National Judicial College of Australia Session 2: Engaging Behaviour Change

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National Judicial College of AustraliaSession 2
Engaging Behaviour Change
Solution-Focussed Judging

• Dr Astrid Birgden
• Forensic Psychology Consultant
• astrid99_at_hotmail.com

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• Overview

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Therapeutic Jurisprudence

• The work of Wexler Winick (US)
• Legal theory concern for physical and
  psychological well-being of individuals affected
  by the law
• Utilises social science knowledge to determine
  ways in which the law can enhance psychological
  well-being
• Focus on the law, legal procedures and legal roles

emphasises increased well-being in individuals
in contact with the law
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1. The Law

• When the law seeks to promote therapeutic
  objectives, the impact of the law should be
  carefully examined to see whether it does so.

e.g. does criminalisation of drug use result in
anti-therapeutic consequences?(Wexler , 1990)
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2. The Legal System

• The legal system should be examined and perhaps
  be restructured to maximise its therapeutic
  effects and minimise its anti-therapeutic
  consequences.

e.g. should the law be reformed to ensure
therapeutic consequences for defendants?
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3. Legal Roles

• The roles and behaviours of judges and lawyers
  may need to change to mesh better with
  professional ethics and to be therapeutically
  beneficial.

e.g. can judges harness the law to engage
defendants in behaviour change?
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5 Principles

• The law can increase, decrease or have a neutral
  effect on well-being.
• The law should capitalise on the teachable
  moment to trigger pro-social lifestyles.
• The law should be a multidisciplinary endeavour
  that is cooperative not antagonistic.
• The law balances community protection and
  individual rights.
• TJ is values-based and maximises the aims of the
  law (treatment/therapy does not trump the law).
• (Birgden, 2002)

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Example
Piano Stairs   http//www.youtube.com/watch?v2lXh
2n0aPyw
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The Will
The Way (Motivation)
(Skills)
Defendants

• Behaviour Change

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The Will The Way
Defendant
The Will (Motivation)
The Way (Skills)
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The Will The Way
Defendant Judicial Officers
The Will
The Way
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• The Theory
• Natural Justice
• Contingency Contracting

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Procedural Justice cont

• Those who experience a legal procedure they
  consider unfair, have less respect for the law
  and legal authorities and are less likely to
  accept judicial decisions.
• This can undermine the potential for
  rehabilitation learned helplessness- leads
  to apathy, restricts change and causes
  individuals to give up.
• (Gould, 1993 Seligman, 1992)

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Example

• THIS AMERICAN LIFE- VERY TOUGH LOVE- A DRUG
  COURT IN GEORGIA- 25/3/11
• Charlie at 19yo was caught in a police sting
  buying LSD. He was in the last 3 months of the
  Drug Court Program and obtained a ve drug test
  result. Charlie denied drug use and 2 more tests
  were immediately taken that were ve. He had
  never missed a meeting or failed a previous drug
  test.
• Charlie was told by Judge Williams that she did
  not believe him, he was sentenced 17 days to
  prison, and directed to spend 3.5 years instead
  of 2 years in the Program when he was close to
  finishing.
• The journalists (Ira) stated it is exactly the
  result that research studies show is the problem
  with an overly punitive approach it made him
  rebel... ...it the Drug Court took a model
  participant and turned him into a failure.

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Example cont

• Charlie Once that day came it was a big, it was
  like a big slap in the face. You know, everything
  I'd pretty much put my trust into had turned its
  back on me. I'd sat here and dedicated 22 months
  of my life to changing it. I felt like everything
  I'd done was for nothing.
• Ira And then December of that year you screen
  positive for marijuana.
• Charlie Yeah. Yeah, I smoked some pot. At that
  time, I was over it. I was just disappointed,
  extremely disappointed.
• ? A month later Charlie missed his first group
  meeting and a warrant was issued for his arrest.
  It took him 4 years to finish the Program.

