Labrecque et al. Health and Justice
(2021) 9:23
https://doi.org/10.1186/s40352-021-00151-9

Health and Justice

RESEARCH ARTICLE

Reforming solitary confinement: the
development, implementation, and
processes of a restrictive housing step
down reentry program in Oregon

Open Access

Check for
updates

Ryan M. Labrecque1* , Jennifer J. Tostlebe2, Bert Useem3 and David C. Pyrooz2

Abstract
Background: Over the past decade there have been numerous and impassioned calls to reform the practice of
solitary confinement in U.S. prisons. This article examines the development, implementation, and processes of a
restrictive housing reentry program in the Oregon Department of Corrections. It draws on data from official
documents, site observations, and interviews with 12 prison officials and 38 prisoners. The Step Up Program (SUP)
seeks to improve the living conditions in restrictive housing over business-as-usual, alleviate physiological and
psychological harms of solitary confinement, and use rehabilitative programming to increase success upon
returning to the general prison population or community.
Results: The impetus to change the culture and structure of restrictive housing was primarily the result of internal
administrative reform. Prisoners assigned at random to housing assignments offered accounts of their daily
activities suggesting that the SUP provides more time out-of-cell and greater access to other services and activities.
Program participants preferred the living conditions in the SUP because they had more opportunities for social
interaction and incentives for compliant behavior. However, views on the value of programming among
respondents were mixed.
Conclusions: The launch of the SUP occurred in early 2020, which was soon followed by the COVID-19 pandemic.
As a result, the program was never fully implemented as intended. As Oregon returns to more normal operations, it
is possible that the SUP will be able to include even more out-of-cell time, greater socialization opportunities, and
increased access to programming and other beneficial activities. As we await the opportunity to conduct
prospective psychological and behavioral analyses, this study provides tentative support for the use of step down
reentry programs in restrictive housing units.
Trial registration: Open Science Framework, Preparing adults in custody for successful reentry: An experimental study
of a restrictive housing exit program in Oregon. Registered 4 October 2019, https://osf.io/t6qpx/
Keywords: Prison, Administrative segregation, Restrictive housing, Mental and physical health

* Correspondence: ryan.labrecque@ucf.edu
1
Department of Criminal Justice, University of Central Florida, 12805 Pegasus
Drive, Orlando, FL 32816-1600, USA
Full list of author information is available at the end of the article

BMC

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Labrecque et al. Health and Justice

(2021) 9:23

Do we really think it makes sense to lock so many
people alone in tiny cells for 23 hours a day, sometimes for months or even years at a time? That is
not going to make us safer. That’s not going to make
us stronger. And if those individuals are ultimately
released, how are they ever going to adapt? It’s not
smart.
– U.S. President Barack Obama, Remarks at the
NAACP Conference, July 14, 2015

Page 2 of 15

psychological or physiological detriment (Haney, 2020;
Luigi et al., 2020; Morgan et al., 2016; Reiter et al., 2020;
Strong et al., 2020; Wildeman & Andersen, 2020).
Just as there has been a swing away from the excesses
of mass incarceration after decades of unbridled growth
(Lobuglio & Piehl, 2015), a new consensus has emerged
from these controversies that it would be desirable to reduce the scale and scope of restrictive housing in U.S.
prisons (see Garcia, 2016).
Strategies to reduce the use of restrictive housing

Background
Solitary confinement—isolating prisoners for 22 or more
hours daily—has become the subject of intense debate
and policy reconsideration over the last decade. One
controversy focuses on the conditions in restrictive
housing settings. While restrictive housing typically does
not entail complete isolation or sensory deprivation,
meaningful social interaction, and other lifelines (e.g.,
visitation, phone calls, and programming) are severely
curtailed. This has led to extensive litigation based on
Eighth Amendment protections against the use of cruel
and unusual punishment. For example, the class-action
lawsuit Ashker v. Governor of California, was settled in
September of 2015, nearly 6 years after the initial pro se
complaint was filed (Center for Constitutional Rights,
n.d.; Reiter, 2016), ending California’s use of indeterminate placement in restrictive housing.
A second point of controversy has been an alleged
overuse of restrictive confinement (Sakoda & Simes,
2021). Around 4% of state and federal prisoners were
held in restrictive housing, and nearly 20% spent at least
one night in this setting over a 12-month period (Beck,
2015; see also Correctional Leaders Association & the
Arthur Liman Center for Public Interest Law, 2020; and
Pyrooz & Mitchell, 2020). Restrictive housing is thought
to be reserved for the “worst of the worst” (Butler
et al., 2013; Reiter, 2012); however, not all individuals
held in isolation may need to be separated from the
general population to ensure institutional safety and
order (Labrecque, 2018; Lovell et al., 2000). Segregation units disproportionately house vulnerable
populations (e.g., people with serious mental illnesses;
Siennick et al., 2021) and individuals based on their
identity rather than behaviors (e.g., gang affiliates;
Pyrooz, 2016).
A final point of controversy pertains to the potential
for negative effects. Placing prisoners in restrictive housing units is believed by many to exacerbate behavioral
and health problems. While the evidence is mixed
whether the use of restrictive housing increases the
safety of prisons or deters misconduct among prisoners
(Labrecque & Smith, 2019a; Morris, 2016; Steiner &
Cain, 2016), most studies find some level of

Broadly speaking, there are three types of approaches to
achieve the goal of shrinking the footprint of restrictive
housing. One approach has been to address the “onramps”—tightening the guidelines for whom or what
qualifies for placement in restrictive housing settings.
Prisoners are typically placed in restrictive housing for
disciplinary reasons, such as rule violations, or administrative reasons, such as membership in security threat
groups (Labrecque, 2016; Mears, 2016). Abolitionists
seek to eliminate restrictive housing altogether, while defenders of the practice contend that some level of its use
is required to respond to the challenges of disorder and
violence in prison (see Labrecque & Mears, 2019; Mears
& Castro, 2006). In 2016, the Federal Bureau of Prisons
reduced the maximum punishments for disciplinary
sanctions and eliminated juveniles from being placed in
restrictive housing (Office of the Press Secretary, 2016).
Another on-ramp strategy involves proactively targeting
those who are at higher risk for ending up in restrictive
housing with increased case management and treatment
services in order to reduce the need for placement
(Labrecque & Smith, 2019b).
A second approach is to address the “off-ramps”—reducing the dosage of restrictive housing. Shortening the
length of stay in these conditions would require eliminating the practice of indeterminate placement. Gang affiliates, for example, would no longer have to debrief in
order to return to the general prison population (Toch,
2007). It would also require limiting fixed sentences to
restrictive housing. Approximately 10% of federal and
state prisoners reported spending 30 or more days in restrictive housing in the last 12 months (Beck, 2015).
That proportion would drop even further, allowing U.S.
prisons to fall more in line with the United Nations’
2015 standards of prisoner treatment, which prohibits
placement in restrictive housing for 15 days or more
(Frost & Monteiro, 2016). Among the 50 guiding principles set out by the U.S. Department of Justice (2016) is
that correctional agencies should develop plans that result in the prompt return of prisoners to the general
population.
A third approach—and the subject of this article—involves altering the environment within restrictive

