Prisoners with Special Needs: Making Programs Work

Prisoners with Special Needs:Making Programs Work Richard Parker Principal Psychologist ACT Corrective Services richard.parker@act.gov.au

What Works in Reducing Recidivism: A primer • Risk: Treatment to higher risk, assess risk using actuarial instruments, e.g. LSI-R, LS/CMI • Needs: Address multiple criminogenic needs • Responsivity: Deliver services in a manner which suit the target group/individual • Human Services: Not punishment • Treatment Integrity: Deliver what you intended • Coordination of Strategies • Adapt interventions to local needs/culture

Special Needs? • Traditionally thought of as “unusual” categories of offenders e.g. • Intellectual disabilities • Minority racial group • Mental Illness • Illiterate, etc. • This thinking leads to a wide range of specialised programs for each sub-group of offenders • Not feasible for small (or poor) jurisdictions • Presumes homogeneity within each sub-group

Mentally Disordered Offenders • Recommendations (Muller-Isberner & Hodgkins, 2000) • Assess Risk & Needs • Address treatment needs for mental disorder and criminogenic needs • Collaboration between treatment providers

Mentally Disordered Offenders • …require all the treatments and services needed by non-offenders who suffer from these disorders, plus additional components which teach them skills for autonomous living and the skills necessary to prevent further aggressive behaviour and/or non-violent criminality” • (Hodgkins, 2001)

Offenders with Brain Damage • Recommendations (Nedopil, 2000) • Behaviour can be modified • Patients present with multiple deficits and social tasks can overwhelm them and lead to frustration and maladaptive behaviours • Inappropriate treatment demands provoke acting out by patient and resignation on the part of the staff

Personality Disordered Offenders • Recommendations (Burke & Hart, 2000): • Identify criminogenic needs and target them with a combination of pharmacotherapy and Cognitive Behavioural Therapy (CBT)

Psychopathic Offenders • Recommendations (Wong, 2000): • Highly structured CBT • Use positive reinforcers (rewards) • Trained & experienced staff • Actuarial Assessments • Relapse Prevention • Decent dosage • Address criminogenic needs

Special Needs or Individual Needs? • All offenders have special needs • No two are alike (although many share similarities) • E.g. They may have the same criminogenic needs, but have different pathways to resolving them

Special Needs • The same criminogenic need may require different approaches. • e.g. Antisocial associates • One offender may simply need to recognise the impact of these and make a decision to return to previous positive associates • Another may be wedded to their antisocial ties and know no other world

The Challenge • The Challenge is not to develop special adaptations of every type of program, e.g. • Cog Skills for Women • Cog Skills for Indigenous • Cog Skills for Young Offenders • Cog Skills for Older Offenders • Cog Skills for long termers • But to design interventions which are flexible enough to cope with diversity at the micro cultural level • Some categories (e.g. Intellectually disabled) may still require their own special programs

Culture • Broad Culture - e.g. Aboriginal • Sub-Culture - The group from Smith St who use heroin together • Micro-culture - particular styles of thinking, relating and viewing the world.

Making Programs Work • Rationale: Some programs work under certain circumstances, and then they don’t under others • E.g. Cognitive Skills Programs in UK

Findings 161 (2002) &Findings 206 (2003)

What Goes Wrong? • Doing “to” not “with” • Going through the motions • Undermining/ not owning the interventions • Not containing drop outs/poor referral practices • Wrong staff • Unsupported/untrained staff

Doing “to” not “with” • Many programs appear to presume that the offender will change simply by being exposed to certain material: • “By the 22nd lesson, participants are ready to evaluate themselves using a skills checklist” • What if they aren’t ready? • What about those who were ready at Week 10?