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Procedural Justice cont

• Conversely, those who feel they have been treated
  fairly, respectfully and with dignity
• have greater satisfaction and
• (b) are more inclined to accept responsibility
  for their behaviour.
• (Tyler, 1990 Ronner, 2001)

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Procedural Justice cont

• Due process is made up of
• Participation- present their own view and share
  in decision-making, so they perceive the
  procedure as fair (even if it may not influence
  the outcome).
• Dignity, respect, and politeness- defendant
  rights and values as a competent, equal citizen,
  and human being are acknowledged.
• Trust- the authority that allows the person to
  present evidence, displays dignity and respect,
  and clearly explains decisions is considered more
  trustworthy.
• ? Greater compliance with the law.
• (Tyler, 1990, 1996)

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Procedural Justice cont

• Put another way, the 3 Vs
• Voice- a chance to tell their story to the
  decision-maker.
• Validation- if they feel heard and listened to
  then more likely to feel a sense of validation.
• Voluntariness- voice validation experience
  the procedure as less coercive .
• ? Greater compliance with the law.
• (Ronner, 2001)

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MacArthur Foundation Studies (US)

• Risk
• Enhanced risk assessment and management of
  violence (MI does not equal violent offending).

Coercion Involuntary treatment and the patients
perception of coercion.
Competence The capacity for the person to (a)
understand information, (b) appreciate the
implications, (c) make rational
decisions. www.macarthur.virginia.edu/home.html
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Perceived Coercion

• Dont ask Is involuntary treatment effective?
  (for medical patients) but ask how can leverage
  best be used to assist?
• (Zdanowicz, 2006)
• Leverage access to government disability
  benefits, government housing, specifying
  treatment preferences in advance or having a
  proxy decision-maker, and avoiding gaol or
  hospital (for psychiatric patients).
• (Monahan, Redlich Swanson et al, 2005)

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Perceived Coercion cont

• Interviewed 433 psychiatric patients within 48
  hours admission into hospital ( clinicians and
  family members).
• Administered MacArthur Admission Experience
  Interview (perceived coercion scale).
• Force and -ve pressure (legal force, threats,
  and giving orders) feelings of coercion
• Persuasion and ve pressure does not result
  in feelings of coercion.
• (Lidz, Mulvey Hoge et al., 1998)
• http//ness.sys.virginia.edu/macarthur/members.
  html - MacArthur Research Network on Mental
  Health and Law

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Twisting Arms? OR Helping
Hand?
Coercion

• Legal coercion is OK.
• Psychological coercion through ve pressure to
  compel change is not OK.
• But psychological coercion through ve pressure
  is OK- motivate/persuade/induce through rewards
  (Winick, 2003)

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Decision-Making Capacity

• Medical Decision-Making
• Understand appreciate reason communicate a
  choice
• (Appelbaum Grisso, 1995 Grisso, Appelbaum,
  Mulvey, Fletcher, 1995).

1. Understand- paraphrase whats been disclosed
   about the disorder recommended treatment
   risks and benefits
2. Appreciate- explore whether fully understands
   because of delusions or distorted thinking.
3. Reason- recheck the patients initial choice,
   including no-treatment option, and look for
   logic.

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Making Choices

• The decision to enter a PSC must be based on an
  informed decision/genuine choice serves
  therapeutic dignity ends.
• (Boldt, 1998).

• Although this may be hard choice within a
  coercive context, it is a legally voluntary
  choice- not benevolent coercion- as long as
  there is no duress or improper inducements-
• once the individual chooses in favour of such a
• treatment option, of course, his or her future
• actions are constrained, but they are constrained
  
• as result of a choice voluntarily entered into
• (Winick, 2003c, p. 184).

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Example
Driving Reinforcement 54 secs   http//www.youtube
.com/watch?vKcaKocRXCB4featurerelated
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Contingency Contracting

• A positive approach to behaviour change.
• Empirically-based approach for increasing
  motivation to change.
• Systematic method of consequences (rewards
  sanctions) which are unique, not mirror images.
• Emphasise rewards not sanctions (41 ratio).
• The systematic application of ve reinforcement
  immediately follows a desired behaviour.
• Try to be stronger than offending behaviour
  natural reinforcers.
• Reinforcement schedule escalating rewards for
  target behaviours and a reset for a lapse.
• Only sanction violation of (institutional) rules.
• Developing behavioural contract with the
  defendant.

