Liana Taylor, Matthew Hiller, Cynthia Robbins, … · CJ-DATS is funded by NIDA in collaboration...
Transcript of Liana Taylor, Matthew Hiller, Cynthia Robbins, … · CJ-DATS is funded by NIDA in collaboration...
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA
Liana Taylor, Matthew Hiller, Cynthia Robbins,
Wayne Welsh, Gary Zajac, Gerald Stahler,
Michael Prendergast
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Assessment is an evidence-based practice for
the care of offenders with drug abuse problems
National Institute of Corrections
National Institute on Drug Abuse
Assessment is essential to evidence-based
models of correctional treatment
Assessment is an Evidence-based Practice
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Use of standardized risk assessments was
limited (34%); substance abuse
assessments were more common (58%)
Widespread use of unstandardized
assessments
Use varied by settings. Substance abuse
treatment prisons more likely to use
standardized assessments and use them
with a greater proportion of cases
Significant Gaps Exist in the Use of Evidence-
based Instruments (Taxman et al., 2007)
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Risk principle
High risk, greater intensity treatment
Standardized risk assessments
Needs principle
Treatment specifically targets criminogenic needs
Standardized assessments of criminogenic needs
Responsivity principle
General responsivity
Specific responsivity
▪ Non-Criminogenic needs
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Central Eight Criminogenic Needs
Antisocial peers
Antisocial attitude
Antisocial behavior
Antisocial personality
Substance Use
Family/Marital
Leisure Activities/Recreation
School/Work
Big Four
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Objective review of physical files rather
than survey of administrators
Focused on determining use of
standardized risk assessments as well as
the assessment of criminogenic risks and
needs
Informed by Risk-Need-Responsivity
(RNR) framework (Andrews, Bonta, Hoge,
1990).
The Current Study
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
How many agencies collected evidence-
based assessments of risk and of substance
abuse? For what percentage of cases?
What criminogenic risks and needs were
assessed? For what percentage of cases?
What non-criminogenic needs were
assessed? For what percentage of cases?
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Case plans were coded using the Assessment
and Recommendations for Treatment Rating
Form (ART-RF) instrument.
ART-RF was based on MATRS criteria:
MEASURABLE, ATTAINABLE, TIME-LIMITED, REALISTIC,
SPECIFIC
ART-RF form was developed and pilot tested
over a period of about 18 months.
At each site, cases were selected based on their
eligibility for admission/transfer to the community
treatment agency.
The ART-RF Measure
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Preliminary dataset of Baseline ART-RFs
from 4 CJDATS research centers
(7 different agencies)
N=364 (# of case plans sampled ranged
from 27 to 90 per agency)
Descriptive analysis of assessment
process prior to implementation of the
Organizational Process Improvement
Intervention (OPII)
Sample and Analyses
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Evidence-based Assessments for
Criminogenic Risk and Substance Abuse
Evidence-based
Assessments
# of
Agencies
Using
Average % of
Cases1
Range % of
Cases
Across
Agencies1
Risk assessment 4 of 7 99% 97%-100%
OST/FROST 2 of 7 100% 100%
LSI-R or RST 2 of 7 99% 97%-100%
AOD assessment 7 of 7 70% 17%-100%
Used ASI 3 of 7 70% 37%-91%
Used TCUDS 4 0f 7 68% 37%-100%
Used ASUS-R 3 of 7 36% 15%-78%
Used DSM-IV-TR 2 of 7 45% 45% 1 Calculation was based only on agencies that assessed this.
