn't make the community safer, it weakens the community. These women need health care, drug treatment, and mental health treatment, as well as job training and parenting skills.

They are lonely and isolated and they have to be connected to productive communities. Family focused programs are essential as is effective discharge planning and follow-up care. These must be multifaceted and must address all of the relationships through which women tend to define themselves, including the family, social structure, employment, and childrearing practices.

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