Annotated Bibliography of Published DTAP Research 

Over the years, DTAP has been continuously monitored and examined with rigorous scientific methods.  This array of studies has made DTAP one of the most scrutinized prosecutorial innovations in the country.  External agencies that have participated in the evaluation of the program include the Vera Institute of Justice, New York City Criminal Justice Agency, the National Center on Addiction and Substance Abuse at Columbia University, the Treatment Research Institute at the University of Pennsylvania, and the Research Triangle Institute.  Findings from these research collaborations have been reviewed by leading experts in the field of drug abuse treatment and published in prestigious scholarly journals.  DTAP research publications have made a tremendous contribution to current understanding of the impact of criminal justice interventions in the rehabilitation of drug-abusing offenders.   As new assessment efforts are being planned, DTAP will remain a valuable source of information and inspiration for the years to come.

Below is a brief annotated bibliography of this rich DTAP literature. References are grouped by topics and listed in chronological order. 

Cost-Benefits

Zarkin, G., Dunlap, L., Mamo, D., Belenko, S., & Dynia, P. (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, 1-25.

ABSTRACT: This study analyzed the costs and benefits of DTAP.  Findings indicated that in comparison to the traditional criminal justice process, DTAP provided a cost-beneficial alternative to prison for nonviolent felony drug offenders.  The results indicated that 57 percent of DTAP participants were rearrested during the follow-up period compared with 75 percent of the comparison group.  Moreover, only 30 percent of DTAP participants had a new jail sentence and only 7 percent had a new prison sentence compared with 51 percent and 18 percent, respectively, of comparison subjects.  The benefits increase in each subsequent year of analysis, underscoring the importance of adopting a long-term perspective to criminal justice policy.  The 6-year cumulative cost of the programs indicated that the DTAP program saved an average of $88,554 over the study period.  Data from a 6-year longitudinal quasi-experimental design with 2 groups--150 DTAP participants and a matched comparison group of 130 drug offenders who entered prison-- were analyzed. 

Employment and Reentry

Sung, H.-E., & Richter, L. (2006). Contextual barriers to successful re-entry of recovering felony offenders. Journal of Substance Abuse Treatment, 31, 365-374.

ABSTRACT:  Recidivism among recovering ex-offenders is usually conceptualized as an outcome of the interplay between personal traits and treatment interventions.  This focus on the individual to the exclusion of the socio-legal context in which recovery and reintegration take place has limited extant policy initiatives.  Recidivism data from 440 DTAP graduates were examined.  All else equal, recovering offenders who began their reentry during times of high unemployment and/or low risk of incarceration for new offenses were found more likely to recidivate during their first year in the community. These findings highlight the promise of blending effective drug abuse treatment with credible sanctions against drug offenses as well as the need for job training, placement, and advocacy services. 

Sung, H.-E. (2001). Rehabilitating felony drug offenders through job development: A look into a prosecutor-led diversion program. Prison Journal, 81, 271-286.

Sung, H.-E. (2000). Employment and recidivism reduction: A Brooklyn tale. Alternatives to Incarceration, 6, 14-15.

ABSTRACT:  Between 1989 and 1998, more than 224,000 adult arrests for felony and misdemeanor drug offenses were made in Brooklyn, New York. The DA’s office created DTAP to break the vicious cycle of poverty and drug abuse.  The program seeks to improve the human capital of participants through in-treatment educational and vocational training and to enhance their social capital through job counseling and placement services.  Data show DTAP graduates enjoy improved employment, which is associated with lower recidivism.  

HIV/AIDS Risk and Mental Health Needs 

Belenko, S., Lin, J., O’Connor, L., Sung, H.-E., & Lynch, K. G. (2005). Sexual and physical victimization as predictors of HIV risk among felony drug offenders. AIDS and Behavior, 9, 311-323.

ABSTRACT:  Injection and other drug use and high-risk sexual behaviors put criminal offenders at increased risk for HIV infection.  Studies in other populations, especially females, have found that a history of sexual or physical victimization increases engagement in HIV-risk behaviors, and drug-involved offenders have high rates of such prior victimization.  However, there has been little research among male offenders.  In a sample composed of 247 DTAP participants and comparable inmates from New York City, prior sexual victimization was related to a higher number of sex partners and lower proportion of protected sex acts in the 30 days before arrest.  Prior physical abuse was related to cocaine injection, but not heroin injection or high-risk sex behaviors.  These results suggest a complex relationship between sexual and physical abuse and HIV risk among male offenders.  Assessing for specific prior abuse histories of offenders and providing targeted interventions may be useful for developing more effective primary and secondary HIV prevention services for this high-risk population.

