Managing High Risk Young Persons in Social Welfare Institutions MultifunC

1. Managing High Risk Young Persons in Social Welfare Institutions MultifunC Multifunctional Treatment in Residential and Community Settings Developmental Project in Norway and Sweden

2. The project is sponsored by theMinistryofChildren and Equality in Norway, The National BoardofInstitutionalCare (SiS) and Centre for Evaluationof Social Services (IMS) in Sweden. • Reviewoftheresearchonresidentialtreatmentofantisocialbehaviour in juveniles (2001-2002). • Developmentof a residentialtreatment program basedontheresearch (2003-2004). • Implementingthetreatment program – MultifunC- in Norway (sixunits) and in Sweden (threeunits) (2005-2007). • Evaluationofthe program (2008-10?)

3. Basis ofMultifunC • MultifunC is basedonresearchonpredictorsofantisocialbehaviour (risk factors), onthe”PrinciplesofEffectiveIntervention” – Risk, Need and Responsivity and ”The PsychologyofCriminalConduct”which is a teorethicalexplanation for criminalbehaviour, and thechangeofthis (Andrews, Gendreau, Cullen and Bonta, 1990, 2006). • The principlesaresupported by severalmeta-analysis (Andrews og Dowden, 2000; Lipsey og Wilson, 1998; Tong og Farrington, 2006; Lowenkamp and Latessa, 2006; Lipsey, 2007, and other).

4. Principles of Effective Intervention Risk Principle:Intensivity of intervention should match individual risk level. Target high-risk offenders Need Principle:Targets of interventions should be known dynamic risk factors (criminogenic needs). Responsivity Principle:The intervention should be matched to the individual learning style. Use methods based on cognitive behaviour and social learning theory

5. Major Risk Factors

6. Effects for 13200 placed in institutions (Risk principle ) (Lowenkamp og Latessa, 2002, 2006) Effects for low risk Effects for high risk Matched with the same risk level in interventions outside institutions

7. Major Risk and Need Factors and Promising Intermediate Targets for Reduced Recidivism(Need Principle) Factor Risk Dynamic Need History of Antisocial Early & continued Build noncriminal Behavior involvement in a number alternative behaviors antisocial acts in risky situations Antisocial personality Adventurous, pleasure Build problem-solving, self- seeking, weak self management, anger mgt & control, restlessly coping skills aggressive Antisocial cognition Attitudes, values, beliefs Reduce antisocial cognition, & rationalizations recognize risky thinking & supportive of crime, feelings, build up alternative cognitive emotional states less risky thinking & feelings of anger, resentment, & Adopt a reform and/or defiance anticriminal identity Antisocial associates Close association with Reduce association w/ criminals & relative criminals, enhance isolation association w/ prosocial people from prosocial people Adopted from Andrews, D.A. et al, (2006). The Recent Past and Near Future of Risk and/or Need Assessment. Crime and Delinquency, 52 (1).

8. Major Risk and Need Factors and Promising Intermediate Targets for Reduced Recidivism Factor Risk Dynamic Need Family and/or marital Key elements are Reduce conflict, build caring, better positive relationships, monitoring and/or communication, enhance supervision monitoring & supervision School and/or work Low levels of performance Enhance performance, & satisfaction rewards, & satisfaction Leisure and/or recreation Low levels of involvement Enhancement involvement & satisfaction in anti- & satisfaction in prosocial criminal leisure activities activities Substance Abuse Abuse of alcohol and/or Reduce SA, reduce the drugs personal & interpersonal supports for SA behavior, enhance alternatives to SA Adopted from Andrews, D.A. et al, (2006). The Recent Past and Near Future of Risk and/or Need Assessment. Crime and Delinquency, 52 (1).

9. The Treatment Principle Slide 9 The most effective interventions are behavioral • Focus on current factors that influence behavior • Action oriented • Offender behaviors are appropriately reinforced The most effective behavioral models are • Social learning—practice new skills and behaviors • Cognitive behavioral approaches that target criminogenic needs

10. In addition to theworkofthereaserchers from Carleton University, MultifunC is basedonresearchonseveralothertopicsthat areimportant in residentialtreatment; • Structure and support (Gold and Osgood, 1992; Brown et al, 1998), control and autonomy (Sinclair and Gibbs, 1998), peer culture (Dodge, Dishion and Lansford, 2006), re-integration and aftercare, (Altschüler, 2005; Liddle , 2002), fidelity..............……………… • Liddle, 2002: Residential treatment needs to be understood as part of a continuum of services. The quality of the post-treatment environment--particularly relationships with family and non-criminal friends and involvement in school and pro-social activities--are critical predictors of recovery.

11. Peer culture and the Risk ofiatrogeniceffectsofgrouptreatment • Influence of antisocial peers and antisocial peer cultures are important risk factors. • In residential settings an unintended consequence might be that the group might contribute to the development and maintenance of antisocial behaviour, and then to iatrogenic effects of the treatment (Dodge, Dishion and Lansford, 2006). • The risk of negative influence from antisocial peers implies that the period of time used in residential setting should be as short as possibly, and should be linked to community services.

