RNR Tool for Reentry

Report
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RNR Simulation Tool
Phillip Barbour
Master Trainer for Center for
Health and Justice at TASC (CHJ)
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Risk, Needs, Responsivity (RNR) and
Recidivism: An Update on Theory
Center for Advancing Correctional Excellence (ACE!)
George Mason University
www.gmuace.org/tools
BJA: 2009-DG-BX-K026; BJA: 2010-DG-BX-K077; SAMHSA: 202171; Public Welfare
Foundation
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Faye S. Taxman, Ph.D
University Professor
Center for Advancing Correctional Excellence
Criminology, Law and Society
George Mason University
10519 Braddock Road Suite 1900
Fairfax, VA 22032
James M. Byrne, Ph.D.
Professor
University of Massachusetts, Lowell
Griffith University
April Pattavina, Ph.D.
Discrete Event Model
Associate Professor
University of Massachusetts, Lowell
Avinash Singh Bhati, Ph.D.
Simulation Model
Maxarth, LLC
Michael S. Caudy, Ph.D.
Stephanie A. Maass, M.A.
Erin L. Crites, M.A.
Lauren Duhaime, B.A.
Amy Murphy, MPP
Joseph Durso, M.A.
Gina Rosch
Special Acknowledgements:
• Bureau of Justice Assistance
▫ BJA: 2009-DG-BX-K026
• Center for Substance Abuse
Treatment
▫ SAMHSA: 202171
• Public Welfare Foundation
• Special Thanks to:
▫ Ed Banks, Ph.D.
▫ Ken Robertson
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What affects recidivism?
The good, the bad, and the ugly!
 Understand Risk
 Understand What Affects Recidivism
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67%
Reducing Recidivism:
The RNR Framework
 Target individual risk
 Target needs that are amendable to change
 Offer quality programs
 Engage offenders in change process
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What is Risk?
• Risk is the likelihood that an offender will
engage in future criminal behavior (recidivate).
• Risk does NOT refer to dangerousness or
likelihood of violence
• Static Risk Factors have a demonstrated
correlation with criminal behavior
▫ Historical – based on criminal history
▫ Cannot be decreased by intervention
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CJ Risk Matters…(3 year, all offenses)
Risk is static factors: history of arrests, age of onset,
history of incarceration, history of escapes, etc.
Ainsworth, Crites, Caudy, & Taxman, 2011
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Age & Rearrests
Langan & Levin, 2002
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Gender Matters
Ainsworth, et al 2011
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Evidence-Based Practices Lead to Better Outcomes
• Education (Psycho-Social)
• Non-Directive Counseling
• Directive Counseling
•
•
•
•
Motivational Interviewing
Moral Reasoning
Emotional Skills
12 Step with Curriculum
• Cognitive Processing
• Cognitive Behavioral
(Social Skills, Behavioral Management,
etc.)
• Therapeutic
Communities (TC)
• Contingency
Management/Token
Economies
•
•
•
•
Intensive Supervision
Boot Camp
Case Management
Incarceration
• TASC
• DTAP (Diversion to TX, 12 Month Residential)
• Treatment with Sanctions (e.g. Break
the Cycle, Seamless System, etc.)
• Drug Courts
• RNR Supervision
• In-Prison TC with
Aftercare
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Better Outcomes via Tx Matching
Caudy, et al (2011). Using Data to Examine Outcomes: A review of Kansas Department of Corrections.
Fairfax, VA: George Mason University.
