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Learning Objectives Participants will review and discuss proper phase structuring for adolescents – and why this matters in the proper use of incentives and sanctions. Participants will learn about what DOES and what DOES work to promote positive behavior change in youth. Participants will learn about contingency management for adolescent’s substance abuse and use. Participants will learn how about contingency management theories and they work in juvenile drug courts. Participants will learn how to develop behavior and activity contracts.
Citation preview
S
Effective Use of Incentives and Sanctions in Juvenile Drug Court
Jacqueline van Wormer, Ph.D.Washington State University
This I BelieveI believe juvenile drug
court teams and professionals are
strengthened, enlightened, and
reinvigorated when I provide valuable training, technical assistance, and
resources, which improves their knowledge level and
adherence to the preferred model, which, in
turn, may increase positive outcomes for
youth and families in their community.
Learning Objectives
Participants will review and discuss proper phase structuring for adolescents – and why this matters in the proper use of incentives and sanctions.
Participants will learn about what DOES and what DOES work to promote positive behavior change in youth.
Participants will learn about contingency management for adolescent’s substance abuse and use.
Participants will learn how about contingency management theories and they work in juvenile drug courts.
Participants will learn how to develop behavior and activity contracts.
Are juvenile drug courts effective?
4
Yes! But not always….
Depends on how (and if) they implement the model
Are juvenile drug courts effective?
Early research: Small samples and poor designs. Negative effects found by Hartmann &
Rhineberger (2003); No effects on recidivism found by Wright and
Clymer (2001); Anspach et al., (2003) Positive Findings:
Lutze & Mason (2007); Latessa et al (2002), Rodriguez & Webb (2004), Shaffer et al., (2008) Hickert (2010), Hennegeler (2006, 2012), NPC Research (2006, 2010)
Latessa report (2013) Meta-Analysis:
Null-findings for both Wilson et al (2006); Shaffer (2006)
Small effect size – Mitchell et al (2012)
Taking a Closer LookCC BC HC SMC AA
Savings $9,070 $8,762 $5,702 $2,962 -172
Court Sessions
357/29 407/26 283/12 341/13 315/40
2 weeks 2 weeks 3 weeks 4 weeks weekly
Drug Tests 71 37 55 34 Self pay
Family Counseling Yes Yes No No Self pay
Parenting Yes No No No No
Treatment Youth and parent
Youth Gender
Specific + MH
Youth + MH Youth Self pay
S
Part IBuilding a Responsive Phase
Structure
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 in your JDC?
What do youth behaviors look like during phase one?
How do you want them to look by phase four?
Frustrating Behaviors
It begins with the phase structure
Phase One
Phase Two
Phase Three
Phase requirements for youth and family should start out small, increase, and then decrease again after the youth work through
treatment and court related goals.
Phase I: setting the stage
Phase II: learning skills
Phase III: maintaining the change
Readiness and engagement
Involvement, stabilization
Reflection, enrichment
Focus on compliance Beyond compliance Maintain drug testing, court appearance
High level of structure Skill development Expanded development activities
Clarifying expectations, building trust
Completing assignments
Enriching community connections
Phase StructureSource: Betty Gurnell
The Four Steps
Behavior to target Current behavior Desired behavior Small, achievable increments
Decision Matrix – Phase I
Phase I Incentives Sanctions
Behavior *Response Response
Attend school at least 18 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
Phase II Incentives Sanctions
Behavior *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
Phase III Incentives Sanctions
Behavior *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
7 (Easy) Steps to Individualizing Your Juvenile Drug CourtStart with…
1. Screening and assessmentAnd
2. Use the results to drive case planningSo we can…
3. Emphasize individualized responses over generic, pre- determined requirements
Which should help us…
4. Work with youth and families to inform the processAnd
5. Focus on strengthsAnd
6. Create lasting educational linkagesAnd
7. Develop individualized incentives and sanctions
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Part IIIncentives and Sanctions
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)
Why We Want to Use Alternatives
Probation/court monitoring, group homes, and correctional facilities have, at best, only modest
favorable effects on subsequent recidivism. Some studies show negative effects (Lipsey and Cullen, 2007;
Petrosino, Turpin-Petrosino, and Guckenburg, 2010).
Why We Want to Use Alternatives
Deterrence-oriented programs that focus on discipline, surveillance, or threat of punitive consequences (e.g., prison visitation Scared
Straight–type programs, boot camps, and intensive probation supervision) have no effect on recidivism
and may actually increase it (Lipsey, 2009).
Because…
“Therapeutic” programs oriented toward facilitating constructive behavior change have shown very
positive effects—even for serious offenders (Lipsey, 2009; Lipsey and Cullen, 2007; Lipsey and
Wilson, 1998).
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
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 in your JDC?
What do youth behaviors look like during phase one?
How do you want them to look by phase four?
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
So how do we strengthen the use of CM in our treatment settings,
and utilize the same methods within our Juvenile Drug Courts?
Point & Level Reward Systems
Contract
Reward Menu
3 for 3
Most Valued Privilege
Checkbook System
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)
3 for 3 Program
1. Pass all UAs
2. Bring JTDC Notebook
3. Make all appointments / contacts with case manager
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
Behavioral Contract Example
Goal Behaviors/Tasks
Incentives Non-compliance
Sanction
Enroll in GED program
•Call or visit GED center by xxxxx date
•Praise•Recognition from Team•Appointment Calendar•XXXXXX
Failure to contact by XXXX
•Increased reporting to PO•Increase in curfew•EM
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
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)
Contact Information
Jacqueline van Wormer, Ph.D.Washington State UniversitySAC 403ASpokane, WA(509) 628-2663 (cell)[email protected]@gmail.com