Transcript Moving EBPs Into Practice - Center for Advancing

Danielle S. Rudes
Center for Advancing Correctional Excellence (ACE!)
George Mason University
Department of Criminology, Law and Society
Presented at OAR of
Fairfax, 13 February 2013
What are EBPs?
 Evidence-based practices are…
 Scientifically studied workplace practices that have been
shown effective through rigorous research. Started in
the early 1990s with the term “evidence-based
medicine.”
 The contemporary definition of EBP is “The integration
of the best research evidence with clinical expertise and
patient [client] values" (Sackett, et al. 2000, p. x).
Slide courtesy of Dr. Faye S.
Taxman
Understanding the Science

Evidence: How is it obtained?

Translation: From another
discipline (law enforcement,
psychology, business, etc.) to
corrections and crime prevention

Decision Making: Move away
from sensationalized politics
(reactionary) and gut-level
decisions
Try www.crimesolutions.gov
Slide courtesy of Dr. Faye S.
Taxman
3
Ways to Create Science
 #1:
Examine only research studies that
use randomized field experiments as
the “Gold Standard”
 #2: Examine ALL available research
(regardless of design) on a particular topic
 #3:
Conduct a nonscientific review,
simply say“evidence based” & then
offer your own listing of best practices
or use a subset of all available research
based on liberal or conservative
ideology.
Slide courtesy of Dr. Faye S.
Taxman
4
Implementation is a Process,
not an Event
 It is not just about an idea (EBP)
 It is more about:
 How you take an idea and make it work (DRIVE)
 The people that you involve in making it work
(RELATIONSHIPS)
 The willingness to learn together (LEARN)
 The ability to set criteria to judge “impact” (FIT)
 The coming together to create the values and norms
within a community (GOAL SETTING)
Common EBPs in Corrections
 Risk/Needs Assessment Instruments
 Motivational Interviewing
 Some cognitive behavioral programming/treatment
The majority of correctional
programs fall into these areas.




