Correctional Policy: Preparing for EBPs

1. G E O R G E M A S O N U N I V E R S I T Y Correctional Policy: Preparing for EBPs Faye S. Taxman, Ph.D. University Professor George Mason University Advancing Correctional Excellence! http://gunston.gmu.edu/cebcp/ ftaxman@gmu.edu Acknowledgements: NIDA U01 DA 16213; CJ-DATS is funded by NIDA in collaboration with: SAMHSA, CDC, NIAAA, and BJA; NIDA R01 DA017729

2. Acknowledgements • Anne Rhodes, M.S., George Mason University • Carrie Oser, Ph.D., University of Kentucky • Craig Henderson, Ph.D., Sam Houston University GMU

3. Business leaders, political leaders, military leaders, entrepreneurs all need to learn and practice the same fundamental rule of thumb: Ask the last question first. And that is: What’s the point of this exercise? If you do not begin a new campaign, enterprise, military engagement or business with a clear definition of victory, you’ve set yourself for failure. If you don’t know what success is, how do you know when you’ve achieved it? If you don’t know if your strategy and tactics will take you there? If you don’t have a clear understanding of what you hope to achieve, how will you be able to justify the time, energy, human and financial resources you commit to the effort? It’s the lesson that the United States learned in the Vietnam War, in which we managed to win every battle and still left the country having lost the war. The critical missing element to that ill-conceived war was a lack of clear definition of victory. Alan Webber, founder of Fast Company Magazine, Washington Post, Sun Aug 30, 2009. GMU

4. What Works for Offenders? • ASSESSMENT & CASE PLANNING: Use standard tools to identify problem severity and link to programming • TREATMENT: • Treatment that is multi-dimensional, includes criminogenic risk factors & criminal thinking • Address co-occurring disorders, criminogenic factors, etc. • Skill building, recovery models, not traditional alcohol/educational programs and outpatient programs • Dosage (length of treatment) is important through stages: motivate, change, reinforce • COMPLIANCE MANAGEMENT: Rewards & Incentives • WORKING ALLIANCE: Rapport, Relationship GMU

5. The Quest of EBPs • Evidence-based practices are specified systems, programs, and services that are based on research on facets that reduce criminal behavior OR reduce drug use • EBPs are a tool kit that can be used to advance actual practice, if the goal is to reduce recidivism • Significant gaps exist between best practices identified by research and their implementation in routine care(Institute of Medicine, 2006). Is the public or correctional agencies ready for research-based correctional programs? GMU

6. Proponents Why EBPs are important…. Opponents Effect sizes (~ 10%) are too small to have an huge impact Drastic policy change like length of incarceration or probation will have a greater impact Goal is to prevent crime, not reduce recidivism Too hard Deterrence is more important Politicians do not support this movement EBPs are a formula for success EBPs can help to professionalize corrections Effects are small because.. NOT MUCH IMPLEMENTATION Existing structures serve a small number—7% daily population Corrections should be part of the service system to improve outcomes Human rights GMU

7. Source of Data • Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative (www.cjdats.org) • National Criminal Justice Treatment Practices Survey (NCJTPS) is a stratified cluster sample of prisons, jails, community corrections, and substance abuse treatment agencies (n=647) (Taxman et al., 2007). GMU

8. National Surveys: Response Rates • Survey administered via mail • Multi-level (state agency executive, facility administrator, staff, tx providers, drug court coordinators) • No differences in response rates based on region and facility type • Criminal Justice Treatment Practices • N = 1,902 • Adult: 67% Administrators, 75% State Executives • Juveniles: 54% Administrators, 70% State Executives • COD Survey (only facility administrators of NCJTP) • N = 757 • Adult: 63% Administrators • Juvenile: 65% Administrators • Community Treatment Providers: 61% • Drug Treatment Court Survey • N = 208 • Drug Court Coordinators: 68% • Treatment Providers: 75% GMU Taxman, et al 2007; Melnick, et al 2008; Taxman and Perdoni, in press

9. Research Questions • What impact does the perspectives of administrators have on the adoption of evidence based practices? • What impact, if any, does the nature of the reform have on the adoption of evidence-based practices? GMU

10. The Challenge: Using EBPs Standardized risk assessment Standardized substance abuse assessment Addressing co-occurring disorders Treatment duration of 90 days or longer Comprehensive Services Use of therapeutic community/CBT Continuing care or aftercare Use of graduated sanctions and incentives Systems integration Use of drug testing in treatment Use of techniques to engage and retain clients in treatment Assessment of treatment outcomes Family involvement in treatment Availability of qualified treatment staff Developmentally appropriate treatment GMU Friedmann, Taxman, & Henderson, 2007: Young, Dembo, & Henderson, 2007; Henderson, Taxman & Young, 2008

11. % of Respondents Providing EBPs % of Agencies • = Treatment directors were not assessed on this item • ^ = Facility administrators were not assessed on this item • ~ = Adult program treatment directors/facility administrators not assessed on this item GMU

12. Cumulative # EBPs Offered % of Agencies # of EBPs GMU

13. Competing Values: Importance of SUD Treatment to other CJ Services GMU

14. SA TX Compared to Other Programs • High Believers: More use of EBPs, County run, in Midwest/Northeast, • stronger belief in rehabilitation • Low Believers: South • Equal/Ambivalence: Marginal use of EBPS, Support Rehabilitation, in South/Northeast GMU Henderson & Taxman, 2009

15. What style of reform do CJ Agencies pursue? Clinical orientation=focus on treatment such as therapies and working alliance CJ Innovators=Focus on punishment (sanctions), drug testing, treatment None=No clear direction, responsive to setting GMU

