Transcript Early Effective Interventions to Recidivism Learning the Ropes

Presented by:
Mark McDonald, MS, CRADC, CCGC




The primary goal of prevention is to delay the first
use of alcohol or other drugs.
Research indicates that adolescents who begin
drinking before age 14 are significantly more likely
to experience alcohol dependence at some point in
their lives compared to individuals who begin
drinking after 21 years of age.
That's why delaying the age of first use of alcohol
and drugs is a critical goal of prevention
protective factors, especially proactive parenting
and strong family bonds, can help delay
adolescents' experimentation with drugs and
alcohol and thus help reduce long-term problems.
Prevention needs a
comprehensive,
communitywide approach
Personal
Self-talk, imaginings
and visualizations,
attitudes, beliefs
and cognitions
Interpersonal
Modeling and
reactions of others.
Degree of anti-social
vs. pro-social
influence
Community
Reinforcement
Physical environment
and cultural “group”
elements that
maintain reward-cost
contingencies





Old information
Old attitudes and
beliefs
Old motivators
Old skills and
behaviors
Taking the Easy way
out-impulsive, no
plan





New Information
New
Beliefs/values/and
attitudes
New motivations
New skills and
behaviors
Follow the plan
Arthur Mendelson: You're focusing on the
problem. If you focus on the problem, you
can't see the solution. Never focus on the
problem!
Arthur Mendelson: See what no one else sees.
See what everyone chooses not to see... out of
fear, conformity or laziness. See the whole
world anew each day!
1.
Target those with a higher probability of risk
2.
Provide most intensive prevention/treatment
to those at higher risk and fewer protective
factors
Pervasive, consistent messages to young people
about drugs and alcohol can prevent substance
abuse.
1.
Attitudes, values, and beliefs
2.
Friends
3.
History of involvement in antisocial behavior
4.
Personality
5.
Employment/work ethic
6.
Family
7.
Early Substance Use/Abuse
1.
Talking cures
1.
Medical model
2.
Drug education
2.
Self esteem
3.
Biblio-therapy
3.
Punishing smarter
programs
4.
Self-help programs

Scared Straight – deterrence theory; “make them fear
prison.”
Nearly every study over the past 25 years has found dismal results, many
even showing higher recidivism rates for Scared Straight participants. Has
been characterized as criminal justice malpractice.
o

Drug Abuse Resistance Education (DARE) – didactic
model; “kids don’t know drugs are bad for them.”
o

Most studies have found neutral effects for DARE. More recent versions of
DARE, based upon cognitive-behavioral principles, have been more
promising
Sheriff Joe Arpaio’s (Maricopa County Jail, Arizona) Tent
Cities and Chain Gangs – more deterrence theory;
“make them hate prison.”
o
By the jail’s own admission, its recidivism rate exceeds 60 percent


Let’s develop the Network of Addiction and as
we dismantle it.
Let us develop the Network of Support needed
to reduce or intervene in the need and potential
risk of those we serve.















Curiosity
Conviviality
Competition
Opportunity
Environment
Social expectations
Social requirements
Family
Peers
Easy way out
Risk factors
Antecedents
Beliefs
Consequences
Models (many anti social
models)












Education
Sense of self
Identity away from peers
Ability to intervene
Skills training
Self regulation and self
decisions
Self efficacy
Communication connections
Monitoring/accountability
Appropriate individualized
sanctions
PIC-R
Mentors and models (Pro social
influences)

Addiction
















Addict
Drug of Choice
Supplier
Money
Work or Crime
Family
Friends
Relationships
Connections
Rituals
Enablers-including criminal justice
system)
Paraphrenalia
Geography
Socialization
Criminogenic (anti-social)
thinking/self defeating thoughts
and behaviors
beliefs

Recovery


Addict
AA/NA-Self Help Meetings

















Sponsorship
Literature
Church or spirituality Influence
Treatment-long term
Accountability/Supervision
Coping skills/living skills
Sanctions/Incentives/Motivators
Ongoing assessment of
Risks/Needs
Case Management-Resources
Job Skills/Education opportunities
Family
Friends
Assist in removing barriers
Enlist ongoing support
Support for lifestyle changes
Develop internal supports for self
efficacy
Medication Assisted Recovery
Move anti-social thinking and negative emotional states
toward a pro-social direction. ƒ
Reduce association with antisocial peers/others while
enhancing association with pro-social models and
mentors. ƒ
Build self-regulation and problem-solving skills. ƒ
Help others with a history/family history of substance
abuse and antisocial behavior acquire and practice lessrisky behavior in safe peer groups. ƒ
Enhance rewards for non-using behavior through home,
school/work, and leisure settings. ƒ
Reduce substance abuse sufficient to shift the reward
structure from anti-social to pro-social behaviors.


We learn much of what we do through
observing and speaking with others
(“models”), rather than through personal
experience
We form a cognitive image of how to perform
certain behaviors through modeling, and use
this image as a guide for later behaviors
Parents
Pop Stars
Political
Leaders
Historical
Figures
Many anti-social role models
Be a Canadian Hero
Be Violent
or
Be a Jack-Ass
You treat a disease, you win,
you loose. You treat a
person, I guarantee you,
you'll win, no matter what the
outcome.