November 3, 2010 King County Melds EBP with Smart Technology Louisville, Ky 1
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META ANALYSIS 3
Criminal sanctions - .07 (30 tests) Inappropriate treatment - .06 (38 tests) Intensive probation/parole - .07 (47 tests) Unspecified treatment .13 (32 tests) Appropriate treatment .30 (54 tests) 4
Dynamic risk factors that have been clinically proven to be predictive of future criminal behavior. 5
.38 0.22/0.48 0.22/0.48 0.18 0.18 0.10/0.14 (* Andrews & Bonta 1994, Simourd 1993: see nicic.org/pubs/2000/pps-uei-files/section3.pdf) 6 Justice System Assessment & Training http://www.j-sat.com
Reduction in recidivism Increase in Recidivism Target 1-3 Target 2-4 non-criminogenic needs criminogenic needs Source: Gendreau P., French S.A., and A. Taylor (2002). What Works (What Doesn’t Work) Revised 2002 Invited Submission to th e International Community Corrections Association Monograph Series Project 7
Aspirin & reduced risk of death by heart attack .02 8
Ibuprofen & reduced pain .14 9
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EIGHT GUIDING PRINCIPLES of Evidence-Based Practice 13
• Risk • Need • Responsivity • Treatment • Program Integrity 14
IF IT AIN’T BROKE . . . . DON’T FIX IT or Match level of services to level of risk • Reserve resources for higher risk cases • High risk cases require more intensive intervention • Low risk cases require minimal or no intervention 15
Percent with New Arrest 70 Low Risk Medium Risk High Risk 58.9 60 50 40 34.3 30 20 9.1 10 0 Low 0-14 Medium = 15-23 High = 24-33 Source: Latessa, 2009 16
= Up % Recidivism: Impact on Offender Authors of Study Tx by Risk Level Risk Level = Down Recidivism Minimum Tx Intensive Tx ( 6%) Low Risk 16% 22% O’Donnell et al, 1971 ( 22%) High Risk 78% 56% ( 7%) Low Risk 3% 10% Baird et al, 1979 ( 19%) High Risk 37% 18% ( 5%) Low Risk 12% 17% Andrews & Kiessling, ( 27%) High Risk 58% 31% 1980 ( 17%) 12% 29% Low Risk Andrews & Friesen, ( 67%) 92% 25% High Risk 1987 * Some studies combined intensive Tx with supervision or other services 17
R e c i d i v i s m R a t e 18
Source: Latessa, 2009 19
• If you have100 High risk offenders about 60% will fail • If you put them in well designed EBP for sufficient duration you may reduce failure rate to 40% • If you have 100 low risk offenders about 10% will fail • If you put them in same program failure rate will be 20% Source: Latessa, 2009 20
Match Services (Interventions) to Criminogenic Needs Prioritize treatment to highest scoring criminogenic needs; in the case of a tie treat the intrinsic need first, and/or acute needs first. 21
Big Six – Roadblock Wall to Pro-social Lifestyle Source: Justice System Assessment & Training http://www.j-sat.com The more you SCHOOL help offenders School Retention/ 6 drive down Pro-social Achievement criminogenic relations needs, the 5 better are their Dysfunctional chances of Family 4 Relations quitting crime Substance Abuse 4 3 Anti-Social Companions 2 Anti-Social Attitudes 1 Low Self-Control Callous Personality Stable/ Low Satisfying Employment Extrinsic Intrinsic [ Least under offender’s control ] [ Most under offender’s control ] 22
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•“Case management” defined as: “Prevention or intervention using case manager or case team to develop service plan and arranges services.” • Using a needs-assessment driven case/supervision plan to drive service referral you become a case manager, and you’re arranging services for the offender, and thus doing precisely what was correlated with that 20 – 60% reduction. *Lipsey, et al. 2009 24
• Journal of Offender Rehabilitation -- December 2008 25
Time Devoted to Discussions of Criminogenic Needs Time Spent Discussing Criminogenic Need Percent Recidivated 0 to 19 minutes 49% 20 to 39 minutes 36% More Than 40 Minutes 3% 26
Time Devoted to Discussing Conditions of Probation Time Spent Discussing Conditions of Probation Percent Recidivated 0 to 15 minutes 18.9 More than 15 minutes 42.3 27
Implementing the PRIME in King County
Reclaiming Futures: King County Robert Woods Johnson Foundation • Early Identification • Screening • Assessment • Treatment
The PRIME: What is it?
