Post on 21-Dec-2015
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Juvenile Drug Courts (Part II): Incentives and Sanctions
Sandra J. Altshuler, Ph.D., L.I.C.S.W.Spokane County Behavioral Health Therapeutic Courts
With thanks toJacqueline van Wormer, Ph.D.Washington State University
andNATIONAL COUNCIL OF JUVENILE AND FAMILY COURT JUDGES
Learning Objectives
Participants will review briefly the need for diversion programs for juveniles and the research on Juvenile Drug Courts (JDCs).
Participants will review and discuss proper phase structures in JDCs.
Participants will learn about JDC Incentives and Sanctions that DO and DO NOT work to promote positive behavior change in youth.
Participants will learn about contingency management (CM) and its use in JDCs for adolescent’s substance abuse and use.
Participants will learn how to develop behavior and activity contracts.
Can We Strengthen Our Court Sessions to Bring About Stronger Behavior Change?
What is the purpose of using sanctions in your JDC?
What is the purpose of using incentives?
Goal-Oriented Incentives and Sanctions
Strategy Fifteen: “Respond to compliance and noncompliance with incentives and sanctions that are designed to reinforce or modify the behavior of youth and their families”
Research: Gendreau (1999) NPC (2006, 2010) Henggeler et al., (2006, 2012 (a) (b)) Salvatore et al., (2010)
Incentives & Sanctions, Continued
Historical CJ responses vs. modification of behavior through a coordinated and thoughtful (research informed) process
Punishment for a “wrong” is not the goal – behavior change is the goal
The JDC should use a balance of incentives, sanctions and treatment responses
Incentives and Sanctions, continued
Key components: Immediate, certain, fair and of appropriate intensity Do not rely solely on standardized “lists” Should be proportional and balanced Punishment alone is least effective way to change behavior Be comfortable in combining incentives and sanctions Be cognizant of time Perceptions of fairness – it all begins with individualization Make sure youth understand their positive and negative
reinforcers
Contingency Management
What is Contingency Management (CM)?
And
How do we strengthen the use of CM in our treatment settings, and utilize the same methods
within our Juvenile Drug Courts?
Contingency Management
“Contingency management or systematic use of reinforcement is a type of treatment used in the mental health or substance abuse fields. Patients' behaviors are rewarded (or, less often, punished); generally, adherence to or failure to adhere to program rules and regulations or their treatment plan.” (Wikipedia)
Reasons Why JDCs Should Implement CM
Theories are based on cognitive behavioral therapy, which has been proven to work with adolescents, and is vastly used in outpatient settings
It can be easily adapted within the JDC
In their study of six juvenile drug courts, Henggeler et al (2006) found stronger outcomes for those youth who received MST AND CM then standard process
Behavior Contracts
“Rewards for Responsible Behavior in Other Domains” (Henggeler et al, p. 131) How to target specific behaviors (i.e., school attendance) How to add a step-by-step process for the youth to follow How to get youth working towards “things” they are
interested in How to engage families/guardians in the process How to increase communication between the youth and
judge And…how to implement these components in your
program
The Four Steps in Addressing Problem
Behaviors
Identify (define) the targeted behavior
Identify (define) the current behavior
Identify (define) the desired behavior
Use small, achievable increments
Decision Matrix – Phase I
Phase I Incentives Sanctions
Behavior *Response Response
Attend school at least ?? out of 20 days
• Teacher signs attendance card each day present and acknowledges
•Small prize or coupon for each week with no absences
• After school study hall for each day absent over the limit to make up all missed work
Decision Matrix – Phase II
Behavior Incentives Sanctions
*Expectation *Response *Response
Attend regularly
Complete all assignments
•Select a book , notebook, pen after two weeks of success•Praise from teacher, family, court•Grades improve
•After school study hall to complete assignments (with help as needed)
Decision Matrix – Phase III