Belenko, S., Lang, M. A., & O’Connor, L. (2003). Self-reported psychiatric treatment needs among felony drug offenders. Journal of Contemporary Criminal Justice, 19, 9-29.

ABSTRACT:  This study estimated dual diagnosis in felony drug offenders with substance use disorders and was based on self-report of psychiatric treatment need and present symptomatology.  Participants were 150 DTAP participants and 130 prison comparisons that were arrested during 1995 and 1996.  The sample was primarily male, 33 years-old, and Hispanic.  The individuals were categorized into two groups: the first reported a history of receiving psychological treatment and the second had no such history.  The findings suggest that depending on the criteria used between 40 and 60 percent of the sample of felony drug sale offenders with substance use or abuse disorders may be dually diagnosed.  Forty-three percent of the sample may have a co-existing mental health disorder.  A history of inpatient psychiatric treatment was not significantly associated with self-report of current psychiatric treatment need.  A history of outpatient rather than inpatient psychiatric treatment was significantly associated with self-report of treatment need.  There were four significant predictors associated with reporting a need for psychiatric treatment.  The need treatment respondents were more likely than the no need group to experience recent cognitive difficulties, more likely to experience any recent mental or emotional problems, and more likely to have a history of psychiatric outpatient treatment.  The strongest predictor found the need treatment group 35 times more likely to report being distressed over psychiatric symptoms within the past 30 days. 

Lang, M. A., & Belenko, S. (2001). A cluster analysis of HIV risk among felony drug offenders. Criminal Justice and Behavior, 28, 24-61.

ABSTRACT:  A study was conducted to investigate HIV risk among felony drug offenders using cluster analysis.  Findings identified two clusters of risk type, one distinguished by high frequency of unprotected sex behaviors and one by high frequency drug use, which suggested that HIV risk reduction interventions may be tailored to target specific types of HIV risk behaviors, either sex- or drug-related. 

Sung, H.-E., Tabachnick, C., & Feng, L. (2000). Heroin injection among felons: Testing extant theories.  Deviant Behavior, 21, 381-406.

ABSTRACT:  The study tested the stratification, market forces, social network, risk-taking syndrome and career intensification hypotheses.  Sample included 366 DTAP participants.  Variables derived from these hypotheses correctly predicted 76 percent of the cases.  Hypotheses with the strongest empirical support were the social network and risk-taking syndrome.  According to the social network hypothesis, age, gender and ethnic groups developed their own heroin subcultures that influence injecting behavior. In the risk-taking hypothesis, users who engaged in other non-drug reckless behaviors were at a higher risk of injecting heroin.  The availability (street price) of heroin was the strongest correlate of heroin injection as more users self-identified as injectors during periods of lower availability.  Age and longevity of heroin use negatively correlated with injection.

History and Philosophy

Belenko, S., Sung, H.-E., Swern, A., & Dornhauser, C. (2008). Deferred sentencing in the war on drugs:  The Drug Treatment Alternative-to-Prison program. In J. L. Worrall and M. E. Nugent (eds.), The changing role of the American prosecutor (pp. 111-137). Albany, NY: SUNY Press.

ABSTRACT: The birth and growth of DTAP is analyzed in the context of the broader war on drugs.  The evolution and performance of the program are documented.  Eight lessons for future prosecutorial innovations are drawn.  They are: targeting high-risk prison-bound offenders, sustaining political support, building in program flexibility, maintaining continuous evaluation, manipulating and calibrating legal coercion, demanding long-term treatment, striving for cost-savings, and emphasizing social integration.  

Sung, H.-E., & Belenko, S. (2006). From diversion experiment to policy movement: A case study of prosecutorial innovation in the United States. Journal of Contemporary Criminal Justice, 22, 220-240.

