S

Effective Use of Contingency Management in Juvenile Treatment Courts

Jacqueline van Wormer, Ph.D.

NCJFCJ

Washington State University

Learning Objectives

S Participants will review and discuss proper phase structuring for adolescents – and why this matters in the proper use of incentives and sanctions.

S Participants will learn about what DOES and what DOES work to promote positive behavior change in youth.

S Participants will learn about contingency management for adolescent’s substance abuse and use.

S Participants will learn how about contingency management theories and they work in juvenile drug courts.

S Participants will learn how to develop behavior and activity contracts.

What led to the Development of the JDTC

Guidelines?

S Early 1990’s: Adult drug court models were adapted for juveniles by

placing emphasis on family-based and developmentally-appropriate

services for adolescents.

S Juvenile Drug Courts: Strategies in Practice (2003). Consensus

document - served as a framework for planning, implementing, and

operating a JDC.

S Have juvenile drug courts worked?

S Overall, evaluations regarding the effectiveness of juvenile drug

courts has been inconclusive. There is a lack of rigorous

research and consistent implementation.

5Objective 5. Implement contingency management, case management, and community supervision strategies effectively.

S

Part IBuilding a Responsive Phase Structure

Responsible Practices in Juvenile

Justice

S Do no Harm

S Applying Adolescent Development Lens

S Informed Use of Detention

S Individualized

S Offender based rather than offense based – Procedural Justice

S Use of Risk/Needs/Responsivity

S Certain, Fair and of Appropriate Intensity

S Gender and Culture competence

S Treatment

S Occurs in the Community

S With family

S Use of Data

Five Critical Components

of Procedural Justice

1. Voice: Youth has an opportunity to be heard.

2. Respect: Person is treated with dignity and respect.

3. Trust/Neutrality: Youth perceives decision makers as neutral and competent and their decisions as unbiased and accurate.

4. Understanding: Youth understands decisions including the reasons for those decisions.

5. Helpfulness: Person perceives that decision makers have a genuine interest in their needs and personal situation.

Do No Harm

S Delinquency/criminality is age-limited

S Most youth will desist from crime in mid-late 20’s, depending on type of crime

S Studies vary, but only 5-9% of youth go on to long-term adult criminal careers (depends on crime type)

S What causes desistence?

S Significant relationships

S Employment

S Brain development

S Do not saddle youth

S

Adolescent

Development

S This is not a child brain, or undeveloped adult brain. It is a biologically unique brain characterized by the ability to change and grow (Geidd, 2015).

S Adolescence begins at puberty (biological function) and ends with a social definition of adulthood.

S Mismatch between limbic system (emotion) and prefrontal cortex:

S Biology encourages separation of the young adolescent from family in order to explore and recreate

S Found in all social mammals

S “What most determines teen behavior, then, is not so much the late development of executive functioning, or the early onset of emotional behavior, but the mismatch of timing between the two.” Jay Geidd, 2015

Proper Use of Detention

Detention Research:

S To Summarize:

S Detention can slow or interrupt the natural aging out of delinquency

S There is no correlation between increasing amounts of time spent in detention and future reductions in recidivism.

S Formally detained youth have reduced success in the employment market and will earn significantly less in their life time

S 40% of incarcerated youth have learning disabilities and cannot successfully navigate their way back into school

S Detention has a negative impact on the mental health of youth –especially those that enter with mental health conditions

S Source: The Dangers of Detention: Justice Policy Institute

Continued:

S Most importantly:

S The use of detention increases the odds that youth

will continue on the path of delinquency.

S Must carefully apply detention or the juvenile court

may in fact be negatively impacting public safety

S Detention serves a vital purpose for our high-risk,

violent and serious offending youth. 70% of youth in

detention are classified as non-violent.

Individualized

S Risk/Needs/Responsivity

R-N-R

SRISK: who to treat

SNEED: what to treat

SRESPONSIVITY: how to treat

The RISK Principle

S Because criminal behavior can be predicted, services should be matched to each person’s risk of reoffending

S To reduce recidivism:

S Higher risk youth need additional services

S Lower risk youth need little to no intervention

The (Criminogenic) NEED Principle

S The Central Eight

S The Big Four (Tier I)

S antisocial personality traits, thinking, and attitudes

S criminal associations

S Tier II

S Substance abuse

S Family/marital relationships

S Education and employment

S Positive leisure activities S Source: Andrews & Bonta (2010) The Psychology of

Criminal Conduct

The RESPONSIVITY Principle

S Service delivery should be responsive to the

learning style and capabilities of each

individual youth

S What protective factors does the youth

possess that will assist with participation in

and completion of services?