OST/FROST (Offender Screen Tool, Field Reassessment of the OST), LSI-R (Level of Services Inventory-Revised), RST (Risk
Screening Tool), ASI (Addiction Severity Index), TCUDS (TCU Drug Screen), ASUS-R (Adult Substance Use Survey Revised),
DSM-IV-TR (Diagnostic and Statistical Manual IV Text Revision)
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Criminogenic Risks and Needs “The Big 4”
“Big 4”
Criminogenic
Risks and
Needs
# of
Agencies
Assessing
Average %
Cases1
Range
% of
Cases
Across
Agencies1
(Outliers)
% w/ these
removed
Range
% of
Cases w/
Outliers
Removed
Antisocial Peers 4 of 7 53% 6-100% (2) 100% 100%
Antisocial
Attitudes 7 0f 7 63% 15-100% (0) 63% 15-100%
Antisocial
Behavior 7 of 7 95% 52-100% (0) 95% 52-100%
Antisocial
Personality --- --- --- --- ---
1 Calculation was based only on agencies that assessed this.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Criminogenic Risks and Needs “Other Central 8”
“Other Central
8”
Criminogenic
Needs
# of
Agencies
Assessing
Average %
Cases1
Range
% of
Cases
Across
Agencies1
(Outliers)
% w/ these
removed
Range
% of
Cases w/
Outliers
Removed
Substance Use
Severity 7 of 7 97% 81-100% (0) 97% 81-100
Family/Marital 7 of 7 72% 3-100% (1) 83% 26-100%
Leisure /
Recreation --- --- --- --- ---
Education
Employment
7 of 7
7 0f 7
74%
76%
3-100%
5-100%
(1) 86%
(1) 88%
37-100%
37-100% 1 Calculation was based only on agencies that assessed this.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Non-Criminogenic Needs
Non-
Criminogenic
Needs
# of
Agencies
Assessing
Average %
Cases1
Range
% of
Cases
Across
Agencies1
(Outliers)
% w/ these
removed
Range
% of
Cases w/
Outliers
Removed
Domestic
Violence
Perpetrator
6 of 7 54% 6-100% (1) 64% 11-100%
Housing 7 of 7 64% 3-100% (2) 89% 52-100%
Mental Health 7 of 7 77% 8-100% (1) 88% 37-100%
1 Calculation was based only on agencies that assessed this.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Overall, agencies were more likely to use an
evidence-based instrument to assess substance
abuse than criminogenic risks and needs
Although only tentative conclusions may be drawn
until the data from every agency in the OPII study
can be compiled and analyzed, findings suggest that
despite national practice guidelines, a number of
agencies still do not use evidence-based risk
assessments
Conclusions Evidence-based Assessments
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
For the “Big 4” risk/needs factors, agencies did well assessing
a history of antisocial behavior and antisocial attitudes, but
less well on antisocial peers.
For the remaining R-N-R risk/needs factors, agencies did well
assessing educational achievement, employment history, and
substance abuse severity, but less well with family
assessments.
The limited use of assessments of antisocial peers and family
support is a concern because if the homes and communities
to which the offenders return are bereft of support from
prosocial family and friends, the risk for recidivism is much
greater.
Conclusions Criminogenic Risks/Needs
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
There was greater variation in the assessment of
needs like domestic violence treatment, housing,
and mental health treatment than in the
assessment of criminogenic risks and needs.
Although these “noncriminogenic” needs are not a
part of the Central 8 risk/needs factors in the R-N-
R model, they do present particular challenges to
offender reentry; especially when they are not
sufficiently addressed.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Effective planning for an offender’s reentry requires reliable
information about his or her risks and needs. The absence of
evidence-based risk assessments from case files, therefore,
means that information needed for guiding appropriate referrals
to community treatment is missing.
Not knowing whether a prisoner will have adequate housing or
the support of prosocial family members and/or friends means
critical opportunities are missed for placing those without these
into supportive environments upon reentry.
More comprehensive assessments with standardized
instruments, therefore, are needed to improve reentry planning
and chances for success after returning to the community
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Findings and conclusions are based only on a small
number of agencies. Additional data collection and
analysis is needed to determine whether findings
similar to those reported here are found for the full
sample of agencies.
The study procedure failed to code whether
assessments of antisocial personality and use of
leisure/recreation were included in case files, but most
of the key criminogenic risks and needs were coded
and this provides valuable information to the field.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA
Liana Taylor, Matthew Hiller, Cynthia Robbins,
Wayne Welsh, Gary Zajac, Gerald Stahler,
Michael Prendergast
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
The goal of the study is to test the use of an
organizational improvement strategy (i.e.,
Change Team and Facilitator) to bring about
improvements in the quality of assessment
and case planning procedures for
substance-abusing offenders transitioning to
community supervision and treatment.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Phase Primary Outcome(s) Duration (in weeks)
1. Pre-Phase Local Change Team (LCT) is formed and the project is
introduced to them. 4- 6
2. Needs
Assessment
LCT completes a Process Improvement Needs
Assessment that identifies the relative strengths &
weaknesses in the agency’s current assessment and case
planning processes.
8 – 12
3. Process
Improvement
Planning
LCT develops and adopts a Process Improvement Plan
that identifies goals and objectives for improvements in
one or more the four core dimensions of the assessment
continuum.