Behavior Incentives Sanctions
*Expectation *Response *Response
Attend regularly
Complete all assignments
Improve grades
•Praise from teacher, family, court for improvement•Certificate of achievement•Select school related gift: tuition, book
•Determine if tutor is needed
•Attend extra class or session for help
•Tighten curfew
Behavioral Contract Example
Goal BehaviorsSteps needed (Expectations)
Responses if steps done
Responses if steps not done
Support Services
Enroll in GED program
•Call or visit GED center by xxxxx date
•Praise•Recognition from Team•Appointment Calendar•XXXXXX
•Increased reporting to PO•Increase in curfew•EM
•Find GED center phone number•Bus pass and route
Youth’s Signature of Agreement:
Caregiver(s) Signature of Agreement:
Case Manager’s Signature of Agreement:
Behavior Contract: School
Work with your partner to develop
a fictional behavior contract
Example of a “behavioral contract”
Goal Behaviors/Tasks Incentives Non-compliance Sanction Support Services
Improve school grades
- Attend school daily- Keep a planner or homework log- Organize books/school supplies- Complete all assignments
PraiseRecognitionAdd 3 points for each day youth attends school*Recognition from teachers/team/family *Grades improve
Failure to attend school/classes Failure to get a planner Failure to complete assignments
Limit free time After school study hallLimit TV time/video game time *Failing/poor grade
Transportation assistanceTutoringAlarm clockHealth assessmentEye exam
Youth’s Signature of Agreement:
Caregiver(s) Signature of Agreement:
Case Manager’s Signature of Agreement:
Most Valued Privilege
This is a privilege that the youth values and will work hard to earn
Work with the youth and family to determine what the MVP is, preferably a family-based reward (i.e., video games, cell phone use, time w/ friends)
The MVP is given or taken away with each drug screen IMPORTANT – youth does not earn points if
there is a positive drug screen but points that have already been earned are not taken away
(Henggeler et al, p. 107-108)
Make it Transparent MVP
Sally – Use of cell phoneJohn – Curfew extension on Saturday nightMary – Allowed to use Mom’s car on Friday afternoonJack – Ride to school, rather than walk
Checkbook System
Basic checkbook set up – date; transaction description; debit/credit; and balance
Basic personal checks that the youth can draft and use to purchase items on the reward menu Make this very visual and tangible for the youth Consider working with a local bank to provide life
skills training on how to keep a checking account and write checks or to provide free checkbooks and/or personalized checks
(Henggeler et al, p. 126-127)
Recommended Reading
Contingency Management for Adolescent Substance Abuse: A Practitioner’s Guide, by: Scott W. Henggeler, Phillippe B. Cunningham, Melisa D. Rowland, Sonja K. Schoenwald and Associates
Contingency Management in Addiction Treatment. by: Nancy L. Petry. Psychiatric Times: http://www.psychiatrictimes.com/addiction/contingency-management-addiction-treatment-0
Making Sense of Incentives and Sanctions in working with the Substance-Abusing Youth: Answers to Frequently Asked Questions (Juvenile & Family Justice TODAY. 2012, Volume 21, Number 2)
Enhancing the Effectiveness of Juvenile Drug Courts by Integrating Evidence-Based Practices (Journal of Consulting and Clinical Psychology. 2012, Vol. 80, No. 2, 264-275)
Themes of Effective Programs
Team Approach – Good communication
Well specified target population, theory of change (targeting risk and protective factors), interventions, and training
Ongoing quality assurance (fidelity checks)
Empower caregivers to support favorable outcomes (involve the family)
Themes of Effective Programs
Individualized to youth/family strengths and weaknesses (not one size fits all)
Comprehensive services (individual, family, peer, school, community) provided
Use of behavioral tracking and intervention techniques such as CBT (problem solving skills, drug refusal skills) and implementation of reward/punishment contingencies
Treatment delivered in natural environment (not in out-of-home placements)
Contact Information
Sandra J. Altshuler, Ph.D., L.I.C.S.W.Spokane County Superior Court1116 W. BroadwaySpokane WA 99203(509) 477 6355saltshuler@spokanecounty.org sandyaltshuler@gmail.com
Ncjfcj.org