Intensive

Supervision
Boot Camp

Case Management
Incarceration
Non-Directive
Counseling
Directive
Counseling




TASC
Diversion to

Treatment (DTAP) 
Treatment with

Sanctions
Outpatient
Treatment in
Source: Taxman, 2009. Evidence-Based Practices in the United States.
Supervision
Emotional Skills
Moral Reasoning
12-Step with
Curriculum
Slide courtesy of Dr. Faye S.
Taxman
7
The Current Evidence
 Risk & Needs Assessment Should Drive
Program Participation: High risk (not need)
offenders should receive more rehabilitative
programs
 Sentencing & Program Placement Should
Address Criminogenic Needs: Not all needs are
criminogenic
 Treatment Quality: Treatment and programs
should be of sufficient duration and certain
content to change behavior.
 Procedural Justice: Clarifying expectations with
clear and precise rules of program participation
and rules for program completion are likely to lead
to improved outcomes. Also creates trust and
rapport for building commitment to change.
Slide courtesy of Dr. Faye S.
Taxman
8
Aligning EBPs with existing system(s)
 Every system has its own processes
 Align, refine and fit but make sure to
 Keep the core principles
 Know when “it” is no longer “it”
 Ensure support from sister/collaborating agencies and
other stakeholders
An example of EBP implementation: Contingency
Management in a criminal justice setting
 Evidence-based treatment
 Shape behaviors through rewards
 Focus on a social contract for behavior
 Technique to replace immediate “drug using”;
structured rewards
Adaptation
 Fit to Environment
 Include Sanctions
8 Main CM Principles
 Positive incentives w/ point system
 Clear guidelines about earning points
 Emphasize abstinence
 Early incentives
 Point escalation
 Integrating point system into existing system
 Bonuses
 Focus on no more than 3 behaviors at a time
Site Overview
Site
One
Two
Three
Four
Five
Initial
Drug Court
Drug Court
Drug Court
Regular Caseload
Undetermined
Added
-Reentry Court
Reentry Court
-Halfway House
& Drug Court*
*Started with one ideas regarding implementing in one location/program
but realized program not far enough along for CM. When program was
ready they added it back into JSTEPS.
Year 1: MOU,
software design,
baseline site
visits, org survey
Year 2:Adoption
&
implementation
processes
moving toward
sustainability
Participant
teams selfdesign and
finalize CM
protocols; TA
JSTEPS
Learning
Collaborative
Session
Study Design with
Continual Feedback
Loops
Feedback reports, follow
up phone calls &emails
some joint external
presentations by
researchers and
participants
Feedback
reports, on-site
coaching and
TA
Practitioner
teams consider
feedback;
some revised;
follow-up sitevisits
Research development phases
Phase 1
Phase 2
Adoption
0
6
Months
Site visits
at S1, 2a,
2b, 3a, 4,
Learning
Meeting
& Org
survey
Site visit at
S5, followup TA,
feedback
reports &
telephone
calls
Phase 3
Implementation
12
2nd
Follow up site
visits at S1, 2a/b, learning
meeting
3a, 4 &5; site
visit S3b, TA,
feedback
reports & follow
up phone calls
Sustainability
18
Follow up
phone
calls &
feedback
reports
24
Wrap up
site visits
& phone
calls
Site development phases
ADOPTION
Months
0
S1
A
S2a A
S2b
S3a A
S3b
S4
A
S5a
S5b
6
12
18
24
A
A
A
A
What we learned from Adoption Phase…
Acceptability (unobjectionable) & Feasibility
(suitable)
 Yes, acceptable/feasible but some challenges include: 1) too many
behaviors in CM model; 2) intra-org challenges, and 3) balancing
sanctions with rewards
 (Rudes et al. (2011) Journal of Substance Abuse Treatment)
Adaptability (understandable)
 Mostly acceptable with little difference between social & material
rewards. Female and non-PO more accepting.
 (Murphy, Rhodes & Taxman (2011) Journal of Substance Abuse
Treatment)
Site development phases
IMPLEMENTATION
Months
S1
S2a
S2b
S3a
S3b
S4
S5a
S5b
0
6
12
18
24
I
I
I
I
I
I
I
I
What we learned from implementation phase…
 Probation Officer Roles
 PO roles matter greatly for court and
adoption/implementation processes. POs use three types
of power 1) informational; 2) technical, and 3) relational to
sway decisions to a certain end.
 (Rudes & Portillo, 2012)
 Transportability of EBPs
 EBP transportability is processual with front-line CJ workers
adapting EBPs by first adopting EBP language (loose
coupling) with few adjustments to work activities. These
processes have both positive and negative
potential/implications.
 (Portillo, Rudes & Taxman, in progress)
More learning from implementation phase…
 Judicial Roles & Decision Making in PS Courts
 Role judges take affect collaboration and decision making regarding
court and adoption/implementation processes.
 Portillo, Rudes, Viglione, Nelson & Taxman, Victims & Offenders
2013)
 Redefining the Win
 Problem-solving court attorneys often work to achieve the courts’
collaborative goal using covertly adversarial processes in a
therapeutic jurisprudence environment including: 1) battling; 2)
insider trading; 3) silent treatment, and 4) evidence as a weapon.
This action affects court and adoption/implementation processes.
 (Rudes & Portillo, under review at Law & Social Inquiry)
Site development phases
SUSTAINABILITY
Months
S1
S2a
S2b
S3a
S3b
S4
S5a
S5b
0
6
12
18
24
S
S
S
S
What does this all mean?
 Stay true to core principles of EBPs
 Do not use a one-size-fits-all approach, individual




organizational context matters
Use mixed method design to study both process &
outcome simultaneously and long-term
Follow implementation from adoption to
implementation to sustainability
Account for fidelity
What else?
Questions?
Dr. Danielle S. Rudes
[email protected]
Thank You!