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Contingency contracting cont
1. Set the ground rules to reduce confrontation/
confusion. 2. Retain consistency in program
delivery (integrity). 3. Ensure that consistent
responses to behaviour can be anticipated
(predictability control). 4. Ensure
accountability (defendant for behaviour, judicial
officers toward participant). 5. Empower
participant to take responsibility and staff to
manage program. 6. Be pragmatic in placing
realistic expectations on the participant. 7. Uti
lise partnership between judicial officers and
the defendant.
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• The Practice
• Stages of Change
• Motivational Interviewing

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• Triggering Change
• It is expected that defendants will experience
  psychological discomfort or distress when
  appearing before the law. With psychological
  distress comes contemplation of change (Draycott
  Dabbs, 1998).
• While some individuals respond to environmental
  pressure to change, others will become defensive
  (Prochaska DiClemente, 1982 Miller, 1985).
• The court can harness the potential teachable
  moment to promote a therapeutic outcome (Rottman
  Casey, 1998) if the defendant asks how can I
  live my life differently? (Ward Stewart,
  2003).

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The Process
The Stage (the right thing)
(the right time)
Engaging Change

• Behaviour Change

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The Process (Verbal)

• Consciousness-raising
• Increase awareness of causes, consequences and
  strategies for offending behaviour
  
  ? mild confrontation

Dramatic Relief Emotional arousal about current
behaviour and change ?psychodrama techniques
Environmental Re-evaluation Affective and
cognitive assessments of the impact of behaviour

? empathy
training
Self Re-evaluation Affective and cognitive
assessment of long-standing lifestyle ?
self-narrative to support a pro-social lifestyle
Self Liberation The belief that change can occur
and act on that belief (self-efficacy) ?drug
treatment court as a public commitment
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The Process (Behavioural)

• Helping Relationships
• Combine care, openness, trust, acceptance and
  support for change
• ? therapeutic alliance or ethic of care (the
  helping hand)

Contingency Contracting Systematic rewards and
sanctions with rewards emphasised ? contingency
management
Counter conditioning Replace anti-social
behaviour with pro-social behaviour ? counter
negative self-statements
Stimulus Control Increase cues to prompt
pro-social behaviours and decrease cues that
tempt anti-social behaviours
? remove drug-using
implements from the environment (Prochaska
Levesque, 2002)
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• Any Questions?

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• Think of a behaviour....
• You have changed
• 2. Are in the midst of changing
• 3. Are thinking about changing

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The Stage

• Pre-contemplation
• Do not intend to change in the forseeable future
  (next 6 months) ?I dont have a problem.

Contemplation Intend to take change in the future
(next 6 months) ? I think I
have a problem, but..
Preparation
Intend
to change in the immediate future (next 1 month)
? I have started to take small steps
to stop offending.
Action

Have made specific changes to behaviour (past 6
months) ? Im actively developing a plan
to stop offending.
Maintenance Work to maintain change and avoid
relapse for the future (6 months - 5 years)

?Ill keep
maintaining my rehabilitation plan. (Miller
Rollnick, 2002 Prochaska Norcross, 1994)
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Stages of Change Model
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Stage of Change
Pre-contemplation No intent to change
Contemplation Thoughts about change
Preparation Small behavioural changes
Action Modify behaviour and the environment
Maintenance Consolidate gains and efforts (Birgden, 2004)
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Stage of Change Underlying Process
Pre-contemplation No intent to change Consciousness-raising Dramatic relief Environmental re-evaluation
Contemplation Thoughts about change Self re-evaluation Dramatic relief Environmental re-evaluation Self re-evaluation
Preparation Small behavioural changes Self-liberation
Action Modify behaviour and the environment Helping relationships Contingency contracting Counter-conditioning Stimulus control
Maintenance Consolidate gains and efforts (Birgden, 2004) Helping relationships Contingency contracting Counter-conditioning Stimulus control
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Stage of Change Judicial Officers
Precontemplation No intent to change MI to elicit problem recognition
Contemplation Thoughts about change MI to elicit expression of concern
Preparation Small behavioural changes MI to elicit intention to change
Action Modify behaviour and the environment MI to elicit optimism about change
Maintenance Consolidate gains and efforts (Birgden, 2004) MI to maintain optimism about change
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Stage of Change Judicial Officers Clinicians
Precontemplation No intent to change MI to elicit problem recognition MI to elicit problem recognition
Contemplation Thoughts about change MI to elicit expression of concern MI to elicit expression of concern
Preparation Small behavioural changes MI to elicit intention to change MI to elicit intention to change
Action Modify behaviour and the environment MI to elicit optimism about change Apply cognitive-behavioural intervention and develop a good lives plan
Maintenance Consolidate gains and efforts (Birgden, 2004) MI to maintain optimism about change MI to maintain optimism about change (if required)
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Motivational Interviewing Techniques cont

