Assessing Responsivity PRESENTED BY: MARK MCDONALD, MS, CRADC

Transcription

1 Assessing Responsivity PRESENTED BY: MARK MCDONALD, MS, CRADC

2 Defining Evidence Based Practice Everyone is asking for them, so what are Evidence Based Practices? Evidence-Based Practices (EBPs) are approaches which have been empirically researched and proven to have measureable positive outcomes. In the context of problem solving courts, this typically means they reduce general recidivism, but other indicators of success include incarceration reductions, reduced costs or increased efficiency, community restoration, and improved social or health outcomes.

3 Established EBPs While a great deal of attention has been paid to Risk-Need-Responsivity (RNR) in recent years, there is an established tradition of other evidence based practices in problem solving courts: o o o Procedural Justice Focused Deterrence Efforts Collaboration

4 Why the Hype about RNR Beginning in 1970s, a trend in criminological thinking that nothing works to rehabilitate offenders took root, as reflected in this famous quote by Robert Martinson: With few and isolated exceptions, the rehabilitative efforts that have been reported so far have had no appreciable effect on recidivism our present strategies cannot overcome, or even appreciably reduce, the powerful tendencies of offenders to continue in criminal behavior. (Martinson, 1974) Risk-Need-Responsivity theory has played a central role in discrediting the nothing works perspective, and thereby revitalizing the movement for rehabilitation.

5 Risk Need Responsivity Theory Risk-need-responsivity theory is based primarily on theories of behavioral psychology and is intended to support efforts at crime prevention through providing services targeted toward individual criminogenic risk factors. Within the social science literature, criminogenic simply means that the need or risk factor has been statistically associated with future offending.

6 RISK Overall Risk (Final) Clinical Discretion (Override) RNR Clinical Wellbeing (Final) Overall Risk (Initial) Clinical Wellbeing (Initial) NEED Risk Factors Static Need Factors Dynamic (Criminogenic) Specific Risk/ Need Factors Nonquantitative Protective Factors Strengths Other Client Needs Noncriminogenic Service Provider Characteristics RESPONSIVITY Client Responsivity Type of Treatment Client Characteristics Monitoring and Supervision Effective Correctional Intervention Other Clinical and Social Services 6

7 Risk-Need-Responsivity Principles o Risk Principle Match the level of service to the individual s risk to re-offend. There is growing support in the research for reserving treatment resources for higher risk offenders. (Be careful not to overtreat low risk) o Need Principle Assess each person for known criminogenic needs and target treatment based on their most salient needs. (target criminogenic needs in treatment-not just AOD) o Responsivity Principle Maximize the potential success of rehabilitative intervention by providing cognitive behavioral treatment and tailoring the intervention to the learning style, secondary needs, motivation, and strengths of the offender. (Heaviest lift-often ignored by providers)

8 A Closer Look at the Risk Principle Risk Principle: Vary treatment intensity by risk (defined as risk of re-offending absent intervention). High- or Medium-Risk: Target for intensive treatment. Low-Risk: Use less intensive intervention. Treatment can be counter-productive: o o o Removes offenders from work and school Surrounds offenders with moderate or high risk peers, while potentially removing them from low risk peers Deepens criminal justice involvement (potential for negative labeling and negative effects on selfconcept)

9 Why is assessing criminogenic risk so important?

10 What are the Known Criminogenic Risk factors? Criminogenic Risk and Need Factors (the big 8 ) 1. Criminal History (static) 2. Antisocial Personality Pattern (dynamic ) 3. Pro-criminal Attitudes (dynamic) 4. Social Supports for Crime (dynamic ) 5. Substance Abuse (dynamic) 6. School/Work Failure (dynamic) 7. Family or Relationship Problems (dynamic) 8. Lack of Pro-social Activities (dynamic)

11 A Closer Look At the Need Principle Need Principle: Assess and target criminogenic needs for treatment needs that, if left unmet, lead to criminal re-offending. Returning to the Big 8 what can/should be treated? (in theory everything except criminal history): Criminal Thinking, Antisocial Personality Pattern, Social Supports for Crime, Substance Abuse, School or Work Problems, Family or Marital Problems, Lack of Pro-Social Recreation.