PRIME Graphic 31
STEP 1 – Administer Assessment Tool, in This Case, GAIN SS Is Completed 32
STEP 2 - Information Entered for Scoring 33
STEP 3 - Software Provides Reminder: Release of Information Must Be Obtained 34
STEP 4 - Referrals Are Selected Based on the Scores in Drug and Mental Health PENDING 35
STEP 5 - PRIME Selects Provider Based on Parameters Like Language Requirements, Type of Service and Location/Distance Provider selection returned 36
STEP 6 - Appointment Time Is Selected 37
STEP 7 - Referral Is Accepted Immediately 38
STEP 8 - Provider Completes Diagnosis and Sends It Via PRIME back to Probation 39
What Happens When Johnny Fails to Attend? Provider notes the missed appointment and reschedules The Probation Officer is notified within seconds The Probation Officer can review the log from start to finish The youth is held accountable in real time with immediate responses from the provider and probation. 40
How does the PRIME fit with the Eight Guiding Principles of EBP?
EIGHT GUIDING PRINCIPLES of Evidence-Based Practice 42
Access Actuarial Risk The PRIME facilitates the appropriate and controlled sharing of assessment results. Better information leads to better results 43
RISK PRINCIPLE: IF IT AIN’T BROKE . . . . DON’T FIX IT or Match level of services to level of risk • Reserve resources for higher risk cases • High risk cases require more intensive intervention • Low risk cases require minimal or no intervention 44 44
Enhanced Intrinsic Motivation The PRIME helps remove barriers to offender meeting with the provider. Many probation/parole agencies report that their clients fail, not because they fail to complete their treatment, but because they fail to show up for their treatment. On-the- spot appointment scheduling and confirmation can be just the motivation needed for successful engagement and follow through 45
Target Interventions The PRIME targets the appropriate Provider treatment and interventions by matching the offender’s prioritized needs – as determined by the actuarial risk assessment – with the appropriate and available Provider services 46
NEED PRINCIPLE: Match Services (Interventions) to Criminogenic Needs Prioritize treatment to highest scoring criminogenic needs; in the case of a tie treat the intrinsic need first 47
Engage On-going Community Support The PRIME facilitates access to services in the community for the offender, and enhances communication between the community service Providers and the Referring Agency 48
Measure Relevant Practices The PRIME aggregates referral and Provider data, making it easier, e.g. to measure effectiveness of a Provider’s quality assurance program 49
Measurement Feedback The PRIME, as an integral part of the Assessments.com software system, provides a single repository of critical process and outcome information that can be easily managed, analyzed, measured and reported. In addition, the PRIME can be integrated with local MIS, creating a solid basis from which to make informed decisions about needed changes. 50
Reduce Recidivism What brings offenders in? 4 th Gen Tool Researched What keeps them out? Standardize-QA ID Risk and Protective Training-QA Factors Effective Criminogenic Needs Interventions Moderate/High Low Risk Risk Individual Individual Style/Skills Motivational Interviewing Staff Buy-In Positive Judges/PA/DA Buy-In Outcomes Management Buy-In Change in Infrastructure 51
The PRIME: What are its benefits?
PRIME Benefits • Real-time, proactive communication between the Referring Agency and its servicer and treatment Providers, including appointment transactions, on-going case status reporting, and service outcomes. 53
PRIME Benefits • Promotes accountability for offenders to show up for their Provider treatment services. 54
Benefits cont. • Improved communication and relationship between the Referring Agency and Providers, with enhanced ease of managing Provider enrollment for the Referring Agency and easier access to needed information for both the Providers and the Referring Agency. 55
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