ABSTRACT:  This analysis of the DTAP program documents the process by which the medical model of drug addiction was revived in the midst of a severe drug epidemic in the county.  The Kings County District Attorney’s Office (KCDA) first changed the procedures for the local adjudication of serious drug cases to reflect the view that drug addiction is a medical problem that requires treatment rather than punishment as the primary strategy for addressing it.  At the initial planning stage, Brooklyn prosecutors focused on securing funding; establishing procedures and protocols; and gaining the support of judges, defense attorneys, and probation and parole boards.  These interactions across agencies and personnel ensured that open and frank discussions would not only ensure support for the program but also make clear what was expected from each party in implementing the DTAP strategy.  As a consequence of the demonstrated success of the DTAP program, the KCDA has rallied bipartisan support for its strategy at the Federal level.  

Hynes, C. J. (2004). Prosecution backs alternative to prison for drug addicts. Criminal Justice, 19, 28-38.

ABSTRACT: In examining and understanding the disease of drug addiction and adopting effective means of confronting it in the criminal justice system, criminal justice practitioners are becoming better acquainted with meeting the challenge of maintaining a safe society. Two key premises behind DTAP are that the criminal recidivism of addicts can be reduced if the addiction is treated and that legal coercion can be a powerful motivator to get addicts to succeed in treatment.  This article presents an overview of the DTAP program, specifically how it works, the evolution of DTAP, identifying DTAP candidates, the screening process, plea agreement and guilty pleas, the treatment phase, sentencing in the event of program failure, successful program completion and post-completion assistance, and the success of DTAP.  

Belenko, S., Sung, H.-E., & O’Connor, L. (2003). Crossing the bridge: An evaluation of the Drug Treatment Alternative to Prison (DTAP) program. New York: The National Center on Addiction and Substance Abuse at Columbia University.

ABSTRACT: This five-year evaluation focuses on the Drug Treatment Alternative-to-Prison (DTAP) Program in Brooklyn, NY.  Findings revealed that DTAP participants had rearrest rates that were 26% lower and reconviction rates that were 36% lower two years after leaving the program, compared a matched group.  More than half of participants graduated from DTAP, and these offenders were 3 1/2 times more likely to be employed than they were before arrest. Moreover, graduates' rearrest rates were 33% lower, their reconviction rates were 45% lower, and they were 87% less likely to return to prison.  The results were achieved at about half the average cost of incarceration  

Legal Coercion 

Young, D. (2002). Impacts of perceived legal pressure on retention in drug treatment. Criminal Justice and Behavior, 29, 27-55.

Young, D., & Belenko, S. (2002). Program retention and perceived coercion in three models of mandatory drug treatment. Journal of Drug Issues, 32, 297-328.

ABSTRACT:  Despite the proliferation of drug courts and other mandatory treatment models, few studies have compared the impact of different program features comprising these models.  This study compared three groups of clients mandated to the same long-term residential treatment facilities.  Study participants were referred from DTAP, TASC, probation or parole.  These clients varied substantially in their perceptions of legal pressure, and these perceptions generally corresponded to the programs' different coercive policies and practices.  Retention analyses confirmed that the odds of staying in treatment for six months or more was nearly three times greater for clients in the most coercive program compared to clients in the third group.  Results support the use of structured protocols for informing clients about legal contingencies of participation and how that participation will be monitored, and developing the capacity to enforce threatened consequences for failure.

Merit Mentions by Federal Government Agencies 

Substance Abuse and Mental Health Services Administration. (2005). Substance abuse treatment for adults in the criminal justice system. Rockville, MD: SAMHSA.
ABSTRACT: The Substance Abuse and Mental Health Services Administration (SAMHSA) is a services agency of the U.S. Department of Health and Human Services charged with the responsibility of focusing attention, programs, and funding on the improvement of the lives of people with or at risk for mental and substance abuse disorders.  SAMHSA convened a consensus panel of leading national experts to provide best practice guidelines in the treatment of substance-abusing criminal offenders. The panel recommended Brooklyn’s DTAP program as one of the treatment models that “exemplify effective diversion programs” (p. 151). DTAP’s program description, process statistics, and performance measures were examined vis-à-vis other criminal justice-based diversion programs. 

Bureau of Justice Assistance. (1997). Improving the nation's criminal justice system: Findings and results from state and local program evaluations effective programs (NCJ 166821). Washington, DC: BJA.
ABSTRACT: The Bureau of Justice Assistance (BJA) is an agency of the U.S. Department of Justice and provides leadership and services in grant administration and criminal justice policy development to support local, state, and tribal justice strategies to achieve safer communities. Through its Effective Program Initiative, BJA identified six most successful criminal justice programs assisted by Byrne Formula Grant Program. Brooklyn’s DTAP, recognized as representing exceptional advances in combating drug abuse based on sound programming, was presented as one of the six model programs. An entire chapter was devoted to the discussion of the history, modality, and impact of DTAP with data collected and analyzed by the Vera Institute of Justice.       

