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Maximizing the Benefit of the Carey Guides. A Hands-On Workshop. Introductions and Goals. Objectives Understand the purpose of the Guides Understand the theory behind the Guides Understand how to use them properly Understand their limitations Demonstrate effective use behaviorally.

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Maximizing the benefit of the carey guides l.jpg

Maximizing the Benefit of the Carey Guides

A Hands-On Workshop


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Introductions and Goals

  • Objectives

    • Understand the purpose of the Guides

    • Understand the theory behind the Guides

    • Understand how to use them properly

    • Understand their limitations

    • Demonstrate effective use behaviorally

The Carey Group; 2009


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Assumption

  • All participants have been trained in evidence based practices concepts

  • We will do a short recap of the key elements around risk, need, and responsivity

The Carey Group; 2009


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Discussion

  • When you are going to greet your next appointment, what preparation thoughts are running through your head? What is your objective?

  • How much do you prepare?

  • How do you use the case plan?

  • How much do you control the interview objective?

  • How much impact are you having?

The Carey Group; 2009


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Five Dimensions of Successful EBP Staff

  • “The Importance of Staff Practice in Delivering Effective Correctional Treatment: A Meta-Analytic Review of Core Correctional Practice”

    Craig Dowden and D.A.Andrews

The Carey Group; 2009


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Five Dimensions of Successful EBP Staff

The Carey Group; 2009


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Five dimensions of Successful EBP Staff (continued)

The Carey Group; 2009


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Agenda

  • Introductions and Goals

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Remaining Q and A

The Carey Group; 2009


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Goal One of Five

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Remaining Q and A

The Carey Group; 2009


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Why Carey Guides?

  • Most commmon question after ebp training:

    • “Ok, Ok, I get it. I understand that I have to target criminogenic needs. But…..”

      • “How do I do this when I only have 15 minutes with a probationer. How can I change their behavior during that time?”

      • “How am I supposed to do this when I don’t have resources to send them to?”

      • “How realistic is this? They aren’t motivated”

The Carey Group; 2009


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Therapist Competency and Recidivism (FFT and ART)

Source: Washington State Institute for Public Policy, 2004

Outcome Evaluation of Washington State’s Research-Based Programs for Juvenile Offenders

The Carey Group; 2009


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FFT Results

The Carey Group; 2009


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ART Results

The Carey Group; 2009


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For the Case ManagerCarey Guides are Designed to:

  • Target your intervention in 1-1 session on the top criminogenic needs

  • This is NOT DESIGNED TO BE AN ADD-ON

    • It is HOW you spend the time

    • It does require that you spend sufficient time

The Carey Group; 2009


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Bonta “Black Box” Research (08).

Exploring the Black Box of Community Supervision Journal of Offender Rehabilitation, Vol. 47(3), 2008. Pp. 248–270

The Carey Group; 2009


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Time Devoted to Discussion on Criminogenic Needs

The Carey Group; 2009


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For the Case ManagerCarey Guides are Designed to:

  • Structure your interview and give a clear purpose/objective

  • Avoid subject wandering

  • Aid in your case planning and management (place on the case plan)

  • Be readily available at a moment’s notice when the need arises

The Carey Group; 2009


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For the ProbationersCarey Guides are Designed to:

  • Be simple and easy to understand

  • Be used for juvenile and adult; male and female (with clinical adjustments by case manager)

  • Be used as homework/assignment or completed in lobby prior to appointment

  • For the pre-contemplative offender

The Carey Group; 2009


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Stages of Change

  • Reminder of the likely motivation level of offender

  • Circumstances required for change to occur

  • Expect gradual, non-linear change

  • Expect relapse

  • Avoid discouragement

The Carey Group; 2009


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More Effective if Strength Based

  • Some Key Reminders:

    • Focus on strength, not pathology/deficits

    • Need for strong bond between case manager and client

    • Needs and goals influenced by offender

    • Aggressive outreach by case manager

    • Case manager assists ability to learn, grow, and change; give choices

    • Use praise and reinforcements

The Carey Group; 2009


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Guide Tools

The Carey Group; 2009


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Response to stages

PERMANENT EXIT

Avoid Demoralization

Relapse

Maintenance

Provide Information

Relapse Prevention

Pre-Contemplation

Action

ENTER

HERE

Practical Strategies

Contemplation

TEMPORARY

EXIT

Increase Ambivalence

BY: Prochaska & Diclemente

The Carey Group; 2009


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Response to stages

PERMANENT EXIT

Relapse

Late Tools

Maintenance

Pre-Contemplation

Action

ENTER

HERE

Middle Tools

Early Tools

Contemplation

TEMPORARY

EXIT

BY: Prochaska & Diclemente

The Carey Group; 2009


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As an interventionCarey Guides are Designed to:

  • Be used:

    • As a sole, standalone intervention

    • As a way to reinforce what is being learned in other programming (extend circumstances whereby learning is applied)

    • As an ad hoc intervention when a behavior or attitude emerges (teaching moment)