• Person-centred how the client views the world.
• Directive the judicial officer works
  specifically on resolving ambivalence.
• (Miller Rollnick, 2002 Farrall et al, 2003)

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5 MI Principles Practice
1. Express empathy Acceptance facilitates change Ambivalence is normal Reflective listening Problem-solving approach Avoid arguments !DONT NAG! ? Client explores problems in a trust setting
2. Develop discrepancy Highlight discrepancy between present behaviour and goals to motivate change Confront attempts to resolve difference, if absent ? Client argues for change to raise awareness
3. Avoid arguing Arguing is counterproductive, unnecessary and produces defensiveness Confront client but dont be aggressive as client will read this as personal conflict (or attack) ? Client resistance is a signal to change strategies
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5 MI Principles Practice
4. Roll with resistance Invite, dont impose, new perspectives If the client resists, youve introduced the topic too soon ? Use clients as a problem-solver
5. Support self-efficacy (Birgden, 2002) Belief in the possibility of change is an important motivator The client chooses from options ? Assist client to translate change into action and so experience mastery
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Communication orientation and its impact
on motivation and engagement combining influence
and authority

• Influence is the capacity to carry out a task
  with others by
• recruiting their interest, energy and commitment
  to a common goal
• or purpose
• Authority is the power to achieve an end or carry
  out a
• responsibility through others
• Authority emerges from a role influence from
  personal qualities,
• communicative abilities and ultimately, from
  authenticity.
• Being present (engaged) and bringing your
  experience to bear on
• these interactions enables program participants
  to engage with the
• process.

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• Motivational Interactions
• A short/sharp strategy
• Skills (reflective listening and core Qs)
• Concepts (cycle of change)
• Strategies (develop/maintain motivation)
• Process (how to)
• Farrall, M. Emlyn-Jones, L., Emlyn-Jones, R.
• (2003). ignition Creative Learning (for
  Corrections Victoria)

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Stage of Change Court Staff Strategies
Precontemplation No intent to change MI to elicit problem recognition Explore Roll with Resistance
Contemplation Thoughts about change MI to elicit expression of concern Develop Change Talk Develop Importance and Confidence Decisional Balance
Action Modify behaviour and the environment MI to elicit optimism about change Goal setting Change planning
Maintenance Consolidate gains and efforts MI to maintain optimism about change Reinforce Prepare
Lapse and Relapse MI to maintain optimism about change Debrief Optimism and acceptance
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• Exercise 1 (5 mins)
• In pairs-
• Person A is a researcher who
• has read that using a mobile
• phone may cause brain
• tumours.
• Strongly persuade Person B
• to cease using a mobile
• phone.

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• Exercise 1 Debrief
• Feedback re how mobile
• phone user/researcher
• Felt
• Behaved
• Relationship between them
• What happened to resistance

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TRAP Description
1. EXPERT Trap Researcher appears to be the expert with all the knowledge, knowing whats right, having a solution. ? The user is the expert and their knowledge needs to be explored to find solutions.
2. POWER Trap The researcher has all the power of research and data behind them which may make the user feel powerless or forced to fight back. ? The user has the power to change so need to empower not disempower them.
3. PROBLEM SOLVING Trap The researcher may feel they need to provide the solution and may do so too soon and get frustrated. ? The user will dig their heels in if they are not ready to change.
QUESTION ANSWER Trap The researcher interrogates the user which shuts down the conversation. ? Need to allow user to explore issues.
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TRAP Description
5. YES BUT... Trap The researcher comes up with reasons why the user should change resulting in the user coming up with reasons why not to change. ? The user should come up with the arguments re why they may want to change.
6. BLAMING Trap The researcher tries to make the user feel bad which causes a lot of damage to the relationship. ? The user needs to feel that they can change and deserve to something better (self-efficacy).
7. LABELLING Trap The researcher labels the user in some way, rather than seeing them as a person. ? The user feels judged and defensive.
8. CONFRONTATION Trap The researcher and user concentrate on who will win the battle. ? User will fight back or acquiesce but there wont be a helping relationship.
PERSUASION EFFECT Likely resistance and denial which are coping strategies, not personality traits or flaws.
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• Exercise 2
• Weve all been to school
• what were the qualities and
• characteristics of
• Your least favourite teacher?
• Your most favourite teacher?

