S The Beginning - AODTC Conference 2019aodtc-conference2019.org.nz/wp-content/uploads/... · Ratio...
Transcript of S The Beginning - AODTC Conference 2019aodtc-conference2019.org.nz/wp-content/uploads/... · Ratio...
“All Behavior is followed by a consequence, and the nature of that consequence modifies the organisms tendency to repeat the behavior in the future”
• B.F. Skinner
The Beginning
(Applies to humans as well as rats!)
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Positive ReinforcementINCENTIVES
SANCTIONS
Basic Terminology
Increase or START behavior
Decrease or STOP behavior
Therapeutic Adjustments
Treat sick behavior
Supervision/Drug tests Monitors behavior
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Consistent Detection(Behavior and Immediate
Consequence)
Reliable detection
(Detection allows the gathering
of information needed by judge
and team to determine
appropriate response)
Speeding ex.
Certainty
Supervision
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• Urine drug testing at least twice per week
• Random testing all 7 days
• Continuous detection methods (patches, bracelet)
• Electronic monitoring
• Home visits (Extend supervision into natural social
environment - work, home, school, street, cell phones)
• Include law enforcement on the team
• Case manager, supervision, treatment
Reliable DetectionH
Pre-Court CONSIDERATIONSBEHAVIOR RESPONSES:
• WHO are they in terms of risk and need?
• WHERE are they in the program (phase)?
• WHY did this happen (circumstances)?
• WHICH behaviors are we responding to?
– Proximal or distal?
• WHAT is the response choice/ magnitude?
• HOW do we deliver and explain response?
TREATMENT / SUPERVISION CHANGES?
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NOWLATER
LATER
• Show up
• Try hard
• Tell the truth
• Abstain from use
• Accept disease
• Work Recovery
Proximal = Proximate/Close Distal = Distant
Proximal? Distal? What the heck is that?
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SETTING THE STAGE
FOR EFFECTIVE
COMMUNICATION
Establishing Trust, Rapport and Safety
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PUTTING CLIENTS AT EASE
• “Never forget how scary you look.”
• Bad experiences with authority figures, esp.
–Judges, DA’s, Law enforcement,
even Probation
–We have the power to send
them to jail
• Develop Rapport
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ITS ALL IN THE
DELIVERY
“Its not just what we
say, it’s HOW we say it.”
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Tone matters
• No “Judge Judy”
• No snarky comments
• No shaming or attacking
• Respectful, firm, clear, but not harmful
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Deliver Responses With Care• Be patient and explain.
• Be consistent.
–When clients treated differently, explain WHY
• Afford Due Process.
–No blindsides
– Listen, give opportunity to explain
–Utilize team attorney
HELPING HAND AWARD
Presented to
JENNY H.
In thankful re
cognition fo
r
encouraging fellow clients, providing
transporta
tion and moral support!
__________________________
Date: ___________ H
on. Diane Bull, J
udge Presiding
Presented to
ROBIN BROWN
In Recognition for
Achieving and Maintaining Sobriety
For at Least 90 days!
__________________________
Hon. Diane Bull, Judge Presiding
Date: ___________
SHINING STAR AWARD
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Understand Who You are
Speaking to
• Addicted and traumatized brains hear, retain, and interpret differently.
• This is a group that yearns for validation.
• What does, “You’re doing great” mean?
• We must be specific.
• They may not yet understand the value of prosocial behavior.
• Clients don’t know what “normal” is.
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UNDERSTAND TRAUMA
• Almost all our clients (veterans and non-veterans, combat or no-combat) have experienced significant trauma– but some may not realize it.
• Traumatized individuals process information differently
• Face significant hurdles and may need “more”.
• Screen at Orientation and design a treatment plan that meets individual needs.
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Trauma Impedes Communication
Traumatized clients cannot hear or retain what we are saying.
They will not open up.
They are in “survival mode.”
• Use handbooks that clearly define rules.
• Use detailed forms when clients are sanctioned
• Use MI techniques, ask open-ended questions.
• Create a warm, positive atmosphere.
• Some clients don’t want to be touched.
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PUTTING PARTICIPANTS AT EASE
• Solution: Re-orient the courtroom.
• When clients feel safe, they will
open up.
• Caveat: This will extend your
Court Review!
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C
CM
DA
LE DC
AUDIENCE
WALLS
BENCH
JURY BOX
T
Att
J
C
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Focus on Incentives
Number one incentive is acknowledgment from the judge
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INCENTIVES
• Tracking incentives increases use.
• Reinforcers should far outnumber punishers.
• How many incentives is enough?
:
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Prob
ab
ilit
y o
f IS
P S
uccess
Ratio of Rewards to Punishments
Goal:
70 – 80%
Completion
rate
Ratio of Rewards to Punishments and Probability of Success on Intensive Supervision
Widahl, E. J., Garland, B. Culhane, S. E., and McCarty, W.P. (2011). Utilizing Behavioral Interventions to Improve Supervision Outcomes in Community-Based
Corrections. Criminal Justice and Behavior, 38 (4).
