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Effective Strategies for Individual Interventions An in-depth look at the skills in the EPICS Model Myrinda Schweitzer Smith, Ph.D. University of Cincinnati Corrections Institute Presented at the Fall Substance Abuse Conference St. George, Utah September 21, 2017
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Effective Strategies for Individual Interventions

An in-depth look at the skills in the EPICS Model

Myrinda Schweitzer Smith, Ph.D. University of Cincinnati

Corrections Institute

Presented at the Fall Substance Abuse Conference St. George, Utah

September 21, 2017

What is EPICS? PURPOSE •  This model strives to more fully utilize POs as agents of change

and ensure clients receive a consistent message throughout the continuum of correctional services

•  The EPICS model is not intended to replace more intense cognitive-behavioral treatments that address specific domains

What is EPICS? DESIGN •  Applies the RNR framework to one-on-one settings

•  Trains staff on core correctional practices •  Trains staff to intervene where the offender is deficient in making

decisions (Behavior Chain)

•  Includes measures of fidelity and coaching sessions

What is EPICS?

RISK

WHO

Deliver more intense intervention

to higher risk offenders

NEED

WHAT

Target criminogenic needs to reduce risk

for recidivism

RESPONSIVITY

HOW

Use CBT approaches

Match mode/style of service to offender

Why EPICS? IMPORTANCE OF THE TRAINING •  Bonta et al. (2010) have been collecting data in Canada after

implementation of the Strategic Training Initiative in Community Supervision (STICS)

•  Results indicated that trained officers had 12% higher retention

rates in comparison with untrained officers at six months

Why EPICS?

Bonta et al. (2010) The Strategic Training Initiative in Community Supervision: Risk-Need-Responsivity in the Real World. Public Safety Canada.

Why EPICS?

IMPORTANCE OF THE TRAINING •  Strategic Techniques Aimed at Reducing Re-Arrest (STARR) •  Results indicated that the application of core correctional

practices and adherence to the RNR model can improve offender outcomes (Robinson et al., 2011)

Why EPICS?

0"5"

10"15"20"25"30"35"40"45"

Moderate"Risk" High"Risk"

Control"Experimental"

Robinson, Vanbenschoten, Alexander, and Lowenkamp, Forthcoming, Federal Probation, Sept. 2011.

Why EPICS?

EPICS PILOT RESEARCH

•  Effective Practices in Community Supervision (EPICS)

•  Results indicated that staff trained in the EPICS model demonstrated more consistent use of core correctional practices

•  Trained staff also became more proficient in their use of the skills over time as a result of participation in additional practice sessions

Smith et al. (2012) 9

Why EPICS?

23

0  10  20  30  40  50  60  70  80  90  

100  

Session  1   Session  2   Session  3   Total  

Trained

Untrained

% of audiotapes

Trained staff were more likely to spend time discussing criminogenic needs

0  10  20  30  40  50  60  70  80  90  

100  

Session  1   Session  2   Session  3   Total  

Trained Untrained

% of audiotapes

Trained staff were more likely to make effective use of social reinforcement

Why EPICS?

24

0  10  20  30  40  50  60  70  80  90  

100  

Session  1   Session  2   Session  3   Total  

Trained Untrained

% of audiotapes

Trained staff were far more likely to identify antisocial thinking

Why EPICS?

25

Why EPICS?

EPICS RESEARCH

•  Evaluation of EPICS in Ohio

•  Involved 21 trained and 20 untrained staff and 272 offenders

•  Staff trained in EPICS outperformed untrained staff in the use of core correctional practices during contact sessions

•  High risk offenders assigned to high fidelity staff had significantly lower incarceration rates than high risk offenders assigned to low fidelity staff

13 Latessa et al. (2013)

Why EPICS?

14

0  

10  

20  

30  

40  

50  

60  

Use  of  Core  Correc;onal  Prac;ces  

Treatment  Control  Pe

rcen

tage  

EPICS RESEARCH

Latessa et al. (2013)

Why EPICS?

0

5

10

15

20

25

30

35

Incarcera;on  

High  Fidelity/High  Risk  

Low  Fidelity/High  Risk  

15

EPICS RESEARCH

Latessa et al. (2013)

Percen

tage  

WHAT CAN COMMUNITY SUPERVISION LEARN FROM THESE STUDIES? Adhere to the principles of effective Intervention:

•  Assess risk and need levels •  Target moderate and high risk offenders •  Target criminogenic needs •  Use cognitive behavioral interventions

Use core correctional practices: •  Quality collaborative relationship •  Reinforcement, Disapproval, Use of Authority •  Cognitive restructuring •  Structured skill building •  Problem solving skills

Why EPICS?

16

What Does EPICS Look Like?

Restrict their situations in the community

AND

Teach clients to recognize high-risk situations

Restructure their antisocial thoughts

Teach emotional regulation skills

Teach alternative behaviors

Reinforce positive behavior

Sanction negative behavior

What Does EPICS Look Like?