The Carey Group; 2009


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Example as a sole, standalone intervention

  • Use it as a sole intervention when the offender:

    • Can’t get into a program (due to lack of availability, time constraints, fees, other reasons)

    • Does not appreciate why they need a program (ie, use it as a motivation enhancement technique-a pre-contemplative primer) and you want to prepare him/her for a referral

The Carey Group; 2009


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Example as a way to reinforce what is being learned in other programming

  • Use it as reinforcement when the offender:

    • Has graduated from a program that addressed the criminogenic need and you can reinforce what they learned

    • Needs to demonstrate to you that he/she learned what they needed to learn in the program from which they graduated from

    • Went through a program but didn’t graduate (but still learned skills)

The Carey Group; 2009


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Recidivism Rates (T4C)

28%

reduction

50%

reduction

Source: Latessa and Lowenkamp, 2006, Tippecanoe County, Indiana,

The Carey Group; 2009


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Example as an ad hoc intervention when a behavior or attitude emerges

  • Use it as an ad hoc intervention when the offender:

    • Experiences an event that exposes a problem solving deficit

    • Acts inappropriately around a criminogenic need

    • Is in potential violation of his/her supervision

    • Look for teachable moments!

The Carey Group; 2009


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Matching Exercise

  • Go to the exercise booklet and match the use with the need

Possible Uses

  • Sole, standalone intervention

  • Reinforce what wa learned in other program

  • Transfer what was learned in program

  • Ad hoc-teachable moment

  • Get treatment ready

The Carey Group; 2009


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Goal Two of Five

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Remaining Q and A

The Carey Group; 2009


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Reminder:Risk, Need, Responsivity

  • Risk is the who

  • Need is the what

  • Responsivity is the how

The Carey Group; 2009


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Potential Impact on Recidivism

The Carey Group; 2009


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The Big Four

The Carey Group; 2009

Adapted from Ed Latessa, Ph.D.


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The Next Four

The Carey Group; 2009

Adapted from Ed Latessa, Ph.D.


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Recidivism Reductions as a Function of Targeting Multiple Criminogenic vs.

Non-Criminogenic Needs*

Better outcomes

More criminogenic than non-criminogenic needs

More non-criminogenic than criminogenic needs

Poorer outcomes

(Andrews, Dowden, & Gendreau, 1999; Dowden, 1998)

The Carey Group; 2009


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Need Principle

Criminogenic

Anti social attitudes

Anti social friends

Substance abuse

Lack of empathy

Impulsive behavior

Non-Criminogenic

Anxiety

Mental illness (most types)

Leadership

Low self esteem

Creative abilities

Medical needs

Physical conditioning

36

The Carey Group; 2009


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Responsivity

Reminder:

Average recidivism reduction/gain

Inappropriate treatment -.06

Appropriate treatment .30

37

The Carey Group; 2009


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Responsivity Principle

Styles & modes of service must be matched to the learning styles & abilities of the offender

Matching the characteristics of the individual offender to the intervention; AND

Matching the personnel delivering the service to the population

38

The Carey Group; 2009


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Responsivity Principle

Motivation

Learning Style

Gender

Age

Culture

Anxiety

Depression

Mental Illness

Intelligence

Learning Disability

39

The Carey Group; 2009


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How people change

  • Social Learning Theory

    • The most powerful theory on behavioral shaping

The Carey Group; 2009


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Theories to Treatment

The Carey Group; 2009


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Skill

Stated Knowledge

BEHAVIOR

Cognitive Theory

What and How the

Higher Risk Offender

Thinks, Feels, and Behaves

THOUGHTS

FEELINGS

More likely

aware

COGNITIVE STRUCTURE

(THINKING PATTERNS)

BELIEFS AND ATTITUDES

Underneath

The surface

The Carey Group; 2009


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How to Change: Social Learning

  • A role model the individual can relate to

  • Direct instruction

  • Demonstration

  • Role play

  • Positive reinforcement

  • Feedback

  • Skill practice

  • Transfer of skill

  • Use of sanctions and rewards

  • Relapse planning

The Carey Group; 2009


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Key components of Positive Reinforcement

  • Noticing (most of us don’t notice behavior unless it is negative)

  • Praise progress, any progress

  • The more attention you pay to a behavior, the more it will be repeated

The Carey Group; 2009


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Remember……

  • It works best when it contains behavioral components

    • Use of role plays

    • Practice skill

    • Report on application outside of classwork

The Carey Group; 2009


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Behavioral vs. Non-Behavioral

Percentage of Reduced

Recidivism

Percentage

of Increased

Recidivism

Source: Andrews, D.A.1994. An Overview of Treatment Effectiveness.

Research and Clinical Principles, Department of Psychology, Carleton University.

