Desmond Lomax, CMHC, NCC State of Utah Dept. of Corrections

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1 Using Solution-Focused, Mindfulness, and ACT Treatment to enhance Accountability in Difficult Clients Desmond Lomax, CMHC, NCC State of Utah Dept. of Corrections

2 About me 17 years working in the field of mandated clients(co, Police Office, Sergeant, Therapist and Therapist Supervisor). Past-President of the Utah Mental Health Counselor s Association Current member of numerous committee focusing on the application of JRI, and Treatment for the Criminal Justice system. Current Director of the Community Programming Unit for the Department of Corrections.

3 Where we have been: Justice Reinvestment Act Created to address the rise in the inmate population across the state. Includes strengthening of probation and parole supervision Improves and expands reentry and treatment services Supports local corrections systems Ensures oversight and accountability of public and private organizations

4 JRI- Community Impact Expanding of treatment services Increase resources to reduce recidivism Investment in victim services.

5 JRI- Policy Changes Control Substance - Reduction of Penalty Change in Sentencing Guidelines- Rewards for reduction in recidivism Case Action Plans- Address Risk and Needs Graduation Sanctions and Incentives Earned Compliance Credit Supervision Standards- based on Risk and Needs Assessment

6 Policy Changes Con t Treatment: Standards and Certification R523- Administrative Rule R523-4 Screening, Assessment, Prevention, Treatment and Recovery Support Standards for Adults Required to Participate in Services by the Criminal Justice System.

7 Admin Policy requires LSI -R:SV- screening version in jails LS/RNR used for full assessment version Criminogenic Assessment,ASAM Assessment of Developmental, functional level, social, emotional, communication abilities and strengths. Individual tx plans and assessments

8 Finding Balance With every policy implementation there are consideration that need to be address. Evidence has shown that client relationship and other factors also have a strong effect on change in treatment. JRI presents challenges in creating an evidence-based individualized program, while assessing for criminogenic factors and assessing for other needs when necessary. Doing all of this while maintaining some level of outcome can be difficult and timeconsuming.

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10 Balance Cont d 3 distinct sections can be address 1. RNR Approach & Individualized Tx. 2. Evidence based tx. & Outcome based tx. 3. Programming led tx & Client led tx

11 Ex. Not creating class that are determined by Risk. RNR Approach Addressing issues according to Criminogenic risk. 1. Targeting the High Risk population 2. Providing more intense tx 3. Reduction of tx for the low risk population 4. We cannot forget the Responsivity to the RNR. Ex. Matrix Sanctions that don t include treatment. Ex. Using the term Maximum Benefit

12 Criminogenic Factors Big 8 Anti-Social Behavior Anti-Social Personality Patterns Anti-Social Cognitions Anti-Social Peers

13 Big 8 continues Family School/Work Leisure/Recreation- For year this score was always highest in LSI evaluations Substance Abuse

14 Challenges with a Criminogenic focus Very heavily focused on Felons Very strong in the CBT and social learning theory M anualized treatment has become emphasized for tx Completions rate and motivation scales are not strongly measure CPC assessment done by the U of U for local authorities and their tx recognize that many local authority feel their tx is being geared toward the criminogenic skills.

15 Success Rate remain the same The Department of Corrections continues to have low success rate in tx (45 percent) after making significant changes to treatment based on JRI recommendation. We decided to focus on skills in tx we could used to address accountability in our clients.

16 Where we are going: Accountability in Tx While making great stride to address Risk/Needs/Responsivity we still need to address keys elements such as Motivation and Accountability in Tx to: I mprove success rates Address acute behavioral issues I mprove long term self- efficacy C reate a simple weekly check in in regarding to learning, and motivation

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21 EBP

22 Common issues: Program Directed We are the expert Top Down Mentality We standardized treatment We make assumptions Morality police We quickly address the problems with the ways we want to fixed it. We monitor our success by how the person is overcoming their problems The law of primacy - What ever is first discuss will have focused.

23 Common issues: Client Directed-Criminal Justice System Lack of motivation Wants the quickest option available to treatment Struggles with having a vision Pressure is on the program Fix them

24 Client s Theory of Change

25 Solutions Directed Programming Regarding the client to process and establish their own values and meaning The program will help determine the means and methods to moves towards values and meaning Weekly accountability regarding what s working and work needs to be adjustment(process between the client and the program). Use of quick easily accessible treatment modalities that can still obtain desired results with your clients. Each clinical modalities help to self educate the client- reduces tx time and energy Can be using in acute situations to bring clarity while addressing emotional

26 Some clinical methods that increase this type of Solution-Focused Programing. Individual Client Feedback and Status (Worksheet)(Criminal Justice) Solutional Focus Behavior Therapy ACT (Acceptance Commitment Therapy) Matrix M ORE (M indfulnes Oriented Recovery Enhancement)

27 Weekly questionnaire from clients Do you understand your treatment goals? How are you working on them? Do you understand you criminal risk factors? H ow are you addressing them in treatment? Access treatment engagement and accountability based on these questions. PVP programming and Weekly questionnaire

28 Current solutions ARE the problem Solution Focused Brief Therapy - Basic Philosophy Change is constant and inevitable Clients are the experts at defining goals Future orientation history is not essential Emphasis is on what s possible & changeable - do something differently Short-term Only small amount of change needed Clients want change

29 Basic Philosophy Problems are maintained by: Doing More of the Same Solution Focused If it ain t broke don t fix it Once you know what works, do it more If it doesn t work, do something different

30 Criminal Justice Application Systems Focused(Work within) I want my own business (business licenses and felons) Values Focused Values definition- Important, M eaning, Works(All 3 must apply) Destination vs. Path View self as an expert of change, not an expert in addiction or about the client Evaluation is done from a stance of discovering evidence the client does not have a problem.

31 Some of my best SFBT questions 1. What would you like to gain from group or individual today? 2. So what made your day on okay day? And not a Awesome day? 3. Scaling Questions 4. How have you endure this difficulty and make it to treatment today? 5. Telling me what successful looks like?

32 SFBT- Handout

33 ACT - Matrix Acceptance Commitment Therapy- Created by Steven Hayes M atrix-model assess Psychological flexibility in a step by step handout. (Dr. Kevin Polk) Client is then responsible for the solutions that are processed.

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36 ACT Handout and Exercise

37 MORE Mindfulness Oriented Recovery Enhancement Created by Eric Garland, PH D, U of U Social Work Dept.

38 Activity Mindfulness breathing

39 Summary Our goal is to strengthen EBP and JRI implementation by enhancing accountainable through mean, and methods that are simplistic, easy applied, and cost effective.

40 Questions?

41 Desmond Lomax- C ommunity Programming D irector Adult Probation and Parole/D epartment of C orrections dlomax@utah.gov Please reach out to me with new ideas and suggestions. T hank you.

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