Program Profile: Drug Treatment Alternative to Prison (DTAP)

This program is the first prosecution-led, residential drug treatment diversion program designed to divert people convicted of nonviolent felony drug offenses to community-based residential treatment. This program is rated Promising. Controlling for time spent in the community following release from prison, the intervention showed statistically significant positive effects on recidivism, time to first rearrest, and rearrest for program participants, compared with the control group.

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals

The Drug Treatment Alternative to Prison (DTAP) program was developed by the Kings County District Attorney’s Office in Brooklyn, N.Y., and is the first prosecution-led residential drug treatment diversion program in the country. The program’s objective is to reduce recidivism and drug use by diverting people convicted of nonviolent felony drug offenses to community-based residential treatment. The program attempts to incorporate three fundamental components of effective treatment: a high level of structure, a long period of intervention, and flexibility.

Target Population/Eligibility

DTAP targets all drug-addicted, nonviolent repeat felony offenders arrested in Brooklyn that face mandatory sentencing under New York State’s second felony offender law (the Rockefeller Drug Laws in New York State were revised in April 2009 to remove mandatory minimum sentences). To be eligible to participate, defendants must be 18 years or older, currently charged with a felony, and have at least one prior felony. Defendants must also be addicted to drugs and in need of substance abuse treatment; the addiction should be a contributing factor in their criminal activities. To avoid net-widening and ensure the program is serving a prison-bound population, cases are accepted if the District Attorney’s Office can determine that the evidence assures a high likelihood of felony conviction. Defendants who meet the eligibility criteria receive a clinical screening and assessment by Treatment Alternatives to Street Crimes (or TASC), a nonprofit criminal justice case management organization in New York City. Case information is also reviewed by DTAP’s enforcement team. After a thorough review of the screening information, the final decision to accept a defendant into the program is made by the Alternative Programs Bureau of the District Attorney’s Office.

DTAP uses a deferred-sentencing model. Defendants that are accepted into the program plead guilty to a felony but the prison sentence is deferred while participants enter intensive residential drug treatment, followed by optional aftercare services. Those participants who successfully completed DTAP treatment are permitted to withdraw their guilty plea and have the case dismissed. Those participants who drop out or fail the program are brought back to court and sentenced on the guilty plea.

Services Provided

DTAP participants are sent to long-term, intensive, residential drug treatment programs for a duration of 15 to 24 months. The programs follow the traditional therapeutic community philosophy and structure, which includes providing participants with treatment services in a highly structured and supervised community-based residential environment. Treatment services emphasize self-help in recovery through individual and group counseling sessions and by using the dynamics of communal living to teach participants about positive, personal, and social values and behavior.

DTAP participants go through an orientation period during the first 3 months of treatment in order to adjust to the therapeutic community environment. Participants learn about the program’s policies and procedures, and are introduced to the core issues of addiction and recovery. The primary treatment period occurs during the next 4 to 18 months of the program. During this time, participants go through individual, group, and family counseling sessions that focus on personal and relationship problems. The program also provides vocational and educational programs and assigns in-house work assignments and responsibilities to prepare participants for employment after treatment. Finally, participants begin a gradual reentry process back into the community once they have secured a job and found an appropriate living arrangement. The focus of treatment becomes maintaining sobriety, preventing relapse, and adjusting to independent living. Aftercare is supervised by the case manager and also includes access to a job developer, and an informal, voluntary alumni group.

DTAP staff monitors participants’ progress through treatment. Treatment providers submit monthly progress reports, and participants who receive poor reports are brought back to court and warned of the legal consequences of noncompliance. DTAP staff is notified by treatment providers within 24 hours if a participant absconds from the program. The District Attorney’s Warrant Enforcement Team obtains an arrest warrant and is responsible for apprehending and returning absconders to court.

Key Personnel

The DTAP program involves a collaboration of six key criminal justice players, including the assistant district attorney, the TASC organization, the District Attorney’s Warrant Enforcement Team, New York City Department of Probation and the New York State Department of Parole, defense attorneys, and the presiding judge.

Study

Dynia and Sung (2000) compared the recidivism rates of Drug Treatment Alternative to Prison (DTAP) program participants to similar people who did not participate in the program. The study sample included 487 people who were arrested in police undercover busy-and-bust operations for drug sales from December 1990 to December 1991. All of them were initially eligible to participate in DTAP. In total, 272 people opted to participate in DTAP treatment. Of those, 184 successfully completed treatment and 88 left treatment before completion. The remaining 215 from the study sample did not participate in DTAP, either because they declined to participate or because they were rejected during the screening process.