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Good Teacher Bad Teacher
Treating you as an individual Listening Being approachable Clear boundaries Fair Warm, human, empathic Interested in your work Thinking the best of you Humiliating Not interested Favourites/ scapegoats Thinking worst of you Bullying
What would these teachers have said about your level of motivation? What would these teachers have said about your level of motivation?
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ACTIVE LISTENING

• Show them you understand (in words)
• that they feel strongly
• what they feel strongly about
• why they feel strongly about it

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SUMMARISING

• To check you heard what they intended
• To acknowledge and note their concerns
• To demonstrate they have been heard

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REFRAMING

• Ensure whats said is clear consistent
• If its not clear to you, its not clear
• Mutualise understanding

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REFRAMING

• Listen for feelings and needs
• Identify problematic language negative,
  self-defeating, powerless emphases
• Re-state what has been said so that the concern
  or issue is made clear without the unfortunate
  packaging
• Ask yourself if the reframe is accurate

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• Q What is a reflective statement?

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• Reflective Statement
• 3 elements
• Content- paraphase relevant content
• (not like a parrot though!).
• 2. Meaning- guess what the person is saying and
  help the client clarify meaning and correct you.
• 3. Feelings- reflect feelings back to the person
  to invite them to express them (rather than how
  did it make you feel?).
• ? A bit more directive

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• Reflective Statement
• Example
• 1. Content
• Paraphrase the content
• D Ill tell you what, Ive had it up to here.
  My life is shit. This program is no use. No one
  is helping me. No matter what I do, it all ends
  up the same. They all criticise me, they all
  think Im useless, but its not my fault, none of
  it.
• JO You feel like no-one is helping you when you
  need it.

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• Reflective Statement cont
• Example
• 2. Meaning
• What you think lies behind the words- what does
  the client really want to say?
• D Ill tell you what, Ive had it up to here.
  My life is shit. This program is no use. No one
  is helping me. No matter what I do, it all ends
  up the same. They all criticise me, they all
  think Im useless, but its not my fault, none of
  it.
• JO It sounds like youd like things to be
  different.

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• Reflective Statement cont
• Example
• 3. Feeling
• What is the emotional content of what is being
  said?
• D Ill tell you what, Ive had it up to here.
  My life is shit. This program is no use. No one
  is helping me. No matter what I do, it all ends
  up the same. They all criticise me, they all
  think Im useless, but its not my fault, none of
  it.
• JO Youre pretty unhappy about how things are at
  the moment.
• Note- reflective statements go down at
• the end of a sentence

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• You can create resistance by
• Using persuasion.
• Pushing against it.
• ? Resistance may make the D look like they are in
  pre-contemplation, but you may be focusing on the
  problem too soon
• ? Resistance is a sign to change strategies

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Resistance
JO introduces R- you must change
D becomes resistant guilt/shame about behaviour
or fear of change
JO pushes harder or gives up
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RESISTANCE EXAMPLE

• Participant (interrupting, on a rising tide of
  anger and frustration, pointing a finger at the
  judge)
• No, you listen to me. All I ever hear is talk,
  talk, talk. No one listens to me. All the staff
  do is tell me off, tell me what Im doing wrong,
  tell me how I should try harder. What would they
  know? What would any of you know? You all go
  home to your comfy houses and forget about people
  like me, and Ive had it. I tell you, this is
  the end.

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• Q What are some resistance statements
• you experience?

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• Roll and Explore Questions
• Instead, roll with resistance
• Can you tell me how you feel about being
• here?
• What is going on for you right now?
• Where does X fit for you?
• What are some helpful things about X?

67

• Exercise 3 (5 mins)
• Person A is a resistant defendant and
• Person B applies roll explore
• The D may not see their behaviour as a problem.
• ? Help the D explore the problematic behaviour.
• ? Help D develop a greater understanding about
  the reasons.
• ? Avoid arguing/confronting.

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• Exercise 3 Debrief
• What did you do to generate
• resistance?
• What did you do to lower
• resistance?

