A systematic review of therapeutic alternatives to segregation placement: Progress toward rehabilitative goals or a euphemistic rebranding?

The use of segregation in U.S. correctional institutions is an overused method of containing high-risk and difficult-to-manage behavior, resulting in increasing calls for reform. To meet these demands, many agencies have initiated therapeutic alternatives, predominately in the form of diversion or step-down programs. To date, there have been no known attempts to systematically review what these programs look like in the field and whether they seem to be effective in improving psychological or behavioral functioning. Of the 699 documents produced from a comprehensive search, 10 met inclusionary criteria for a systematic review. Most evaluations were conducted in U.S. state departments of corrections and with men. While some studies showed favorable outcomes for alternative programs, many of these studies were rated as having lower scientific rigor. Overall, evidence of efficacy was mixed. Further, many articles provided limited or unclear details about the program content/structure, its delivery, demographics of the client population, or staffing requirements. We aggregate other key points from these studies and make a case for researchers and corrections departments to be more proactive and transparent about their efforts to reduce the reliance on segregation, including clearly reporting relevant outcomes associated with alternative programming.