SAMSHA Adult Criminal Justice Treatment and Offender Reentry Program (ACJT/ORP) Grantee Meeting

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Advancing Uptake of EBPs in CJS through Sound
Organizational Change Processes

• SAMSHA Adult Criminal Justice Treatment and
  Offender Reentry Program (ACJT/ORP) Grantee
  Meeting
• Faye S Taxman, Ph.D.
• University Professor
• George Mason University
• ftaxman_at_gmu.edu
• Funded by NIDA, R01 DA18759 NIDA U01 DA 16213
• MD Department of Public Safety Correctional
  Services
• Center for Advancing Correctional Excellence!
• http/gemini.gmu.edu/ebct 
•  

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The long and winding road
Uptake of EBPS in CJS
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Expectation that Good Ideas are worthwhile enough
to influence practice
Use by Staff
What factors affect uptake?
Idea
Accept
Feasibility
Uptake
Routinize
Time..
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The Challenge Adopting EBPsThe Greater
Challenge Implementation
Less than 1/3 adopted

• Standardized risk assessment
• Standardized substance abuse assessment
• Addressing co-occurring disorder
• Treatment duration of 90 days or longer
• Comprehensive Services
• Use of therapeutic community/CBT
• Continuing care or aftercare
• Use of graduated sanctions and incentives
• Systems integration
• Use of drug testing in treatment
• Use of techniques to engage and retain clients in
  treatment
• Assessment of treatment outcome
• Family involvement in treatment
• Availability of qualified treatment staff
• Developmentally appropriate treatment

Setting Mean EBPs Adopted
Adult Prison 5.6
Adult Jail 3.9
Adult CC 5
Juvenile Res. 5.7
Juvenile CC 4.8
Drug Court 5.6
GMU
Friedmann, Taxman, Henderson, 2007 Young,
Dembo, Henderson, 2007 Henderson, Taxman
Young, 2008
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of Respondents Providing EBPs
of Agencies

• Treatment directors were not assessed on this
  item
• Facility administrators were not assessed on
  this item
• Adult program treatment directors/facility
  administrators not assessed on this item

GMU
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Should Screen for

• Criminal Justice Risk
• Actuarial based Models
• Historically used to determine sanction
• Main Factors
• Age of first arrest
• Number of arrests and/or convictions
• Number of failed attempts on probation (or
  parole)
• Number of incarcerations
• Number of escapes
• Substance Abuse
• Main Tools
• Composite Score of Criminal History
• Wisconsin Risk/Needs
• Level of Service Inventory
• Other Tools (Specialized)

• Substance Abuse
• Screen for SA Problem (Based on DSM-IV)
• Triage Method
• In CJ, used to refer to clinical assessment
• Many tools exist
• CSATs SSI
• ASI
• Co-Occurring Disorders

GMU
Most Frequently used
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Actuarial Risk Tools Few In Place
GMU
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Standardized SA Tool is More Prevalent
Dr Tx Prison ASI (55), TCUDS-II (39)/Generic
Prison SASSI (39), TCUDS-II or ASI (33)/Jail
ASI (58), MAST (29)/State Comm Corr SASSI
(58), ASI (47)/Local Comm Corr SASSI (46),
ASI (43) Chi-Square17.8, plt.01 for Use of SA
Tool by setting
GMU
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Tx Practices in Practices
Administrators Reporting Facility Use

• 20 report the use of Cognitive Behavioral
  Treatments few use manuals

GMU
Taxman, Perdoni Harrison, 2007 Young, Dembo,
Henderson, 2007
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The long and winding road
Uptake of EBPS in CJS
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Training for organizational change

• One session is ineffective-less than 10 percent
  uptake on knowledge, even less utilization
• Knowledge will not lead to utilization
• A mental model of the vision increases
  utilization
• Training methods (see meta-analysis by Agunisis
  Kraiger, 2009)
• Most effective training programs involve
  cognitive and interpersonal skills, followed by
  psychomotor skills or tasks
• Training focused on mental models (conceptual)
  with rehearsal of tasks increases declarative
  knowledge and task performance
• Training should include declarative knowledge
  (what, facts, meaning of terms), procedural
  knowledge (how ), strategic knowledge (when to
  apply the technique)