SESSION OVERVIEW Each session should be structured in the following way:

1. Check-In 2. Review 3. Intervention 4. Homework

Core EPICS Skills

Relationship Skills: •  Active Listening •  Reflective Listening •  Giving Feedback

Behavioral Modification Skills: •  Effective Reinforcement •  Effective Disapproval •  Effective Use of Authority

Core EPICS Skills

Interventions to address antisocial thinking: •  Behavior Chain •  Identification of high risk thinking and new thinking •  ABC Model •  Thinking Report Interventions to address behavioral deficits: •  Structured Skill Building •  Problem Solving

Core EPICS Skills

Interventions to address motivation: •  Cost-Benefit Analysis •  Card Sorting

Interventions for emotional regulation: •  Predetermined Counters •  Structured Skill Cards

Cost-Benefit Analysis

PURPOSE •  Weighs both short-term and long-term costs and

benefits of antisocial target behavior and an alternative prosocial behavior

•  Helps build motivation towards changing problem behaviors

22

Cost-Benefit Analysis

Behavior: RISKY

+ - Short-term

Long-term

23

Cost-Benefit Analysis

Behavior: ALTERNATIVE PROSOCIAL

+ - Short-term

Long-term

24

Cost-Benefit Analysis

It’s time to practice!!!

The Behavior Chain: Examining the Thought-Behavior Link

•  Examine thinking •  Challenge risky thoughts •  Create replacement

thoughts

27

People, places or

things that can lead to

trouble

Triggers Invitations Activating

Events Antecedents

Ways we interpret the situations

What we tell

ourselves

Present-tense

Drive

feelings and behaviors

Emotions that are

influenced by

thoughts

They influence

our behavior

Influenced by thoughts & feelings

What we choose to do

Increases likelihood a behavior will occur again

Decreases likelihood a

behavior will occur

again

28

Old friend approaches me and asks

me to get high

“Smoking sounds really

good right now”

“I miss

getting high”

“It’s only one time”

“I wanna

have a good time with my

friend”

Eager

Anxious

Get high with friend

Get high

Have fun with friend

Relapse

Disappoint Family

Jail

Violation

Behavior Chain

It’s time to practice!!!

Cognitive Restructuring

GOAL: Change behavior TO CHANGE BEHAVIOR:

30

IDENTIFY ANTISOCIAL THINKING

REPLACE WITH PROSOCIAL

THINKING

31

Old friend approaches me and asks

me to get high

Confident

Resolute

“I’m going to get caught if

I smoke”

“I don’t want to lose

everything I’ve worked so hard for”

“It’s really

not worth it”

Tell friend no and go home

Stay sober

No problem with

supervision

Feel proud/gain

confidence

Old friend gets mad

Don’t get relief from

getting high

Cognitive Restructuring with the Behavior Chain

It’s time to practice!!!

Structured Skill Building

PURPOSE •  Used when problem behavior is likely being caused

by a skill deficit

•  Teaches prosocial behavioral responses to high risk situations

33

Structured Skill Building

STEPS OF STRUCTURED SKILL BUILDING

1.  Introduce the skill 2.  Obtain offender buy-in 3.  Teach the skill following the concrete steps 4.  Model the skill 5.  Role play the skill 6.  Provide feedback to the offender

34

Structured Skill Building

There are many skills to engage in pro-social behavior: •  All skills involve steps. •  Skill development involves breaking down the steps

for participants. •  Steps are often not thought about—“unconscious.” •  Some steps involve thinking, while others involve

action.

Structured Skill Building

It’s time to practice!!! Watch the following demonstration of how to model a skill. Select a skill you want to model. Write a script for your model ensuring you follow each step. Practice modeling your skill with your partner.

Structured Skill Building

STRUCTURED SKILL BUILDING TIPS FOR SUCCESS •  Target a criminogenic need when using structured skill building

•  Apply the skill being taught to a specific risky situation

•  Differentiate clearly between thinking and actions steps

•  Model exactly how you want the client to use the skill- always act as a realistic, prosocial model during skill building

37

Problem Solving STEPS OF PROBLEM SOLVING 1. Identify your problem and goal:

Have the offender state their problem objectively. Determine what exactly the offender wants to happen in the situation and what is best for him/her and everyone involved

2. Brainstorm options and choose the best one:

Brainstorm possible solutions to the problem. Review all the alternatives generated and discuss the short-term and long-term consequences of the solutions

3. Plan and try your solution:

Develop concrete action steps in this stage and role play the plan. The offender will then use this plan to solve the problem

38

EPICS In Summary… •  Prioritizes higher risk offenders

•  Targets criminogenic needs using cognitive-behavioral interventions

•  Teaches staff core correctional practices

•  Increases dosage

•  Can improve agency outcomes

Thank You!

Myrinda Schweitzer Smith, PhD.

Deputy Director University of Cincinnati Corrections Institute

[email protected]


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