It begins with the phase

structure

Phase One

Phase Two

Phase Three

Phase requirements for youth and family should start out small, increase,

and then decrease again after the youth work through treatment and court

related goals.

Phase I: setting

the stage

Phase II: learning

skills

Phase III:

maintaining the

change

Readiness and engagement Involvement, stabilization Reflection, enrichment

Focus on compliance Beyond compliance Maintain drug testing, court

appearance

Structure Skill development Expanded development

activities

Clarifying expectations,

building trust

Completing assignments Enriching community

connections

Phase Structure

Source: Betty Gurnell

The Four Steps

SBehavior to target

SCurrent behavior

SDesired behavior

SSmall, achievable increments

Decision Matrix – Phase I

Phase I Incentives Sanctions

Behavior *Response Response

Attend school at least 18

out of 20 days

• Teacher signs attendance

card each day present and

acknowledges

•Small prize or coupon for

each week with no absences

• After school study hall for

each day absent over the

limit to make up all missed

work

Decision Matrix – Phase II

Phase IIIncentives Sanctions

Behavior *Response *Response

Attend regularly

Complete all

assignments

•Select a book ,

notebook, pen after two

weeks of success

•Praise from teacher,

family, court

•Grades improve

•After school study hall

to complete

assignments (with help

as needed)

Decision Matrix – Phase III

Phase IIIIncentives Sanctions

Behavior *Response *Response

Attend regularly

Complete all

assignments

Improve grades

•Praise from teacher,

family, court for

improvement

•Certificate of

achievement

•Select school related

gift: tuition, book

•Determine if tutor is

needed

•Attend extra class or

session for help

•Tighten curfew

S

Part IIIncentives and Sanctions

Why We Want to Use

Alternatives

Probation/court monitoring, group homes, and correctional

facilities have, at best, only modest favorable effects on

subsequent recidivism. Some studies show negative effects (Lipsey and Cullen, 2007; Petrosino, Turpin-Petrosino, and

Guckenburg, 2010).

Why We Want to Use

Alternatives

Deterrence-oriented programs that focus on discipline,

surveillance, or threat of punitive consequences (e.g., prison

visitation Scared Straight–type programs, boot camps, and

intensive probation supervision) have no effect on recidivism

and may actually increase it (Lipsey, 2009).

Because…

“Therapeutic” programs oriented toward facilitating

constructive behavior change have shown very positive

effects—even for serious offenders (Lipsey, 2009; Lipsey

and Cullen, 2007; Lipsey and Wilson, 1998).

Reasons Why JDCs Should

Implement CM

S Theories are based on cognitive behavioral therapy,

which has been proven to work with adolescents,

and is vastly used in outpatient settings

S It can be easily adapted within the JDC

S In their study of six juvenile drug courts, Henggeler

et al (2006) found stronger outcomes for those youth

who received MST AND CM then standard process

Incentives & Sanctions, Continued

S Historical CJ responses vs. modification of behavior through a

coordinated and thoughtful (research informed) process

S Punishment for a “wrong” is not the goal – behavior change is

the goal

S The JDC should use a balance of incentives, sanctions and

treatment responses

Incentives and Sanctions,

continued

S Key components:

S Immediate, certain, fair and of appropriate intensity

S Do not rely solely on standardized “lists”

S Should be proportional and balanced

S Punishment alone is least effective way to change behavior

S Be comfortable in combining incentives and sanctions

S Be cognizant of time

S Perceptions of fairness – it all begins with individualization

S Make sure youth understand their positive and negative reinforcers

Contingency Management

So how do we strengthen the use of CM in

our treatment settings, and utilize the same

methods within our Juvenile Drug Courts?

Point & Level Reward Systems

S Contract

S Reward Menu

S 3 for 3

S Most Valued Privilege

S Checkbook System

Most Valued Privilege

S This is a privilege that the youth values and will work

hard to earn

S Work with the youth and family to determine what the

MVP is, preferably a family-based reward (i.e., video

games, cell phone use, time w/ friends)

S The MVP is given or taken away with each drug screen

S IMPORTANT – youth does not earn points if there is

a positive drug screen but points that have already

been earned are not taken away

(Henggeler et al, p. 107-108)

Make it Transparent MVP

Sally – Use of cell phone

John – Curfew extension on Saturday

night

Mary – Allowed to use Mom’s car on

Friday afternoon

Jack – Ride to school, rather than walk

Checkbook System

S Basic checkbook set up – date; transaction description; debit/credit; and balance

S Basic personal checks that the youth can draft and use to purchase items on the reward menu

S Make this very visual and tangible for the youth

S Consider working with a local bank to provide life skills training on how to keep a checking account and write checks or to provide free checkbooks and/or personalized checks

(Henggeler et al, p. 126-127)

Program-Wide Incentives

The Fun Theory

https://www.youtube.com/watch?v=2lXh2n

0aPyw

Rocket Docket

Go First

And

Leave Early!!!