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Transferthe problem

• Transfer methods allows for generalized to the
  job context and maintained over a period of time
  (Baldwin Ford, 198863).
• Individual Level Characteristics motivation to
  transfer, perceived utility/value, anxiety,
  self-efficacy, organizational commitment
• Training and Transfer Methods clear goals and
  objectives in the materials that are job
  specific, establish proximal goals for
  utilization of training materials, designs
  focused on feedback, reinforcement and
  remediation, overlearning (i.e., repeated
  practice )
• Environment supportative climate, social network
  support (peers and colleagues), opportunities to
  use new knowledge/skills
• Failure to get management support undermines
  adoption and implementation
• Lacks of mental model/conceptual framework
  reduces success RNR principles is a conceptual
  model
• Overall agencies will keep with old familiar
  models unless they are challenged to move ahead

see Burke Hutchins, 2007
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Technical Assistance Efforts in USA

• Model 1 Let the agency request based on their
  needs
• Model 2 Have one declarative knowledge event
  followed by agency-requested assistance
• Model 3 Drug Court Model
• Funding Stream PlanImplementEnhance
• Core Sanctions and Incentive Curriculum (NADCP)
• Model 4 NIC Model (evolving)
• Select Sites
• Focus on organizational development/benchmarks
  long term
• Most models lack well-defined skill building
  components, mental model, or transfer applications

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What Matters in Adoption of EBPS? Overview of
NCJTP Findings
Qualities of Leaders 1. Community Setting 2 Administrator Human Services Increased Knowledge of EBPs Supports Rehabilitation Pursue Reforms from Clinical Perspective 3. State Executive Support (even for county)
Training Resources Secure Physical Facilities Internal Support Training Resources
Organizational Culture Climate Learning Performance Emphasis Quality Tx State Support
Network Connections Integration
GMU
Friedmann, Taxman, Henderson, 2007 Henderson,
Taxman Young, 2008
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Special Edition of Drug and Alcohol Dependence,
August 2009
Fletcher, B. W., Lehman, W. E., Wexler, H. K.,
Melnick, G., Taxman, F. S., Young, D. W.
(2009). Measuring collaboration and integration
activities in criminal justice and substance
abuse treatment agencies. Drug and Alcohol
Dependence, 103(Supplement 1), S54-S64.
Henderson, C. E., Taxman, F. S. (2009).
Competing values among criminal justice
administrators The importance of substance abuse
treatment. Drug and Alcohol Dependence,
103(Supplement 1), S7-S16. Henderson, C. E.,
Young, D. W., Farrell, J., Taxman, F. S.
(2009). Associations among state and local
organizational contexts Use of evidence-based
practices in the criminal justice system. Drug
and Alcohol Dependence, 103(Supplement 1),
S23-S32. Lehman, W. E., Fletcher, B. W., Wexler,
H. K., Melnick, G. (2009). Organizational
factors and collaboration and integration
activities in criminal justice and drug abuse
treatment agencies. Drug and Alcohol Dependence,
103(Supplement 1), S65-S72. McCarty, D.,
Chandler, R. K. (2009). Understanding the
importance of organizational and system variables
on addiction treatment services within criminal
justice settings. Drug and Alcohol Dependence,
103(Supplement 1), S91-S93. Melnick, G.,
Ulaszek, W. R., Lin, H., Wexler, H. K. (2009).
When goals diverge Staff consensus and the
organizational climate. Drug and Alcohol
Dependence, 103(Supplement 1), S17-S22. Oser, C.
B., Knudsen, H. K., Staton-Tindall, M., Taxman,
F., Leukefeld, C. (2009). Organizational-level
correlates of the provision of detoxification
services and medication-based treatments for
substance abuse in correctional institutions.
Drug and Alcohol Dependence, 103(Supplement 1),
S73-S81. Oser, C., Knudsen, H., Staton-Tindall,
M., Leukefeld, C. (2009). The adoption of
wraparound services among substance abuse
treatment organizations serving criminal
offenders The role of a women-specific program.
Drug and Alcohol Dependence, 103(Supplement 1),
S82-S90. Taxman, F. S., Kitsantas, P. (2009).
Availability and capacity of substance abuse
programs in correctional settings A
classification and regression tree analysis. Drug
and Alcohol Dependence, 103(Supplement 1),
S43-S53. Taxman, F. S., Henderson, C. E.,
Belenko, S. (2009). Organizational context,
systems change, and adopting treatment delivery
systems in the criminal justice system. Drug and
Alcohol Dependence, 103(Supplement 1), S1-S6.
Young, D. W., Farrell, J. L., Henderson, C. E.,
Taxman, F. S. (2009). Filling service gaps
Providing intensive treatment services for
offenders. Drug and Alcohol Dependence,
103(Supplement 1), S33-S42.
GMU
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• What does it take for caseworkers to 1) develop
  a case plan based on the risk of an individual
  and their criminogenic needs? 2) to refer/place
  the person in appropriate services and use
  appropriate controls?

