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Digital treatment in restrictive housing: Lessons from Utah’s year 1 pilot

Digital Treatment in Restrictive Housing

Summary

Delivering evidence-based treatment in restrictive housing is one of corrections’ greatest challenges due to security constraints, staffing shortages, and high behavioral health needs. This article shares year-1 results and implementation lessons from the Utah Department of Corrections’ pilot using Atlas and Interactive Journaling® to expand access to digital substance use treatment while maintaining safety, fidelity, and measurable outcomes.

 

The Change Companies was pleased to co-present with the Utah Department of Corrections (UDC) at the American Correctional Association (ACA) Winter Conference in Long Beach, California on February 6, 2026. Dr. Lena Gustafson, Clinical Deputy Director of Reentry and Rehabilitation from UDC, and Valerie Bagley, Chief Program Officer at The Change Companies, presented the early outcomes and lessons learned from a collaborative pilot delivering digital substance use treatment in restrictive housing.


The question driving the session was one many correctional leaders are wrestling with:
How do we expand access to evidence-based programming in secure housing environments—without compromising safety, staffing realities, or treatment fidelity?
After 18 months of implementation and one full year of pilot data, Utah’s experience offers practical insights for agencies considering a similar path.

 

Research foundations

Utah’s pilot used a self-directed digital platform called Atlas built on Interactive Journaling®—an evidence-based approach grounded in motivational interviewing (MI), cognitive behavioral therapy (CBT), stages of change, and expressive writing. Interactive Journals in Atlas feature a range of behavior change topics. In similar settings to those in this pilot, research has demonstrated that:

  • In a self-directed jail setting, participants had 15% lower recidivism rates for the experimental group.

  • In a therapeutic diversion unit, there were improvements in cognitive restructuring and a decrease in DSM-5 symptom measures of depression, anxiety, anger, and others.

  • In an incentives-based program in a restrictive housing unit, 52% of participants had no violations at six months post-completion.


Challenges to delivering treatment in restrictive housing

Restrictive housing environments present a unique combination of barriers:

  • High behavioral health needs, particularly substance use disorder (SUD)

  • Limited group access

  • Staffing constraints

  • Security requirements

  • Policy pressures to increase meaningful programming

UDC’s goal was to use Atlas to deliver structured, evidence-based, risk-need-responsive programming to individuals who historically have had limited access to treatment.

 

Essentials for successful implementation

In order to effectively address the barriers described above, the Atlas pilot required six key implementation essentials:

1. Risk-need-responsivity (RNR) alignment

Journal assignments were linked to criminogenic needs to make treatment as tailored and effective as possible. Programming topics included cognitive-behavioral skills, substance use education, self-control, family relationships, employment, and mental health.

2. A self-directed structure

Participants, who were in a locked-down environment for 23 hours a day, would need to complete Journals independently, using unstructured time in a productive and prosocial way. Atlas provided this opportunity by delivering paced programming content via the tablets.

3. Red flag indicators

Due to the risks associated with program delivery with this population, staff needed a built-in flagging system that would alert them to concerning responses or potential disengagement. Atlas’s “red flags” feature alerts staff in real time to potential threats; and “yellow flags” provide insights into possible disengagement with program content.

4. Program pacing

Sessions were opened at a defined pace rather than unlocked by completion alone. This discouraged “speeding through” and supported deeper processing.

5. Accessibility features

Read-aloud functionality and expanding Spanish-language support increased usability across diverse literacy needs.

6. Supportive of broader programming goals

UDC created a milestone in their Offender Management System (OMS) tied to Atlas completion. This supported case action planning and board contingencies and ensured the pilot was operationally embedded.

 

Year 1 pilot results

After one full year of pilot data:

  • 85% of participants were actively engaged
  • 6,200 total sessions were completed
  • 2,600 Journals were completed
  • 214 participants were enrolled at the Antelope site

The most frequently selected topics were:

  • Cognitive-behavioral programming
  • Substance use education
  • Self-control
  • Family relationships
  • Employment
  • Mental health education

Additionally, participants were administered a survey at 30 days of Atlas use. Across 52 participants, the response was as follows:

  • 92% found Interactive Journaling in Atlas helpful
  • 81% reported that Atlas helped them work toward their treatment goals
  • 77% said they understood themselves better
  • 79% said Atlas helped them share their thoughts and feelings.

 

UDC staff reported:

  • Strong engagement from enrolled clients
  • Ease of facilitator oversight
  • Immediate ability to provide written feedback
  • Visibility into participant progress
  • Productive use of time in restrictive housing

Importantly, staff highlighted that flagged responses allowed facilitators to quickly identify individuals who might need additional support.

The self-paced format was described as flexible and reflective rather than compliance-driven.

 

Broader implications for corrections leaders

Utah’s experience suggests digital programming in restrictive housing can:

  • Increase access to evidence-based SUD treatment
  • Improve engagement in environments traditionally limited in programming
  • Provide measurable indicators of change
  • Integrate with case planning and board processes
  • Allow staff to focus attention strategically through flag systems

Most importantly, it demonstrates that restrictive housing does not have to mean the absence of structured, risk-responsive treatment.

For agencies facing staffing pressures, reform mandates, and rising behavioral health needs, digital programming may offer a scalable pathway to expand access while maintaining accountability and clinical integrity.


Atlas devices

Evidence-based, behavioral health Interactive Journaling® curricula are available digitally on Atlas. Atlas can save staff time while supporting fidelity to evidence-based practices.

Ready to see what Atlas can do for your program? Visit our website to schedule a personalized demo today. Learn more about Atlas →

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