Incentives and Sanctions: Practical
Application of the Science of
Behavior Change
Shannon M. Carey, Ph.D.
Based on Need to Know Fact Sheet by NDCI
Purpose
What is the purpose of Sanctions?
What is the purpose of Incentives?
What other court responses are there?
Overview
• Brief review of the science of behavior
change
• Research on application in drug courts
• Sample incentives, sanctions and
treatment responses (guidelines)
• Implementing incentives and sanctions
(Review and discuss videos)
Certainty
1:1 Schedule for
initiation
Reliable detection
“Trust but verify”
Reliable detection
• Urine drug testing at least twice per week*
• Do not decrease frequency of testing until last
phase
• Do tests with short detection windows in field
• Random testing all 7 days
• Extend supervision into natural social
environment (work, home, school, street, cell
phones)
• Include law enforcement on the team
*Or use continuous detection methods
Reliable detection
Cell Phone Transcript from Phone during
Court Session - 1
• SF B Chic Nov 18 3:29pm R u getting anything in la?
•
• SF B Chic Nov 18 3:35pm Can we go in on the deal. If I
got 4 would u get 2 so we could do the 540
•
• SF B Chich Nov 18 3:45pm Toats
Reliable detection
Cell Phone Transcript from Phone during
Court Session - 2 • ?? Nov 18 6:47pm If you need a source for tina Hit up
714-647-0410 Tell them dan sent ya..Good stuff…
• AM Nov 18 6:48pm How lomng doles xaanax stay in system
• ?? Nov 18 6:48pm 72hrs to a week
• AM Nov 18 6:49pm anyway to clear em out
• ?? Nov 18 6:49pm Do you ever get swabbed!!!???????
• AM Nov 18 6:50pm Occasionally ans I no it doesn’t test for
that
• ?? Nov 18 6:50pm Well if ur dirty dirty.. Always check urself
into the ER for a panic attack or something.. do that day of
probation..Walk outta there with a hospital/dr ltr
Reliable detection
Participant in his outpatient substance abuse group
• AM Nov 18 6:22pm Plzbring tibaasement pLII
• AM Nov 18 6:23pm Theyre randomly testing me tnite
• AM Nov 18 6:25pm IM in grop
• AM Nov 18 6:27pm Plese bring to basement bathroom
• AM Nov 18 6:27pm Plzzzzzzzzzzzzz
• S Nov 18 6:29pm Ok
• AM Nov 18 6:29pmHit me up when ur down there ill walk out
• AM Nov 18 6:30pm How long bro
• S Nov 18 6:30pm Like 20
• AM Nov 18 6:34pm Im in the bathroom in the basement plz hurry im
trippin out
• S Nov 18 6:35pm Leavin hollies rite now
• AM Nov 18 6:36pm Shit whats ur eta from there
Reliable detection
Participant in his outpatient substance abuse group (cont)
• S Nov 18 6:37pm 15
• S Nov 18 6:38pm Shuld I wait in basement bathroom
• AM Nov 18 6:38pm Plz tell me u gotta vial to pissi in
• S Nov 18 6:38pm Ya
• AM Nov 18 6:42pm Put the vial of piss in bathrroom trashcan
• AM Nov 18 6:42pm I gotta go bak to geoup9 hit me up when its dun
• S Nov 18 6:54pm Its in the trash
Timing is Everything
• Effects degrade exponentially
• New behaviors interfere
• Status hearings every two weeks the first few
months
• Bring non compliant participants in sooner
• Continue hearings monthly until participants have
engaged in continuing/after care plans
Keep Centered
Effective
Zone Ceiling
Effects
Habituation
Effects
MINIMAL MODERATE
EF
FE
CT
IVE
NE
SS
SEVERE
Keep Centered
NDCI Handout
http://ndcrc.org/content/list-incentives-and-sanctions
Do Due Process
• Allow participants to explain
• Explain judge/team decision
• Be respectful (and expect respect)
• Have written incentive/sanction
guidelines
• Allow reasonable discretion
• The brain and decisions about
punishment
Sanctions or Treatment
Responses?
• Abuse or dependence?
• Proximal or distal behaviors
• Dependent: Expectations change over
time (Phases) – treatment then
sanctions
• Abuser: Higher level sanctions sooner
• Separate status hearings
• Rely on clinical expertise
Targeting
Targeting
• Define behavior clearly (both bad and
good)
• Point direction (describe positive
behavior you are looking for)
• Target the behavior not the person (be
respectful)
Remember that
unaddressed co-occurring
disorders may impede the
client’s ability to achieve
abstinence
Incentive and Sanction
Highlights
• Verbal acknowledgement
• The A Team
• Fish bowl (having your name in the
bowl is a reward)
• Being chosen as a mentor
• Peer nominated participant of the
month
Decision
Dollars
$
$
Incentive and Sanction
Highlights
• Thought Paper or Recording
• Community Service (giving back
meaningfully)
• Jury Box
• Jail
Courts that use jail greater than 6 days have worse (higher) recidivism
Incentive and Sanction
Highlights
• For some, incarceration is NOT the worst
punishment – (for some it is trauma)
– The threat of jail works best on those who have
something to lose by incarceration.
– Positive reinforcement works on those who have
nothing to lose by incarceration.
• Treatment responses may be perceived as
punishments-communication is the key to
explaining the difference.
Incentive and Sanction
Highlights
FOCUS ON THE POSITIVE BEHAVIOR
• People need to know what positive behaviors
are - before they can perform them
• They know what not to do, they need to
know what to do instead
• Bring up the participants doing well first (the
A team), and ask them what they are doing
that helps them succeed. (This will have the
most positive impact on those watching).
Incentive and Sanction
Highlights
Video 1: Highlighting the positive
Video 2: The A Team
Videos 3a-3d: Positive UA with jail sanction
Video 4: Learning experience with thought
paper
Incentive and Sanction
Highlights
During video, think about whether the judge:
• Is Respectful
• Allows the participant to explain
• Provides a clear explanation of behavior
being sanctioned
• Provides a clear explanation of what to do
instead
• Provides a learning experience for other
participants
Sample Incentive and
Sanction Schedules
• http://ndcrc.org/content/list-incentives-
and-sanctions
• http://ndcrc.org/content/incentives-and-
sanctions-fact-sheet-0
Other good info on incentives and sanctions:
• www.drugcourtonline.org
Sample Incentive and
Sanction Schedules
• Washington D.C.
• Merced, CA
• Kansas
• NDCI
Sanction Exercise
Behavior
First 30 days
Question T2: John
Abuser
T1: Allen
Addict
Positive for
cocaine
Proximal or Distal?
Sanction low, middle
or high?
Missed
Treatment
Session
Proximal or Distal?
Sanction low, middle
or high?
Missed Court
Session
Proximal or Distal?
Sanction low, middle
or high?
P D
M/H L
P P
M M
P P
M M
Incentives Exercise
Behavior
After 180 days
Question T2: John
Abuser
T1: Allen
Addict
Negative drug
tests for last 30
days
Proximal or Distal?
Incentive low,
middle or high?
Made all
Treatment
Session on time
for last 60 days
Proximal or Distal?
Incentive low,
middle or high?
P P
H M
P P
M M
“All Behavior is followed
by a consequence, and
the nature of that
consequence modifies
the organisms tendency
to repeat the behavior in
the future”
• B.F. Skinner
Normal methamphetamine addict 15 months post
abstinence
Patience: we are in this for the long haul.