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Study Design

• 4 Control Offices
• MI 1 day
• training only

• Statewide
• Survey of CMs
• in all 33
• Offices
• CM Best
• Practices
• Organizational
• Measures

• Office
• Random
• Assignment
• Stratification
• CM Practices
• Org Measures
• Office Size
• Location (urban,
• suburban, rural)

• 4 Standard
• Training Offices
• MI 1 day
• JARPP 3 day
• Booster training

• 4 Enhanced
• Training Offices
• MI 1 day
• JARPP 3 day
• Procedural boosters
• mentors

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Training Data Collection
Statewide Survey 1-Day Training 3-Day
Training 1st Booster 2nd Booster 3rd
Booster
All 33 offices N435
Baseline Youth Cohort (6-10 mos
pre-training) C-247 S-239 E-287
Baseline Staff Survey C-62 S-47 E-62
1st Youth Follow-Up (0-4 mos post-training) C-222
S-247 E-320
2nd Youth Follow-Up (6-10 mos post-training) C-206
S-253 E-260
6-Month Staff Follow-Up C-49 S-40 E-48
12-Month Staff Follow-Up C-XX S-XX E-XX
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Organizational Surveys Attitudes and Values

• ORGANIZATIONAL SCALES
• Individual Level
• Staff cynicism for change
• Organizational climate
• focus on performance
• support for staff development
• support for innovation
• communication
• Supervisory leadership
• Office Level
• Integration with courts
• Integration w/ MH agency
• Integration w/ CB providers

• CM PRACTICES SCALES
• Screening Assessment
• Standardized instruments
• Multiple needs, factors
• Treatment Planning
• Match with needs
• Involve youth family
• Comprehensive plan
• Placement Monitoring
• Ensures placement
• Monitors participation

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Youth-Based Measures

• CASE MANAGEMENT
• SERVICE UTILIZATION
• Assessments
• Contacts
• Service-oriented
• placements
• Secure detentions
• placements

• RECIDIVISM
• Re-referrals
• Type and time
• to re-referrals
• Adjudications
• adjudication
• charges

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Statewide Survey Findings

• Factors related to greater use of CM best
  practices (in HLM analyses)
• lower levels of staff cynicism for change
• more favorable perceptions of supervisory
  leadership
• greater integration with community based service
  providers
• Factors not related to CM best practices
• office climate
• integration with courts and MH agencies 
• staff characteristics (job tenure, education, and
  gender)

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Juvenile Assessment, Referral, Placement, and
Treatment Planning The JARPP Project
Outcomes
Increase in ? Organizational Commitment
(Staff/Mgrs) ? Goal Cohesion (Staff/Mgrs) ?
Service Utilization (Staff/youth) ? Case
Planning (Staff) Decrease in ?Rearrests
Site Conditions
Enhanced (4 sessions) Juvenile Justice
Experts Multitasking Stress Management
Rehearse, Learn Case specific

• Skill Building
• 3-Day Session
• Rapport
• Use of Risk
• Need Tools
• Case Plan