12. Conclutionsonwhatworks in residentialtreatment for juvenile offenders Target high risk juveniles: • Adress both individual and contextual factors (criminogenic needs) including cognition, attitudes, education, peer associations, and family issues • Are able to manage serious negatively behaviour (violence) • Enhance intrinsic motivation through use of constructive communication, such as motivational interviewing • Balance between control and autonomy • Balance between structur and support • Systematic and structured training in social skills • Use cognitive behavioural techniques • Training in school or work • Are linked to community and help establish prosocial contacts • Includes aftercare as an integrated part of the intervention • Measures performance and use this information for continuous improvement (quality assurance)

13. The MultifunC-institutions • Small units (8 juveniles in each unit) • Open institutions (non-secure). This does not mean that they are free to go……….. • Located close to community services (school, leisure/recreation activities and communication /transport) Makes it possibly to establish prosocial contacts, to be in local schools, training in new skills in natural settings, and to maintain contact with family.

14. Target group for MultifunC • Juveniles withseriousbehaviour problems (crime, substanceabuse, violence, etc.). • High risk for futurecriminalbehaviour(high total sum of risk factors – static and dynamic) • Beforeplacementthebehaviour is assessedwithAchenbach’scheck lists (CBCL), and the Risk level is assessedwiththe risk inventoryYouthLevelof Service/Case Management Inventory (YLS/CMI)

15. Assessment Static riskfactors Behaviour and Risk-assessment Target group Dynamic riskfactors Treatment-targets and -plans Responcivity / personality-factors Treatment methods and targets

16. Peers • Family • Parental skills • Communication • Decrease antisocial • Increase prosocial Treatment Targets Juvenile School • Behaviour • Skills • Attitudes • Attendance • Skills • Behaviour

17. Treatmentprocess Residential / institution Community Inntake Treatment Transition Reintegration / aftercare MotivationMotivationPrepareFamily AssesmentFocusedTreatmentre-entry support StructureTreatmentclimate Duration of residential stay: Duration of aftercare: about 6 months (not fixed) about 4-5 months (not fixed) Juvenile School Focus of treatment Peers Family

18. Organizationalmodel for eachMultifunC-unit Leader Assessment and Planning team Mileau therapy -team Educational/ Pedagogical team Family- and follow up team For each juvenile there will be Treatment teams across all teams including one or several staff from each team.

19. Treatmentthattakesplace during theresidentialstaywithfocusontheyouth • The treatmentmileau: • Control wherethis is neccesary, butnounneccessarycontrol • Involvementofthe juveniles whereverthis is possibly • Structure, but not unneccessarystructure • Principles from ”Corecorrectionalpractice” - staff behaviour • Interventionswithfocusonindividual juveniles: • Motivating for change (basedonMotivationalInterviewing) • Behaviouralanalysis and/or MST’sfit-cirkel • Contingency Management Systems/Toceneconomy and Behaviouralcontracts • AggressionReplacementTraining (ART) • Weeklytreatment goals and evaluationof progress (intesivity)

20. AggressionReplacementTraining (ART) • Toceneconomy and MotivationalInterviewingmotivates for change. The basis for actualchange is new skills which makes changespossibly. • AggressionReplacementTraining (ART) consistsof a multimodal intervention design thatcombines: • Training in controlofaggression (ACT), • Trainingofsocial skills, and • Learningof moral thinking (Goldstein og Glick, 1994).

21. Treatment during theresidentialstaywithfocusonexternal or systemicfactors • Promoteprosocialinfluence (contactwithprosocial peers outsidetheinstitution – school and leisure) • Moderate antisocialinfluence (decreasecontactwithantisocial juveniles outsidetheinstitution and antisocialcommunicationamong juveniles withintheinstitution) • Increaseparticipation in school and performance in schoolsituation (support to the juveniles and theschool). • Increase parental function and familyprocesses (trainingofparents in theinstitution and during the juveniles home-visits).

22. Family support and aftercare Focus • Increasingfamilyaffection/communication • Increasingmonitoring/supervision skills Methods: • Principles from Parental Management Training (PMT) during theresidentialstay • Principles from MultisystemicTherapy (MST) during leaves and aftercare

23. Model for Aftercare Youth Family team Parents School or work Peers

24. Qualityassurance systems • Written Manuals for each topic (assessment, treatment, aftercare and so on) is included in the treatment model • Weekly phone-consultations with checklists and discussions with each institution • Regularly visits at all the institutions • Regularly Boosters on spesific topics • Future: Regularly interviews with juveniles and parents

25. Design for Study ofeffects

26. The nine existing MultifunC- institutions Tromsø Youth Centre Stjørdal Youth Centre Bergen Youth Centre Oslo Margrete Lund Sandefjord Youth Centre Ås Youth Centre Brättegården Råby Youth Centre

27. Five major dimensionsofsuccessful programs Assess target populationbasedon risk faktors predictiveofrecidivism and select more seriousoffenders Adresscriminogenic risk faktors open to changewithin target population Developtheoretical basis for intervention and expectedoutcomes Design interventionsshown to be effective (cognitivebehaviour) Implementwithquality and fidelity to the program design Support and Resources surrounding the Intervention AgencyMissionAgencyLeadershipAgencyFunding Community Support Connectionsacross Services Ashley (2005), King County Departement of Community and Human Services

28. We have some guidelines from research, butthere is no ”Magic Bullet” (Lipsey, 2007) The End Tore.Andreassen@hibo.no

29. Stages ofimplementation • Exploration and adoptation • Program installation • Initial implementation • Full operation • Innovation • Sustainability