The study sample was divided into three groups: completers (n = 184), failures ( n = 88), and nonparticipants ( n = 215). Completers were 77 percent male, and 56 percent Hispanic, 34 percent Black, and 9 percent white, with an average age of 31 years. Failures were 76 percent male, and 63 percent Hispanic, 28 percent Black, and 9 percent white, with an average age of 28 years. Finally, nonparticipants were 80 percent male, and 57 percent Hispanic, 37 percent Black, and 6 percent white, with an average age of 30 years. There were no significant differences between the groups in terms of gender, race, and criminal history. The age between DTAP completers and failures was statistically significant; participants who completed treatment were slightly older than those who dropped out or were expelled.

Recidivism data were collected from New York State criminal history records. Official arrest charges were classified by penal law severity (felony versus misdemeanor) and offense type (drug versus nondrug). The analysis looked at the following time periods for program completers: 3 years before the DTAP arrest, time during treatment, and 3 years after treatment. For DTAP failures, the analysis looked at 3 years before the DTAP arrest, time during treatment, at-large time (time between treatment drop out and apprehension by the DTAP warrant enforcement team), and 3 years following release from prison. For nonparticipants, the analysis looked at 3 years before the DTAP arrest, pretrial, time during sentence, and 3 years after prison release or sentence competition.

To assess public safety risk, the analysis compared rearrest prevalence rates for DTAP completers and failures during treatment and at-large periods, respectively, to the rearrest rate for nonparticipants during the pretrial and sentence periods. To assess treatment effectiveness, rearrest rates were compared for the 3-year pre- and post-periods between the three groups. Two different analyses were performed: chi-square and survival analysis.

Study

Belenko, Foltz, Lang, and Sung (2004) used a longitudinal quasi-experimental design to analyze the recidivism impact of DTAP on program participants. The study included a prospective treatment sample of 150 people diverted to DTAP (90 of whom completed DTAP and 60 of whom dropped out or failed) and a comparison sample of 130 people sentenced to State prison. The study also used retrospective samples of 64 DTAP graduates and 68 DTAP dropouts who were randomly selected from all DTAP participants who entered the program before the current evaluation began (May 1995) but who graduated or dropped out during the same time that the prospective sample was in treatment. It was necessary to include this retrospective sample because DTAP residential treatment can last up to 24 months, and comparison group members are usually sentenced to several years in prison. Therefore, the retrospective sample ensured a sufficient number of participants were available to track recidivism in the community for a multiyear follow-up period.

Participation in the study was voluntary. The prospective treatment group members were repeatedly convicted of felony offenses and arrested in Brooklyn, N.Y., in 1995 and 1996 but diverted to DTAP. The comparison group members were repeat felons sentenced to prison from other boroughs of New York City. The comparison group was sentenced to prison terms that were equal to sentences that DTAP participants would have received if they had not been diverted to treatment (about 18 to 36 months). The study participants were 88 percent male, and 59 percent Hispanic and 38 percent African American. Average age of the participants was 33 years. There were no significant differences between the groups, except that comparison group members had a greater number of prior misdemeanor convictions.

At intake, a number of interview instruments were administered to prospective study participants, including items related to drug use, prior treatment history, criminal activity, employment and earnings, physical and psychological health, HIV risk behaviors, and social stability. Standardized assessment instruments included the Addiction Severity Index (ASI), the Michigan Alcohol Screening Test (MAST), the Risk Behavior Assessment, and the Texas Christian University’s Self Rating Form.

Data were collected from the offender tracking database maintained by the New York City Criminal Justice Agency on all arrests as of July 31, 2002. The follow-up period ranged from 0 to 103 months, because DTAP program participants completed treatment or members of the comparison group were released from prison for their original target arrest between January 6, 1994, and April 14, 2003.

Recidivism was measured as new arrest after admission (to DTAP treatment or prison) and new convictions for a criminal offense following release from prison or treatment. The analysis distinguished between charge severity (felony or misdemeanor) and charge type (drug and nondrug). The recidivism data also captured new prison and jail sentences that occurred after release from DTAP treatment or prison. The total months that study participants were incarcerated for these new sentences were found by summing the minimum sentence length received for prison and jail sentences.

DTAP dropouts and comparison group members had less opportunity to reoffend because they were incarcerated for part of the follow-up period, whereas DTAP participants who completed treatment had a longer time in the community and thus had more opportunity to recidivate. These factors could confound any observed treatment effect. Therefore, the analysis required an adjusted annualized rearrest rate to address the differential time in the community across groups.

