Transform Your Practice By Using Guidelines Informed by Research, Staff and Justice-Involved Individuals

What are the practices?

In-Patient & Out-Patient Treatment

Most individuals who enter the criminal legal system (the “criminal justice” or “legal” system is referred to as the criminal legal system in this document) either have substance use difficulty or were using alcohol or illegal drugs during the time of their crime.

  • Alcohol and drug treatment offered to those on supervision can reduce substance use and subsequently reduce recidivism.
  • The treatment offered by supervision comes in many types, including alcohol and drug education (see psychosocial education for drug use statement for more), intensive out-patient, out-patient treatment, in-patient treatment, and medication-assisted treatment.
  • In-patient/residential treatment broadly refers to therapeutic interventions provided in varied residential settings where patients live during some periods of treatment.
  • Out-patient treatment broadly refers to interventions provided in settings where recipients live in the community at their usual place of residence.
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Mental Health Screening and Evaluation

  • Because mental illness can affect a client’s quality of life and may serve as a barrier to their achieving certain prosocial goals (e.g., employment), it is important to conduct mental health screenings and evaluations with clients who need them.
    • Screening is the process for determining if a client has symptoms associated with mental illness. The outcome is typically yes or no.
      • Screening is often done with a short form that an officer completes with a client.
      • Screening should be completed with all clients at intake, or if they start to show signs of mental illness or high stress.
    • Evaluation is the process of defining the nature of the problem, determining the diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis (SAMHSA, 2019).
      • Evaluation should be completed if a mental health screener indicates the presence of a mental illness.
  • There are many cases where clients who screen positive for mental illness may not need/want intervention to address that illness. Officers should always be ready to provide resources/referrals to assist clients with mental illness, but mandatory treatment is often unnecessary.
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Substance Use Screening and Evaluation

  • Screening is the process of evaluating the possible presence of a problem. The outcome is typically yes or no.
  • Evaluation is the process of defining the nature of the problem, determining the diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis (SAMSHA).
  • Alcohol and substance abuse is one of the more prevalent needs individuals exhibit on community supervision.
  • Substance use behavior is often a symptom of other needs the client has (e.g., mental health).
  • Clinical experts recommend that all clients receive a substance-use screening upon intake to supervision.
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Alcohol and Drug Use Education

  • Alcohol and drug use education (ADE) is a strategy meant to prevent, delay, or reduce alcohol and/or drug use by providing knowledge of the consequences of such use and/or abuse.
  • ADE programs typically have two components: education and skill development.
    • The first component covers knowledge about the consequences of using and abusing substances.
    • The second component teaches coping strategies to resist social pressures to use.
  • ADE is an intervention that typically targets young people, but that is often included as a part of most in-patient and out-patient SUD treatment services to increase awareness about the neurobiological effects of using substances.
  • ADE programs are based on the following assumptions:
    • People use drugs because they do not have adequate knowledge about the consequences of using. If they did have such knowledge, they would make the rational choice not to use.
    • People experience a great deal of social pressure from certain peers to use drugs and alcohol.
    • There are skills individuals can learn to help them resist this pressure to experiment or use substances.
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Cognitive Behavioral Techniques

  • Cognitive behavioral (CB) techniques are based on the principles of cognitive behavioral therapy (see Appendix A for more information) and can be used in individual sessions/meetings. These are evidence-based strategies for correctional and non-correctional settings to facilitate behavior change.
  • CBT addresses issues related to decisions that individuals make that affect their behavior.
  • CBT and techniques are an evidence-based practice/treatment.
  • CB techniques
    • could include working with clients to identify prosocial goals, then changing thought and behavior patterns to help clients achieve those goals
    • involve engaging in active listening to understand the client’s perspective and sharing decision-making to empower the client to make decisions
    • can be used effectively by officers with no background in clinical skills
  • CB techniques come in multiple forms and may be distinct from traditional therapy-based CBT.
    • CB techniques often incorporate strategies used in conversation or face-to-face contacts.
    • Officers using CB techniques may focus on aspects of a client’s life choices and events that contribute to criminal behavior.
      • Officers can focus on and act upon factors (e.g., housing, food security, transportation, etc.) that can affect a client’s life and contribute to criminal behavior.
      • Officers can refer clients to licensed clinical practitioners for traditional CBT if the client suffers from a psychological disorder (see Appendix A).
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  • Incentives are an important part of the behavior change process.
    • Incentives are reinforcers for desired behaviors.
    •  “Contingency management” refers to the offering of incentives or rewards for positive behavior change.
    • Contingency management is effective in substance use treatment settings.
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Prosocial Modeling

  • Prosocial modeling refers to the display of positive behaviors that benefit others, such as kind interactions, addressing conflict instead of getting angry, and respecting others.
  • Prosocial values include respect for others and the legal authorities.
  • Prosocial modeling includes the following skills:
    • prosocial expressions and actions
    • negatively reinforcing or confronting pro-criminal actions in a manner that addresses the behavior while allowing for the possibility of change
    • collaborative problem-solving instead of demanding one perspective; weighing costs and benefits
    • role clarification
      • establishing the boundaries of the officer’s law-enforcement and social work roles
      • transparent discussions about the use of authority
      • providing space for clients to express preferences and concerns about officers’ role and/or use of authority
      • collaborative decision-making
    • Clients perform better on supervision when they work with officers who exhibit these skills.
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  • Sanctions rely on coercion.
    • Coercion is defined as the “act or process of persuading someone forcefully to do something that they do not want to do” (Collins Dictionary). It often involves threats or intimidation.
    • In the context of probation and parole, coercion can appear as POs presenting clients with an ultimatum: either they change their behavior, or they will receive a sanction. In this case, the threat of the sanction is used to motivate the client to change their behavior.
  • While similar, coercion and accountability mechanisms are different.
    • Coercion is done for the purpose of inducing behavior change in clients. Accountability mechanisms ensure that the client has changed their behavior; if the client has not changed, sanctions (often involving incapacitation to keep the client from harming others) may be applied.
  • There is little evidence of coercion’s effectiveness in changing client behavior in probation and parole settings.
    • Some evaluations have found that sanctions can be effective in changing behavior when they are applied swiftly and certainly in response to noncompliant behavior.
      • These studies have not been replicated widely, and there is evidence that programs using this approach are not more effective than traditional probation.
      • Evidence indicates that incentives to reinforce legal mandates/requirements are more effective than coercion.
    • Open, honest, and respectful relationships between POs and clients are more effective drivers of behavior change than sanctions.
      • To the extent that coercion damages such a relationship (e.g., by making the client resentful toward or distrustful of the PO), it may not create behavior change.
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Environmental Restructuring

  • Environmental restructuring is defined as “changing the physical or social context”1 of an individual.
    • Examples of physical context include place of residence, work, or leisure activities.
      • Physical context includes the places a client frequents and the characteristics of such places (dangerous vs. peaceful, dirty vs. clean, etc.).
    • Examples of social context include family members, friend(s), and recreational activities a client engages with or is around.
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Transportation Resources

  • Transportation resources are resources provided by the officer/supervision agency to the client to help them access transportation.
  • Transportation can be public (e.g., bus, metro) or private (e.g., Uber, Lyft, taxi).
  • Resources can come in the form of vouchers, fare passes, or even officers calling a taxi or Uber for the client.
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