In-Patient & Out-Patient Treatment
Monitor Compliance
- Clients are often mandated to treatment as a part of their conditions of supervision. If this is the case, their participation and progress in treatment can be monitored.
- Treatment providers and officers should be familiar with each other to offer the client the best possible support for participation and progress in treatment.
- Quality working relationships with the client increase the possibility that clients will discuss difficulties they are having with treatment. This can prevent clients from abstaining from treatment and thus violating their supervision.
Supervision Tool
- Both in-patient and out-patient treatment are rehabilitative tools designed to help clients reduce their use and improve their lives.
- An officer can reinforce their position as a change agent by offering treatment services in response to their client’s difficulty with substance use.
- If a client relapses, an officer can reinforce their position as a change agent by understanding and encouraging while working with their client to determine what adjustments would improve chances of long-term abstinence.
- Often clients need multiple attempts at treatment programming before they remain abstinent long-term. Because of this, officers should not view treatment failure as proof that their client is not capable of change.
- Substance use is a relapsing disorder that requires various strategies to obtain long-term success.
Mental Health Screening and Evaluation
Monitor Compliance
- Screening and evaluation should never be done with the purposes of monitoring the client.
Supervision Tool
- If a client begins to have a small-to-moderate amount of compliance issues, screening and evaluation can be an appropriate response to noncompliance to determine the role mental illness is playing.
- When the screener/evaluation has identified a mental illness and when client behavior is connected to the mental illness, psychological interventions (e.g., CBT, DBT, individual or group therapy) are an appropriate response for medium- and high-risk clients with a lot of compliance problems. Such interventions should only be used as a last resort and in cases where the client’s noncompliance is clearly and directly connected to mental illness (e.g., an individual with schizophrenia who is unwilling to apply for a job due to paranoid thought patterns).
- In all cases, the officer should encourage the client to seek treatment voluntarily first.
Substance Use Screening and Evaluation
Monitor Compliance
- Officers should not use treatment evaluation as a form of punishment for their clients.
- When a client is referred to treatment through the evaluation process, officers should discuss the consequences of noncompliance (e.g., relapse, not completing).
- Emphasis should be on helping the client address substance use need.
- Officers should minimize the use of authoritarian communication when using these tools or discussing their results.
Supervision Tools
- Screening and evaluation are best viewed as a therapeutic process.
- If administered correctly, the screening and evaluation process can solidify an officer as a helper, improving the working alliance.
- Screening and evaluation should never be used as a control tool.
Alcohol and Drug Use Education
Monitor Compliance
- ADE is not a tool to monitor compliance.
Supervision Tool
- ADE is by nature a rehabilitative tool meant to assist clients in reducing drug use and, subsequently, recidivism.
- As a change agent, officers can recommend ADE to their clients as a part of treatment services.
Cognitive Behavioral Techniques
Monitor Compliance
- CB techniques should not be used to monitor client compliance or determine if they are able to follow supervision conditions.
- Cognitive behavioral techniques can be a useful tool to review and process (deconstruct) noncompliant events.
- Officers can use CB techniques to have clients walk them through their thought process leading up to a noncompliant decision.
- While CB techniques are generally appropriate for clients regardless of their compliance level, there are some circumstances where it may be ineffective or even detrimental.
- If a client is noncompliant with some conditions of supervision and seems unreceptive or resistant to CB techniques, forcing the client to participate is unlikely to lead to positive outcomes.
- CB techniques work better with clients who are more engaged and interested in the process.
- If a client is unreceptive to CB techniques, it may be better to first focus on explaining to them why the process is important and addressing their concerns in order to achieve buy-in.
- Client motivation and engagement may be area-specific—they may be more ready to engage in CB techniques targeting one aspect of their life than another.
- It can be helpful to “go where the motivation is” and address those areas of a client’s life that they are ready to work on. This can be a helpful way to establish buy-in and trust before transitioning to addressing other areas of a client’s life as they become ready.
- It can also be helpful to work with a client to set priorities. This happens when the client picks one aspect of their life to address and the officer picks another. Both aspects are subsequently worked upon, so both parties have a say in what is discussed.
- CB techniques may be a useful tool to get clients interested in the therapeutic process if they are not yet ready to engage with full CBT.
- Client motivation and engagement may be area-specific—they may be more ready to engage in CB techniques targeting one aspect of their life than another.
- If a client is noncompliant with some conditions of supervision and seems unreceptive or resistant to CB techniques, forcing the client to participate is unlikely to lead to positive outcomes.
Supervision Tool
- CB techniques can
- improve quality of life
- change cognitions
- facilitate behavior change and desistance (including reduced recidivism)
- promote prosocial relationships (including between officer and client)
- facilitate conversation and direct attention at achieving goals
Incentives
Monitor Compliance
- Incentives are designed to change client behavior and should not be used to monitor compliance.
Supervision Tool
- Incentives can encourage positive behavior (e.g., seeking employment, taking educational classes, participating in community activities, etc.) and compliance with supervision conditions.
- Incentives can help with establishing goals.
- Incentives discourage negative behavior that can lead to the client not receiving the incentive (e.g., refraining from hanging out with friends the client has identified as detrimental to the desired behavior change, successfully resisting a temptation to commit a crime, etc.). This discourages noncompliance with supervision conditions.
Prosocial Modeling
Monitor Compliance
- Prosocial modeling is not designed as a tool to monitor compliance.
Supervision Tool
- Officers who model the prosocial behaviors they promote to their clients establish their legitimacy.
- Officers exhibiting prosocial behaviors while using communication techniques to reinforce their client’s positive behavior solidifies their position as a change agent.
- The skills included in prosocial modeling (i.e., exhibiting empathy, respect, positive communication, active listening) are aligned with those promoted by evidence-based supervision models.
Sanctions
Monitor Compliance
- Sanctions should not be used to monitor compliance. It undermines the efforts to engage individuals in behavior change.
- Sanctioning is not the same as boundary setting, where the PO clearly articulates what is considered appropriate behavior. Boundary setting, including informing the individual of what constitutes compliant and noncompliant behavior, is important.
Supervision Tool
- While there is little evidence of their effectiveness, sanctions are often used as a supervision tool to change client behavior.
- Very limited evidence suggests that the threat of swift and certain sanctions in response to noncompliant behavior may be effective in some contexts.
- Incentives are more effective.
Environmental Restructuring
Monitor Compliance
- Environmental restructuring should not be used to monitor compliance.
Supervision Tool
- Environmental restructuring is an effective way to help clients find positive and supportive physical and social contexts.
- This can help an individual change behavior and comply with supervision conditions.
Transportation Resources
Monitor Compliance
- Transportation resources are intended to help the client and should not be used to monitor compliance.
Supervision Tool
- Transportation resources help the client find employment, attend treatment, meet with the supervision officer, and otherwise get where they need to go.
- This can help clients remain in compliance with supervision conditions (e.g., attending treatment) and complete the supervision process.
- Some evidence suggests that clients without access to transportation may be less likely to come to the supervision office for scheduled visits, making them more likely to abscond.
- « Previous
- 1
- 2
Feedback
Use the form below to contact the team behind the Appropriateness Statement Package.