The analysis used logistic regression to compare the various recidivism measures, and analysis of variance was used to compare group arrest rates. Survival analyses were conducted on the time to first rearrest, while regression models were used to predict the adjusted annual rearrest rate. Wald Chi-Square tests were conducted to examine differences in cumulative prevalence for the analysis of rearrest by time in the community.

An analysis by Zarkin, Dunlap, Belenko, and Dynia (2005) focused on the benefits and costs of the Drug Treatment Alternative to Prison (DTAP) program from the perspective of the criminal justice system. The analysis relied on the outcome results of rearrest and reconvictions rates from the longitudinal, quasi-experimental study described in the Evaluation Methodology and Evaluation Outcomes sections (Belenko, Foltz, Lang, and Sung, 2004). <br><br> The benefit–cost analysis looked at the costs of operating the DTAP program (incurred by participants only), such as treatment costs and program monitoring and administration. The analysis also looked at other criminal justice costs (incurred by arrested people as they progressed through the traditional judicial process), such as pretrial detention and prison costs. <br><br> The analysis found that the DTAP program costs $40,718 per participant, which covers an average length of stay in treatment (487 days) plus costs for screening, pretreatment detention, and program monitoring and administration. Not surprisingly, costs were higher for participants who completed the program ($50,886) than for participants who did not complete the program ($26,451) because completers remained in the program longer. However, the other criminal justice costs for DTAP participants was lower for completers ($9,952) compared to noncompleters ($73,611), mostly due to the prison costs incurred by DTAP noncompleters after they were incarcerated for leaving the program. <br><br> Due to longer prison sentences and higher rearrest rates, the comparison group incurred $124,995 in criminal justice costs compared to $36,441 incurred by all DTAP participants (completers and noncompleters). This translates into DTAP benefits (or cost savings) of $88,554. Across all 6 years, the DTAP program benefits exceeded the costs, and saved $47,836 in criminal justice costs per participants, or $7.13 million over 6 years for the cohort of 149 DTAP participants who were studied.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Hynes, Charles J. 2004. “Prosecution Backs Alternative to Prison for Drug Addicts.” Criminal Justice 19:29–38.

Lang, Michelle A., and Steven Belenko. 2000. “Predicting Retention in a Residential Drug Treatment Alternative to Prison Program.” Journal of Substance Abuse Treatment 19:145–60.

Lang, Michelle A., and Steven Belenko. 2001. “A Cluster Analysis of HIV Risk Among Felony Drug Offenders.” Criminal Justice and Behavior 28(1):24–61.

The National Center on Addition and Substance Abuse (CASA) at Columbia University. 2003. Crossing the Bridge: An Evaluation of the Drug Treatment Alternative-to-Prison (DTAP) Program . A CASA White Paper.

Sung, Hung–En. 2001. “Rehabilitating Felony Drug Offenders Through Job Development: A Look into a Prosecutor-Led Diversion Program.” The Prison Journal 81(2):271–86.

Sung, Hung–En. 2000. “Employment and Recidivism Reduction: A Brooklyn Tale.” Alternatives to Incarceration 6(2):14–15.

Sung, Hung–En. 2003. “Differential Impact of Deterrence vs. Rehabilitation as Drug Interventions on Recidivism After 36 Months.” In Nathaniel J. Pallone (ed.). Treating Substance Abusers in Correctional Contexts: New Understandings, New Modalities. London, England: Haworth Press, 96–108.

Sung, Hung–En. 2011. “From Diversion to Reentry: Recidivism Risks Among Graduates of an Alternatives to Incarceration Program.” Criminal Justice Policy Review 22(2):219–34.

Sung, Hung–En, and Steven Belenko. 2005. “Failure After Success: Correlates of Recidivism Among Individuals Who Successfully Completed Coerced Drug Treatment.” Journal of Offender Rehabilitation 42(1):75–97.

Zarkin, Gary A., Laura J. Dunlap, Steven Belenko, and Paul A. Dynia. 2005. “A Benefit–Cost Analysis of the Kings County District Attorney’s Office Drug Treatment Alternative to Prison (DTAP) Program.” Justice Research and Policy 7(1):1–25.

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Rehabilitation Programs for Adults Convicted of a Crime

This practice includes programs that are designed to reduce recidivism among adults by improving their behaviors, skills, mental health, social functioning, and access to education and employment. They may become participants in rehabilitation programs during multiple points in their involvement with the criminal justice system. This practice is rated Promising for reducing recidivism among adults who have been convicted of an offense.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?