F-14 RESEARCH AND CLINICAL PRACTICE IN JUVENILE CORRECTIONS

Embedding Research in a Large Scale Treatment

Program

Barry Burkhart, Ph.D., ABPP - Auburn UniversityPatrick Cook, M.S. - Auburn University

Ray Sumrall, Ph.D. - University of Alabama

History• 1999 – Alabama State legislature mandated all

juvenile sex offenders be treated.

• Department of Youth Services (DYS) ill-equipped to respond to mandate.

• Consortium between Auburn University Department of Psychology and University of Alabama Department of Social Work responded. Public-Public partnership founded.

History, continued

• Best Practices Model–Required DYS to strive for excellence–Constant program evaluation and review

• Empirical Foundation– Student Assessment (e.g.., pre-treatment, post-treatment)-Program Assessment (e.g., staff interventions, treatment components)

State of Alabama - Department of Youth Services Mt. Meigs Correctional Facility

Accountability Based Sexual Offender Program (ABSOP) Mt. Meigs Correctional Facility

Assessment Fundamentals

3 Fundamental Goals:• Rich and accurate clinical assessment to

facilitate and focus treatment services• Serves as the foundation of a sound empirical

database from which theoretical and practical assumptions can be measured

• Allow for accurate and conceptually articulated assessment of outcomes

Comprehensive Assessment Protocol

Pre-treatment Assessment Battery

-Extensive multi-dimensional Clinical Interview (e.g., adjudicating offense information, history of trauma/abuse/neglect, medical history, family, school/peers)-Intellectual Assessment-Achievement Assessment-Current/Past Psychopathology-Personality Assessment/Psychopathy -Actuarial Risk of Re-offense

Comprehensive Assessment Protocol, continued

Post-Treatment Assessment Battery-Post Treatment Interview/Oral Examination-Actuarial Risk of Re-offending-Intelligence Assessment-Achievement Assessment-Personality Testing-Psychopathology

-Therapist/Case Manager Ratings -Performance in Individual/Group Treatment-Overall Rating of “Success”

Offender Demographics- 772 Offenders (586 JSOs, 184 NJSOs) since 2000

- Avg. Age = 16.01 Years (SD = 1.53 Years); Avg. Grade = 8.67 Grade (SD = 1.99 Grade)

- Racial composition: Caucasian (50.7%), African American (46.0%), Bi-racial (1.7%), Hispanic (1.0%), and “Other” (0.6%)

- Most frequent JSO charges: Sexual Abuse, 1st Degree (30%), Sodomy, 1st Degree (17.6%), Rape, 1st Degree (14%) and Sexual Misconduct (11.3%)

- Most frequent NJSO: Theft of Property (18.3%), Burglary (13.9%), and drug offenses (13.8%).

x

Database

Data has informed treatment and program decisions

• Comparisons JSO vs. NJSO• Offender Types (cluster analysis)• Outcome Measures (Pre-Treatment/Post-

treatment)

Comparisons JSO vs. NJSO

• Are Juvenile sex offenders “different” compared to delinquent, non-sex offending peers?

• Treatment/Program implications • Examined 716 offenders (N=554 JSOs, 162

NJSOs)• Personality, IQ, Achievement, psychopathy ,

psychopathology

JSO vs. NJSO Comparisons• The Millon Adolescent Clinical Inventory (MACI)

Self-report inventory specifically designed to measure unique psychosocial concerns, personality styles, and clinical symptoms via a true-false format.

• The Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) A semi-structured interview protocol is designed to assess 82 current and past symptoms related to 20 different diagnostic areas found within the DSM-IV.

• Hare Psychopathy Checklist: Youth Version (PCL:YV) Consists of a semi-structured interview and review of collateral information to measure interpersonal, affective, and behavioral features of psychopathy.

• The Wechsler Adult Intelligence Scale (WASI) Uses the vocabulary, similarities, block design and matrix reasoning subtests similar to those of the WAIS to provide an estimate of full scale IQ.

• The Wide Range Achievement Test-3rd edition (WRAT-3) A brief achievement test measuring reading recognition, spelling, and arithmetic computation

Juvenile Sex Offender Clusters• Juvenile sexual offenders – heterogeneous

• Victim selection (e.g., peer-age, child- molester, mixed pattern) incomplete in providing useful treatment information

• Empirically derived heterogeneous groups formed based on personality traits

• Treatment/program implications

Clusters, contd.

440 Juvenile Sexual OffendersFive cluster solution based on MACI scores - Broadly Disturbed(N=42; 9.5%)- Anxious/Submissive/Passive (N=171; 38.9%)- Dysthymic/Shame/Negative Self-Image (N=94;

21.4%)- Narcissistic Delinquent (N=83; 18.8%)- Distressed Delinquent (N=50; 11.4%)

1 Broadly Disturbed (N=42)2 Anxious/Submissive/Passive (N=171)3 Dysthymic/Shame/Negative Self-Image (N=94)4 Narcissitic Delinquent (N=83)5 Distressed Delinquent (N=50)

Outcome Measures

• Is treatment effective?

• Comparison of Pre-treatment and Post-treatment measures

• Personality Functioning• Actuarial Measure of Re-offending• Psychopathology

Iatrogenic Effects

Conclusion

• Base line data critical/essential

• Empirical evaluation of effectiveness

• Need to be able/open to make changes informed, in part, by data.