Liana Taylor, Matthew Hiller, Cynthia Robbins, Wayne Welsh

Liana Taylor, Matthew Hiller, Cynthia Robbins, Wayne Welsh, Gary Zajac, Gerald Stahler, Michael Prendergast

CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA

Assessment is an Evidence-based Practice 

Assessment is an evidence-based practice for the care of offenders with drug abuse problems  National Institute of Corrections  National Institute on Drug Abuse



Assessment is essential to evidence-based models of correctional treatment

CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.

Significant Gaps Exist in the Use of Evidencebased Instruments (Taxman et al., 2007) 

Use of standardized risk assessments was limited (34%); substance abuse assessments were more common (58%)



Widespread use of unstandardized assessments



Use varied by settings. Substance abuse treatment prisons more likely to use standardized assessments and use them with a greater proportion of cases




Risk principle  High risk, greater intensity treatment  Standardized risk assessments



Needs principle  Treatment specifically targets criminogenic needs  Standardized assessments of criminogenic needs



Responsivity principle  General responsivity  Specific responsivity ▪ Non-Criminogenic needs


Central Eight Criminogenic Needs Antisocial peers Antisocial attitude Antisocial behavior Antisocial personality Substance Use Family/Marital Leisure Activities/Recreation School/Work CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.

Big Four

The Current Study  



Objective review of physical files rather than survey of administrators Focused on determining use of standardized risk assessments as well as the assessment of criminogenic risks and needs Informed by Risk-Need-Responsivity (RNR) framework (Andrews, Bonta, Hoge, 1990).




How many agencies collected evidencebased assessments of risk and of substance abuse? For what percentage of cases?



What criminogenic risks and needs were assessed? For what percentage of cases?



What non-criminogenic needs were assessed? For what percentage of cases?


The ART-RF Measure Case plans were coded using the Assessment and Recommendations for Treatment Rating Form (ART-RF) instrument.  ART-RF was based on MATRS criteria: 

 MEASURABLE, ATTAINABLE, TIME-LIMITED, REALISTIC,

SPECIFIC

ART-RF form was developed and pilot tested over a period of about 18 months.  At each site, cases were selected based on their eligibility for admission/transfer to the community treatment agency. 


Sample and Analyses 





Preliminary dataset of Baseline ART-RFs from 4 CJDATS research centers (7 different agencies) N=364 (# of case plans sampled ranged from 27 to 90 per agency) Descriptive analysis of assessment process prior to implementation of the Organizational Process Improvement Intervention (OPII)


Evidence-based Assessments for Criminogenic Risk and Substance Abuse Evidence-based Assessments

# of Agencies Using

Average % of Cases1

Range % of Cases Across Agencies1

Risk assessment

4 of 7

99%

97%-100%

OST/FROST

2 of 7

100%

100%

LSI-R or RST

2 of 7

99%

97%-100%

7 of 7

70%

17%-100%

Used ASI

3 of 7

70%

37%-91%

Used TCUDS

4 0f 7

68%

37%-100%

Used ASUS-R

3 of 7

36%

15%-78%

Used DSM-IV-TR

2 of 7

45%

45%

AOD assessment

1 Calculation

was based only on agencies that assessed this.

OST/FROST (Offender Screen Tool, Field Reassessment of the OST), LSI-R (Level of Services Inventory-Revised), RST (Risk Screening Tool), ASI (Addiction Severity Index), TCUDS (TCU Drug Screen), ASUS-R (Adult Substance Use Survey Revised), CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA. DSM-IV-TR (Diagnostic and Statistical Manual IV Text Revision)

Criminogenic Risks and Needs “The Big 4” Range % of (Outliers) Cases % w/ these Across removed Agencies1

Range % of Cases w/ Outliers Removed

“Big 4” Criminogenic Risks and Needs

# of Agencies Assessing

Average % Cases1

Antisocial Peers

4 of 7

53%

6-100%

(2) 100%

100%

Antisocial Attitudes

7 0f 7

63%

15-100%

(0) 63%

15-100%

Antisocial Behavior

7 of 7

95%

52-100%

(0) 95%

52-100%

---

---

---

---

---

Antisocial Personality 1 Calculation



Criminogenic Risks and Needs “Other Central 8”