Labrecque et al. Health and Justice

(2021) 9:23

housing settings. Whereas the theory of change for the
prior approaches entails restricting the on-ramps and
expanding the off-ramps, this approach targets the
mechanisms believed to bring out problem behavior and
poor health among the people who are placed in restrictive housing, namely the excessive deprivations and limited social interaction with others (see Haney, 2020).
First, one of the most frequently mentioned harms of
solitary confinement by criminologists, psychologists,
and public health experts alike is the lack of meaningful
social contact experienced in these units (Cloud et al.,
2015; Haney, 2020; Scharff-Smith, 2006). This is because
restrictive housing units provide limited to no opportunities for time out-of-cell or social interaction (e.g., phone
calls, visitation, hanging out with other prisoners, engaging with correctional staff). Prison culture is also inherently coercive in nature (Wooldredge, 2020), which
can impede the positive interactions between prisoners
and correctional staff and increase non-compliance and
other forms of rule breaking (e.g., Beijersbergen et al.,
2015; Steiner & Wooldredge, 2018). Providing more opportunities for time out-of-cell, quality social interaction,
and cultural changes away from coercion should lessen
incidence of misconduct and improve indicators of
health and psychological well-being. Second, and relatedly, there is a lack of rehabilitative programming geared
toward reintegration and increasing pro-social behavior
through problem solving and conflict resolution (Butler
et al., 2018; Meyers et al., 2018, 2020). As many individuals are placed in restrictive housing settings because of
rule violations and threat assessments, by restricting
access to programming, it is unlikely these behaviors or
the threat will be reduced. Finally, there are minimal
incentives for compliance in restrictive housing units.
Incentives such as extra phone calls, opportunities to
play card and video games with others on the unit, and
access to a wider food select can be powerful tools to
encourage compliance and boost morale (Digard et al.,
2018; Smith, 2016).
This approach aims to construct an environment that
permits people to leave restrictive housing in a better
position than when they arrived. Elements of a “better”
environment include: (1) allowing more time out-of-cell,
higher quality interaction between prisoners and staff,
and more amenities, (2) incorporating rehabilitative programming into restrictive housing units with the goal of
reintegrative success, and (3) providing incentives for
compliant behavior that are comparable to the privileges
found in general population housing. If implemented,
these changes are expected to improve prisoner wellbeing (including physical and psychological health), decrease problem behavior, and reduce their likelihood of
being sent back to restrictive housing after returning to
the general prison population.

Page 3 of 15

Across the United States, prison systems have
developed what has been termed “step down programs” in restrictive housing settings. Their purpose
is to help prisoners transition from more to less
restrictive conditions (Ghafar, 2017; Vanko, 2019).
These programs contain two or more levels that
provide prisoners with increasingly greater privileges with each “step.” They may gain more recreational time, access to the canteen, contact with
family, or opportunities to engage in rehabilitative
programming.

The current study

It is estimated that as many as 30 prison systems operate
a step down program (Association of State Correctional
Administrators & the Liman Center for Public Interest
Law, 2018; Chammah, 2016); however, information
on the origins, implementation, processes, and impacts of these programs is largely absent from the
social science literature. Toward the goal of filling
key aspects of this research gap, we focus on the
task set forth by the Oregon Department of Corrections (DOC) to create a new unit that is committed
to rehabilitative programming, increased socialization
opportunities, incentivizing reintegration, and blunting some of the harsher conditions of restrictive
housing.
This article examines the development and implementation of a restrictive housing step down reentry program in an Oregon prison. It is organized into three
sections. First, we outline the research methodology
of the evaluation generally and for this article specifically. Our data are based on official documentation,
observations, and interviews with prison officials and
prisoners with respect to two housing units: (1) the
newly-devised Step Up Program (SUP) unit, and (2)
the business-as-usual Intensive Management Unit
(IMU). Second, we describe the origins of the SUP,
including what motivated its development, the procedures for putting it into place, and opinions about it
from the perspective of correctional staff tasked with
its implementation. Finally, based on interview data
with prisoners we describe their use of time and perceptions of programming, comparing prisoners randomized to placement in the SUP and those who
remained in the IMU. These results are not intended
to serve as a complete evaluation of the program, but
instead to share knowledge on an operational
innovation in light of the coronavirus (COVID-19)
pandemic’s far-ranging effects on prisons (Novisky
et al., 2020). In response to the COVID-19 pandemic,
the Oregon DOC prevented outside visitors from entering its prisons and reduced programs and other

Labrecque et al. Health and Justice

(2021) 9:23

services and activities, including temporarily suspending the SUP referral process in April 2020.1

Methods
The authors coordinated with correctional staff to conduct a randomized controlled trial (RCT) of the SUP.
This is noteworthy for two reasons. First, researchers are
typically involved in post-hoc evaluations of policies,
practices, and programs. In this study, however, we were
able to observe the origins and development of the SUP,
which permitted our team to produce a richer account
of processes and impacts. It also allowed us to share
knowledge on practical and theoretical advances derived
from research on restrictive housing, helping the DOC
make decisions about the contours and functions of the
SUP. Second, RCTs are rare in prisons (Farrington &
Welsh, 2005; Weisburd, 2000) and within restrictive
housing settings more specifically (Butler et al., 2018;
Meyers et al., 2018, 2020). The use of an RCT in this
context is important because this strategy reduces the
problem of selection bias (Elwert & Winship, 2014;
Ridgeway, 2019), which is common in research on restrictive housing.
Study design and procedure

This study assesses prisoner viewpoints of the living
conditions in the SUP and IMU, as well as the prison officials’ perceptions of the SUP as it was being implemented. This research was approved by the Oregon
DOC Office of Research and by the Institutional Review
Boards at the authors’ respective institutions. A nonsecurity staff member from the Oregon DOC compiled a
list of prisoners as they were admitted into the IMU at
the Snake River Correctional Institution (SRCI).2 The
IMU security staff then reviewed the list of names with
input from the correctional officers in the unit to determine eligibility for the SUP. Reasons for exclusion
included recent attacks against staff, history of violence
with a weapon, or otherwise posing an immediate and
serious threat to safety and security. Additionally, if a
prisoner was scheduled to be released directly to the
community from IMU they would automatically be

1

On March 12, 2020, the Oregon DOC announced it was suspending
all visiting at all 14 state prisons beginning March 13, 2020 (Oregon
Department of Corrections, 2021a). The first COVID-19 positive case
was reported on April 1, 2020 and was an employee at the Oregon
State Penitentiary. On April 2, 2020, the first adult in custody (AIC)
within the Oregon DOC tested positive for COVID-19 at Santiam Correctional Institution.
2
Prisoners are eligible for IMU after serving time in disciplinary
segregation. The prisoners in our sample spent an average of 131 days
(SD = 39 days) in disciplinary segregation before being transferred to
the IMU.

