Peer 1: Prison, death or recovery

Paul Thompson started sniffing glue at 10 years old. It seemed harmless enough at first but it was the first step on a road to addiction and crime.

At 17 he was sentenced to 10 years in prison by a court in Boulder, Colorado for armed robbery. After his release he spent further stints in prison for parole violations, Thompson says.

Shunned by family and friends, Thompson says he had no one to call. That’s when, in 1989, the "tough love" of Peer 1 in Denver, Colorado, came in. He contacted the facility on the advice of a fellow inmate, and, aged 36, was accepted into the programme. More than two decades later Thompson is still at the treatment centre, where he is now the assistant director.

Men at the 126-bed drug and alcohol rehabilitation facility, many having spent years in and out of prison, are responsible to each other. If one breaks the rules, others are obliged to report it or suffer the same sanctions imposed by their Peer 1 brothers.

With histories of abuse as children and living on the streets, the men live in for up to 12 months. The therapy comprises sessions from family group therapy to confrontational group accountability sessions and trust-building exercises.

"It’s hard for a person who's been a criminal all his life to tell on another Peer brother," says Thompson. "We teach them 'no more victim, no more victimising'," he says. "It’s OK to hold someone accountable."

Peer 1 is a Therapeutic Community where members work to change their lifestyles and support each other. More than 600 such programmes operate in the United States and Canada, focused on substance use and mental health, according to Treatment Communities of America, a professional association.

The programme, part of the Department of Psychiatry at the University of Colorado’s School of Medicine, targets men with long and often complex criminal histories for offences from theft to burglary, possessing and dealing in drugs to assault and fraud.

Sanctions for breaking the rules -- smuggling in cigarettes, making a disallowed phone call -- take the form of what the community calls a "therapeutic benefit" such as having to stare at a wall and meditate for stretches of an hour at a time or making and wearing an object that illustrates wrongdoing.

"It’s kind of humiliating but it forces them to rethink their actions," says Ilse Goethals, a lecturer at University College, Ghent, who has done research on Therapeutic Communities in Belgium.

Under the programme, the most serious transgressions are possessing drugs and threatening or using physical violence. Consequences for participants range from having their heads shaved publicly to being thrown out of the programme and sent back to prison.

"Clients who are in prison often start with less internal motivation but they tend to stay in therapy long enough for it to have some benefit," said Goethals. About 60 percent of clients complete intensive Therapeutic Community programmes in Colorado, Peer 1 among them, the state’s Division of Criminal Justice (DCJ) says.

Most men who join Peer 1 display antisocial behaviour, programme staff say. Their pasts include parole violations, rejection from other programmes and failed probation. Where others have said there's no hope for them, Peer 1 aims to give them another chance.

Of those in Colorado who complete intensive therapy such as this two-year programme in Denver, 11 percent commit another crime within 1 year and 21 percent within 2 years, the DCJ says.

No comparable rates for prisoners who had not taken part in such treatment were available, said Kim English, DCJ research director.

"We are not here to treat the career criminal," says director Kenneth Gaipa. "We believe that the criminality is tied to the substance abuse and if we treat the substance abuse the criminality will go by the wayside."