Applying Research to Practice:Applying Research to Practice:
Using Risk and Need Factors to Determine Systems ResponsesUsing Risk and Need Factors to Determine Systems Responses
TRIscience
addiction
Presented By Cary Heck, Ph.D.
University of Wyoming/NDCI
Criminogenic Criminogenic RisksRisks
TRIscience
addiction
• Age during rehabilitation < 25 yearsAge during rehabilitation < 25 years
• Criminal onset < 16 yearsCriminal onset < 16 years
• Prior rehabilitation failuresPrior rehabilitation failures
• History of violenceHistory of violence
• Antisocial Personality DisorderAntisocial Personality Disorder
• Psychopathy Psychopathy
• Familial history of crimeFamilial history of crime
• Criminal associationsCriminal associations
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction
TRIscience
addiction
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
TRIscience
addiction
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
TRIscience
addiction
} Abstinence is a distal goal
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
Drug Abuse or MisuseDrug Abuse or Misuse
TRIscience
addiction
} Abstinence is a distal goal
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
Drug Abuse or MisuseDrug Abuse or Misuse
TRIscience
addiction
} Abstinence is a distal goal
Abstinence is a proximal goal}
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
Drug Abuse or MisuseDrug Abuse or Misuse
Collateral needsCollateral needs– E.g., dual diagnosis, HIV+E.g., dual diagnosis, HIV+
TRIscience
addiction
} Abstinence is a distal goal
Abstinence is a proximal goal}
Criminogenic Criminogenic NeedsNeeds
Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms
Drug Abuse or MisuseDrug Abuse or Misuse
Collateral needsCollateral needs– E.g., dual diagnosis, HIV+E.g., dual diagnosis, HIV+
TRIscience
addiction
} Abstinence is a distal goal
Abstinence is a proximal goal}
} Regimen compliance is proximal
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
AccountabilityAccountability&&
TreatmentTreatment
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
AccountabilityAccountability&&
TreatmentTreatment
TreatmentTreatment
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
AccountabilityAccountability&&
TreatmentTreatment
TreatmentTreatment
AccountabilityAccountability
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
AccountabilityAccountability&&
TreatmentTreatment
TreatmentTreatment
PreventionPrevention
AccountabilityAccountability
Risk & Needs MatrixRisk & Needs Matrix
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
AccountabilityAccountability&&
TreatmentTreatment
TreatmentTreatment
PreventionPrevention
AccountabilityAccountability
Practice ImplicationsPractice Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Status hearingsStatus hearings Intensive treatmentIntensive treatment ComplianceCompliance is proximal is proximal Restrictive sanctionsRestrictive sanctions Positive reinforcementPositive reinforcement
Intensive treatment Intensive treatment AttendanceAttendance is proximal is proximal
Positive reinforcementPositive reinforcement
Status hearingsStatus hearings
AbstinenceAbstinence is proximal is proximal Restrictive sanctionsRestrictive sanctions
Prevention Prevention AbstinenceAbstinence is proximal is proximal
Policy ImplicationsPolicy Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Policy ImplicationsPolicy Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Drug CourtDrug Court
Policy ImplicationsPolicy Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Drug CourtDrug Court
Drug CourtDrug Court
OrOrTrack 2Track 2
Policy ImplicationsPolicy Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Drug CourtDrug Court
Drug CourtDrug Court
OrOrTrack 2Track 2
TraditionalTraditional
adjudicationadjudication
Policy ImplicationsPolicy Implications
TRIscience
addiction
High RiskHigh Risk Low RiskLow Risk
High High NeedsNeeds
Low Low NeedsNeeds
Drug CourtDrug Court
Drug CourtDrug Court
OrOrTrack 2Track 2
Pre-trial Pre-trial
diversiondiversion
TraditionalTraditional
adjudicationadjudication