12 Evidence-based Interventions Cognitive-behavioral interventions have been shown to be effective treatment for criminal thinking, antisocial behavior patterns and other criminogenic needs including substance abuse. CBT Interventions Focus on: The Present: current people, places, and behaviors Thinking Errors: external locus of control, sense of hopelessness, sense of victimization Cognitive Restructuring: effort to disrupt the automatic thoughts & feelings that lead to (e.g.) crime and drug use

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14 A Closer Look at the Responsivity Principle Even if they don t make the Big 8, there are many other needs that greatly affect individual well-being and can mitigate the effectiveness of intervention/treatment. The importance of assessing and treating these needs is acknowledged by the responsivity principle. Mental Illness Trauma history Cognitive or Developmental problems The responsivity principle also recommends we consider strengths in our program development such as motivation for change, different learning styles and strong social supports for recovery.

15 Responsivity Principle General responsivity principle use behavioral, social learning, cognitive behavioral strategies (That means you have to know what your service provider s programs are) Specific responsivity principle match intervention modes and strategies to learning styles, motivation, and demographics of case (That means you have to know what moves and motivates your clients for best strategies) 15

16 General Responsivity Cognitive Behavioral Strategies Examples of Cognitive Skills Tx Programs whose Curricula, Staff, and Dosage meet Program Integrity standards: Family/Marital Functional Family Therapy (FFT) Companions Pathways to Personal Empowerment Alcohol/Drug Problem Strategies for Self-Improvement and Change Program Criminal History Procriminal Attitude/ Orientation Antisocial Pattern Reasoning and Rehabilitation Moral Reconation Therapy Cognitive restructuring programs (oftentimes unresponsive to Tx) 16

17 Specific Responsivity Specific responsivity calls for treatment interventions to consider personal strengths and socio-biological-personality factors. Treatment should then be tailored to these factors, as they have the potential to facilitate or hinder treatment.

18 Specific Responsivity (cont ) The essence of this principle is that treatment can be enhanced if the treatment intervention pays attention to personal factors that can facilitate learning. Most have heard the principle that one must vary teaching methods to suit visual learners and auditory learners. Offender treatment programs involve teaching offenders new behaviors and cognitions and to maximize this learning experience requires attention not only to whether the offender is a visual learner or an auditory learner but a whole range of personal-cognitive-social factors.

19 Responsivity Good offender assessment is more than making decisions on level of risk. If one only cared about differentiating low risk from high risk offenders so that the high risk offenders can be controlled through incapacitation or strict monitoring then second generation risk scales can suffice. However, this may be short-sighted as it largely ignores the fundamental human condition of change.

20 Responsivity At the same time it has the potential of violating our sense of fairness. Offenders, like all human beings, are always changing their behaviors as a consequence to environmental demands and through their own deliberate, autonomous, self-directed change. By adhering to the need and responsivity principles through the assessment of criminogenic needs and responsivity factors we acknowledge that change is an important aspect of life and behavioral change can be facilitated by the appropriate intervention.

21 Responsivity Client Responsivity Factors General Population Factors more common in offenders Anxiety Poor social skills Self-esteem Inadequate problem-solving skills Depression Concrete-oriented thinking Mental illness Poor verbal skills Age, Gender, Race/ethnicity

22 RNR RNR is about building on strengths and rewarding noncriminal alternatives to the risk factors that are favoring criminal activity. Motivation can be highly individualistic and indeed vary in importance: acute states of deprivation or satiation, variation in the density of the consequences, and human spontaneity. Density refers to the number, variety, quality, and magnitude of the consequences and the immediacy, frequency, and regularity of their delivery. Behavior is multifunctional. Whether the focus is on the development, maintenance, or modification of noncriminal alternative patterns of thinking, feeling, and/or acting,

23 Looking at the individual consider the personal characteristics of each and every offender prior to determining what kind of approach is likely to work best with him or her. There is a long history in the offender treatment literature that supports differential treatment approaches for different offenders. Rather than ignoring these important individual differences, the specific responsivity principle demands that we attend to these differences.

24 The Value of Responsivity The value of the principle of specific responsivity will increase with systematic introduction and empirical investigation of new classification systems in regard to: interactions among person, therapist, treatment, and setting variables.

25 Responsivity focus factors The responsivity principle focuses attention on client characteristics that influence their ability to learn within a therapeutic situation. Some responsivity factors (such as concrete thinking and poor verbal skills) appear more frequently among offenders, suggesting that structured behavioral programs may be more effective than other intervention strategies. Other responsivity factors (such as anxiety and shyness) are not specific to offenders, but must still be considered in programming that targets criminogenic needs.

26 Responsivity Responsivity factors also often change, but they are not necessarily need factors. (They are dynamic) In general, responsivity factors do not serve as treatment targets, they are simply individual attributes that affect the achievement of treatment goals. At times, responsivity factors bear no relation to criminal behavior and are, therefore, not risk factors.