8 – 12
4. Implementation LCT works in a collaborative manner to implement the
objectives and attain the goals identified in their Process
Improvement Plan. 16 – 26
5. Follow-Up LCT assesses the relative sustainability of both the
process improvement targets achieved and the LCT
method for facilitating process improvements. 26
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Improvements in: congruence between transitional offender assessments
and case plans
presence of accepted principles of case plan
development in case plans
conveyance of case plans correctional agencies to
community-based treatment programs
the utility of case plans for community treatment programs
staff perceptions of the assessment-case planning
process will occur only after the introduction of a specific
and structured process improvement initiative.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Success in achieving the goals of a Process Improvement Plan will be positively related to: ▪ degree to which Local Change Teams are faithful to
the change model
▪ degree of commitment by the Local Change Team members to goal achievement
▪ level of staff satisfaction with the implementation strategy
▪ degree of management support
▪ strength of the working alliance between the Facilitator and the members of the Local Change Team
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Measurement &
Instrumentation
Concerned with the breadth and quality of the screening
and assessment processes that correctional agencies use
to identify the strengths, weaknesses, and service needs of
substance- abusing offenders.
Integration with the
Case Plan
Concerned with the extent to which the case plan
developed by the correctional agency explicitly addresses
the needs identified in the assessments.
Conveyance &
Utility
Concerned with the extent to which the correctional agency
shares or conveys the assessment and the case plan with
community-based treatment programs and the extent to
which these programs find the case plan useful.
Service Activation &
Provision
Concerned with the extent to which community-based
treatment programs provide the type and nature of services
to offenders that were identified or recommended in their
case plans.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Common Training
Research staff was provided with special training (via webinar) in the use of the Assessment and Recommendations for Treatment Rating Form (ART-RF).
Site-Specific Training
At each site, two ART RF raters and a member of the CJDATS senior research staff for that site reviewed case files, compared ratings, discussed discrepancies, developed site-specific coding guidelines, and attempted to reach consensus on coding guidelines before proceeding.
After introduction into the field, each site randomly selected 5% of the ART RFs to be reviewed by two raters.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Determine individual risk level with standardized
instruments with proven predictive validity
Target offenders with a higher risk of
recidivism/relapse
Provide the most intensive treatment to those
with higher risk levels
Intensive treatment may increase
recidivism/relapse for lower-risk offenders
Assess the changes in risk level over time
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Assess, then target the known dynamic
characteristics and circumstances of high-risk
offenders that predict re-offender
Target the dynamic factors (can be changed) rather
than the static (cannot be changed).
Relationship between factors and
recidivism/relapse must be supported with
empirical evidence.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Effective treatment services are those matched
with the needs and learning styles of high-risk
offenders
Most effective are social learning and cognitive-
behavioral in approach and reinforce pro-social
thinking and behaviors
Programs must have treatment contingencies
for targeting weak motivation for participation
Since targeted needs are dynamic, anticipation
of change should be part of ongoing treatment
and requires regular client re-assessment.
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
(1) Improve organizational and interagency
processes around the assessment of offenders.
(2) Better connect assessment to case plans.
(3) Improve transfer of information from corrections
to community-based substance abuse treatment
providers.
(4) Improve client access/receipt of substance
abuse services consistent with the case plans.
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CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Externally facilitated, interagency Local Change
Teams (LCTs), composed of representatives from
both correctional agencies and community
partners, will conduct a four phase change process
to address selected improvements directed at this
goal.
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CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
1. Conduct implementation research on how to more
effectively implement and sustain improvements in
the HIV Services Continuum for offenders under
correctional supervision
2. Evaluate relative effectiveness of a local change team
(LCT) process improvement approach for improving
HIV service implementation in criminal justice settings
3. HIV services viewed as a continuum including prevention
for those at risk for HIV, testing for those at risk whose
status is unknown, and treatment – including linkage to
care for inmates re-entering the community
CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.
Medication-Assisted Treatment Implementation in
Community Correctional Environments (MATICCE)
Specific Aims: Aim 1: Improve service coordination between Community
Corrections agencies and local MAT-providing treatment agencies.
Aim 2: Improve CC agents’ knowledge, perceptions, and information
about referral resources and intent to refer appropriate clients to
community-based MAT.
Aim 3: Increase the number of CC clients linked with MAT.
Aims will be accomplished by testing: a staff-level Knowledge, Perceptions, and Information (KPI) training
intervention; and an interorganizational linkage intervention.