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http://www.gmuace.org/tools/
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The RNR Simulation Tool
• Provide decision support tools for the field that
enhance existing practices
▫ Individual level
▫ Program feedback
▫ System building capability
• Program Tool focuses on:
▫ Classifying programs to target specific needs
▫ Rating key program features
▫ Linking to meta-analyses/systematic reviews
Compiled National Database (20,000+) or
Develop Your Own Database
Race
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
White
…
Black
Black
Black
Black
…
Other
…
•
•
•
•
Gender
Male
Male
Male
Male
Male
Male
Male
Male
Male
Male
Male
Male
Female
Female
Female
Female
Female
Female
Female
Female
Female
Female
Female
Female
…
Male
Male
Male
Male
…
…
…
Age
16-27
16-27
16-27
16-27
16-27
16-27
28-35
28-36
28-37
28-38
28-39
28-40
16-27
16-27
16-27
16-27
16-27
16-27
28-35
28-36
28-37
28-38
28-39
28-40
…
16-27
16-27
16-27
16-27
…
…
…
Risk
High
High
Medium
Medium
Low
Low
High
High
Medium
Medium
Low
Low
High
High
Medium
Medium
Low
Low
High
High
Medium
Medium
Low
Low
…
High
High
Medium
Medium
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Recidivism
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
…
Recidivist
Non-Recidivist
Recidivist
Non-Recidivist
…
…
…
Placement Option 1
Placement Option 2
Placement Option 3
Prevalence Implication Prevalence
Implication
Prevalence
Implication
Prevalence
Implication
630
74%
595
70%
610
72%
623
73%
220
255
240
227
240
65%
130
…
…
…
…
…
…
…
…
35
60%
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Base Recidivism Rate
Risk & Need Information
Destabilizers—performance inhibitors
Programs
Expected outcomes
Reflect Expected Reductions in
Recidivism (from Meta-Analysis)
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Model to Improve Outcomes: Big Picture
• Current recidivism hovers around 67%
▫ 3 year re-arrest rate
• How can we make a dent in this at the system and
individual level?
Offender Individual
Risk & Need Factors
Program Quality
Implementation
Organizational
Culture
Correctional
Programming
Individual Outcomes
(Reduced Recidivism)
Focus of EBP Research
Focus of RNR & RNR Simulation Tool
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RNR via Andrews & Bonta
Andrews & Bonta
Updated research
•
•
•
•
•
•
 Responsivity, Recidivism, &
Clinical Relevance
 Substance dependence vs. abuse
 Spectrum of needs can override
risk (3+)
 Change is a function of problem
severity
 History of antisocial behavior is
risk (cannot be changed)
 Recidivism reduction is
function of targeting specific
needs within programs
Antisocial personality patterns
History of antisocial behavior
Antisocial peers
Antisocial attitudes
Family/marital factors
Employment/educational
deficits
• Lack of prosocial leisure
activities
• Substance Abuse
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Major Criminogenic Needs
• Severe Substance Use Disorders
▫ A pattern of harmful use of any substance for
mood-altering purposes
▫ Includes 6 or more of the following:
 Increased tolerance, withdrawal, increased time
spent using, difficulty quitting or cutting back, or
continued use despite negative consequences
▫ Not the same as substance abuse
▫ Drug of choice matters
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Major Criminogenic Needs
• Criminal Thinking/Lifestyle
▫ A pattern of thinking that rationalizes and
supports criminal behavior
▫ Involvement with criminal lifestyle
▫ Should be assessed using a validated instrument
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What is Responsivity?
• Treatment to address criminal behavior should be
cognitive and/or behavioral based programming
that has been shown to effectively reduce recidivism.
• Deliver controls and treatment in a manner that is
consistent with individuals’ learning styles
▫ Considers age, gender, culture, intelligence,
motivation, etc.
▫ Translate Risk & Need into Program Placement/Case
Decisions
▫ Needs trump risk when there is 3+ needs
▫ Destabilizers require more social controls
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CJ RISK
Criminogenic Needs
Substance Tolerance for “Hard Drugs”
3+ Criminal Lifestyle—attitudes, family, peers, personality,
substance abuse
Stabilizers
Supportive Family
Stable Employment
Education > HS Diploma
Stable Housing
Location in non-Hot
Spots
Destabilizers
Alcohol Abuse
Drug Abuse
Family Dysfunction
Poor Mental Health Status
Employment-Related Issues
Literacy Related Problems
Housing Instability
Location in Hot Spots
Gender & Age
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What Information do I Need?