Page 4 of 15

placed in the SUP.3 This, of course, limits the inferences
that can be made about the impact of SUP versus IMU on
outcome variables. However, this paper is centered on
description and process, not the impact of the program.
The list of eligible cases was de-identified and sent to
the first author for random assignment into either the
treatment group (i.e., SUP) or the control group (i.e.,
IMU). RCTs may raise ethical concerns in the correctional context because they deliberately withhold a
“treatment” from some individuals to allow for an unbiased comparison with those who are untreated. In this
study, random assignment was reasonable because bed
space in the SUP was limited. Oregon officials needed a
strategy to assign prisoners to the SUP who met the eligibility criteria and random assignment provided a fair
procedure. This strategy also provided the opportunity
for the collection of high-quality evidence to evaluate
the program’s effectiveness. Still, even though prisoners
understood that the invitation to enter the SUP or remain in the IMU was random, they were not mandated
to move, and in fact, many exercised their right to remain in the IMU (see below). Declination to move to
the SUP had no impact on prisoners’ incarceration, generally, or duration spent in the IMU, specifically.
The first cohort of randomized study participants was
moved to the SUP on January 7, 2020. For those
assigned to SUP, the average length of stay in IMU before the transfer was 33 days (SD = 17 days). The minimum number of days was 11 and the maximum was 72.
Thus, while all prisoners had some exposure to IMU,
that exposure for the SUP participants was much shorter
than the 7 months (~ 213 days) individuals placed in
IMU normally experience in this setting.
Our research strategy involved interviews with prisoners. These interviews occurred about 2 weeks prior to
their release from SUP or IMU. Travel to SRCI for prisoner interviews was scheduled to occur April 2020. This
trip, however, was cancelled when SRCI was closed to
outside visitors to slow the spread of the COVID-19
virus (Oregon Department of Corrections, 2021a). Despite this logistical setback, our research team collaborated with prison officials to devise an alternative
strategy for conducting the interviews by phone (Pyrooz
et al., 2020). We interviewed prisoners in private attorney rooms located within the IMU. Correctional staff
first notified prisoners of the study at their cell, asking if
they wanted to speak with us voluntarily; some refused,
and thus did not participate in the study. If they agreed
to learn more about the study, prisoners were escorted
3

Given the infrequency of prisoners released directly from IMU to the
community, our survey sample includes only individuals who were
intended to return to the general prison population before their release
from prison.

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Page 5 of 15

to the location where non-security staff dialed our phone
number. These interactions were assured the privacy
protections of an attorney call; staff did not monitor or
record the conversations. We initiated the phone call
with our consent form. After obtaining verbal consent,
we administered the survey instrument and audiorecorded the interview with the prisoner’s permission.
Information about our response and participation rates
is provided below.
The SUP stopped accepting new participants in April
of 2020 due to COVID-19 but continued to operate in a
modified format for those already enrolled through August. In an effort to slow the spread of the virus, congregate recreation and program activities were eliminated.
The program staff, nevertheless, endeavored to safely get
SUP prisoners out of their cells as much as possible.
This involved single-man outdoor recreation time and the
incorporation of packet-based programming that could be
completed alone in one’s cell. Program participants were
afforded greater access to the phone and other benefits,
such as more access to television, canteen privileges, and
out-of-cell time, compared to those in the IMU.
Participants

The authors conducted semi-structured interviews with
12 prison officials at the SRCI in private rooms. A

purposive sampling method was used to identify staff of
different ranks and duties, including correctional officers, case managers, and mid-level and senior administrators. The goal of these interviews was to ascertain
staff views on the IMU and SUP, including the motivation and processes behind the development of the
SUP. The interviews ranged from 20 min to just over 1 h
in length.
A total of 56 prisoners from seven cohorts were enrolled in the study between January 7 and April 21,
2020, of whom 30 were randomly assigned to the SUP
treatment condition and 26 were randomly assigned to
the IMU control condition. Thirteen of the individuals
refused to leave their cell to learn more about the study
and three declined to participate at the consent stage
(71.4% response rate, 93.0% participation rate). Two respondents provided consent but completed only a partial
interview, missing the key sections reported in this
study. The 38 consenting participants were evenly split
between the treatment and control group. The authors
conducted these structured interviews remotely on four
multi-day occasions between April 3 and June 30, 2020.
Table 1 contains descriptive statistics based on
administrative data for the full sample (i.e., all people randomly assigned) and the analysis sub-sample (i.e., those
who were interviewed) partitioned by their random

Table 1 Demographic and Institutional Descriptive Statistics, Total and Analysis Samples
Total Sample

Analysis Sample

Characteristic

% Total
(N = 56)

% IMU
(n = 26)

% SUP
(n = 30)

t or z score

p-value

% Total
(N = 38)

% IMU
(n = 19)

% SUP
(n = 19)

t or z score

p-value

Mean age (SD)

29.8 (6.9)

29.0 (6.4)

30.6 (7.2)

0.89

.377

30.1 (6.7)

29.5 (7.0)

30.7 (6.6)

0.55

.587

White

57.1

50.0

63.3

1.01

.315

52.6

57.9

47.4

−0.65

.516

Black

8.9

11.5

6.7

−0.64

.524

10.5

10.5

10.5

0.00

1.000

Hispanic

26.8

23.1

30.0

0.58

.560

29.0

15.8

42.1

1.79

.074

Asian

1.8

3.9

0.0

−1.08

.278

2.6

5.3

0.0

−1.01

.311

American Indian

5.4

11.5

0.0

−1.91

.056

5.3

10.5

0.0

−1.45

.146

76.8

73.1

80.0

0.61

.541

76.3

68.4

84.2

1.15

.252

MH-0

28.6

23.1

33.3

0.85

.397

26.3

26.3

26.3

0.00

1.000

MH-1

28.6

19.2

36.7

1.44

.150

23.7

10.5

36.8

1.91

.056

MH-R

30.4

53.9

10.0

−3.56

<.001

36.8

63.2

10.5

−3.36

<.001

MH-2

12.5

3.9

20.0

1.82

.068

13.2

0.0

26.3

2.40

.016

Low-risk

48.2

42.3

53.3

0.82

.410

52.6

42.1

63.2

1.30

.194

Moderate-risk

50.0

53.9

46.7

−0.54

.592

44.7

52.6

36.8

−0.98

.328

High-risk

1.8

3.9

0.0

−1.08

.278

2.6

5.3

0.0

−1.01

.311

44.6

38.5

50.0

0.87

.386

44.7

36.8

52.6

0.98

.328

Race/ethnicity

Gang affiliation
Mental health

ACRS

Prior IMU

Note: IMU = Intensive Management Unit; SUP = Step Up Program; MH = Mental Health; ACRS = Automated Criminal Risk Score. p-value refers to IMU to SUP
differences derived from two-tailed t-tests or equality of proportions tests