Common Program Mistakes* • Packing sessions as much as possible with activities … from ice breaking to closing; • Overloading with simplified explanations of too many concepts (with overuse of acronyms); • Setting the agenda (often with poor sequencing) and assuming that offenders are willing to move on to new concepts or learn new skills at our pace; (*Porporino, 2003)

Common Program Mistakes • Constantly questioning offenders, supposedly “socratically” as a technique to engage, but oftentimes without any rhyme or reason at all (and in such a repetitive, staccato fashion that would undoubtedly enrage most of us). • Packaging “motivational enhancement” front pieces to programs to adequately “motivate” before programs are actually delivered; • And, perhaps most importantly, giving little if any time for offenders to reflect, for themselves, on meaning and significance of what is being said.

Going Through the Motions • Why do results of pilot programs often not continue in the full roll-out? • Pilot • “Who Wants to run a new Program?” • “Me, me!! Please pick me!” • Full Roll-out • “You have to run a program” • “What!! I already have too much to do”

Drop-Outs/Referral Practices • “Gondolf & Foster (1991) reported attrition rates of 73% between initial enquiry into the program and the intake assessment phase and a rate of 86%by the time clients entered counselling. After 12 session had passed, 93% of the initial treatment referrals had dropped out, and at the end of the full 8 month program, only 1% of the men had successfully completed.” (Wormith & Olver, 2002)

Drop outs • This is fairly typical result in Community Corrections - completion rates tend to be higher in custodial environments as there are less incentives for non attendance (what else are you going to do with your time?)

Drop-out/Exclusion Types • Client initiated • Agency initiated • YAVIS (Young, Attractive, Verbal, Intelligent, Socially Skilled) • Administrative (For reasons other than the offender or program) • High risk offenders are much more likely to drop out or be excluded from programs

Attitude Problems by Staff/Courts • He’s not a real sex offender (What is a “real” sex offender?) • Programs don’t work/ don’t work for this type of offender (How do you know?) • You can lead a horse to water, but you can’t make it drink (You can add some sugar to the water) • The offender is resistant (as opposed to resisting what he thinks we are trying to do to him)

Undermining, not owning • Strongest predictor of program completion was “effective liaison between case managers and program staff”. r = 0.39

Finding a Language • We may have a concept we want an offender to adopt, but they cannot do so until we present it in a manner they can relate to • E.g. “Russian Roulette” instead of “Risk” • This cannot be imported, it has to make sense for your offenders (who are not all the same, hence you may need numerous languages)

How to Find a Language • Be open • Be patient • Be positive & optimistic • Use videos, role plays, examples, real life stories from group members • Listen to your participants (particularly the ones who are doing well)

Cognitive Self Change: A flexible Program • Open ended • Offenders can progress at their own pace; • New members can join as soon as a vacancy occurs; • Task based graduation • Participants graduate when they have competently demonstrated the four steps of cognitive self change

Cognitive Self Change: A flexible Program • Adaptable • Facilitators continually assess the factors that underpin each participant’s offending, and assign tasks which will lead the offender to address that issue • Assumes offenders are unmotivated and will often agree to participate to avoid some sanction. These offenders will plan to “jump through the hoops”

Cognitive Self Change: A flexible Program • Strategy of Choices • You can choose to attend this program and abide by the rules (which include homework and presentations in session); or • You can choose to not participate (and face whatever consequences may arise from that decision); • However, we will not allow you to attend and break the rules! • What is your choice right now?

Cognitive Self Change • Learn to observe objectively your own thoughts and feelings, attitudes and beliefs. • Learn to recognize the thinking (thoughts, feelings, attitudes and beliefs) that leads you to do offending behavior. • Find new thinking that doesn’t lead you to do offending behavior, and that helps you feel good about yourself when you use it. • Practice using it until you’re good at it.

In Summary • No need to have a large suite of programs • A few carefully chosen programs will do • Pay as much attention to the circumstances you place a program into as you do to the selection/design of the program itself • Make sure your programs are flexible and that staff are trained to use that flexibility without losing the integral core of the program

Prisoners with Special Needs: Making Programs Work