27 o Evidence Based Screening and Assessment Evidence-based Assessment is typically a 2-step process. Step 1: A short screen is conducted to identify overall risk-level and to flag primary criminogenic needs. Step 2: If the defendant/offender flags on some dynamic needs, longer assessment may be indicated. o o The two step nature of assessment is particularly important for the court context, given time and resource constraints. There is a need for a third step-assessing Responsivity

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29 Move anti-social thinking and negative emotional states toward a pro-social direction. Reduce association with antisocial peers/others while enhancing association with pro-social models and mentors. Build self-regulation and problemsolving skills.

30 Help others with a history/family history of substance abuse and antisocial behavior acquire and practice less-risky behavior in safe peer groups. Enhance rewards for non-using behavior through home, school/work, and leisure settings. Reduce substance abuse sufficient to shift the reward structure from anti-social to pro-social behaviors.

31 The Responsivity Principle involves matching the style, modes, and influence strategies of service with the learning styles, motivation, aptitude, and ability of offenders

32 General Responsivity (Service Provider Characteristics) Relies on general approaches drawing from structured behavioral, social learning, and cognitive behavioral-influence strategies. Examples: Reinforcement Modeling Skill acquisition through reinforced practice in the context of role playing and graduated skill building Behavior extinction Cognitive restructuring (modifying thinking patterns and their emotional counterparts) Enhancing offender motivation to change through high quality interpersonal relationships characterized as open, warm, non-hostile, non-blaming, and engaging; a prime example is the use of Motivational Interviewing (MI).

33 Specific Responsivity Examples Key offender characteristics being addressed by different modes of Tx: Psychopathy Motivational level-stick or carrot Gender-specific programming Culturally-specific programming Integrate the several personality models Static and dynamic responsivity factors Mental disorder 33

34 Specific Responsivity (Client Characteristics) refers to personality, ability, motivation, strengths, age, gender, ethnicity/race, language, and various barriers to successful participation in treatment. Regarding personality, a responsivity example might include avoiding highly confrontational treatment programs for offenders who experience interpersonal anxiety.

35 Motivationally, a responsivity example would be matching treatment style and goals with an offender's level of motivation for change. Another important responsivity factor is the offender s readiness to change. Regarding strengths, a responsivity example would be to make use of personal, interpersonal, and environmental strengths in planning and delivering service (e.g., strengths: positive characteristics such as problem-solving skills, supportive spouse or family, a pro-social friend, being gainfully employed, etc.).

36 Offender Motivation Coerced Treatment Extrinsic Intrinsic Motivation Engagement The Offender Is In Charge

37 Coerced Treatment Coerced treatment is effective; offenders are rarely motivated to change behavior at the outset, and coercion can get the offenders into treatment and keep them there longer. Procedural Fairness Better results when the offender views the court process as fair : Views bench as impartial Has an opportunity to participate Is treated with respect Trusts the motives of the decision maker

38 External/Intrinsic Pressures External pressure and controls only work as long as the pressure is applied. The goal is to avoid the condition where the offender is only entering or remaining in treatment under coercion and going through the motions of compliance. Ultimately, offenders must become self-motivated; they must progress from extrinsic to intrinsic motivation. The ability to change must ultimately be accompanied by a willingness and a desire to change. The way the court and judge interact with the offender can play a major role in either promoting or retarding the development of intrinsic motivation.

39 Engagement The court can play an important role in preparing the offender to change by engaging the offender in the change process. 30% of the likelihood of a successful outcome depends on the offender s engagement in the change process which is in large part the result of an offender s relationship with a change agent a friend, probation officer, therapist, or judge who inspires, initiates, promotes, or supports the offender s commitment to the change process.

40 The Offender is in Charge The first step in the engagement process is to acknowledge that the offender is in charge and controls the result; even if the offender has the ability to change, change will not occur until the offender decides to make some changes. Respecting that the offender is in charge of whether the offender and judge will succeed in changing the offender s behaviors, places responsibility and accountability for those changes squarely on the offender as the starting point for the change process.

41 In summary, match type of service intervention to criminogenic need (beginning with the highest scoring); do not stress treatment of non-criminogenic needs.

42 Summary 1. Treatment must be matched to the offender s individual characteristics. 2. Use the Stages of Change model Useful tool for understanding offender readiness to change Offers corresponding strategies to facilitate behavioral change 3. Intrinsic motivation is a critical requirement for offender behavioral change.

43 Summary 4. The judge can be a change agent by treating the defendant fairly and encouraging the offender s engagement in the sentencing process. 5. Use motivational interviewing skills 6. Avoid threatening, lecturing, arguing, shaming, or sympathizing