Forum Replies Created

Viewing 10 posts - 1 through 10 (of 27 total)
  • Author
    Posts Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF |  
  • in reply to: Assigning dosage when using cognitive tools
    DebbieSmith
    DebbieSmith
    Participant

    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 2 months, 1 week ago by DebbieSmith DebbieSmith.
    in reply to: Working with high risk and containment cases
    DebbieSmith
    DebbieSmith
    Participant

    Hi Amy,

    Thank you for getting in touch with us through the EBP Peer-to-Peer Forum.

    I was wondering if you could clarify which case planning model you were referring to in your question.

    ~Debbie

    in reply to: Populations with whom not to use the Carey Guides
    DebbieSmith
    DebbieSmith
    Participant

    We were recently asked whether there are any populations with whom the Carey Guides should not be used.

    Generally, we don’t recommend using the Guides with these populations:

    1. Low risk individuals. The Guides won’t harm low risk individuals—and this population may take to the Guides quite readily—but they also probably do not require an intervention in order to stay out of the justice system.
    2. Youth 14 years or younger. While it is possible that some youth of this age may benefit from the Guides, normally their developmental age makes other forms of intervention more appropriate.
    3. Highly resistant individuals. Offenders who are recalcitrant and unwilling to cooperate should not be forced to use the tools as it will likely not be a positive experience for either them or the PO. That being said, while many offenders appear to be uncooperative, a skilled PO can often get them to the point where they would make an effort.
    4. Highly impaired individuals. Clients with a very low IQ or severe mental health disorder will likely not benefit from the Guides. However, some, such as those with a borderline IQ or with a mental health condition that is under reasonable control, could benefit with adequate coaching and a slower pace.

    We hope that is helpful.

    • This topic was modified 3 months ago by DebbieSmith DebbieSmith.
    in reply to: Opiate User
    DebbieSmith
    DebbieSmith
    Participant

    Tricia,

    We agree that a Carey Guide for opioid users would be very useful. While not currently in development, we will consider this in the future and will post an announcement on our website if and when we add this resource.  We want to thank you for bringing this to our attention.

    In the meantime, we will continue to monitor the Forum to see if someone else has discovered a useful case manager resource on this subject.  Thanks.

    in reply to: Impact on Substance Use
    DebbieSmith
    DebbieSmith
    Participant

    Offenders with substance abuse issues require treatment from certified counselors. The Carey Guides related to this topic (e.g., Substance Abuse, Meth Users, Impaired Driving) are provided to help the case manager reinforce what is learned in treatment and are designed to support, not replace, the individual’s treatment. Other Carey Guides (e.g., Problem Solving, Antisocial Thinking, Emotional Regulation, etc.) teach skills related to criminogenic needs, and we would expect to see improvements in those areas. Research conducted by the North Carolina Department of Public Safety points to the benefits of using structured worksheets such as the Carey Guides to lower recidivism rates, lessen violations, and increase offender engagement and other positive outcomes (see http://www.thecareygroup.com/structured-worksheets-yield-positive-results). However, substance abuse-specific results should be tied more closely to the treatment that clients receive.

    in reply to: Tracking the use of the Carey Guides
    DebbieSmith
    DebbieSmith
    Participant

    An agency is working on a plan to track the completion of the Carey Guides internally and is debating if credit should be given for each tool completed or for completion of an entire Guide. Underlying their decision is the question “Are clients expected to complete all the tools in a Carey Guide before moving on to the next Guide?” We’ve broken our response into two parts:

    1. Does one need to go from the first tool to the next tool in the Guides? The Guides are built with the idea that an individual is likely pre-contemplative or contemplative when they start.  So, the first tool gets them thinking about the issue, taking stock of their life as it relates to the topic, and—in some cases—doing a mini self-assessment. The tools then moves into skill-building and maintenance, where appropriate. That said, no one person is alike, and we understand that it may be useful to begin at a different stage in the Guide sequence, as determined by a client’s motivation level and circumstance.
    2. Is it acceptable practice to skip around from Guide to Guide with an individual client? We strongly recommend that work on criminogenic needs/skill deficits be done with the proper intensity/dosage. Skimming across topics too quickly does not create long-lasting change. “Going deep” and working on a major criminogenic need over a few months is better than addressing one issue or another for short periods of time.  The number of times one has to repeat a skill before it becomes muscle memory is significant. So, that is our caution about moving from Guide to Guide too quickly. The exception to this would be when someone has already worked on their driver (the criminogenic need that is at the root of their illegal behavior) and is now simply picking up some additional skills that would help them.  In that case, you might select various tools from various Guides and put together a customized package of tools/skills.

