For the Defense - Vol. 8, Issue 3 - 59

and completing consent forms and assessments remotely. Fifth,
because the DRP continues to provide services via telehealth,
sessions are both more accessible as the provision of treatment no
longer requires travel and impacted by limited privacy. Sessions
are frequently cancelled, rescheduled, or interrupted because
clients attempt to attend sessions while driving or from locations
that are not quiet, private, and distraction-free. Lastly, clients
often initially do not see the value in participating in therapy
or learning skills for reentry. This is somewhat offset by the
incentive from the STAR court to receive time off their community
supervision sentence, but motivational interviewing techniques
are regularly employed to increase client engagement.
The DRP utilizes several approaches to mediate the effects
of barriers to client engagement. First, in response to limited
technological skills and difficulties with inconsistent attendance,
the DRP introduced a " patient navigator " position in October
2020. The patient navigator is responsible for reviewing the
telehealth platform used by the DRP to ensure that clients have
the skills needed for telehealth sessions and providing them
with technical support throughout the duration of treatment.
The patient navigator also provides session reminders using
text messaging and telephoning; this has yielded significant
improvements in attendance consistency and timely client
communication. Second, in addition to the motivational
enhancement session, clinicians utilize motivational interviewing
techniques throughout treatment. Motivational interviewing
aims to resolve treatment ambivalence and enhance motivation
for change through (1) gradually developing therapeutic
rapport using validation, empathetic listening, open-ending
questions, reflections and summarizations, affirmative
language emphasizing client strengths and progress, and
acceptance of the client's stage of change, (2) identifying
shared goals, (3) evoking change talk that emphasizes selfefficacy
within treatment and decision-making, (4) exploring
the client's intrinsic motivation to change, and (5) utilizing a
collaborative approach to treatment planning.12
Third, DRP
clinicians collaborate with STAR probation officers to identify
individual barriers that interfere with treatment engagement
and coordinate quarterly meetings during which probation
provides client updates, feedback, and recommendations to
improve client care. Additionally, the STAR court is provided with
ongoing updates regarding client engagement, attendance, and
progress. That information is used to determine what may be
interfering in treatment, to increase motivation to participate, or
to praise continued progress during clients' bi-weekly meetings
with their reentry court judge. Fourth, the DRP acknowledges
the difficulties associated with community reintegration and
increased need for mental health services within this population,
so flexibility is important in response to treatment-interfering
behaviors (e.g., inconsistent session attendance). Because of
limited availability and privacy, sessions are often held using
non-traditional settings, such as parked vehicles and semiprivate
locations at their place of employment, and frequently
interrupted by individuals with whom they live (e.g., children
and family). The intervention provided by the DRP is designed
to be completed within 3-6 months, which is often unattainable
for clients who have difficulty with consistent attendance and
prioritization of treatment over other responsibilities such as
employment. Clinicians recognize that clients have competing
responsibilities and require organizational skills relevant to
treatment engagement. Therefore, clinicians are flexible with
rescheduling sessions, providing evening availability, working
with probation to identify ways to increase motivation and
improve consistency, and avoiding terminating treatment, unless
attendance grossly interferes in treatment efficacy. Although
treatment duration and session location are often less than
ideal, limited flexibility interferes with access to care and may
decrease motivation to voluntarily participate in mental health
services. Lastly, the DRP has an open-door policy in which clients
who are unable to prioritize treatment due to decreased interest
or competing demands are welcome to resume services in the
future. Many clients who initially decline treatment or decide to
terminate services prematurely subsequently contact the DRP to
resume treatment, often following changes to their availability
or in response to reentry-related life stressors.
Since its inception, the DRP has increased access to care for
justice-involved populations within the Philadelphia area,
provided training and consultation to newly developed reentry
programs, and developed new partnerships to improve treatment
engagement and client outcomes. In early 2023, the program
expanded and began accepting participants from the federal
mental health court in the Eastern District of Pennsylvania
(called Strategies That Result In Developing Emotional Stability,
or STRIDES). This court seeks to address the needs of participants
who are diagnosed with severe and persistent mental illness
and/or have substance use disorders. Our work with STRIDES
clients involves the use of a manualized, CBT-based approach to
address wellness, risk-reduction, and prevention of recidivism. In
addition to the STRIDES program, the DRP recently developed
a partnership with the Beck Institute, an organization that has
advanced the use of evidence-based interventions within the field
of psychology. As part of this collaboration, the DRP's treatment
manual now incorporates Recovery-Oriented Cognitive Therapy
(CT-R) that focuses on empowerment, recovery, and resiliency
to reduce barriers to treatment engagement amongst justiceinvolved
populations, as well as individuals with severe and
persistent mental illness.
During our multiple years of partnership with the STAR court,
we have experienced both larger and more limited successes.
Both clinicians and clients have found that by the end of the two
modules, clients are typically using the skills learned in treatment
and reporting that these skills have improved their quality of
lives. The DRP collects anonymous data from clients on their
reactions to participation in treatment, and the responses have
been overwhelmingly positive. The DRP updates the manual
yearly using feedback from clinicians, clients, and the STAR
program.
Conclusion
The Drexel Reentry Project was designed to help address
a growing demand for community-based services for justiceinvolved
individuals in the United States. We anticipate that the
need for such services will increase during the next decade as rates
of incarceration fall and community-based services are needed
to support alternative options such as diversion, problem-solving
courts, and probation-and to assist individuals returning from
prison to achieve a healthier integration into the community
with a lower risk for reoffending.
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For the Defense - Vol. 8, Issue 3

Table of Contents for the Digital Edition of For the Defense - Vol. 8, Issue 3

Contents
For the Defense - Vol. 8, Issue 3 - 1
For the Defense - Vol. 8, Issue 3 - 2
For the Defense - Vol. 8, Issue 3 - Contents
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