16. EBP by Type of CJ Innovators GMU

17. Correlates of Latent Class Membership Clinical vs. CJ System Innovators * p < .05, ** p < .01, *** p < .001 GMU

18. Correlates of Latent Class Membership Clinical Innovators vs. Non-Innovators * p < .05, ** p < .01, *** p < .001 GMU

19. Correlates of Latent Class Membership CJ Innovators vs. Non-Innovators GMU * p < .05, ** p < .01, *** p < .001

20. The Importance of Type of Reform Efforts • Agencies pursue different avenues regarding their adoption of evidence-based practices • Some focus on a more clinical perspective; others reinforce an offender management (safety) perspective • Criminal Justice Innovators were more likely than Clinical Innovators to be a community corrections agency • Clinical Innovators perceived a higher need for training than Criminal Justice Innovators • Relative to the Non-Innovators: • Clinical Innovators had higher rehabilitation orientations, saw a greater need for training, and had more internal support for new programming • Criminal Justice Innovators also had higher rehabilitation orientations GMU

21. What Matters in Adoption of EBPS? GMU Friedmann, Taxman, & Henderson, 2007: Henderson, Taxman & Young, 2008

22. Factors to Improve Networkness? Integration or Boundaryless Processes of SA & CJ Agencies Most Typical Activities: • Share Information with agencies • Develop Client Eligibility Across Agencies • Written Program Programs • Joint Staffing of Program • Modified Program to Meet Correctional and SA Agencies • Written MOU between agency • Average Number of Activities Integrated: • Drug Court=6.1 • Probation/Parole=4.5 • Prison=3.2 • Jails=3.7 • Interagency integration is associated with more use of EBPs, more holistic services, and improved outcomes Fletcher, et al 2009; Taxman & Perdoni, 2007 GMU

23. Unlikely to Reduce Recidivism • Too few offenders exposed to treatment • Less than 11% can receive tx a year; on any given day, ~7.6% are in treatment • Treatment is inconsistent with needs • Not multi-dimensional—should address 3+ conditions including criminal values/thinking GMU

24. End Goal? • What should be the content of correctional reform? • Volatile environment • Reducing sentence lengths is only a short term and does NOT clarify the mission • Punishment vs. Prosocial Behavior • Where should we go? • Therapeutic Alliance • Working Alliance/Relationship • Get political support through mandating legislation • Focus on Administrators as Leaders AS the means to advance practice GMU

25. The Failure to Define the Mission of Corrections to include EBPs and Service Orientation Impacts….. • Use of working relationships with other organizations • Emphasis on recidivism reduction practices • Training of staff • Staff Orientation • Types of Administrators hired • Legitimacy of correctional practice A renewed focus on viewing corrections as a service provider (public health) will serve better outcomes GMU

26. Useful Resources TIP 44. Substance Abuse Treatment for Adults in the Criminal Justice System GMU

27. Special Edition of Drug and Alcohol Dependence Fletcher, B. W., Lehman, W. E., Wexler, H. K., Melnick, G., Taxman, F. S., & Young, D. W. (2009). Measuring collaboration and integration activities in criminal justice and substance abuse treatment agencies. Drug and Alcohol Dependence, 103(Supplement 1), S54-S64. Henderson, C. E., & Taxman, F. S. (2009). Competing values among criminal justice administrators: The importance of substance abuse treatment. Drug and Alcohol Dependence, 103(Supplement 1), S7-S16. Henderson, C. E., Young, D. W., Farrell, J., & Taxman, F. S. (2009). Associations among state and local organizational contexts: Use of evidence-based practices in the criminal justice system. Drug and Alcohol Dependence, 103(Supplement 1), S23-S32. Lehman, W. E., FLETCHER, B. W., Wexler, H. K., & Melnick, G. (2009). Organizational factors and collaboration and integration activities in criminal justice and drug abuse treatment agencies. Drug and Alcohol Dependence, 103(Supplement 1), S65-S72. McCarty, D., & Chandler, R. K. (2009). Understanding the importance of organizational and system variables on addiction treatment services within criminal justice settings. Drug and Alcohol Dependence, 103(Supplement 1), S91-S93. Melnick, G., Ulaszek, W. R., Lin, H., & Wexler, H. K. (2009). When goals diverge: Staff consensus and the organizational climate. Drug and Alcohol Dependence, 103(Supplement 1), S17-S22. Oser, C. B., Knudsen, H. K., Staton-Tindall, M., Taxman, F., & Leukefeld, C. (2009). Organizational-level correlates of the provision of detoxification services and medication-based treatments for substance abuse in correctional institutions. Drug and Alcohol Dependence, 103(Supplement 1), S73-S81. Oser, C., Knudsen, H., Staton-Tindall, M., & Leukefeld, C. (2009). The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program. Drug and Alcohol Dependence, 103(Supplement 1), S82-S90. Taxman, F. S., & Kitsantas, P. (2009). Availability and capacity of substance abuse programs in correctional settings: A classification and regression tree analysis. Drug and Alcohol Dependence, 103(Supplement 1), S43-S53. Taxman, F. S., Henderson, C. E., & Belenko, S. (2009). Organizational context, systems change, and adopting treatment delivery systems in the criminal justice system. Drug and Alcohol Dependence, 103(Supplement 1), S1-S6. Young, D. W., Farrell, J. L., Henderson, C. E., & Taxman, F. S. (2009). Filling service gaps: Providing intensive treatment services for offenders. Drug and Alcohol Dependence, 103(Supplement 1), S33-S42. GMU