69
Stage of Change Court Staff Strategies
Precontemplation No intent to change MI to elicit problem recognition Explore Roll with Resistance
Contemplation Thoughts about change MI to elicit expression of concern Develop Change Talk Develop Importance and Confidence Decisional Balance
Action Modify behaviour and the environment MI to elicit optimism about change Goal setting Change planning
Maintenance Consolidate gains and efforts MI to maintain optimism about change Reinforce Prepare
Lapse and Relapse MI to maintain optimism about change Debrief Optimism and acceptance
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Contemplation

• 1. Decisional Balance

2. Change Talk
3. Importance and Confidence
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• Ambivalence
• Resolve dilemmas by exploring
• ambivalence
• What you shouldnt do
• Solve the problem for the D
• Invest in a particular outcome or solution and
  so only see the benefits of that outcome
• Suggest change without letting the D explore how
  they feel and weigh the pros and cons

72

• Ambivalence cont
• Resolve dilemmas by exploring
• ambivalence
• What you should do
• Encourage the client to explore the benefits of
  the current situation/behaviour
• Help the client weigh the costs
• ? Maximise the chance that ambivalence will
• be resolved and a decision reached.
• ? Pros of status quo and cons of change ?
• resistance, but one side of ambivalence.
• ? Work at their stage of readiness (not yours).

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• DECISIONAL BALANCE

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Decisional Balance

• After the D has identified that change would be
  beneficial and has come up with ideas, then gains
  and losses of change can explored.

What would be the best thing about X? What would
be worst thing about X?
?The questioning is extreme because the D needs
to feel that the benefits of new behaviour (the
change) outweighs the costs of old behaviours
(staying the same). ? Highlights the ves about
change rather than than the -ves of no change
which is the usual focus of the CJS
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The Will and the The
Way (decision-making
(decision-making volition)
capacity)

Autonomy

• D has to make an informed decision about what the
  ves are for them

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The good things about continuing are... The good things about changing are...

The bad things about continuing are... The bad things about changing are...

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• CHANGE TALK

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What is Change Talk?

• Anything the D may say that shows that change is
  on the agenda.

• Awareness of a problem
• Concern about the situation
• Intention to change
• Optimism about benefits of change

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Change Talk is....
Recognise a problem I keep getting into
trouble Statement of concern Im wasting my
life Wish to change Ive had enough of all
this Dislike of current situation My partner
says shes had enough of me Statement of purpose
Im going to take my medication regularly
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You need to-

• Hear Change Talk when it happens
• Reinforce Change Talk
• Elicit Change Talk
• Understand that Change Talk can be ve or ve

81
Support Change Talk by-
Asking strategic questions that help clients
explore and identify their Change Talk to elicit
self-motivating statements. It is not asking
questions to problem solve. Have 5 reflections
to 1 strategic question.
82
CHANGE TALK QUESTIONS
You have mentioned some helpful things about X,
what are some of the less helpful things?
Reflect On the one hand, some helpful things
are... On the other hand, less helpful things
are... Summarise What is the best thing/worst
thing about taking medication? Reflect Imagine
its 1 year down the track and things have
changed, what would be the best thing that could
be happening? Reflect Imagine its 2 years down
the track and things havent changed, what would
be the worst thing that could be happening?
Reflect
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• Exercise 5 cont
• Change Talk
• Person A raises a problem behaviour they
• would like to change so that it can be explored
• and key strategic questions can be asked.
• We will be sequencing the questions and each
• strategic question will be followed by reflective
  
• listening to allow for
• Exploration
• Clarification
• Expression of empathy
• Affirmation.

84

• Exercise 4 (5 mins)
• Change Talk cont
• In pairs
• I will be stopping starting the conversation.
• The D does not see their behaviour as a problem.
• Help the D explore the problematic behaviour.
• Help the D develop a greater understanding about
  the reasons.
• Avoid arguing/confronting with D.

85

• Exercise 4 cont
• Change Talk
• Scene setting question
• Whats happening with you?
• And follow on with reflective listening
• 2 mins

86

• Exercise 4 cont
• Change Talk
• Decisional balance question
• Whats helpful about current situation/
  behaviour?
• Follow on with reflective listening.
• Then
• Whats not so helpful about current situation/
• behaviour?
• Follow on with reflective listening and
• summarise both sides.
• 2 mins

87

• Exercise 4 Debrief
• Change Talk
• Group feedback re how you found this

88

• Exercise 4 cont
• Change Talk
• 2 year future question
• Imagine yourself 2 years down the track, what is
  the worst thing that could be happening?
• Follow on with reflective listening/
• affirmation/summarising.
• 2 mins

89

• Exercise 4 Debrief
• Change Talk
• Group feedback re how you found this.
• Note- Person B is not trying to get Person A to
• change, but to explore for themselves and
• therefore clarify whether change is required.
• The worst case scenario is based on the
• clients values, not your values.

