Transcript Effective Strategies in Juvenile Drug Courts: Research and Best

Juvenile Drug Courts (Part II):
Incentives and Sanctions
Sandra J. Altshuler, Ph.D., L.I.C.S.W.
Spokane County Behavioral Health Therapeutic Courts
With thanks to
Jacqueline van Wormer, Ph.D.
Washington State University
and
NATIONAL COUNCIL OF JUVENILE AND FAMILY COURT JUDGES
S
Learning Objectives
S Participants will review briefly the need for diversion programs for
juveniles and the research on Juvenile Drug Courts (JDCs).
S Participants will review and discuss proper phase structures in JDCs.
S Participants will learn about JDC Incentives and Sanctions that DO
and DO NOT work to promote positive behavior change in youth.
S Participants will learn about contingency management (CM) and its
use in JDCs for adolescent’s substance abuse and use.
S Participants will learn how to develop behavior and activity contracts.
Can We Strengthen Our Court
Sessions to Bring About Stronger
Behavior Change?
S What is the purpose of using sanctions in your JDC?
S What is the purpose of using incentives?
Goal-Oriented Incentives and Sanctions
S Strategy Fifteen: “Respond to compliance and
noncompliance with incentives and sanctions that are
designed to reinforce or modify the behavior of youth
and their families”
S Research:
S Gendreau (1999)
S NPC (2006, 2010)
S Henggeler et al., (2006, 2012 (a) (b))
S Salvatore et al., (2010)
Incentives & Sanctions, Continued
S Historical CJ responses vs. modification of behavior
through a coordinated and thoughtful (research
informed) process
S Punishment for a “wrong” is not the goal – behavior
change is the goal
S The JDC should use a balance of incentives, sanctions
and treatment responses
Incentives and Sanctions,
continued
S Key components:
S Immediate, certain, fair and of appropriate intensity
S Do not rely solely on standardized “lists”
S Should be proportional and balanced
S Punishment alone is least effective way to change behavior
S Be comfortable in combining incentives and sanctions
S Be cognizant of time
S Perceptions of fairness – it all begins with individualization
S Make sure youth understand their positive and negative
reinforcers
Contingency Management
What is Contingency Management (CM)?
And
How do we strengthen the use of CM in
our treatment settings, and utilize the same
methods within our Juvenile Drug Courts?
Contingency Management
“Contingency management or systematic
use of reinforcement is a type of treatment
used in the mental health or substance
abuse fields. Patients' behaviors are
rewarded (or, less often, punished);
generally, adherence to or failure to adhere
to program rules and regulations or their
treatment plan.” (Wikipedia)
Reasons Why JDCs Should
Implement CM
S Theories are based on cognitive behavioral therapy,
which has been proven to work with adolescents, and is
vastly used in outpatient settings
S It can be easily adapted within the JDC
S In their study of six juvenile drug courts, Henggeler et
al (2006) found stronger outcomes for those youth who
received MST AND CM then standard process
Point & Level “Reward” Systems
SBehavior Contract
SMost Valued Privilege
SCheckbook System
SReward Menu
Behavior Contracts
S “Rewards for Responsible Behavior in Other Domains”
(Henggeler et al, p. 131)
S How to target specific behaviors (i.e., school attendance)
S How to add a step-by-step process for the youth to follow
S How to get youth working towards “things” they are
interested in
S How to engage families/guardians in the process
S How to increase communication between the youth and
judge
S And…how to implement these components in your program
The Four Steps in
Addressing Problem Behaviors
S Identify (define) the targeted behavior
S Identify (define) the current behavior
S Identify (define) the desired behavior
S Use small, achievable increments
Decision Matrix – Phase I
Phase I
Incentives
Sanctions
Behavior
*Response
Response
Attend school at least ?? out
of 20 days
• Teacher signs attendance card • After school study hall for
each day present and
each day absent over the limit
acknowledges
to make up all missed work
•Small prize or coupon for each
week with no absences
Decision Matrix – Phase II
Behavior
Incentives
Sanctions
*Expectation
*Response
*Response
•Select a book , notebook,
pen after two weeks of
success
•Praise from teacher,
family, court
•Grades improve
•After school study hall to
complete assignments (with
help as needed)
Attend regularly
