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Program Overview
The Social Skills Day Treatment Program is an outpatient mental health program at Brown Creek Correctional Institution in Polkton, NC. This institution is an 852-bed medium custody facility for felon, adult male offenders and is located approximately 50 minutes from Charlotte, NC.
The Social Skills Day Treatment Program has been in operation since l992 and has the capacity for 78 chronically mentally ill inmates. Program activities are primarily focused on providing treatment for inmates with a psychotic disorder. The majority of the participants in the program have schizophrenia, though some participants suffer from mood, anxiety, and organic disorders. Many of the participants are also dually diagnosed with intellectual deficits, personality disorders, and psychoactive substance related disorders.
Participants in the Day Treatment Program are typically referred by mental health staff within the NC correctional system. Support staff, including medical, custody officials and program staff, may also be instrumental in referring a particular inmate to their on-site mental health staff for evaluation. The referring clinician then submits a formal referral package for review by the Psychological Services Coordinator or designee at Brown Creek Correctional Institution (BCCI). After approval of this package, arrangements are made to transfer the inmate to BCCI.
Program Philosophy
Day Treatment Programs have been an integral component of community mental health programs for many years. Such programs in the prison setting provide a cost effective means of delivering mental health services to a chronically mentally ill population that is often difficult to program. The Day Treatment approach ensures daily contact with treatment staff in a dormitory housing assignment that allows mentally ill inmates to have more personal freedom and social interaction than is possible within the inpatient and residential facilities. This less restrictive delivery of care encourages the inmate to take responsibility for living as normal a life as possible and promotes personal independence through enhancement of social, vocational, academic, and leisure skills. Consequently, participants in the program may be better equipped for a more successful integration into the regular prison population or the community.
I. Phase I - Social Skills Day Treatment Program
Objectives of this phase of the program include educating an inmate about his mental illness, improving his acceptance of the need for ongoing mental health treatment, reducing the need for psychiatric rehospitalization, enhancing social and interpersonal skills, and encouraging the development of constructive use of leisure time. The maximum 52 inmates who participate in this program live together in a dormitory, attend structured sessions approximately 6 hours per day for four days per week, and receive gain time and various incentives in exchange for their participation in the program. Day five is utilized for treatment team and psychiatric clinic. Completion of Phase I usually takes 6-8 months and may lead to transfer to another unit, promotion to minimum custody, parole, or release from prison. Inmates who continue to require structured programming and are unlikely to adjust to the general population are promoted to Phase II of the Day Treatment Program.
Support staff for this phase of the program includes a contractual Psychiatrist, Staff Psychologist, three Behavior Specialists and two Rehabilitation Therapists.The contractual psychiatrist provides clinical services for inmates in the Day Treatment Program and for mentally ill inmates in the regular prison population. The psychologist provides assessments, individualized supportive sessions, monitoring of mental status, crisis management, coordinates development of treatment goals and chairs the treatment team. The duties of the other employees are highlighted below with a description of program activities.
A. Program Activities
Phase I of the program uses structured modules developed by the UCLA Clinical Research Center for Schizophrenia and Psychiatric Rehabilitation as the core psychoeducational components. Each Social and Independent Living Skills module consists of a trainer's manual, workbook, and videotape that utilize identification of goals, demonstration of skills on videotape, practice of skills through participation in behavioral roleplays, practice in solving resource management and outcome problems, and completion of in-vivo and homework exercises as the methods in step-by-step attainment of skills. Modules used from this series are as follows:
1. Basic Conversation Skills Module: The module is designed for individuals who have little success in developing social relationships, and for those who need re-training and improving of their socialization skills. Deficits in conversational skills limit social networks, lead to loneliness, and limit the quality of life of mentally disabled people. The goal of the module is to teach how to initiate and maintain friendly conversations with acquaintances, co-workers, and strangers and thereby decrease social isolation. The module is divided into five skill areas: a) Verbal and nonverbal communication behaviors; b) Starting a friendly conversation; c) Keeping a conversation going; d) Ending a friendly conversation pleasantly; and e) Putting it all together.
2. Symptom Management Module: The module encourages the development of coping skills for patients with chronic mental illnesses and is primarily directed towards those who suffer from a psychotic disorder. The module is divided into four skill areas: a) Identifying warning signs of relapse; b) Managing warning signs; c) Coping with persistent symptoms; and d) Avoiding alcohol and street drugs.
3. Medication Management Module: The module is designed to help primarily patients with a psychotic disorder become more self-reliant in managing their antipsychotic medications. Participants in the program are encouraged to take an active part in improving their health. The module is divided into five skill areas: a) Obtaining information about antipsychotic medication; b) Knowing correct self-administration and evaluation of medication; c) Identifying side effects of medication; d) Negotiating medication issues with health-care providers; and e) Advantages of long-acting injectable forms of medications.