Labrecque et al. Health and Justice

(2021) 9:23

assignment status. Random assignment produced a wellbalanced distribution of SUP participants and IMU control group members. In the analysis sample, there were
two individuals assigned to the treatment condition who
refused to participate in the SUP and three individuals
assigned to the treatment condition who began but were
terminated early from the SUP for violating institutional
rules.
The respondents in our analysis sample were between
20 and 45 years old at the time of the interview (Mean =
30.1, SD = 6.7). The sample was predominately White
(52.6%), followed by Hispanic (29.0%), Black (10.5%),
American Indian (5.3%), and Asian (2.6%). Approximately three-quarters of the sample (76.3%) were identified as having a history of gang affiliation and nearly half
(44.7%) had been housed in the IMU on a prior occasion. According to the Automated Criminal Risk Score
(ACRS) instrument, 52.6% of the respondents were classified as low-risk, 44.7% as moderate-risk, and 2.6% as
high-risk for post-release recidivism (i.e., a felony reconviction within 3 years of release).
With regard to mental health, the agency classifies
prisoners into five categories, ranging from less severe to
more severe: MH-0: does not require a diagnosis by
mental health services (26.3% of respondents); MH-1:
diagnosis of mental disorder with mild acuity (23.7%);
MH-R: diagnosis of a condition that either needs no active therapeutic intervention or symptoms that can be
controlled through medication (36.8%); MH-2: diagnosis
with one or more of 19 mental disorders, including anxiety, depression, mood, and panic disorder (13.2%); and
MH-3 diagnosis with one or more of nine severe mental
disorders, including bipolar, schizophrenia, and psychotic disorder (0.0%).4
The two groups (IMU vs. SUP) were statistically similar (p > .05) with two exceptions. In the full sample (N =
56), a lower percentage of the SUP group maintained an
MH-R classification than the IMU group (10.0% compared to 53.9%, p < .001). In the analysis sample (n = 38),
the SUP group had fewer MH-R (10.5% vs. 63.2%,
p < .001) and more MH-2 designations than the IMU
group (26.3% vs. 0.0%, p = .016). With 15 comparisons,
this is about what we would expect to occur by chance.
With the exceptions noted, there were no statistically
significant differences found on any of the observed
characteristics between the SUP analysis and total
samples or IMU analysis and total samples. Randomization
resulted in well-balanced groups.

4

Rather than being placed in the IMU, individuals with MH-3 designation are placed in the Behavioral Health Unit, which provides more
specialized mental health treatment.

Page 6 of 15

Prisoner survey

Components of the interviews with prisoners focused on
time use in prison and perceptions of the SUP. Time use
questions were based on the Survey of Inmates in State
Correctional Facilities (SISCF-2004) and involved asking
respondents to describe their typical day in custody, estimating how much time they spent engaged in various
activities (e.g., participating in yard time, hanging around
with other prisoners, participating in programming,
communicating with correctional officers). Perceptions of
the SUP involved inquiry about prisoners’ views of the
program, including asking them to detail how the experience differed from the IMU and to comment on expectations regarding its potential impact on their future.
Analysis

This study employs a mixture of descriptive, quantitative, and qualitative analyses. First, we examine the origins of reforming the IMU and the development and
implementation of the SUP, relying on historical accounts, observations of the unit, and interviews with
prison officials. Second, we compare the daily reported
activities between participants in the SUP and the IMU
to determine if there are differences in the experiences
of prisoners in the respective housing units. Consistent
with an intent-to-treat approach, we make comparisons
based on the assigned treatment condition (Lachin,
2000),5 but given the descriptive aims of the study, we
also make comparisons based on actual housing assignment at the time of the interview. Finally, we review the
transcribed responses to the open-ended questions about
the perceptions of the SUP and IMU.6 This study takes
an inductive approach to the analysis of the qualitative
data. Each of the authors read the transcripts to identify
and collate common themes and conclusions.
We are cautious in the interpretation of our quantitative findings. Indeed, we focus on three aspects of differences between groups, including the direction (i.e.,
positive or negative), statistical significance (i.e., alpha
values), and magnitude (i.e., strength of the association).
Statistical significance is determined through the use of
independent samples t-tests, and we report p-values
albeit without asterisks. Substantive significance is
5

Intent-to-treat procedures are standard practice in RCT designs.
While RCTs are recognized as the “gold standard” study design, the
“incorrect analysis of the data can introduce bias even in the setting of
the correct implementation of a valid random allocation sequence”
(McCoy, 2017, p. 1075). To preserve the integrity of the
randomization process, analysis must be completed according to the
group to which participants were originally assigned. Furthermore,
estimates from an intent-to-treat analysis are generally conservative
(Gupta, 2011).
6
All interviews were transcribed by a professional transcription agency
and were stored on a secure server at the University of Colorado
Boulder.

Labrecque et al. Health and Justice

(2021) 9:23

assessed through the interpretation of Cohen’s d. We
follow Cohen’s (1988) guidelines where d = .2 represents
a small difference, d = .5 represents a medium difference,
and d = .8 represents a large difference in the magnitude
of the SUP effects, using the IMU respondents as the
reference group. Using multiple modes of assessing differences is important for a study design involving an
analytic sample of this size.

Results
Origins of reform

The origins for reforming the structure and culture of
restrictive housing in Oregon are found in two events.
First, in 2015, the Oregon DOC applied for and was selected as one of five correctional agencies to participate
in the Vera Institute of Justice Safe Alternative to Segregation Initiative (Digard et al., 2018). This project involved the review of Oregon’s restrictive housing
policies, observation of correctional facilities, focus
groups with staff and prisoners, and administrative analysis of segregation data. Vera found that prisoners were
often being isolated in segregation cells for up to 23 h
per day with limited opportunities for out-of-cell activities and therapeutic programs. Vera recommended that
the Oregon DOC should seek to improve the conditions
of confinement in restrictive housing settings (e.g., create
de-escalation spaces), increase the availability of out-ofcell programming and congregate activities, and create a
structured reentry process to help prisoners transition
more effectively out of long-term segregation (see also
Hastings et al., 2016). According to an Oregon DOC
administrator that we spoke with:
Vera made the recommendation [for the step down
program]. They liked the fact that we had started
the out-of-cell programming, but they recommended, of course, that we do more and that we
work on a step down program that [would] get folks
ready for a general population.
Thus, Vera provided an impetus to reform the structure of restrictive housing in Oregon.
Second, the Oregon DOC was also chosen to take part
in a correctional staff exchange program with the Norwegian Correctional Service in 2018 (Achen, 2018).7 A
delegation of 14 Oregon correctional administrators and
officers traveled to Norway in 2019 for 9 days to observe
their prison operations and to stay in the homes of their
Norwegian counterparts, and vice-versa (Frost, 2019).
7

This collaboration was supported by Amend; a non-profit
organization based out of the University of California San Francisco’s
School of Medicine that is dedicated to changing the correctional culture in America (Bouffard, 2019).