Treatment Process and Dynamics

Sung, H.-E., Belenko, S., Feng, L., & Tabachnick, C. (2004). Predicting treatment noncompliance among criminal justice-mandated clients: A theoretical and empirical exploration. Journal of Substance Abuse Treatment 26:13-26.

ABSTRACT: This study presents five hypotheses of treatment noncompliance among criminal justice-mandated clients. They include: physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity.  Data from 150 DTAP participants were analyzed to test the hypotheses. Physical prime and supportive social network were the most useful in explaining variations in treatment compliance.  Conventional social involvement and treatment motivation hypotheses were also partially validated. Client age emerged as the strongest and most consistent individual correlate of treatment compliance.  The specific dynamics of these relationships are worthy of more study.

Sung, H.-E., Belenko, S., & Feng, L. (2001) Treatment compliance and problem incidents among criminal justice clients. Journal of Substance Abuse Treatment, 20, 153-162.

ABSTRACT: This study analyzed incidents of drug treatment noncompliance among 150 DTAP participants.  Seven problem types and seven dimensions of noncompliance were identified. The seven problem types are:  (1) psychological withdrawal; (2) conflicts or fights with peers; (3) incidents of disobedience or insubordination toward staff; (4) sexual acting-out; (5) theft; (6) drug relapse; and (7) leaving treatment without permission. The seven dimensions of treatment noncompliance were identified as: (1) prevalence; (2) frequency; (3) types; (4) specialization; (5) temporal distribution; (6) paths; and (7) correlates.  Problems among clients were described as common, nonspecific, or sporadic.  Client characteristics associated with drug treatment noncompliance included young age, poor educational attainment, and early involvement with the criminal justice system.  Policy implications include the importance of designing treatment rules and regulations with more flexibility to encourage compliance and treatment retention. 

Treatment Retention 

Sung, H.-E., & Richter, L. (2007). Rational choice and environmental deterrence in the retention of mandated drug abuse treatment clients. International Journal of Offender Therapy and Comparative Criminology, 51, 686-702.

ABSTRACT: This study proposes a rational choice framework in which treatment retention is viewed as a decision-making process involving calculation of costs and benefits of remaining in treatment.  Environmental factors not directly related to the treatment process are theorized to either reward or punish the course of action taken by each treatment client.  Criminal sanctions against drug offenses, violence in local drug markets, and lack of legitimate job opportunities are hypothesized to be deterrents against premature termination of treatment.  Data from 1,984 DTAP participants were analyzed to test the three hypotheses.  Results corroborated the criminal sanction and unemployment hypotheses.  Holding background factors and treatment experiences constant, mandated clients who had entered treatment during times of high incarceration rates for drug offenders and/or of high unemployment rates stayed in treatment for longer periods of time. No support was found for the violence hypothesis. These findings highlight the necessity of reinforcing perceptions of arrest risks and job prospects during treatment.

Lang, M. A., & Belenko, S. (2000). Predicting retention in a residential drug treatment alternative to prison program. Journal of Substance Abuse Treatment, 19, 145-160.

ABSTRACT: One hundred and fifty DTAP participants completed a comprehensive interview as part of a longitudinal study.  Treatment completion predictors were sought examining intake data (demographics, family, social, employment, medical, psychological, criminal, sexual behavior, drug use and treatment histories).  Logistic regression results found completers had more social conformity and close friends, and less need for employment counseling, felony drug convictions, drug dealing income, and unprotected sex than dropouts.  Completers were also less likely to encounter recent problems with significant other, have a psychiatric history, experience gunshot or stabbing, and commenced heroin use at older ages than dropouts. However, completers reported higher alcohol use than counterparts.  Further analyses explored subcategory models: life choice (substance use, criminal and sexual behavior), static (background and dispositional), and dynamic situational influences (employment, psychological state, recent and past encounters).  Clinical implications considering findings are discussed.  

