Incentives and Sanctions: Practical Application of the Science of Behavior Change. Shannon M. Carey, Ph.D. Based on Need to Know Fact Sheet by NDCI

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1 Incentives and Sanctions: Practical Application of the Science of Behavior Change Shannon M. Carey, Ph.D. Based on Need to Know Fact Sheet by NDCI

2 Purpose What is the purpose of Sanctions? What is the purpose of Incentives? What other court responses are there?

3 Overview Brief review of the science of behavior change Research on application in drug courts Sample incentives, sanctions and treatment responses (guidelines) Implementing incentives and sanctions (Review and discuss videos)

4 Certainty 1:1 Schedule for initiation Reliable detection Trust but verify

5 Reliable detection Urine drug testing at least twice per week* Do not decrease frequency of testing until last phase Do tests with short detection windows in field Random testing all 7 days Extend supervision into natural social environment (work, home, school, street, cell phones) Include law enforcement on the team *Or use continuous detection methods

6 Reliable detection Cell Phone Transcript from Phone during Court Session - 1 SF B Chic Nov 18 3:29pm R u getting anything in la? SF B Chic Nov 18 3:35pm Can we go in on the deal. If I got 4 would u get 2 so we could do the 540 SF B Chich Nov 18 3:45pm Toats

7 Reliable detection Cell Phone Transcript from Phone during Court Session - 2?? Nov 18 6:47pm If you need a source for tina Hit up Tell them dan sent ya..good stuff AM Nov 18 6:48pm How lomng doles xaanax stay in system?? Nov 18 6:48pm 72hrs to a week AM Nov 18 6:49pm anyway to clear em out?? Nov 18 6:49pm Do you ever get swabbed!!!??????? AM Nov 18 6:50pm Occasionally ans I no it doesn t test for that?? Nov 18 6:50pm Well if ur dirty dirty.. Always check urself into the ER for a panic attack or something.. do that day of probation..walk outta there with a hospital/dr ltr

8 Reliable detection Participant in his outpatient substance abuse group AM Nov 18 6:22pm Plzbring tibaasement plii AM Nov 18 6:23pm Theyre randomly testing me tnite AM Nov 18 6:25pm IM in grop AM Nov 18 6:27pm Plese bring to basement bathroom AM Nov 18 6:27pm Plzzzzzzzzzzzzz S Nov 18 6:29pm Ok AM Nov 18 6:29pmHit me up when ur down there ill walk out AM Nov 18 6:30pm How long bro S Nov 18 6:30pm Like 20 AM Nov 18 6:34pm Im in the bathroom in the basement plz hurry im trippin out S Nov 18 6:35pm Leavin hollies rite now AM Nov 18 6:36pm Shit whats ur eta from there

9 Reliable detection Participant in his outpatient substance abuse group (cont) S Nov 18 6:37pm 15 S Nov 18 6:38pm Shuld I wait in basement bathroom AM Nov 18 6:38pm Plz tell me u gotta vial to pissi in S Nov 18 6:38pm Ya AM Nov 18 6:42pm Put the vial of piss in bathrroom trashcan AM Nov 18 6:42pm I gotta go bak to geoup9 hit me up when its dun S Nov 18 6:54pm Its in the trash

10 Timing is Everything

11 Timing is Everything Effects degrade exponentially New behaviors interfere Status hearings every two weeks the first few months Bring non compliant participants in sooner Continue hearings monthly until participants have engaged in continuing/after care plans

12 EFFECTIVENESS Keep Centered Habituation Effects Effective Zone Ceiling Effects MINIMAL MODERATE SEVERE

13 Keep Centered NDCI Handout

14 Do Due Process Allow participants to explain Explain judge/team decision Be respectful (and expect respect) Have written incentive/sanction guidelines Allow reasonable discretion The brain and decisions about punishment

15 Sanctions or Treatment Responses? Abuse or dependence? Proximal or distal behaviors Dependent: Expectations change over time (Phases) treatment then sanctions Abuser: Higher level sanctions sooner Separate status hearings Rely on clinical expertise

16 Targeting

17 Targeting Define behavior clearly (both bad and good) Point direction (describe positive behavior you are looking for) Target the behavior not the person (be respectful)

18 Remember that unaddressed co-occurring disorders may impede the client s ability to achieve abstinence

19 Incentive and Sanction Highlights Verbal acknowledgement The A Team Fish bowl (having your name in the bowl is a reward) Being chosen as a mentor Peer nominated participant of the month

20 $ Decision Dollars $

21 Incentive and Sanction Highlights Thought Paper or Recording Community Service (giving back meaningfully) Jury Box Jail

22 Courts that use jail greater than 6 days have worse (higher) recidivism

23 Incentive and Sanction Highlights For some, incarceration is NOT the worst punishment (for some it is trauma) The threat of jail works best on those who have something to lose by incarceration. Positive reinforcement works on those who have nothing to lose by incarceration. Treatment responses may be perceived as punishments-communication is the key to explaining the difference.

24 Incentive and Sanction Highlights FOCUS ON THE POSITIVE BEHAVIOR People need to know what positive behaviors are - before they can perform them They know what not to do, they need to know what to do instead Bring up the participants doing well first (the A team), and ask them what they are doing that helps them succeed. (This will have the most positive impact on those watching).

25 Incentive and Sanction Highlights Video 1: Highlighting the positive Video 2: The A Team Videos 3a-3d: Positive UA with jail sanction Video 4: Learning experience with thought paper

26 Incentive and Sanction Highlights During video, think about whether the judge: Is Respectful Allows the participant to explain Provides a clear explanation of behavior being sanctioned Provides a clear explanation of what to do instead Provides a learning experience for other participants

Sample Incentive and Sanction Schedules http://ndcrc.

org/content/incentives-andsanctions-fact-sheet-0 Other

27 Sample Incentive and Sanction Schedules Other good info on incentives and sanctions:

28 Sample Incentive and Sanction Schedules Washington D.C. Merced, CA Kansas NDCI

Sanction Exercise Behavior First 30 days Question T2: John Abuser T1: Allen Addict Positive for cocaine Proximal or Distal? Sanction low, middle or high?

29 Sanction Exercise Behavior First 30 days Question T2: John Abuser T1: Allen Addict Positive for cocaine Proximal or Distal? Sanction low, middle or high? P M/H D L Missed Treatment Session Proximal or Distal? Sanction low, middle or high? P M P M Missed Court Session Proximal or Distal? Sanction low, middle or high? P M P M

30 Incentives Exercise Behavior After 180 days Question T2: John Abuser T1: Allen Addict Negative drug tests for last 30 days Proximal or Distal? Incentive low, middle or high? P M P H Made all Treatment Session on time for last 60 days Proximal or Distal? Incentive low, middle or high? P M P M

31 All Behavior is followed by a consequence, and the nature of that consequence modifies the organisms tendency to repeat the behavior in the future B.F. Skinner

32 Patience: we are in this for the long haul. Normal methamphetamine addict 15 months post abstinence

Community Supervision

Community Supervision PROTECT THE PUBLIC SUPPORT RECOVERY ASSESS AND EXTRACT THREATS Helen Harberts Porter93@msn.com These tools are an important part of DWI /Drug Courts! Officer safety first! Probation