• Rapport Building
• 1-Day Session
• Refresh, Clarify Goals
• Skills

Standard (4 sessions) Standard Boosters
Skill-focused
Control None

No impact
Management Initiative to Support RNR Goals
NIDA, R01 DA18759
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Preliminary Findings Organizational Functioning

• Both training interventions lead to greater
  organizational functioning than control (MLGC
  analyses)
• Initial decrease followed by increase between 6
  and 12 months
• Contrasts of each training intervention with
  control condition
• Enhanced training leads to greater organizational
  functioning than control
• Differences between standard training and control
  not significant

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Preliminary Findings Youth Outcomes
 Measure Baseline Baseline 1st Cohort 1st Cohort 2nd Cohort 2nd Cohort
 Measure 6 mo 1 yr 6 mo 1 yr 6 mo 1 yr
Any Referral - E - E
Felony Referral S - E - E
Adjudicated Delinquent - E
Detained - E
Service-Type Placement S S
Surveillance-Type Placement - S - E - E
Residential Placement - E
Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control Note letter shown where p lt .1 p lt .05 p lt .01 S standard training group E enhanced training group group is higher compared to control - group is lower compared to control
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Enhanced key components

• Juvenile Justice Specialists Create in-house
  experts on techniques and application
• Booster Sessions were focused on combination of
  applied skills and case conferencing
• Social networks where consultant had monthly
  phone sessions, easy access quarterly meetings
• Address time management, multitasking, reconcile
  agency priorities
• Focus on value clarification and organizational
  commitment

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• What type of role should the probation officer
  have in their use of risk and needs assessment to
  manage offenders in the community?

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Behavioral Management Strategies in Supervision

• Unclear rules
• Discretionary procedures
• CJ Procedures
• Focus on Conditions,not goals
• Outlaw persona

• Deportment/Respect
• Office Decorum
• Citizen persona
• Social Learning Model
• Mutually Develop Plan Tied to Criminogenic Traits
• Feedback on Risk/Need, Supervision Plan, Progress
• Focus on Prosocial Networks
• Tie to Stages of Supervision
• Positive Reinforcers
• Clarify Expectations for Success

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Positive Findings for new Behavorial
Management Strategies

• Reduced Recidivism
• Reduced Technical Violations
• Increased Access to Treatment
• Increased Retention in Treatment

plt.01

• 38 Reduction in Odds of Rearrest Rates

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What did we do in MD PCS project?

• Model Declarative Knowledge intertwined with
  Procedural Knowledge and Skills, followed by
  job-specific rehearsal, overlearning, and
  organizational support
• Phase 1
• Design the PCS Model (Mental Model with Proximal
  Goals)
• Market the PCS Model in the Agency (Leadership,
  Team, Supervisors)
• Learn MI modified for Probation Environment
• Practice
• Have Supervisors Measure Skills (QCS)
• Phase 2
• Learn Risk, Need, Responsivity (mental model)
• Learn and Practice Level of Service Inventory-R
  (over learning)
• Learn and Practice Case Planning (over learning)
• Book Club (reinforcement)
• Measure Outcomes of Case Plans (proximal)
• Continued Organizational Development
• Train Supervisors in Coaching Skills
• Conferences, Meetings, etc.

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Organizational Change Processes
Impact
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Transforming the Field

• Political and Management Support of the New
  Concept Make sure leadership supports in spirit
  the new concept
• Mental Models based on Conceptual Framework
  Build a picture of how EBPs will improve
  operations work on the same foundation of a
  vision for the field
• Reinforce Clinical Orientation a focus on more
  clinical aspects improves uptake (Henderson, Oser
  Taxman, 2009) (culture and values)
• Enhance staff soft skills in job use
  reinforcement tools
• Focus on strategic transfer where structured
  after training experiences reinforce the mental
  models
• Build internal coaches and expertise

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Reference

• White Paper on Change

• Change Process

• Technology Transfer of Evidence-based Practice in
  Substance Abuse Treatment in Community
  Corrections Settings A White Paper
•  Steven Belenko, Faye Taxman, Harry Wexler
• Funded by National Institute of Corrections,
  Cooperative Agreement 06PEI06GJN8

http//www.nicic.org/Library/020095