Home Forums EBP & Related Research Findings Dosage Concerns

This topic contains 5 replies, has 4 voices, and was last updated by DebbieSmith DebbieSmith March 23 , 2018.

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  • DebbieSmith
    DebbieSmith
    Participant

    Since the research on dosage is still emerging, we, unfortunately, don’t yet have an empirical answer to this question. The lower risk level is good news for your client indeed, and we want to commend you for both keeping watch over his dosage and conducting reassessments. However, our best advice would be for your client to complete his originally assessed amount of dosage (the 200 hours) to reinforce new skills.

    mrsjordanmorris
    mrsjordanmorris
    Participant

    Thank you all for the insight!

    One additional thought…

    John Smith began supervision as a Mod/High risk participant with a target of completing 200 hours of dosage over the course of 15 months with 18 months of supervision.

    12 months after beginning supervision & involved in services he has completed 120 hours of dosage and we conduct a re-assessment. The results indicate that he is now LOW risk to re-offend.

    …do we immediately conclude services, no longer requiring that the total 200 hours be completed? Do we advocate for termination of supervision based on what we know about low risk offenders, despite his initial recommendation being 18 months of supervision?

    DebbieSmith
    DebbieSmith
    Participant

    Jeremy, the research on dosage is still emerging and should be considered a target—not a hard and fast number—but, yes, we do have evidence that suggests that we see diminishing returns when high risk adults receive more than 300 hours of dosage.


    jeremydavis671
    Participant

    Is there a limit to the dosage hours as in going above a certain threshold of hours (300hrs for high risk levels) where you will see a diminishing return or create an overdose of treatment?

    MattMoore
    MattMoore
    Participant

    Jordan,

    You are correct. One of the limitations of the Kroner & Takahashi, 2012 study is its small sample size. The study does confirm the importance of differential dosage and preventing treatment dropout. It also sheds light on the relationship between dosage and treatment fatigue. There are two other recent studies, both out of Ohio. The first is Sperber, Latessa, Makarios, 2013a. This study included 689 adult male offenders successfully discharged from a Community-Based Correctional Facility in Ohio. The results again provide support for matching dosage to risk level. It also further supports the finding that increased dosage produces the strongest effects for high-risk offenders.

    The second recent study is Sperber and Lowenkamp, 2017.This study, published in August of 2017, looked at 980 male offenders who received treatment in a community based correctional program in Ohio. The results again supported matching treatment dosage to risk and showed that dosage time should maximize the use of role-playing.

    An article that addresses some of your concerns regarding specialized populations and dosage, i.e., drug offenders, is Sperber Latessa, Makarios, 2013b. The authors summarize the available evidence on the risk-dosage relationship and identify where more research is needed. In it, they state, “As we continue to research dosage in correctional settings, we cannot assume that a standard number of treatment hours necessary to reduce recidivism exists for all offender populations” They go on to assert that more research is needed on domain-specific dosage. We simply don’t know yet empirically the specific dosage needs of drug offenders. Until we have more specific research, we must apply the existing dosage research across all domains.

    The available research on dosage does not directly address your concern regarding the immediacy of intervention to when the offense was committed. However, keep in mind that the effectiveness of interventions is not as much about the specific offense committed as it is about the offender’s overall history, risk factors, criminogenic needs, and drivers. Effective interventions routinely see strong results with offenders even years after their last offense.

     

     

    Sperber, K. G., Latessa, E. J., & Makarios, M. D. (2013). Examining the interaction between level of risk and dosage of treatment. Criminal Justice and Behavior, 40(3), 338-348. doi: 10.1177/0093854812467942

    Sperber, K. G., Latessa, E. J., & Makarios, M. D. (2013). Establishing a Risk-Dosage Research Agenda. Justice Research and Policy, 15(1), 123-142. doi:10.3818/jrp.15.1.2013.123

    Sperber, K., & Lowenkamp, C. (2017). Dosage is more than just counting program hours: The importance of role-playing in treatment outcomes. Journal of Offender Rehabilitation, 56(7), 1-19. doi:10.1080/10509674.2017.1359222

    mrsjordanmorris
    mrsjordanmorris
    Participant

    Have any additional dosage studies been completed?

    Looking at the Kroner & Takahashi, 2012 study it appears to have been completed on a very small sample size, with the control group being even smaller. The demographic variable “Index Offense” when compared to our supervised population is much different which also raises concerns for me. In our community supervision program 63% of our population are sentenced as a result of a drug offense. I’m slightly concerned in applying this study to our population and curious as to whether that variable would impact the recidivism outcomes. We case-manage only moderate and high risk adults (using the IRAS-CST). Another one of my concerns is we are finding that individuals who are sentenced to our supervision typically have an incredibly long pre-trial duration (average time between charges being filed and a case disposition is 240 days) which certainly must also impact this dosage target effectiveness. How effective is a dosage target when it is being applied years after an offense is committed? Of the case dispositions there are instances where an individual will first serve 1-2 years incarcerated and then transition to community supervision. These are just some things that ran through my mind as we are looking at implementing a dosage target policy. I want to ensure that we are putting our time and energy into something that has been validated with our local population or one demographically similar and I am not convinced that this would be the best use of our resources. Could someone please share some insight that would calm my concerns?

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