Page 7 of 15

The Norwegian correctional system is often touted for
its efforts to make prisons more “humane” and
normalize prisoner/officer interactions. Indeed, a senior
administrator stated: “ … that’s what Norway is about.
They say it’s the recognition that we’re all people who
still have hopes and dreams.” The impetus behind the
exchange program was a belief that correctional staff
would better support and implement more humanistic
and less punitive offender management strategies after
observing first-hand the benefits of this strategy in practice (Ahalt et al., 2020). It was expressed to us that the
benefits of the Norwegian approach were readily apparent during the exchange trip:
I think what we really saw were two things that
were really kind of stunning to us … one [is] just
their rapport and relationships with inmates …
Everything was done together. There was none of
this “us” and “them.” They had professional boundaries, and they were appropriate, but there was
much more integration, so the whole atmosphere
and the tone were different … The other takeaway
that was really big was just how happy and healthy
this staff seemed to be … So, we saw that how they
had their system not only benefited the inmates and
helped them get ready for release, they have the
lowest recidivism in the world, but their staff are
benefiting from it as well.
As part of the exchange program, correctional staff
from the Norwegian Correctional Service were reciprocally sent to the Oregon DOC:
They … train [ed] us on … their concept of the resource team that they use with their difficult inmates in restrictive housing populations. I think
some of the easy things for Americans to believe
about Norway is they can do all that because they
have easy inmates. They don’t have easy inmates.
Their incarcerations and sentencing are different
than ours, but they have rapists, murderers, and terrorists just like we do, so some of the things they’ve
done with their resource team are really profound.
We were trained on that in February of 2019, and
that has really been a real catalyst of support in
some of the culture change in things we’re doing in
our step up program.
The exchange thus contributed to alternative ways of
thinking about the culture found in restrictive housing.
These two events, coupled with the agency Director’s
goal of reducing the use of restrictive housing (Oregon
Department of Corrections, 2021b), have corresponded
with a 30% statewide reduction in the use of the

Labrecque et al. Health and Justice

(2021) 9:23

practice. Out of the 14,734 prisoners incarcerated in July
2019, there were 705 (or 4.8%) who were held in some
type of restrictive housing (Correctional Leaders Association & the Arthur Liman Center for Public Interest
Law, 2020), which was down from the 1025 out of
14,591 (or 7.0%) from Fall of 2014 (Baumgartel et al.,
2015).
Building from this momentum, the Oregon DOC
sought to implement a restrictive housing step down reentry program with the objectives of providing a transition that would help prisoners more effectively move out
of long-term segregation and improving prisonercorrectional staff interactions by putting the “person”
back in the “prisoner.” The Oregon DOC selected the
IMU at Snake River Correctional Institution (SRCI) in
Ontario (located in eastern Oregon near the Idaho
border) as the site for its first location.8
Creating an alternative to business-as-usual

The IMU is reserved for individuals who are believed to
pose a serious risk to the safety of themselves, others, or
the institution (e.g., chronic rule violations, escape attempts, security threat group activity).9 All referrals to
IMU are reviewed by a multi-disciplinary committee,
which includes representatives from institutional operations, behavioral health services, and the office of population management. Placement in IMU involves
confinement in a single cell for the vast majority of each
day (~ 23 h per day) with little-to-no access to meaningful interactions with staff or other prisoners. Stays in
IMU are slated to last 7 months with compliant behavior; however, time in the unit can be extended for violating institutional rules. Individuals with serious mental
illnesses can alternatively be placed in the Behavioral
Health Unit, where they are more closely monitored by
medical and mental health providers.
The IMU operates on a five-level tiered system—Level
1 to Level 5—with prisoners assigned to lower levels
having more restrictions on services and activities than
those in higher levels (e.g., property, commissary, recreation, phone, visits, work; Oregon Department of Corrections, 2019). All prisoners enter IMU under a Level 2
program status and receive a behavior action plan from
their assigned case counselor. The behavior plan outlines
the specific programs and other activities that the prisoner must complete before being considered for release
from IMU. Each month the multi-disciplinary team
meets to review the program status for all of the prisoners in IMU. During these meetings, the committee

Page 8 of 15

decides to advance, demote, or retain prisoners’ assigned
program level.
The SUP was designed with the goals of improving living conditions compared to the IMU, alleviating potential physiological and psychological harms of restrictive
housing, and increasing one’s success upon returning to
the general prison population or community. As part of
the planning process for this transition, the authors provided guidance on the structure of the unit based on the
current inventory of literature. For example, it was recommended that the new unit provide more out-of-cell
time, increased social interaction, and more opportunities for rehabilitative treatment compared to IMU. The
design of the program (e.g., types of programs to be included, phase/incentive system, expanded recreation
yard, video game system in unit), however, was decided
exclusively by staff at the Oregon DOC. The SUP was
developed to include two levels. Prisoners in Phase 1 can
take part in out-of-cell activities at tables in the common
area while restrained and outdoor buddy recreation with
one other person in the unit. Those in Phase 2 have access to out-of-cell activities while partially restrained
(i.e., legs cuffed to table, but arms are free), buddy recreation with up to three other people in the outside recreation area, and unrestrained escorts. The authors also
collaborated with Oregon DOC senior managers, SRCI
administrators, and IMU security, program, and support
staff to devise a strategy for evaluating the impact of the
program on a variety of physiological, psychological, and
behavioral indicators.
The process for converting a wing of the IMU at SRCI
into a 24-person, step down reentry program involved
five critical tasks. First, the new unit required physical
modifications to allow for greater socialization and outof-cell time compared to the IMU. The outdoor recreational area was expanded to provide more space for
prisoners to congregate together. Tables were also installed in the unit to allow prisoners the opportunity to
sit and talk, play games together, and watch television
outside of their cells.
Second, opportunities for social interaction were significantly increased. A goal was set to provide program
participants with 5–6 h of out-of-cell time per day,
which is more than the 1 h per day that prisoners in the
IMU receive.10
Third, given the desire to improve the likelihood for a
successful reentry, treatment services and other activities
were enhanced in the SUP. This involved increasing the
number of programs, including Free Your Mind in

8

The Oregon DOC operates two IMUs: one for male prisoners at the
Snake River Correctional Institution and the other for female prisoners
at the Coffee Creek Correctional Facility.
9
Information about the other types of restrictive housing used in
Oregon is available in Hastings et al. (2016).

10

An unfortunate impact of the COVID-19 pandemic has been the
temporary decreased ability to meet this 5–6 h goal. The prisoners in
the SUP, however, still maintained more out-of-cell time than prisoners in the IMU.