Complete all assignments
Decision Matrix – Phase III
Behavior
Incentives
Sanctions
*Expectation
*Response
*Response
Attend regularly
Complete all assignments
Improve grades
•Praise from teacher,
family, court for
improvement
•Certificate of achievement
•Select school related gift:
tuition, book
•Determine if tutor is
needed
•Attend extra class or
session for help
•Tighten curfew
Behavioral Contract Example
Goal
Behaviors
Steps needed
(Expectations)
Responses if
steps done
Responses if Support
steps not
Services
done
Enroll in
GED
program
•Call or visit GED
center by xxxxx
date
•Praise
•Recognition
from Team
•Appointment
Calendar
•XXXXXX
•Increased
reporting to
PO
•Increase in
curfew
•EM
Youth’s Signature of Agreement:
Caregiver(s) Signature of Agreement:
Case Manager’s Signature of Agreement:
•Find GED
center phone
number
•Bus pass and
route
Behavior Contract: School
Example of a “behavioral contract”
Goal
Improve
school grades
Behaviors/
Tasks
- Attend school
daily
- Keep a
planner or
homework log
- Organize
books/school
supplies
- Complete all
assignments
Incentives
Non-compliance
Sanction
Limit free time
Failure to attend
WorkPraise
with your partner
to develop
Recognition
Add 3 points for each
day youth attends school
*Recognition from
teachers/team/family
*Grades improve
school/classes
After school
study hall
Limit TV
time/video game
time
Failure to get
a
a fictional behavior
contract
planner
Youth’s Signature of Agreement:
Caregiver(s) Signature of Agreement:
Case Manager’s Signature of Agreement:
Failure to complete
assignments
*Failing/poor
grade
Support Services
Transportation
assistance
Tutoring
Alarm clock
Health assessment
Eye exam
Most Valued Privilege
S This is a privilege that the youth values and will work
hard to earn
S Work with the youth and family to determine what the
MVP is, preferably a family-based reward (i.e., video
games, cell phone use, time w/ friends)
S The MVP is given or taken away with each drug screen
S IMPORTANT – youth does not earn points if there is
a positive drug screen but points that have already been
earned are not taken away
(Henggeler et al, p. 107-108)
Make it Transparent
MVP
Sally – Use of cell phone
John – Curfew extension on Saturday night
Mary – Allowed to use Mom’s car on Friday
afternoon
Jack – Ride to school, rather than walk
Checkbook System
S Basic checkbook set up – date; transaction
description; debit/credit; and balance
S Basic personal checks that the youth can draft and use
to purchase items on the reward menu
S Make this very visual and tangible for the youth
S Consider working with a local bank to provide life
skills training on how to keep a checking account
and write checks or to provide free checkbooks
and/or personalized checks
(Henggeler et al, p. 126-127)
Recommended Reading
S
Contingency Management for Adolescent Substance Abuse: A Practitioner’s Guide,
by: Scott W. Henggeler, Phillippe B. Cunningham, Melisa D. Rowland, Sonja
K. Schoenwald and Associates
S
Contingency Management in Addiction Treatment. by: Nancy L. Petry.
Psychiatric Times: http://www.psychiatrictimes.com/addiction/contingencymanagement-addiction-treatment-0
S
Making Sense of Incentives and Sanctions in working with the Substance-Abusing
Youth: Answers to Frequently Asked Questions (Juvenile & Family Justice
TODAY. 2012, Volume 21, Number 2)
S
Enhancing the Effectiveness of Juvenile Drug Courts by Integrating EvidenceBased Practices (Journal of Consulting and Clinical Psychology. 2012, Vol. 80,
No. 2, 264-275)
Part III
Themes of Effective Programs
S
Themes of Effective Programs
S Team Approach – Good communication
S Well specified target population, theory of change
(targeting risk and protective factors), interventions,
and training
S Ongoing quality assurance (fidelity checks)
S Empower caregivers to support favorable outcomes
(involve the family)
Themes of Effective Programs
S Individualized to youth/family strengths and weaknesses
(not one size fits all)
S Comprehensive services (individual, family, peer, school,
community) provided
S Use of behavioral tracking and intervention techniques
such as CBT (problem solving skills, drug refusal skills) and
implementation of reward/punishment contingencies
S Treatment delivered in natural environment (not in out-of-
home placements)
Contact Information
Sandra J. Altshuler, Ph.D., L.I.C.S.W.
Spokane County Superior Court
1116 W. Broadway
Spokane WA 99203
(509) 477 6355
[email protected]
[email protected]
Ncjfcj.org