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Prisoners with Special Needs: Making Programs Work. Richard Parker Principal Psychologist ACT Corrective Services. [email protected] What Works in Reducing Recidivism: A primer. Risk: Treatment to higher risk, assess risk using actuarial instruments, e.g. LSI-R, LS/CMI

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Prisoners with Special Needs: Making Programs Work

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Prisoners with Special Needs:Making Programs Work

Richard Parker

Principal Psychologist

ACT Corrective Services

[email protected]


What Works in Reducing Recidivism: A primer

  • Risk: Treatment to higher risk, assess risk using actuarial instruments, e.g. LSI-R, LS/CMI

  • Needs: Address multiple criminogenic needs

  • Responsivity: Deliver services in a manner which suit the target group/individual

  • Human Services: Not punishment

  • Treatment Integrity: Deliver what you intended

  • Coordination of Strategies

  • Adapt interventions to local needs/culture


Special Needs?

  • Traditionally thought of as “unusual” categories of offenders e.g.

    • Intellectual disabilities

    • Minority racial group

    • Mental Illness

    • Illiterate, etc.

  • This thinking leads to a wide range of specialised programs for each sub-group of offenders

    • Not feasible for small (or poor) jurisdictions

    • Presumes homogeneity within each sub-group


Mentally Disordered Offenders

  • Recommendations (Muller-Isberner & Hodgkins, 2000)

    • Assess Risk & Needs

    • Address treatment needs for mental disorder and criminogenic needs

    • Collaboration between treatment providers


Mentally Disordered Offenders

  • …require all the treatments and services needed by non-offenders who suffer from these disorders, plus additional components which teach them skills for autonomous living and the skills necessary to prevent further aggressive behaviour and/or non-violent criminality”

    • (Hodgkins, 2001)


Offenders with Brain Damage

  • Recommendations (Nedopil, 2000)

    • Behaviour can be modified

    • Patients present with multiple deficits and social tasks can overwhelm them and lead to frustration and maladaptive behaviours

    • Inappropriate treatment demands provoke acting out by patient and resignation on the part of the staff


Personality Disordered Offenders

  • Recommendations (Burke & Hart, 2000):

    • Identify criminogenic needs and target them with a combination of pharmacotherapy and Cognitive Behavioural Therapy (CBT)


Psychopathic Offenders

  • Recommendations (Wong, 2000):

    • Highly structured CBT

    • Use positive reinforcers (rewards)

    • Trained & experienced staff

    • Actuarial Assessments

    • Relapse Prevention

    • Decent dosage

    • Address criminogenic needs


Special Needs or Individual Needs?

  • All offenders have special needs

  • No two are alike (although many share similarities)

  • E.g. They may have the same criminogenic needs, but have different pathways to resolving them


Special Needs

  • The same criminogenic need may require different approaches.

  • e.g. Antisocial associates

    • One offender may simply need to recognise the impact of these and make a decision to return to previous positive associates

    • Another may be wedded to their antisocial ties and know no other world


The Challenge

  • The Challenge is not to develop special adaptations of every type of program, e.g.

    • Cog Skills for Women

    • Cog Skills for Indigenous

    • Cog Skills for Young Offenders

    • Cog Skills for Older Offenders

    • Cog Skills for long termers

  • But to design interventions which are flexible enough to cope with diversity at the micro cultural level

  • Some categories (e.g. Intellectually disabled) may still require their own special programs


Culture

  • Broad Culture - e.g. Aboriginal

  • Sub-Culture - The group from Smith St who use heroin together

  • Micro-culture - particular styles of thinking, relating and viewing the world.


Making Programs Work

  • Rationale: Some programs work under certain circumstances, and then they don’t under others

  • E.g. Cognitive Skills Programs in UK


Findings 161 (2002) &Findings 206 (2003)


What Goes Wrong?

  • Doing “to” not “with”

  • Going through the motions

  • Undermining/ not owning the interventions

  • Not containing drop outs/poor referral practices

  • Wrong staff

  • Unsupported/untrained staff


Doing “to” not “with”

  • Many programs appear to presume that the offender will change simply by being exposed to certain material:

    • “By the 22nd lesson, participants are ready to evaluate themselves using a skills checklist”

      • What if they aren’t ready?

      • What about those who were ready at Week 10?