Labrecque et al. Health and Justice

(2021) 9:23

Segregation (FYM-S); Dialectical Behavioral Therapy
(DBT); Getting Out by Going In (GOGI); Living Well;
Hepatitis, HIV, AIDS Awareness Program (HHAAP);
and Charting a New Course. It also involved providing
opportunities for other recreational activities, such as
watching movies, playing games, and participating in art
projects, that are not available to those in the IMU.
Fourth, a correctional case counselor was assigned to
oversee the treatment plans of all the program participants. The counselor assigns prisoners to the specific
programs and other services available that best match
their individual risk and needs. Although prisoners in
both SUP and IMU work with a case counselor, those in
the former category have much greater access to programs and services that address their risks and needs.
Finally, following the Norwegian model, correctional
officers have been encouraged by SRCI leadership to
take a more humanistic approach toward interacting
with prisoners in the unit. This approach includes
spending time with incarcerated individuals on the unit
by playing cards, video games, or other activities together, which are not typical occurrences in the IMU.
According to a senior security staff member:
To change a culture, you’ve got to drive the culture
and show people it’s okay. It’s okay to go sit down
at the table and play video games with inmates. It’s
okay to go sit down and observe cards or play cards
… You’ve got to role model that … it’s okay to talk
to somebody about their family if they ask you. I do
care about your family. I do care about your kids. I
do care about their success. I know you’re an inmate, but that’s important to you, so it needs to be
important to me. [L] ater that’s going to pay dividends. I promise you. One case at a time.
Implementing the step “up” program

The SUP was piloted on October 21, 2019. Its first residents included eight hand-selected prisoners from the
IMU. Three additional individuals were also identified
for placement but refused to participate. Correctional
staff informed us that the trepidation toward program
participation had to do with gang politics, unknowns
about the program, and the original program name itself—“Step Down Program.” Our research team traveled
to SRCI in late October 2019 for a kick-off meeting with
more than two dozen line to senior staff members. During this meeting, we summarized the state of knowledge
on restrictive housing and offender rehabilitation. We
also discussed the motivation for the project and the research evaluation plan. During this meeting, an IMU
correctional officer asked about changing the name of
the Step Down Program because it was signifying to
some prisoners that it was a gang drop-out program. A

Page 9 of 15

suggestion was made to instead call it the Step Up Program (SUP), which had a more positive connotation.
After a unanimous vote among staff at the meeting, the
name of the program was officially changed.
During our site visit, we toured the IMU and saw the
modifications to the SUP. We also interviewed a range
of correctional officials and staff about their perspectives
on the new program. When asked about the goals of the
SUP, one of the staff members commented, “I think that
the most important thing is to get these guys out of the
cell and communicate with each other and socialize.”
Other staff members reported a general optimism regarding the potential benefits of the program on participants, other prisoners, staff, and the institution.
In my opinion, [the SUP is] really to make them
successful when they do move out into that [general
population] setting. It doesn’t take long for somebody to get uncomfortable with the [general population] setting when they’ve been in [restrictive
housing]. We’ve got some of these guys that have
been in there a long time. There’s no way I can feel
comfortable saying, “Yeah, let’s take this person
whose been in this setting and just throw them back
in to this big pond and see what happens.” If we
want them to be successful then we need to gradually work them out to that … They’re either going
to panic and do something, just enough, to get
them back, or they’re going to panic and freak
out and do something major that’s going to hurt
somebody.
In the view of another staff member:
Anytime we can get a guy out of restrictive housing
with a lower anxiety level, that’s going to make it
safer to the officer supervising the unit, the other
[prisoners] in the unit. They’re not going to be on
edge because they’re already used to those interactions. So basically, we are taking advantage of having the ability to test and observe in a controlled
environment before we just take the cuffs off and
say, “All right. Go be successful.”
However, there was also some trepidation expressed
about the program voiced among correctional staff:
As with all change I think people are really apprehensive of things, especially with dealing with
people because they’re unpredictable. But I would
say that a majority, yeah are supportive of it, especially the staff that worked down here just because
we’re so informed … We’re more informed because
we’re down here [on the unit], but the [general

(2021) 9:23

Labrecque et al. Health and Justice

Page 10 of 15

population] staff, maybe not just because they’re not
informed.
Prisons are typically a beehive of activities, replete with
routines and roles that are stable. Change can be difficult,
even if it is perceived as being for the better. One staff member believed that others would come around to the SUP:
Some of the things that, earlier on, that folks were
negative about, they’ve quickly learned that there’s
things that work. Some of them even admit, they
were so negative about something and then once
they actually saw it implemented and they saw the
results of it, it was like wow … The staff that have
witnessed that themselves or have been part of it
even when they were begrudgingly part of it, we’ve
seen a lot of attitude change. You’re always going to
have the little pockets of negative. That’s fine.
In addition to the tour and staff interviews, we also pilot
tested our survey instrument with prisoners from the first
cohort of SUP participants, drawing on this experience to
identify ways to refine and improve our survey tool.
The SUP in practice

To assess if the living conditions in SUP were modified
as intended, we asked respondents how much time they

spent in the last week engaged in a variety of activities.
Table 2 compares the findings of the study participants
assigned to the SUP and IMU as well as those housed in
the SUP and IMU at the time of the interview. The average daily amount of time spent out of one’s cell was
much greater for the participants assigned to the SUP
compared to those who were assigned to the IMU
(112.9 min compared to 47.4 min, d = .91, p = .008). Although not statistically significant at the .05 level, there
was a moderate positive association detected between
treatment group assignment and two activities: hanging
around with other prisoners (d = .60) and watching TV
(d = .55). There was also a smaller positive association
between treatment assignment and participating in programming (d = .44), engaging in physical exercise (d =
.35), writing (d = .35), and participating in yard time
(d = .23), and a small negative association found for
reading (d = −.47) and communicating with correctional
officers (d = −.27). There were no substantive differences
found between the two groups on the three activities of
drawing, talking on the phone, or engaging in hygiene activities (i.e., absolute values of Cohen’s d < .20). To
summarize, we are observing meaningful differences in
the living conditions between SUP and IMU housing.
Table 2 also compares the responses of individuals
based on their housing location at the time of interview,
as five of the 18 people randomly assigned to the SUP

Table 2 Group Differences in Average Daily Time Use (in Minutes) Over the Last Week, Intent-to-Treat and Housing-at-Interview
Samples
Analysis
Sample

Intent-to-Treat Sample

(N = 38)

IMU (n = 19)

SUP (n = 19)

Housing-at-Interview Sample
p-value IMU (n = 24)

SUP (n = 14)

p-value

Mean (SD)

Mean (SD)

Mean (SD)

d

Mean (SD)

Mean (SD)

Time out of your cell

80.1

(75.6)

47.4

(68.2)

112.9 (75.6)

+ 0.91 .008

44.4

(61.7)

141.4 (66.0)

+ 1.53 .000

Participating in yard time

33.8

(33.5)

29.9

(41.6)

37.7

+ 0.23 .478

30.5

(38.2)

39.4

+ 0.26 .438

(23.3)

(23.5)

d

Watching TV or on a tablet

234.6 (149.7) 194.5 (143.8) 274.7 (148.4) + 0.55 .099

209.0 (137.8) 278.6 (164.1) + 0.47 .170

Reading books, magazines, or
other non-religious material

169.1 (131.7) 199.9 (145.6) 138.3 (111.7) −0.47 .152

173.9 (139.5) 160.9 (121.8) −0.10 .774

Hanging around with other
prisoners

85.4

34.4

(175.7) 33.9

(89.7)