90

• Exercise 4 cont
• Change Talk
• 1 year future question
• Imagine yourself 1 year down the track, and
  youve pulled off this change, what would it be
  like?
• Follow on with reflective listening/
• affirmation/summarising.
• 2 mins

91

• Exercise 4 Debrief
• Change Talk
• Group feedback re how you found this.

92

• Exercise 4 cont
• Change Talk
• Closure question
• Person B summarises the whole conversation and
  self-motivating themes.
• Then
• Where does that leave you?
• Follow on with reflective listening/
• affirmation/summarising.
• 2 mins

93

• IMPORTANCE CONFIDENCE

94

• Exercise 5
• Scaling
• How much MI will assist in the courtroom, from
• 1- not at all
• to
• 10- totally ?

95

• Exercise 5
• Scaling cont
• How skilled you are at applying MI strategies in
  the courtroom, from
• 1- not at all
• to
• 10- totally ?

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• Importance Confidence
• You have just gauged (a) importance and (b)
  confidence in the D in order to maximise the
  likelihood of change.
• How important to you is this change, from 0 (not
  at all important) to 10 (very important)?
• How confident are you that you could make this
  change if you decided to, from 0 (not all all) to
  10 (very confident)?

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The Will
The Way (Importance)
(Confidence)
Defendants

• Behaviour Change

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How would you then build motivation in relation
to importance and confidence?

• So what makes you place yourself at X?
• The tone is enquiring, not doubting.

If the number is low, how do you help them move
up the scale?
Youve put yourself at 4 for X. What could happen
to move you to say 5 or 6? A doing question,
not a what if question.
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Stage of Change Court Staff Strategies
Precontemplation No intent to change MI to elicit problem recognition Explore Roll with Resistance
Contemplation Thoughts about change MI to elicit expression of concern Develop Change Talk Develop Importance and Confidence Decisional Balance
Action Modify behaviour and the environment MI to elicit optimism about change Goal setting Change planning
Maintenance Consolidate gains and efforts MI to maintain optimism about change Reinforce Prepare
Lapse and Relapse MI to maintain optimism about change Debrief Optimism and acceptance
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• Goal Setting Conveying Expectations
• Task is to deliver a message, but its context is
  wider
• To clarify the boundaries of a program so as to
  enable D to step into a safe setting within which
  they can explore and discover their voice and
  their strengths in ways that build their
  autonomy.
• Staff and setting characteristics interact to
  have a positive or negative effect on Ds
• You are setting a climate conducive to
  participation and a solution focus
• In stating what is expected, you motivate
  participants to ask how they can live their lives
  differently

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• Goal Setting
• You should not
• Be too hands-on- take over and give advice
  which undermines the D and may set them off on an
  unworkable plan.
• nor
• Be too hands-off- leaving the D to flounder
  and wanting to change but not knowing how.

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Avoidance Goals Approach Goals
(What you want (What
the D wants to manage risk)
to meet need)
Goal Setting

• Behaviour Change

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• SMART Goals
• Specific- what is the goal exactly?
• Measurable- how will you know when it is
  achieved?
• Achievable- is the client capable of achieving
  it?
• Realistic- is it realisable?
• Time scaled- when should it be achieved by?

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• Change Plan Questions
• Solution-Focussed question If you woke up
  tomorrow and had achieved your goals, what would
  that look like?
• The where are you now question
• As far as achieving that goal is, where are you
  now from 0-10?
• The how do you get there questions
• What would move you from X to X?
• What would you see as the first step?
• How would you know youre making progress?
• What would you/others be doing?
• What might get in the way of your plans?
• What are high risk situations for you?

105

• Exercise 6 Change Plan Questions
• 5 mins
• 3 roleplay
• Defendant
• Judicial Officer
• Observer
• Practice Change Plan questions and previous
• techniques

106

• Change Plan Questions
• Solution-Focussed question If you woke up
  tomorrow and had achieved your goals, what would
  that look like?
• The where are you now question
• As far as achieving that goal is, where are you
  now from 0-10?
• The how do you get there questions
• What would move you from X to X?
• What would you see as the first step?
• How would you know youre making progress?
• What would you/others be doing?
• What might get in the way of your plans?
• What are high risk situations for you?

