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The recent ProDES Outcomes
Report on Bethesda Day Treatment provided selected information on juveniles
entering the program during the four-year period, 1994-1997.
In this report, we focused on three areas of feedback: population
characteristics, changes in clients over the course of the program, and
follow-up six months following discharge from the program.
In order to ground the findings, the same information is provided for day
treatment programs in the aggregate.¹ Below, we present some of the key
findings from that report.
Bethesda’s recidivism rate of 33% is not significantly lower than that
of other day treatment programs (34%). ² What
is different, however, is that while the recidivism rate for day treatment as a
whole has remained stable over time, Bethesda’s rate has declined steadily,
from 37% for the 1994 cohort, to 31% for the 1995 cohort, to 28% for the 1996
cohort. This finding indicates an
increased capacity on the part of Bethesda to improve its performance on this
key outcome.
These recidivism rates need to be viewed in terms of the program’s
client population. Compared to day
treatment programs as a whole, Bethesda’s clients are assessed as being at
greater risk of re-arrest at the point of intake.
Although 34% of the day treatment clients are rated as low risk, only 22%
of Bethesda’ clients are found in this category.
Importantly, too, Bethesda has experienced a steady increase in the
proportion of clients who are occasional or chronic drug abusers (up from 27% in
1994 to 61% in 1997). For day
treatment programs as a whole, there has been a less dramatic increase from 29%
to 46%. There has been a similar increase in the proportion of
clients with mental health problems (7% in 1994, 36% in 1997).
For all day treatment programs, the comparable figures are 9% and 18%.
We expect that program completion will be associated with reduced
recidivism. In this case, 19% of
those youth who successfully completed the Bethesda Program received new
petitions in Family Court within six months following discharge.
This figure is significantly smaller than the overall Bethesda rate of
33%.
In-program recidivism, while infrequent, seems to peak at the 9-12 month
point in the program experience. We
would encourage Bethesda to examine these cases in light of their experiences
with them in order to gain some understanding of this finding.
Using a responsivity typology developed expressly for ProDes, we are able
to identify types of delinquent youths with different recidivism rates.
One type of youth has a 36% recidivism rate in day treatment programs
generally, but has a 15% recidivism rate at Bethesda Day Treatment.
This would suggest that this particular type of juvenile responds
positively to the Bethesda experience. In
contrast, another type of youth with a recidivism rate of 33% in day treatment
programs generally has a 75% recidivism rate at Bethesda.
This type of youth clearly responds negatively to the Bethesda program.
Recidivism rates at Bethesda for the other three types range from 32% to
47%. These results show an
interaction between the Bethesda program and the type of youth.
We recommend that Bethesda analyze individual cases by type to see if
reasons for these discrepancies can be identified and to determine if program
modifications are warranted.
The findings reported here are based on different numbers of Bethesda
clients: 202 youths entered the program over the four year period, and of these,
we have complete intake data on 137; the discharge data are based on 143 cases
for whom 105 have staff assessments. The
follow-up data are based on 97 cases. These
are youths who entered the program and who were discharged at least six months
prior to June of 1997. Because we
need to wait until program experiences and time at risk elapse, readers are
cautioned that the findings that imply trends may turn out to be short-term
fluctuations. Importantly, too, we
cannot infer program impact from these data:
ProDES monitors outcomes but makes no attempt to conduct impact
evaluation. At the same time, the
findings are encouraging in terms of program and system objectives, and the
comparisons to day treatment programs in the aggregate indicate that Bethesda is
leading in achieving those objectives.
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