136.8 (223.3) + 0.60 .071

(81.0)

172.8 (251.5) + 0.84 .017

Doing physical exercise

74.2

(43.1)

66.6

(35.2)

81.9

(49.6)

+ 0.35 .282

65.2

(32.2)

89.7

(55.2)

+ 0.58 .092

Writing

86.9

(90.5)

71.2

(96.5)

102.6 (83.7)

+ 0.35 .291

77.6

(89.7)

102.7 (93.0)

+ 0.28 .416

Drawing/art

43.7

(72.9)

38.7

(66.5)

48.7

(80.2)

+ 0.14 .678

44.4

(73.1)

42.5

(75.2)

−0.03 .940

Participating in programs,
education, counseling

17.1

(27.6)

11.1

(22.8)

23.1

(31.0)

+ 0.44 .181

11.3

(21.3)

27.1

(34.4)

+ 0.59 .088

Communicating/hanging out w/
correctional officers

3.2

(6.6)

4.1

(7.5)

2.4

(5.6)

−0.27 .414

3.3

(6.8)

3.1

(6.4)

− 0.03 .925

Showering, brushing your teeth,
etc.

39.6

(33.0)

38.2

(28.9)

41.1

(37.4)

+ 0.08 .796

37.3

(26.5)

43.6

(42.7)

+ 0.19 .582

Talking on the phone with friends
and family

8.3

(11.2)

8.9

(12.7)

7.7

(9.7)

−0.10 .753

8.9

(12.1)

7.3

(9.8)

− 0.14 .685

Note: IMU = Intensive Management Unit; SUP = Step Up Program. d refers to standardized differences between individuals in the IMU (control group; m1) and
those in the SUP (experimental group; m2). p-value refers to IMU to SUP differences derived from two-tailed t-tests

Labrecque et al. Health and Justice

(2021) 9:23

either did not enter the SUP (i.e., declined) or prematurely left the SUP (i.e., removed due to misconduct).
The results are substantively similar but less noisy. For
example, the number of minutes out-of-cell increased to
141 from 113, while the standard deviation shrunk to 66
from 76 min. The time spent hanging out with other
prisoners also increased to 172 from 137 min. These are
positive signs that, despite the pandemic, the SUP was
operating as intended, lessening the deprivations of restrictive housing.
The qualitative data also suggested that the living conditions in the SUP were preferable to the IMU. When
asked to describe the biggest difference between the two
units, SUP participants reported having considerably
more opportunities for meaningful social interaction
with other prisoners. One respondent stated:
Well just being in close contact with other prisoners, that’s the biggest difference … [I] n regular
IMU, the only time you talk to somebody is through
the crack of your door. You’re not talking to other
prisoner’s face to face … So just that contact around
other people is a big difference.
Others saw value in the additional incentives that were
available in the unit. One individual noted:
You get two more phone calls a week. Once you get
your level three, you get two more phone calls. We
go to yard with somebody, like we know somebody
on the unit with us, we can go to yard with them. It
just breaks up your time better … Well it’s just
more privileges … Once you get to phase two,
you’re not cuffed up no more to be moved around
from in the unit to come out to yard or to go to the
day room. We get day room time, so we get to
come out and play video games or board games,
stuff like that. We go outside to rec with another
person.
The benefits of the SUP were not limited to out-of-cell
time and social interaction. Another respondent
commented:
We can buy more stuff on the canteen. There are
just little things that you don’t think about while
you’re on mainline [general population], but when
you come to IMU, you miss out on.
The program participants, however, shared mixed
views on the value of the programming available in the
unit. When asked if the amount of time spent in the
SUP was enough to make a difference in their future,
some responded with a positive view, such as:

Page 11 of 15

Yes, I do.. . It helps me interact with people to
where I’ll be able to be already somewhat used to it,
as far as just going straight out to mainline [general
population] and being not able to be around people.
Another prisoner responded:
I’ll be honest, I’m kind of a knucklehead. The classes that are in this program... helped me sit myself
down and really evaluate my life, and it’s given me
tools... to deal with calming yourself down or what
you’re going to do in a heated moment, real quick if
there’s a way to get around certain situations that
might land you in trouble, and it’s helped me evaluate more things and brought me closer with my
family.
He added that programming provides opportunities
for interaction with other individuals:
Another thing that I feel helps is you get to come
out of your cell twice a day. You can go out to yard
with one of your friends, and then you can go work
out. And then you can get to come out and play
PlayStation 4 or play cards at a table with people
that you’re compatible with. So, you get that interaction that you would kind of like being on mainline. It makes the time go by really easy.
Others, however, saw little value in the programming
in the SUP as currently implemented. As one prisoner
put it:
Okay. If a person truly wanted to change … if they
truly wanted to change and this program was supposed to help make that a success, then yeah, they
would need more time in it. I don’t really see what
the goal is as of yet … yeah there would need more
of it, it’s not sufficient.
Another prisoner responded:
I think we only have one [program] being in the
Step Up Program, which is... I don’t even know the
name of it, I can’t think of it, but it’s only like 30
min. You know what I mean? When most classes
are about an hour, hour and a half.
One individual also discussed the negative impact of
COVID-19 on the opportunities for socialization and
treatment services in the SUP:
What I think it all boils down to is coming back to
social interaction and stuff like that and being in a

Labrecque et al. Health and Justice

(2021) 9:23

setting where you would be if you were placed in
civilization and society and working from those angles, when they basically throw a book in your cell
and you’re just sitting there doing book work. You
gain stuff if you’re really paying attention but I
mean, who does that? Nobody does that in the real
world. You don’t just isolate in a box and write shit
down in a notebook. That’s crazy. ... And mind you
we’re going through that Coronavirus, so I will say
that there is a couple options that were presented
that were in a classroom setting that are not applicable at the moment, because they’re trying to not let
that spread or whatever, I guess.
To summarize, prisoners viewed SUP as providing
them several advantages over the standard restrictive
housing setting (i.e., IMU). The SUP configuration provides rewards for compliant behavior in the short run
and attempts to prepare prisoners for release to general
population. The differences between the two conditions,
however, were not uniformly perceived.

