Treatment Programs In The United States

878 words - 4 pages

Jefferson M. Fish, Professor Emeritus, former Chair of the Psychology Department as well as a former Director of Clinical Psychology at St. John's University wrote in the Oregon Law Review, "another set of mistaken assumptions underlies current policy regarding...mandatory drug treatment, offered by the courts as an alternative to imprisonment, is an effective and enlightened policy" (Fish, 2013). Fish (2013) attempted to convey to the readers, the absolute necessity of overhauling current United States policies regarding drug treatment. Several topics were touched upon, including the foundational policies of the War on Drugs as well as competing treatment paradigms. Regarding treatment paradigms, Fish (2013) breaks treatment programs down into two possible categories. The first of these are that of compulsory treatment, the second are that of voluntary treatment.

Gostin (1991) further categorizes treatment options with regard to compulsory execution into two sub-categories, civil commitment and diversion. Although they appear to be functionally equivalent and have overlapping terms, there are quantitative differences (Gostin, 1991). “Civil commitment authorizes the state to confine a person for treatment with due process, but without bringing a criminal charge” (Gostin, 1991). Whereas, “diversion from the criminal justice system involves diverting a person already charged with, or convinced of an offense from indictment, trial, or sentencing” (Gostin, 1991). Both Gostin (1991) and Fish (2013) question the efficacy and constitutionality of drug criminalization and welcome academic discourse regarding their effects upon society, however Gostin (1991) states that, “this requires further policy assessment that carefully balances the health benefits of prohibition with its economic and social costs, and the human rights burdens”.

Fish (2013) contends however, that the very nature of compulsory therapy undermines the essential nature of psychological therapy as true trust-relationship is unable to be established.
“In voluntary therapy, the therapist is working for the client, and what happens in therapy is protected by confidentiality. That relationship allows the client to candidly discuss anything, including illegal drug use. If the client feels that therapy isn't working, she is free to leave altogether, or to seek another therapist. By contrast, in compulsory drug treatment, the therapist is working for the court, and seeking to leave therapy can be labeled as uncooperative behavior and result in imprisonment” (Fish, 2013).
Fish's (2013) assertion that compulsory treatment is ineffective resulting from a lack of voluntary trust is contrary to the conventional policy rationale and discredits diversion treatment. Lastly with regard to civil commitment, Fish (2013) argues that, “for non-problem users, therapy turns into a charade”. I believe that Gostin (1991) is correct in that society must weigh the compulsion of treatment against the efficacy,...

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