    This issue makes tracking Carey Guide usage a bit challenging. Agencies could track the use of each tool (generally a good idea), but it would also be important to know if case workers are skipping around the various Guides, in which case there may be a concern about dosage (“going deep”).

    in reply to: Completing all tools in a Carey Guide
    DebbieSmith
    DebbieSmith
    Participant

    We were asked whether clients are expected to complete all the tools in a Carey Guide before moving on to the next Guide. We’ve broken our response into two parts:

    1. Does one need to go from the first tool to the next tool in the Guides? The Guides are built with the idea that an individual is likely pre-contemplative or contemplative when they start.  So, the first tool gets them thinking about the issue, taking stock of their life as it relates to the topic, and—in some cases—doing a mini self-assessment. The tools then moves into skill-building and maintenance, where appropriate. That said, no one person is alike, and we understand that it may be useful to begin at a different stage in the Guide sequence, as determined by a client’s motivation level and circumstance.
    2. Is it acceptable practice to skip around from Guide to Guide with an individual client? We strongly recommend that work on criminogenic needs/skill deficits be done with the proper intensity/dosage. Skimming across topics too quickly does not create long-lasting change. “Going deep” and working on a major criminogenic need over a few months is better than addressing one issue or another for short periods of time.  The number of times one has to repeat a skill before it becomes muscle memory is significant. So, that is our caution about moving from Guide to Guide too quickly. The exception to this would be when someone has already worked on their driver (the criminogenic need that is at the root of their illegal behavior) and is now simply picking up some additional skills that would help them.  In that case, you might select various tools from various Guides and put together a customized package of tools/skills.
    • This topic was modified 11 months ago by DebbieSmith DebbieSmith.
    in reply to: Caseload size
    DebbieSmith
    DebbieSmith
    Participant

    We were recently asked if caseload size has an impact on recidivism reduction and, if it does, what an optimal caseload size is for a misdemeanor probation department.

    According to the report A Multi-Site Evaluation of Reduced Probation Caseload Size in an Evidence-Based Practice Setting (https://www.ncjrs.gov/pdffiles1/nij/grants/234596.pdf), smaller caseload sizes can lead to reduced recidivism rates but only when staff are using evidence-based practices (EBP). Researchers found little evidence that caseload size matters when staff are not using EBP.

    In terms of optimal caseload sizes, states/probation departments may offer guidance. For example, Arizona legislation dictates an average caseload size of 60 adults per probation officer (http://www.superiorcourt.maricopa.gov/AdultProbation/AdultProbationInformation/Supervision/Index.asp).

    Finally, the American Probation and Parole Association suggests the following for achieving effective probation practices (https://www.appanet.org/eweb/docs/APPA/stances/
    ip_CSPP.pdf):

    Adult Caseload Standards

    Case Type                                                                   Cases to Staff Ratio

    Intensive                                                                     20:1

    Moderate to high risk                                                 50:1

    Low risk                                                                       200:1

    Administrative                                                            No limit? 1,000?

    Juvenile Caseload Standards

    Case Type                                                                   Cases to Staff Ratio

    Intensive                                                                     15:1

    Moderate to high risk                                                 30:1

    Low risk                                                                       100:1

    Administrative                                                            Not recommended

    Let us know what recommended caseload sizes are for your department.

    in reply to: Dosage Concerns
    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.

    DebbieSmith
    DebbieSmith
    Participant

    We were recently asked whether the Carey Guides and Brief Intervention ToolS (BITS) can be used in non-justice settings. Not only CAN they be used in non-justice settings; they ARE being used in non-justice settings—for example, in social service settings and in secondary schools—to help clients build skills that would support them in leading successful lives.

    Let’s say you’re working with clients who have education or employment challenges. If you have determined that one of the reasons why a client is having education/employment challenges is because they have antisocial ways of thinking, you can use the tools in the Antisocial Thinking Guide to help them develop more prosocial ways of thinking. If anger management is an issue, the Anger Guide can help them develop strategies to manage their anger. If they are being influenced by antisocial others, the Antisocial Associates and Engaging Prosocial Others Guides or the Who I Spend Time With BITS can be used to help clients recognize who may be a negative influence, how to change or end friendships that are not healthy for them, and how to develop more prosocial relationships. If problem solving is an issue, the Problem Solving Guide and Problem Solving BITS teach five steps that clients can use when confronted with a problem. You get the picture!

    Our one caution is that some of the Guide tools (but not the BITS) do include language that is offender-specific. For example, there are references to “corrections professionals” and to “illegal behaviors.” As you review those tools with clients, you would want to modify the language—either orally or in handwriting, on the tools themselves—to suit the circumstance.

Viewing 10 posts - 1 through 10 (of 27 total)