The first three modules are taught by Behavior Specialists (3) in classes offered three days a week. Additional topics addressed in psychoeducational sessions may include anger and stress management, more detailed information regarding other mental illnesses and their associated medications, substance abuse, HIV and sexually transmitted diseases, current events, etc. Each behavior specialist acts as case manager for approximately 17 inmates and is instrumental in monitoring the individual's progress on treatment goals, completing custody reviews, and developing transfer and release plans including mental health aftercare.
The fourth module in the series is taught by a Rehabilitation Therapist as a supplementary activity during Arts and Crafts sessions.
4. Recreation for Leisure Skills Module: The module is designed to help a wide range of people in all age groups become more self-reliant and resourceful in the use of their leisure time by learning to plan and enjoy recreational activities. The module is divided into four skill areas: a) Identifying benefits of recreational activities; b) Getting information about recreational activities; c) Finding out what's needed for a recreational activity; and d) Evaluating and maintaining a recreational activity.
5. Rehabilitation Activities:
a. One Rehabilitation Therapist leads Arts and Crafts sessions that allow an inmate to choose from a variety of individualized projects including painting, plaster of paris molds, rug-making, basket-weaving, constructing model cars, etc. Class time is allowed for group participation in playing cards and board games. This rehabilitation therapist is instrumental in coordinating recreation in weekly Gym periods. These gym sessions encourage inmates to participate in structured activities such as badminton, wiffleball, basketball, volleyball, ping-pong, etc, and provide access to weight-lifting equipment.
b. The second Rehabilitation Therapist coordinates the Hortitherapy program which allows for "hands-on" practical experience both inside and outside of the on-site greenhouse. Weekly hortitherapy classes stress identification of the factors of plant growth such as light, temperature, nutrition, soil, etc, and encourage the development of skills in seed sowing, transplanting, soil preservation, and the identification and care of plants. Each inmate raises vegetables and flowers in the greenhouse which are later planted in his own garden tract; the individual is then responsible for the maintenance and harvest of his seasonal garden. Strong emphasis is placed on increasing knowledge of life processes and environmental concerns.
II. Phase II - Social Skills Day Treatment Program
The objective for this phase of the program is to provide additional programming for inmates with chronic mental illnesses who continue to demonstrate a need for a semi-structured environment. The maximum 26 inmates in this program have generally completed Phase I of the Day Treatment Program and may soon be preparing for release from prison, working towards transfer to another unit, or seeking promotion to minimum custody. Phase II also serves as a long term housing alternative for those mentally ill inmates who are unable to adjust to a less structured correctional setting. This phase emphasizes development of vocational skills through work activities and fosters greater independence in the management of one's mental illness.
Support staff for this program includes a contractual Psychiatrist, Staff Psychologist, a contractual Behavior Specialist, and two contractual Rehabilitation Therapists. The contractual Psychiatrist provides clinical services for inmates in the Day Treatment Program and for mentally ill inmates in the regular population. The Psychologist provides assessment, individualized supportive sessions, monitoring mental status, crisis management, coordinates development of treatment goals and chairs the treatment team. The duties of the other employees are highlighted below with a description of program activities.
A. Program Activities
Phase II of the program also utilizes a module in the Social and Independent Living Skills series.
1. Community Re-entry Program Module: This module is designed for individuals in mental health programs who need to actively participate in discharge planning. It is also helpful in preparing more seriously disabled, long-term inpatients to transition back into community life. Its skill areas include: a) Meeting goals for discharge; b) Planning with my community case manager; c) Developing a daily schedule; d) Making and keeping appointments; and e) Using a relapse prevention plan.
This module is taught one day per week by a contractual Behavior Specialist who provides case management services for the 26 inmates enrolled in Phase II of the program. Case management includes monitoring progress on treatment goals, completing custody reviews, and developing transfer and release plans including mental health aftercare.
Vocational Assignments: Two contractual Rehabilitation Therapists lead activities that comprise the vocational workshop element of this program. Inmates attend these vocational sessions four days per week.
a. One Rehabilitation Therapist supervises Landscaping projects which utilize plant material raised in the on-site greenhouse and include the development and care of flower beds at the prison.
b. The second Rehabilitation therapist supervises light Production projects which presently involve the reinforcement of dental files and the placing of grommets in inmate medical jackets.
3. Additional Assignments: Inmates in Phase II may also hold
a) an incentive paid position as dorm janitor;
b) an incentive paid position as assistant to the Phase I
Rehabilitation Therapist in Arts and Crafts;
c) an incentive paid position as assistant to the Phase I
Rehabilitation Therapist in Hortitherapy;
d) a gain-time position in the clotheshouse. These four
inmates work alongside assigned inmates from the regular population
on light tasks including stamping and sorting clothes, rolling socks,
sewing on buttons, and shining boots;
e) or enroll in on-site courses taught by Anson Community College
instructors. ABE/GED classes, single college courses, and vocational
degree programs are offered.
Requests for more specific information about this program and employment inquiries may be directed to:
Charles E. Messer, Jr., M.A.
Psychological Services Coordinator
Phone: 704/694-2622
Fax: 704/694-6201