Liana Taylor, Matthew Hiller, Cynthia Robbins, … · CJ-DATS is funded by NIDA in collaboration...

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

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 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

Assessment is an Evidence-based Practice


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

Significant Gaps Exist in the Use of Evidence-

based Instruments (Taxman et al., 2007)


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

Big Four


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).

The Current Study


How many agencies collected evidence-

based 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?


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.

The ART-RF Measure


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)

Sample and Analyses


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%

AOD assessment 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% 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),

DSM-IV-TR (Diagnostic and Statistical Manual IV Text Revision)


Criminogenic Risks and Needs “The Big 4”

“Big 4”

Criminogenic

Risks and

Needs

# of

Agencies

Assessing

Average %

Cases1

Range

% of

Cases

Across

Agencies1

(Outliers)

% w/ these

removed

Range

% of

Cases w/

Outliers

Removed

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 was based only on agencies that assessed this.


Criminogenic Risks and Needs “Other Central 8”

“Other Central

8”

Criminogenic

Needs

# of

Agencies

Assessing

Average %

Cases1

Range

% of

Cases

Across

Agencies1

(Outliers)

% w/ these

removed

Range

% of

Cases w/

Outliers

Removed

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

Employment

7 of 7

7 0f 7

74%

76%

3-100%

5-100%

(1) 86%

(1) 88%

37-100%

37-100% 1 Calculation was based only on agencies that assessed this.


Non-Criminogenic Needs

Non-

Criminogenic

Needs

# of

Agencies

Assessing

Average %

Cases1

Range

% of

Cases

Across

Agencies1

(Outliers)

% w/ these

removed

Range

% of

Cases w/

Outliers

Removed

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%

1 Calculation was based only on agencies that assessed this.


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 Evidence-based Assessments


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.

Conclusions Criminogenic Risks/Needs


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-N-

R 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.

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

Liana Taylor, Matthew Hiller, Cynthia Robbins,

Wayne Welsh, Gary Zajac, Gerald Stahler,

Michael Prendergast


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)

1. Pre-Phase Local Change Team (LCT) is formed and the project is

introduced to them. 4- 6

2. Needs

Assessment

LCT completes a Process Improvement Needs

Assessment that identifies the relative strengths &

weaknesses in the agency’s current assessment and case

planning processes.

8 – 12

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.

8 – 12

4. Implementation LCT works in a collaborative manner to implement the

objectives and attain the goals identified in their Process

Improvement Plan. 16 – 26

5. Follow-Up LCT assesses the relative sustainability of both the

process improvement targets achieved and the LCT

method for facilitating process improvements. 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 &

Provision

Concerned with the extent to which community-based

treatment programs provide the type and nature of services

to offenders that were identified or recommended in their

case plans.


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 site-specific 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.


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 cognitive-

behavioral 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, … · CJ-DATS is funded by NIDA in collaboration...

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