Recidivism

Sung, H.-E. (2011). From diversion to reentry: Recidivism risks among graduates of an alternative to incarceration program. Criminal Justice Policy Review, 22.
ABSTRACT: Reentry usually refers to the transition from incarceration to community living. However, offenders diverted from prison to community-based restrictive sanctions also face the challenge of social reintegration. This study uses a post matching case control design to identify risk and protective factors for 1-year recidivism among completers of the Drug Treatment Alternative to Prison (DTAP) program in Brooklyn, New York. DTAP is a deferred-sentencing program targeting repeat drug-abusing felons arrested for drug sales. Participants are required to plead to a felony charge and spend 18 to 24 months in residential treatment. Forty-seven DTAP completers who had been re-arrested within a year of their dismissal are compared to 47 matched non-recidivists. Results suggest that weak treatment engagement and social isolation considerably increase the risk of recidivism. Certain health conditions and/or medical needs also significantly correlate to re-offending. Implications for reentry policy making and research are discussed.  

Sung, H.-E. & Belenko, S. (2005). Failure after success: Correlates of recidivism among subjects who successfully completed coerced drug abuse treatment. Journal of Offender Rehabilitation, 42, 75-97.

ABSTRACT: This study examined correlates of recidivism among a sample of DTAP graduates. Offenders who recidivated after completing coerced drug treatment were likely to be younger, to have more juvenile arrests, to have disliked treatment rules, and to have found treatment oppressive. Moreover, these recidivists viewed treatment as unnecessarily long and were unemployed and living alone following treatment completion. The findings suggest that in order to lower recidivism rates for drug treatment program completers, it is important to offer highly intensive aftercare that focuses on rule compliance, employment readiness, job placement, and family reunification skills. 

Belenko, S., Foltz, C., Lang, M., & Sung, H.-E.. (2004). Recidivism among high-risk drug felons: A longitudinal analysis following residential treatment. Journal of Offender Rehabilitation, 40, 105-132.

ABSTRACT: This study assessed the long-term effectiveness of DTAP in terms of recidivism reduction. A longitudinal quasi-experimental design was used that included an experimental sample of 150 DTAP participants and a control group of 130 offenders matched on arrest charges, prior felony convictions, age, race, gender, drug use, and desire for drug treatment. Results indicated that DTAP participants showed reductions in the prevalence and annual rate of recidivism, as well as delayed time to first rearrest compared with the control group.  These results remained significant after controlling for criminal history and other covariates.  Long-term, coercive therapeutic community treatment models can be effective at reducing recidivism among serious felony offenders. 

Sung, H.-E. (2003) Differential impact of deterrence vs. rehabilitation as drug interventions on recidivism after 36 months. Journal of Offender Rehabilitation, 37, 95-108.

ABSTRACT: Official arrest data were examined for 263 DTAP participants.  Of these, 182 successfully completed treatment and the remaining 81 failed treatment and were subsequently prosecuted and sentenced to prison.  Both "completers" and "failures" were detained in jail during the preadmission screening period, which averaged 49.5 days for the entire sample.  Recidivism was defined as the first official rearrest that occurred within the 3-year period following treatment completion or prison release. Eighty (30 percent) of the 263 subjects were rearrested during the 3-year follow-up period.  Lengths of incarceration and treatment were the main predictors and reflected the hypothesized conceptual constructs of deterrence and rehabilitation.  Findings show that although all subjects were exposed to both incarceration and residential drug treatment, only treatment decreased the likelihood of recidivism.  No evidence of deterrence was found, and there were some indications of the criminogenic influence of incarceration among studied subjects.  These findings support current efforts to reform draconian mandatory sentence laws for nonviolent drug offenders.

Dynia, P. & Sung, H.-E. (2000) The safety and effectiveness of diverting felony drug offenders into residential treatment as measured by recidivism."  Criminal Justice Policy Review, 11, 299-311.
ABSTRACT: The goal of DTAP is to treat offenders in community-based facilities without endangering public safety and to decrease their recidivism following treatment. Among 487 comparable defendants, 4 percent of DTAP participants were rearrested during treatment, whereas 13 percent of nonparticipants were rearrested during the pretrial and sentence periods.  Of DTAP completers, 23 percent were rearrested during the 3-year period following treatment completion, which was less than half the rate for DTAP failures and nonparticipants.  The study concludes that, when appropriate screening and monitoring procedures are implemented, diverting drug felons to residential treatment is at least as safe as traditional prosecution and sentencing, and that successful completion of treatment is much more effective in reducing recidivism than completion of traditional sentences.