Common Program Mistakes*

  • Packing sessions as much as possible with activities … from ice breaking to closing;

  • Overloading with simplified explanations of too many concepts (with overuse of acronyms);

  • Setting the agenda (often with poor sequencing) and assuming that offenders are willing to move on to new concepts or learn new skills at our pace;

    (*Porporino, 2003)


Common Program Mistakes

  • Constantly questioning offenders, supposedly “socratically” as a technique to engage, but oftentimes without any rhyme or reason at all (and in such a repetitive, staccato fashion that would undoubtedly enrage most of us).

  • Packaging “motivational enhancement” front pieces to programs to adequately “motivate” before programs are actually delivered;

  • And, perhaps most importantly, giving little if any time for offenders to reflect, for themselves, on meaning and significance of what is being said.


Going Through the Motions

  • Why do results of pilot programs often not continue in the full roll-out?

  • Pilot

    • “Who Wants to run a new Program?”

      • “Me, me!! Please pick me!”

  • Full Roll-out

    • “You have to run a program”

      • “What!! I already have too much to do”


Drop-Outs/Referral Practices

  • “Gondolf & Foster (1991) reported attrition rates of 73% between initial enquiry into the program and the intake assessment phase and a rate of 86%by the time clients entered counselling. After 12 session had passed, 93% of the initial treatment referrals had dropped out, and at the end of the full 8 month program, only 1% of the men had successfully completed.”

    (Wormith & Olver, 2002)


Drop outs

  • This is fairly typical result in Community Corrections - completion rates tend to be higher in custodial environments as there are less incentives for non attendance (what else are you going to do with your time?)


Drop-out/Exclusion Types

  • Client initiated

  • Agency initiated

    • YAVIS (Young, Attractive, Verbal, Intelligent, Socially Skilled)

  • Administrative (For reasons other than the offender or program)

  • High risk offenders are much more likely to drop out or be excluded from programs


Attitude Problems by Staff/Courts

  • He’s not a real sex offender (What is a “real” sex offender?)

  • Programs don’t work/ don’t work for this type of offender (How do you know?)

  • You can lead a horse to water, but you can’t make it drink (You can add some sugar to the water)

  • The offender is resistant (as opposed to resisting what he thinks we are trying to do to him)


Undermining, not owning

  • Strongest predictor of program completion was “effective liaison between case managers and program staff”. r = 0.39


Finding a Language

  • We may have a concept we want an offender to adopt, but they cannot do so until we present it in a manner they can relate to

  • E.g. “Russian Roulette” instead of “Risk”

  • This cannot be imported, it has to make sense for your offenders (who are not all the same, hence you may need numerous languages)


How to Find a Language

  • Be open

  • Be patient

  • Be positive & optimistic

  • Use videos, role plays, examples, real life stories from group members

  • Listen to your participants (particularly the ones who are doing well)


Cognitive Self Change: A flexible Program

  • Open ended

    • Offenders can progress at their own pace;

    • New members can join as soon as a vacancy occurs;

  • Task based graduation

    • Participants graduate when they have competently demonstrated the four steps of cognitive self change


Cognitive Self Change: A flexible Program

  • Adaptable

    • Facilitators continually assess the factors that underpin each participant’s offending, and assign tasks which will lead the offender to address that issue

  • Assumes offenders are unmotivated and will often agree to participate to avoid some sanction. These offenders will plan to “jump through the hoops”


Cognitive Self Change: A flexible Program

  • Strategy of Choices

    • You can choose to attend this program and abide by the rules (which include homework and presentations in session); or

    • You can choose to not participate (and face whatever consequences may arise from that decision);

    • However, we will not allow you to attend and break the rules!

    • What is your choice right now?


Cognitive Self Change

  • Learn to observe objectively your own thoughts and feelings, attitudes and beliefs.

  • Learn to recognize the thinking (thoughts, feelings, attitudes and beliefs) that leads you to do offending behavior.

  • Find new thinking that doesn’t lead you to do offending behavior, and that helps you feel good about yourself when you use it.

  • Practice using it until you’re good at it.


In Summary

  • No need to have a large suite of programs

    • A few carefully chosen programs will do

  • Pay as much attention to the circumstances you place a program into as you do to the selection/design of the program itself

  • Make sure your programs are flexible and that staff are trained to use that flexibility without losing the integral core of the program


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