Home Forums EBP Tools for Staff Assigning dosage when using cognitive tools

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  • DebbieSmith

    We know that high risk clients need more intervention than medium risk clients. The science in the corrections field is advancing enough that we can think in terms of “dosage.” Evidence suggests that medium and high risk adults require between 100 and 300 hours of “dosage”—or intervention—over 3–18 months.

    Related to the idea of dosage is the concept of “dosage probation.” The dosage probation model suggests that the length of supervision should be determined by the number of hours of intervention necessary to reduce risk as opposed to a standard probation term, such as 3, 4, 5, etc., years.

    We were recently asked how to count dosage when cognitive tools such as the Carey Guides, Brief Intervention ToolS (BITS), and others are used. While research on the amount of dosage to assign when using cognitive tools has not been conducted, we do have experience from three national sites that are piloting the concept of dosage probation under an NIC-sponsored project. The following approach has been used thus far in these sites:

    • One-on-one appointments count toward dosage if they consist of teaching and skill building around one of the top five criminogenic needs, provided an assessment indicates the criminogenic need is a risk factor for the client. The amount of dosage time is equal  to the amount of time spent working on the need. For example, if 15 minutes of a 20-minute appointment is spent teaching and skill building, the individual would receive 15 minutes of dosage.
    • Homework assignments around criminogenic needs that are identified risk factors for a particular client also count toward dosage. To avoid tedious computations, most agencies give clients 30 minutes of dosage per homework assignment. Note that some tools are longer than others and may be assigned in parts. Each part would be considered a separate homework assignment, and clients would receive 30 minutes of dosage for each part. This is just a guideline, though; in the end, the case worker should use their judgment.
    • Assigning dosage when cognitive behavioral tools are used in groups works similarly: the amount of time the group devotes to addressing one of the top 5 criminogenic needs counts toward dosage. For example, if a group lasts an hour and 45 minutes are spent addressing antisocial peers, and the clients in the group have this as a criminogenic need, then 45 minutes count toward dosage. Note that time spent addressing the criminogenic need could be discussion, skill practice, observing others do skill practice, completing a cognitive behavioral tool, and so on. This would be no different than the way a T4C or ART cog class might work.


    • This topic was modified 1 month, 2 weeks ago by DebbieSmith DebbieSmith.
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