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Does an Emphasis on Incentives
Really Make a Difference?
• State of Texas DWI Ct Program Completion
Rate: 69%
• Harris Co. SOBER DWI Ct Program Completion
Rate: 87%
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What if we have no
budget for incentives?• You don’t need gift cards! (See handouts!)
• Some of the most powerful are free.
• The best , most long-lasting incentives are “natural”: paycheck from a job, diploma, regaining custody, repairing relationships, feeling better, etc.
• Natural reinforcers are the byproduct of good treatment, and will help clients long after probation ends.
• Our responses keep clients engaged until natural reinforcers kick in.
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YOU’RE #1 !
GO 1ST AT COURT
REVIEW !
You’ve got it made
in the shade!!
Subtract 8 HOURS of
community service.
YOU’RE DOING
GREAT!
YOU EARNED A
“LEAVE COURT
EARLY” PASS!
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Effective Punishment
“4:1” Only Works if
the “1” is Occurring
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Punishment is NOT the goal
of imposing of Sanctions
CHANGING BEHAVIOR IS
THE GOAL
“What will they
learn from the
sanction?”
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Punishers Often Include:
• Verbal admonishment
• Curfew, house arrest
• Reduced driving privileges
• Confinement in jury box, holdover cell
• Community work projects
• Escalating periods of jail: 1 – 5 days
max (2-3)
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Courts that typically impose jail longer than 6 days have
worse (higher) recidivism
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Jail
• Often not effective
• Can make client’s situation much worse
• Should be reserved for serious
infractions
–Public Safety
– Illegal activity
–Violation of Behavior
contract
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Therapeutic Responses
• Thinking papers
• Behavior Chain (making connections)
• Treatment level review
• Reassessment
• Volunteering/Giving
back to the community
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Monitoring Responses
• / case management meetings
• / supervision meetings
• / drug testing
• / continuous monitoring for use
• / GPS
• / attendence at court
• / home visits
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• Define behavior clearly for team
and participant (both bad and good)
• Point direction (describe positive
behavior you are looking for)
• Target the behavior not the person
(be respectful)
TargetingS
Skill Steps to
Effective Responses
A Magic Formula for Meaningful Conversations:
• Identify behavior to be reinforced/ punished.
• Immediately tell person WHAT behavior you liked/
disliked.
• Tell the person WHY you liked/ disliked it.
• Discuss short and long term costs/ benefits of the
behavior? (Effect on her goals?)
• Pair the approval* / disapproval with an
incentive / sanction.
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The Script
• I really liked how you showed up on time for Tx becauseit shows me you are considerate and responsible; and you won’t miss information that will really help you.
• Right now, how do you think this behavior has or will help you?
• Can you see where it might have any long term benefits for you?*
• I’m going to give you a raffle ticket for this behavior.
WHY WE DO IT
This method helps clients internalize:
• “I’m not just doing this to get off probation.”
• There are more intrinsic reasons for this change:
boss, spouse, teacher, etc.
We must change the internal tape from:
“I need to be on time to treatment
so I don’t get in trouble” to:
“I NEED TO LEARN SO I CAN GET BETTER.”
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Sanction Script• It was not appropriate that you fell asleep in treatment
because it’s disrespectful and you missed important information that could help you succeed.
• Right now, how do you think this behavior has or could hurt you?
• Can you see where continuing the behavior might cause any problems for you down the road?
• Let’s discuss what you could’ve done instead, and how that would’ve looked (thoughts/ behavior).
• I’m going to give you a 8:00 p.m. curfew for 5 days. I recommend an early bedtime so this doesn’t happen again.”
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A Word About Fairness• Behavior Modification Principle:
Humans Need /Expect Fairness
• Commitment increases when the process is perceived as fair.
– If not, clients disengage.
• Young clients and those with MH issues require special attention
• Take the time to explain.
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Fair doesn’t mean the same.H
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Capitalizing on Hope at Court Review
• Seeing is believing: New clients need to see it all.
• Take later phases first so new clients will see and hear of the other client’s successes every week.
• Take incentives first– unless a “teachable moment.”
• Utilize mentors or your alumni group.
• Generously use incentives until “natural” reinforcers kick in.
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Be Positive, Instill Hope
Use MI techniques:
• Avoid argument.
• Roll with resistance.
• Remain solution-focused.
• Help clients see when their
attitudes hamper their goals.
• Praise positive steps clients
take.
OUR CLIENTS WILL LIE,
MANIPULATE US,
PUSH OUR BUTTONS
AND BREAK OUR HEARTS
Try to find something you
like about every client–
some little seed
of potential.
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