3 for 3 Program

1. Pass all UAs

2. Bring JTDC

Notebook

3. Make all

appointments

/ contacts with

case manager

Fish Bowl

Catch youth doing

something right:

• Showing respectful

behavior

• Coming to court on

time

• Saying something nice

about a loved one in

court

Positive Peer-to-Peer

Reinforcement

• An incentive that is fairly

easy to implement as a

program-wide incentive

• An incentive that creates

some positive peer

pressure

• An incentive that allows

the team to spread

resources over a longer

period of time

Special thanks to the El Paso County, TX JTDC team for this innovative

idea.

Behavior Contracts

S “Rewards for Responsible Behavior in Other Domains” (Henggeler et al, p. 131)

S How to target specific behaviors (i.e., school attendance)

S How to add a step-by-step process for the youth to follow

S How to get youth working towards “things” they are interested in

S How to engage families/guardians in the process

S How to increase communication between the youth and judge

S And…how to implement these components in your program

Behavioral Contract Example

Goal Behaviors/Tasks

Incentives Non-compliance

Sanction

Enroll in GED program

•Call or visit GED center by xxxxx date

•Praise•Recognition from Team•Appointment Calendar•XXXXXX

Failure to contact by XXXX

•Increased reporting to PO•Increase in curfew•EM

Albuquerque, New Mexico

S One of 12 Learning Collaborative sites funded by

NCJFJC/OJJDP

S Engaged in full application of 16 Strategies, use of data

to drive program and adoption of standardized screening.

S Entails intensive support to restructure program to align

with best practices

S 2nd step: To restructure phases to be more responsive to

youth and families

S Removed the “checklist” system and flipped to a reward

system.

S Youth earn points for various activities and earn their way

out of a phase.

Youth can earn points for…

Earning full

pointsAmount

Earning partial

pointsAmount

Earning Zero

points

Attend therapy

and fully

participate or

present work.

2

Attend scheduled

therapy

appointment

1

Missing an

individual or

family therapy

session

Attend school with

no absences2

Attend school with

only one absence1

Two or more

school absences

Check in everyday 2 Check in 6 days 1Fail to check in

two or more days

Special thanks to the Bernalillo County, NM JTDC team for the sample

procedures.

Using points to promote pro-

social activities

Assignment Community Service Bonus Points

Have a family dinner 2 4

Keep planer of assignments

and appointments2 4

Keep a daily journal 6 12

Explore alternative

education program2 4

Create a resume 5 10

Special thanks to the Bernalillo County, NM JTDC team for the sample

procedures.

Reward Cost Purchasing Guidelines

Credit for 1 hour of

community service4 points

No community service

assigned with in the past

week

Extend curfew on 1 day for

1 hour10 points

Must be checking in, cannot

be on house arrest or have

a curfew violation in past 2

weeks

$10 gift card 20 points Must be attending therapy

Rewards the youth can

purchase with earned pointsSpecial thanks to the Bernalillo County, NM JTDC team for the sample

procedures.

Connecting the dots, using

points to “phase-up”

Phase Cost

Move to Phase Two 50 points

Move to Phase Three 70 points

Move to Phase Four 70 points

Graduate 40 points

Special thanks to the Bernalillo County, NM JTDC team for the sample

procedures.

Recommended Reading

S Contingency Management for Adolescent Substance Abuse: A Practitioner’s Guide, by: Scott W. Henggeler, Phillippe B. Cunningham, Melisa D. Rowland, Sonja K. Schoenwald and Associates

S Making Sense of Incentives and Sanctions in working with the Substance-Abusing Youth: Answers to Frequently Asked Questions (Juvenile & Family Justice TODAY. 2012, Volume 21, Number 2)

S Enhancing the Effectiveness of Juvenile Drug Courts by Integrating Evidence-Based Practices (Journal of Consulting and Clinical Psychology. 2012, Vol. 80, No. 2, 264-275)

Questions?