*The n refers to the number of studies


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Our Supervision Approach Should be Behavioral

  • Use rewards and punishers effectively

  • Train, practice, rehearse offenders in pro-social alternatives

  • Completion criteria should be based on acquisition of prosocial skills

The Carey Group; 2009


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Goal Three of Five

  • Introductions and Goals

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Remaining Q and A

  • Wrap Up

The Carey Group; 2009


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Criminogenic Needs

Blue Guides:


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Blue Guides:

Criminogenic Needs(continued)


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Challenging Case Management Topics

Red Guides:


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Red Guides:

Challenging Case Management Topics (continued)


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Challenging Case Management Topics (continued)

Red Guides:

The Carey Group; 2009


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Tip #1 for Best Results

Be Prepared

  • Know which guides to use in which cases

    • Exercise

The Carey Group; 2009


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Tip #2 for Best Results

Prepare the Probationer

  • Know how to engage the probationer in the use of the guides prior to giving the assignment

    • Exercise

The Carey Group; 2009


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Tip #3 for Best Results

Integrate the Guides in the Case Plan

  • Know how to insert the guides in the case planning process so that the offender is properly engaged

    • Exercise

The Carey Group; 2009


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Tip #4 for Best Results

Focus on the Big Four

  • Understand which items to work on first; the drivers

    • Exercise

The Carey Group; 2009


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Tip #5 for Best Results

Engage Supportive Others

  • Guides encourage the participation of supportive others as long as probationer does the work

The Carey Group; 2009


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Homework or in lobby?

The Carey Group; 2009


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They work best when you…

  • Have engaged with the offender

  • Are strength based

  • Use praise and encouragement

  • Don’t use it as a form of punishment but as a teaching tool

  • Don’t rush it; process it over multiple sessions (divide tool into parts)

  • Do the behavioral part of the exercises (each contain at least one role play)

The Carey Group; 2009


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Behavioral vs. Non-Behavioral

Percentage of Reduced

Recidivism

Percentage

of Increased

Recidivism

Source: Andrews, D.A.1994. An Overview of Treatment Effectiveness.

Research and Clinical Principles, Department of Psychology, Carleton University.

The Carey Group; 2009


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Limitations

  • Be aware of dosage

  • Best research results when have structured, groups. May work in a group but it is untested

  • Don’t expect immediate change (keep in mind dosage, length and intensity requirements, and relationship factors)

The Carey Group; 2009


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Dosage and Intensity-Adult

  • Treatment should be:

    • At least 100 hours of direct service (200-300 hours for high risk)

    • Be 3-9 months long (6-18 months for high risk) depending on risk level

  • Intensive treatment (not including aftercare) that last too long (12-36 months) might begin to see diminishing results

Bourgon, G. & Armstrong, B. (2005). Transferring the principles of effective treatment into a

"Real World" prison setting. Criminal Justice and Behavior, 32, 3-25.


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Dosage and Intensity-Juvenile

See Arizona SEP Guidelines

See “The Positive Effects of Cognitive-Behavioral Programs for Offenders: A Meta-Analysis of Factors

Associated with Effective Treatment,” Nana A. Landenberger & Mark W. Lipsey.

Journal of Experimental Criminology, 2005

The Carey Group; 2009


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Continuum of Application….It’s not just one thing

What

How

risk/need supervision cognitive/behav comm.

assessment case plan referral strategies programming supports eval.

criminogenic motivational strength responsivity specialization, fidelity basic modifying for

needs interviewing based intensity, dosage needs outcomes

The Carey Group; 2009


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Goal Four of Five

  • Introductions and Goals

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Remaining Q and A

  • Wrap Up

The Carey Group; 2009


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Example of Case Plan with the Carey Guide

  • Exercise

The Carey Group; 2009


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Video Tape Example

  • Under development

The Carey Group; 2009


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Practice Exercise One: Blue Guides

  • Case example

    • Select a role play partner; determine who will be PO and who will be offender

    • Read case example: Jeremy

    • Review the worksheet completed by offender

    • Conduct an interview using motivational interviewing techniques

The Carey Group; 2009


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Practice Exercise Two: Red Guides

  • Case example

    • Select a role play partner; determine who will be PO and who will be offender

    • Read case example: Monique

    • Review the worksheet completed by offender

    • Conduct an interview using motivational interviewing techniques

The Carey Group; 2009


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Goal Five of Five

  • Why Carey Guides?

  • Theory linkage between EBP and Carey Guides

  • How to best utilize

    • Blue Guides – Criminogenic Needs

    • Red Guides – Case Planning

  • Practice sessions

  • Next Steps

The Carey Group; 2009


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What is Next?

  • Coaching Plan

    • Expectations of users

      • Two half-hour sessions

      • First session within 2-4 weeks of today

      • Schedule through _____

      • Send finished guide and coaching cover sheet seven days in advance of call

    • Expectations of supervisors

    • Call for help- be proactive


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What is Next (continued)?

  • Quality Assurance Plan

    • “No QA, no do”

  • Evaluation Plan

The Carey Group; 2009


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Questions

  • Other thoughts/questions?

The Carey Group; 2009


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For more information

www.thecareygroup.com

(877) 892-2739


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