“Other Central # of 8” Agencies Criminogenic Assessing Needs

Average % Cases1

Range % of (Outliers) Cases % w/ these Across removed Agencies1


Substance Use Severity

7 of 7

97%

81-100%

(0) 97%

81-100

Family/Marital

7 of 7

72%

3-100%

(1) 83%

26-100%

Leisure / Recreation

---

---

---

---

---

Education

7 of 7

74%

3-100%

(1) 86%

37-100%

Employment

7 0f 7

76%

5-100%

(1) 88%

37-100%

1 Calculation



Non-Criminogenic Needs Range % of (Outliers) Cases % w/ these Across removed Agencies1


# of Agencies Assessing

Average % Cases1

Domestic Violence Perpetrator

6 of 7

54%

6-100%

(1) 64%

11-100%

Housing

7 of 7

64%

3-100%

(2) 89%

52-100%

Mental Health

7 of 7

77%

8-100%

(1) 88%

37-100%

NonCriminogenic Needs

1 Calculation



Conclusions Evidence-based Assessments 

Overall, agencies were more likely to use an evidence-based instrument to assess substance abuse than criminogenic risks and needs



Although only tentative conclusions may be drawn until the data from every agency in the OPII study can be compiled and analyzed, findings suggest that despite national practice guidelines, a number of agencies still do not use evidence-based risk assessments


Conclusions Criminogenic Risks/Needs 





For the “Big 4” risk/needs factors, agencies did well assessing a history of antisocial behavior and antisocial attitudes, but less well on antisocial peers. For the remaining R-N-R risk/needs factors, agencies did well assessing educational achievement, employment history, and substance abuse severity, but less well with family assessments. The limited use of assessments of antisocial peers and family support is a concern because if the homes and communities to which the offenders return are bereft of support from prosocial family and friends, the risk for recidivism is much greater.


There was greater variation in the assessment of needs like domestic violence treatment, housing, and mental health treatment than in the assessment of criminogenic risks and needs.  Although these “noncriminogenic” needs are not a part of the Central 8 risk/needs factors in the R-NR model, they do present particular challenges to offender reentry; especially when they are not sufficiently addressed. 








Effective planning for an offender’s reentry requires reliable information about his or her risks and needs. The absence of evidence-based risk assessments from case files, therefore, means that information needed for guiding appropriate referrals to community treatment is missing. Not knowing whether a prisoner will have adequate housing or the support of prosocial family members and/or friends means critical opportunities are missed for placing those without these into supportive environments upon reentry. More comprehensive assessments with standardized instruments, therefore, are needed to improve reentry planning and chances for success after returning to the community






Findings and conclusions are based only on a small number of agencies. Additional data collection and analysis is needed to determine whether findings similar to those reported here are found for the full sample of agencies. The study procedure failed to code whether assessments of antisocial personality and use of leisure/recreation were included in case files, but most of the key criminogenic risks and needs were coded and this provides valuable information to the field.


Liana Taylor, Matthew Hiller, Cynthia Robbins, Wayne Welsh, Gary Zajac, Gerald Stahler, Michael Prendergast

CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA

The goal of the study is to test the use of an organizational improvement strategy (i.e., Change Team and Facilitator) to bring about improvements in the quality of assessment and case planning procedures for substance-abusing offenders transitioning to community supervision and treatment.


Phase

Primary Outcome(s)

Duration (in weeks)

Local Change Team (LCT) is formed and the project is

1. Pre-Phase introduced to them.

LCT completes a Process Improvement Needs 2. Needs Assessment that identifies the relative strengths & Assessment weaknesses in the agency’s current assessment and case planning processes.

3. Process Improvement Planning

LCT develops and adopts a Process Improvement Plan that identifies goals and objectives for improvements in one or more the four core dimensions of the assessment continuum.

LCT works in a collaborative manner to implement the 4. Implementation objectives and attain the goals identified in their Process Improvement Plan. LCT assesses the relative sustainability of both the 5. Follow-Up process improvement targets achieved and the LCT method for facilitating process improvements. CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.