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Stage of Change Court Staff Strategies
Precontemplation No intent to change MI to elicit problem recognition Explore Roll with Resistance
Contemplation Thoughts about change MI to elicit expression of concern Develop Change Talk Develop Importance and Confidence Decisional Balance
Action Modify behaviour and the environment MI to elicit optimism about change Goal setting Change planning
Maintenance Consolidate gains and efforts MI to maintain optimism about change Reinforce Prepare
Lapse and Relapse MI to maintain optimism about change Debrief Optimism and acceptance
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• Lapse/Non-Compliance
• Debrief Questions
• Build Importance Confidence
• Reframe failure as a learning experience
• Can you tell me a bit about what happened?
• What were you thinking before you decided to do
  X?
• How were you feeling before that happened?
• What would you do differently if you were in that
  situation again?
• What was working well before that happened?
• Where does that leave you?
• DONT BE DISHEARTENED, CHANGE IS A PROCESS
  (sometimes a very long one!)

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• SUMMARY
• Do Dont

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Stage of Change Least Helpful Strategies DONT Most Helpful Strategies DO
Precontemplation No intent to change Focus on problem Persuade Argue Use authority to push change Reflective listening Roll with resistance Develop rship Affirmation Open questions Get alongside
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Stage of Change Least Helpful Strategies DONT Most Helpful Strategies DO
Precontemplation No intent to change Focus on problem Persuade Argue Use authority to push change Reflective listening Roll with resistance Develop rship Affirmation Open questions Get alongside
Contemplation Thoughts about change Give advice Problem solve Ignore ves of current behaviour Explore ambivalence Explore pros and cons Develop discrepancy Explore ves of change
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Stage of Change Least Helpful Strategies DONT Most Helpful Strategies DO
Precontemplation No intent to change Focus on problem Persuade Argue Use authority to push change Reflective listening Roll with resistance Develop rship Affirmation Open questions Get alongside
Contemplation Thoughts about change Give advice Problem solve Ignore ves of current behaviour Explore ambivalence Explore pros and cons Develop discrepancy Explore ves of change
Action Modify behaviour and the environment Move too fast Make it your plan Be unrealistic Affirmations Explore ambivalence Negotiate goals Offer advice/information if asked
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Stage of Change Least Helpful Strategies DONT Most Helpful Strategies DO
Maintenance Consolidate gains and efforts Assume job is done Become too needed Forget support Reinforce gains Clarify goals Explore ambivalence Affirmations Prepare for lapse
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Stage of Change Least Helpful Strategies DONT Most Helpful Strategies DO
Maintenance Consolidate gains and efforts Assume job is done Become too needed Forget support Reinforce gains Clarify goals Explore ambivalence Affirmations Prepare for lapse
Lapse and Relapse Feel they have failed Feel that you have failed Underestimate ambivalence Give up Get frustrated Remain supportive Affirmations Explore ambivalence Explore pros and cons Clarify goals
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A cognitive-behavioural approach to culture change
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• Recommended reading (astrid reviewed the
  manuscript)
• Miller, J. Johnson, D. C. (2009) Problem
  solving courts A measure of justice. Maryland
  Rowman Littlefield Publications Inc.
• Reviews
• Miller and Johnson's Problem Solving Courts is a
  fascinating introduction and examination of the
  possibilities and limitations of problem solving
  courts as 'blended institutions' that seek to
  reduce recidivism and protect the community by
  addressing offenders' underlying behavioral,
  socio-emotional, and human capital deficits.
  --Jeffery Ulmer, Penn State University
• This book is creative and fresh in its approach.
  The authors cover the length and breadth of
  socio-legal studies related to Problem Solving
  Courts. By including the voices of repeat
  offenders, classical social scientists, and
  cultural giants such as Shakespeare, they go far
  beyond the conventional. This book poses an
  intellectual challenge to students, legal
  practitioners, and social scientists to draw upon
  a breadth of perspectives in their conception of
  the justice process. The book provides a behind
  the scenes look at Problem Solving Courts, and is
  required reading for anyone interested in
  understanding contemporary jurisprudence.

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• Thankyou for your time!