• Static Risk
▫ From a validated risk assessment tool
▫ Based on criminal history
▫ Demographics
▫ Age and gender
▫ Criminogenic Needs
▫ Substance Use
▫ Criminal thinking/lifestyle
• Stabilizers and Destabilizers
▫ Clinically-relevant factors
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The RNR Program Tool for Adults
 Define target behaviors that drive program
classification
 Understand program group classification system
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Program Groups
• Six program groups based on specific target behaviors
Risk

Type of Need Type of Stabilizers


PROGRAM
GROUP
MECHANISM OF ACTION
RESEARCH EVIDENCE
Group A
Severe Substance
Use/Dependence
Treatments to reduce use of
heroin, cocaine, amphetamines,
and methamphetamine
Holloway, Bennett, & Farrington,
2006; Prendergast, Huang, & Hser,
2008; Prendergast, Podus, Chang &
Urada, 2002; Lipton, Pearson, Cleland
& Yee, 2008; Mitchell, Wilson &
MacKenzie, 2007
Group B
Criminal Thinking
Cognitive restructuring to change
maladaptive thinking and
behavior patterns
Andrews & Bonta, 2010; Lipsey,
Landenberger & Wilson, 2007; Wilson,
Bouffard & MacKenzie, 2005; Little,
2005; Tong & Farrington, 2006 &
2008
Group C
Self-Improvement
and Management
Developing social and problem
solving skills to address MH, SA,
and self-control.
Botvin & Wills, 1984; Botvin, Griffin, &
Nichols, 2006; Martin, Dorken,
Wamboldt & Wootten, 2011
Group D
Structured counseling and
Social and
modeling of behavior to reduce
Interpersonal Skills interpersonal conflict and develop
more positive interactions.
Botvin & Wills, 1984; Beckmeyer,
2006; Wilson, Gallagher & MacKenzie,
2000; Visher, Winterfield &
Coggeshall, 2005
Group E
Life Skills
Andrews & Bonta, 2010; Beckmeyer,
2006
Stabilize education, housing,
employment, and financial
concerns.
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Program Groups for SUD Treatment
• Offenders with SUDs have unique Tx needs
▫ Program Group A: Addicts
▫ Program Group C: Abusers with Lifestyle Factors
• Operationalized essential features
▫ Program content, dosage, implementation fidelity
• Example: Group A – most intensive
▫ Individual profile: all CJ risk levels; dependence on hard drugs;
multiple criminogenic needs and destabilizers
▫ Program profile: cognitive restructuring techniques; adequate
dosage to address high SUD need; clinical staff; evidence-based
curricula; medication-assisted treatment
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Essential Features of Effective
Programs
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Principles of Effective Interventions
• Rehabilitative efforts have a greater impact on
recidivism
• There is no magic program
▫ There is no one program or program type
identified that will consistently have a large
impact on recidivism
• We do know something about common features
of effective correctional practice
▫ What really works?
McGuire, 2002; Lipsey & Cullen, 2007
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Program Quality Matters
• Most programs score < 50% (unsatisfactory)
• Program quality (Implementation, Risk-Need
Assessment, Orientation) related to Recidivism
Lowenkamp, Latessa, & Smith, 2006; see also Nesovic, 2003
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Program Tool Factors
•
•
•
•
Target Population
Program Goals
Program Theory
Client Level Factors
▫ Spectrum of Needs/Severity of Program Needs
▫ Developmental Factors (e.g., age, gender, cognitive,
physical)
• Program Structure
• Program Dosage (a lot unknown, clinical literature)
• Implementation Issues
▫ Staffing
▫ Fidelity Monitoring, Training
▫ Quality Assurance
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Substance Abuse Treatment Program
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• Key Items: Use of a validated risk assessment and
focus on appropriate risk levels
• Justification:
▫ Use of a validated risk assessment is associated
with more effective programs
 (Smith, Gendreau, Swartz, 2008)
▫ Provide more intensive services to higher risk
individuals
 (Lowenkamp, Latessa, and Holsinger, 2006; Andrews &
Dowden, 2006)
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• Key Items: Program focuses on a primary target;
uses appropriate content based on the target
• Justification:
▫ Focus on criminogenic needs
 (Andrews, Bonta, and Hoge, 1990)
▫ Focus on stabilizers and destabilizers
 (Ward & Stewart, 2003)
▫ Treatment is theoretically linked to changes in
the target
 (Cordray & Pion, 2006)
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• Key Items: Program content with better evidence, use of rewards