4- 6

8 – 12

8 – 12

16 – 26

26

Improvements in:     

congruence between transitional offender assessments and case plans presence of accepted principles of case plan development in case plans conveyance of case plans correctional agencies to community-based treatment programs the utility of case plans for community treatment programs staff perceptions of the assessment-case planning process will occur only after the introduction of a specific and structured process improvement initiative.


Success in achieving the goals of a Process Improvement Plan will be positively related to: ▪

▪ ▪

▪ ▪

degree to which Local Change Teams are faithful to the change model degree of commitment by the Local Change Team members to goal achievement level of staff satisfaction with the implementation strategy degree of management support strength of the working alliance between the Facilitator and the members of the Local Change Team


Measurement & Instrumentation

Concerned with the breadth and quality of the screening and assessment processes that correctional agencies use to identify the strengths, weaknesses, and service needs of substance- abusing offenders.

Integration with the Case Plan

Concerned with the extent to which the case plan developed by the correctional agency explicitly addresses the needs identified in the assessments.

Conveyance & Utility

Concerned with the extent to which the correctional agency shares or conveys the assessment and the case plan with community-based treatment programs and the extent to which these programs find the case plan useful.

Service Activation & Concerned with the extent to which community-based Provision treatment programs provide the type and nature of services to offenders that were identified or recommended in their case plans. CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.



Common Training  Research staff was provided with special training (via webinar)

in the use of the Assessment and Recommendations for Treatment Rating Form (ART-RF). 

Site-Specific Training  At each site, two ART RF raters and a member of the CJDATS

senior research staff for that site reviewed case files, compared ratings, discussed discrepancies, developed sitespecific coding guidelines, and attempted to reach consensus on coding guidelines before proceeding.  After introduction into the field, each site randomly selected 5% of the ART RFs to be reviewed by two raters. CJ-DATS is funded by NIDA in collaboration with SAMHSA and BJA.

    

Determine individual risk level with standardized instruments with proven predictive validity Target offenders with a higher risk of recidivism/relapse Provide the most intensive treatment to those with higher risk levels Intensive treatment may increase recidivism/relapse for lower-risk offenders Assess the changes in risk level over time


Assess, then target the known dynamic characteristics and circumstances of high-risk offenders that predict re-offender  Target the dynamic factors (can be changed) rather than the static (cannot be changed).  Relationship between factors and recidivism/relapse must be supported with empirical evidence.


Effective treatment services are those matched with the needs and learning styles of high-risk offenders  Most effective are social learning and cognitivebehavioral in approach and reinforce pro-social thinking and behaviors  Programs must have treatment contingencies for targeting weak motivation for participation  Since targeted needs are dynamic, anticipation of change should be part of ongoing treatment and requires regular client re-assessment. 


(1) Improve organizational and interagency processes around the assessment of offenders. (2) Better connect assessment to case plans. (3) Improve transfer of information from corrections to community-based substance abuse treatment providers. (4) Improve client access/receipt of substance abuse services consistent with the case plans.


29

Externally facilitated, interagency Local Change Teams (LCTs), composed of representatives from both correctional agencies and community partners, will conduct a four phase change process to address selected improvements directed at this goal.


30

1.

Conduct implementation research on how to more effectively implement and sustain improvements in the HIV Services Continuum for offenders under correctional supervision

2.

Evaluate relative effectiveness of a local change team (LCT) process improvement approach for improving HIV service implementation in criminal justice settings

3.

HIV services viewed as a continuum including prevention for those at risk for HIV, testing for those at risk whose status is unknown, and treatment – including linkage to care for inmates re-entering the community


 

Medication-Assisted Treatment Implementation in Community Correctional Environments (MATICCE) Specific Aims:  Aim 1: Improve service coordination between Community

Corrections agencies and local MAT-providing treatment agencies.  Aim 2: Improve CC agents’ knowledge, perceptions, and information about referral resources and intent to refer appropriate clients to community-based MAT.  Aim 3: Increase the number of CC clients linked with MAT.



Aims will be accomplished by testing:  a staff-level Knowledge, Perceptions, and Information (KPI) training

intervention; and an interorganizational linkage intervention.


Liana Taylor, Matthew Hiller, Cynthia Robbins, Wayne Welsh

Recommend Documents