Discussion
The U.S. prison system houses more than 1.4 million
people on any given day (Carson, 2020) and uses restrictive housing settings with some regularity (Beck,
2015). Despite the large-scale use of incarceration, it appears to have reached a state of diminishing returns in
terms of reducing criminal and deviant behavior (Liedka
et al., 2006). Furthermore, incarceration generally, and
restrictive housing specifically, is often criticized for producing adverse effects on prisoner health and psychological well-being (Haney, 2020; Luigi et al., 2020;
Massoglia & Pridemore, 2015; Morgan et al., 2016; Porter & Demarco, 2019; Reiter et al., 2020; Strong et al.,
2020; Wildeman & Andersen, 2020). A number of initiatives have sought to alleviate the potential harmful effects of incarceration, including a national movement to
reform the use of solitary confinement. While much
prison reform has occurred via litigation, this study emphasizes how the Oregon DOC has introduced changes
proactively through internal reform.
Criminal justice reform is challenging (Jacobs &
Olitsky, 2004). It requires motivation to make change
and leadership willing to subject itself to criticism internal and external to the system. Instituting new programs also presents thorny challenges in criminal justice
settings, especially in prisons. A program as it is described on paper is not always the way it performs in
practice (Bourgon & Armstrong, 2005; Gendreau et al.,
1999; Rhine et al., 2006). It is also difficult to evaluate
the processes and impacts of programs within institutional settings, not least because access is difficult to secure (Duwe & Clark, 2015; Miller & Miller, 2015;

Page 12 of 15

Mitchell et al., 2018). All of these issues are especially
salient in restrictive housing. Like many areas of criminal
justice, the politics of reform far outpace the science,
hence the challenges to conduct sound research and
evaluation, including randomized controlled trials.
Over the last decade, the Oregon DOC has entered
into a period of experimentation and change. The
organization invited the Vera Institute of Justice to observe its prison system and make recommendations for
reducing their use of restrictive housing. It also sent a
delegation of correctional officials to observe and learn
from their counterparts in the Norwegian Correctional
Service. More recently, the Oregon DOC established a
restrictive housing step down reentry program to improve the conditions in these living units, incorporate
more rehabilitative programming, and provide incentives
for compliant behavior. This study documented the origins, development, and processes of the SUP. The preliminary results of this experiment are tentative but
encouraging.
When implementing new policies and practices in
prison, it is important to understand the perceptions of
correctional officials. Agency leaders, facility managers,
line-level officers, and support staff are integral to the
prison system and without their buy-in programs and
services are unlikely to be implemented as intended
(Ahalt et al., 2020; Benefiel, 2019). The interviews with
correctional staff in this study revealed a cautious optimism about the SUP, which is a positive sign for the potential success of the SUP. Indeed, had we found
otherwise, that custodial staff did not believe in the program, it would not bode well for accomplishing cultural
change in restrictive housing, which may be equally if
not more important than structural change.
Prisoner accounts of their daily activities suggest that
the SUP operates differently than the IMU in several
ways. The SUP provides prisoners with more out-of-cell
time than offered to those in the IMU. Prisoners have
more opportunities to interact with their peers, engage
in unit activities (e.g., watching television, participating
in yard time), and participate in rehabilitative programming. These changes introduce greater normalcy to restrictive housing custody and, as a consequence, are
expected to facilitate smoother reentry to the general
prison population and eventually to the community. Although the respondents in the SUP reported communicating with correctional officers slightly less often than
those in the IMU, there are two important considerations in interpreting this result. First, prisoners in the
SUP may be less reliant on officers for information than
those in the IMU because there are more opportunities
in the unit to interact with other prisoners. Second, the
length of time spent communicating with officers in
both groups is decisively brief (2.4 min per day for SUP

Labrecque et al. Health and Justice

(2021) 9:23

compared to 4.1 min per day for IMU). While such short
durations and the differences reported between SUP and
IMU might be an artifact of a prisoners’ reflection on
how long they interact with officers in a given week, this
finding emphasizes that efforts ought to be made to increase the prosocial interactions between correctional
officers and prisoners in both units. Such an endeavor is
essential for improving the culture by creating a more
humanistic approach in restrictive housing.
Importantly, however, the SUP in Oregon was never
fully implemented as intended due to COVID-19. As the
impacts of the pandemic begin to wane and prison systems return to more normal operations, the Oregon
DOC will be able to increase the provisions offered in
the unit (e.g., more out-of-cell time, increased opportunities for socialization with other people, and greater access to programming and other beneficial activities). A
stronger dosage of these programmatic elements should
serve to further alleviate the potentially harmful aspects
of this type of housing which, in turn, could improve indicators of prisoner health and well-being. As we await
the opportunity to conduct prospective psychological
and behavioral analyses with a larger sample size once
the SUP returns to normal operations, this study provides tentative support for the use of step down reentry
programs in restrictive housing units.

Conclusions
The Oregon DOC has undertaken several efforts to reform its use of solitary confinement. As this study highlights, one of those strategies was the development and
implementation of a restrictive housing step down reentry program. The authors partnered with the Oregon
DOC to conduct a randomized controlled trial of the
new SUP. This evaluation revealed encouraging process
findings. This research found that it is possible for
prison officials to create conditions in restrictive housing
environments that may be perceived by prisoners as less
harmful and fairer than standard solitary confinement
housing. It remains an open empirical question, however,
whether step down programs will improve behavior, or if
instead they will, through softening punishment, undermine the goals of institutional safety and security. These
results, nevertheless, should motivate researchers to investigate the uses and impacts of reentry programs, especially
on prisoner populations not included in this study, such
as juveniles, women, and individuals with severe mental
health diagnoses, recent histories of serious institutional
violence and disorder, and who will be released to the
community.
Acknowledgements
The authors thank the administrators, correctional officers, support staff, and
respondents from the Oregon Department of Corrections for their assistance
in making this research possible.

Page 13 of 15

Authors’ contributions
RL directed the evaluation with the agency, assisted with the analysis and
interpretation of results, and led the writing of the manuscript. JT analyzed
the quantitative prisoner survey data and assisted in writing the manuscript.
BU identified the themes from the qualitative data and assisted in writing
the manuscript. DP framed the study and was a major contributor in writing
the manuscript. All four authors conducted staff and prisoner interviews as
part of this project. All of the authors have read and approved the final
manuscript.
Funding
Research reported in this publication was funded by the Charles Koch
Foundation. It was also supported by a pilot grant from the Developmental
Core of University of Colorado Population Center, which is supported by the
Eunice Kennedy Shriver National Institute of Child Health & Human
Development of the National Institutes of Health under Award Number
P2CHD066613. The content is solely the responsibility of the authors and
does not necessarily represent the official views of the Oregon Department
of Corrections, the Charles Koch Foundation, or the National Institutes of
Health.
Availability of data and materials
The datasets generated and analyzed during the current study are not
publicly available as the project is still in progress but are available from the
corresponding author on reasonable request.

Declarations
Ethics approval and consent to participate
The study procedures were approved by the University of Colorado Boulder
Institutional Review Board (protocol #: 19–0157) and the Oregon Department
of Correction’s Research Committee.
Consent for publication
All participants provided consent prior to their participation.
Competing interests
The authors declare no competing interests.
Author details
1
Department of Criminal Justice, University of Central Florida, 12805 Pegasus
Drive, Orlando, FL 32816-1600, USA. 2Department of Sociology, University of
Colorado Boulder, Boulder, CO 80309, USA. 3Department of Sociology,
Purdue University, West Lafayette, IN 47907, USA.
Received: 22 March 2021 Accepted: 10 August 2021

Published onlinc: 26 August 2021
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