and sanctions, and addresses specific responsivity factors;
▫ Focus is on treatment matching
• Justification:
▫ Programs more effective if consistent with an individual’s
learning style
 Andrews, Zinger, et al., 1990a; Smith et al., 2009; Taxman, &
Marlowe, Douglas, 2006
▫ Treatment matching improves outcomes
 Mee-Lee, Shulman, Fishman, Gastfriend, & Griffith, 2001;
Thornton, Gottheil, Weinstein & Kerachsky, 1998; Gastfriend &
McLellan, 1997; Barbor, 2008
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• Key Items: completion criteria, appropriate administration
based on target, appropriate staff credentials based on
target, staff communication, program evaluation, use of a
treatment manual, coaching, technical assistance, quality
assurance protocols
• Justification:
▫ Implementation fidelity related to effectiveness
 Landenberger & Lipsey, 2005; Andrews & Dowden, 2005;
McGrew, Bond, Dietzen & Salyers, 1994; Stanard, 1999;
Simons, Padesky, Montemarano, Lewis, Murakami, Lamb et
al., 2010; Taxman & Bouffard, 2000; Fletcher, et al., 2009;
Taxman & Belenko, 2012
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• Key Items: appropriate clinical hours, sufficient duration based
on target, sufficient intensity based on target, sufficient frequency
based on target, phases, and aftercare
• Justification:
▫ Dosage positively related to effect size
 (Landenberger & Lipsey, 2005)
▫ High risk approximately 300 hours of CBT
 (Bourgon & Armstrong)
▫ Higher risk saw recidivism reduction with more dosage in drug
treatment
 (Taxman, Byrne, & Thanner, 2002; Lowenkamp & Latessa, 2005)
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• Key Items: Social controls in programs are
also useful to enhance the impact of the
content and dosage of programs
• Justification:
▫ Increasing social controls for higher risk
individuals can improve outcomes
 (Drake, Aos, & Miller, 2009; Padgett, Bales, and
Blomberg, 2006; Pattavina, Tusinski-Miofsky, &
Byrne, 2009)
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Example Scores
Domain
Max Score
MAT
Drug Tx
Center
Re-entry
Program
Drug Court
Outpatient
Tx
PROGRAM GROUP

A
A
B
A
B
Risk
15
0
0
15
15
5
Need
15
10
10
15
15
15
Responsivity
15
13
10
15
13
13
Implementation
25
17
18
21
21
21
Dosage
20
7
9
9
18
10
Restrictiveness
10
10
6
4
8
5
100
60
53
79
90
69
Total Score
40
New! Specialty Court Output
41
42
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Building a Responsive System
 Identify Core Principles of Responsivity
 Identify Key Stakeholders
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Core Principles of Responsivity
• Individual
▫ Match programming and controls to risk and need
▫ Involve the offender in the assessment of risk-need
information & selection of options
▫ Focus on motivation to change
▫ Provide feedback reports to offenders on progress
• System
▫ Focus on correctional culture to increase receptiveness
to treatment
▫ Measure client outcomes to gauge performance and
share with partner agencies
▫ Increase communication and build systems of care
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What does a “Responsive Jurisdiction” look
like?
• Screening and assessment
▫ Identify risk and primary criminogenic needs
▫ Link assessment info to specific case plans
• Treatment matching
• High-quality, evidence-based programming
▫ Sound implementation
▫ Enough dosage to make change
• Capacity to address population needs
▫ Alignment between needs and services
▫ Collaboration between CJ and Tx
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Identifying Key Stakeholders
• Judges
• Prosecutors
• Defense Attorneys
• Probation/Parole Officers
• Program Directors/Administrators and
Treatment Staff
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Jurisdiction Capacity Limitations
• CJ agencies often lack capacity for responsivity.
• Lack of information within correctional agencies
about the specific nature and availability of
community-based programs.
• Lack of quality decision-support tools to help
them assess both individual-level and system
capacity issues
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Group A
Group B
Group C
Group D
Group E
Group F
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Thank you!!
www.gmuace.org/tools
This project received funding from Bureau of Justice Assistance, Center for Substance Abuse Treatment, and
Public Welfare Foundation. Views expressed here are ours and not the positions or policies of the funders.

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