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Midland CountyDay Treatment Program
USING DATA TO DRIVE EVIDENCE-BASED PRACTICES
Michele M. BellAssistant Director
Midland County Juvenile Care Center
ELEMENTS TO SUCCESSFUL IMPLEMENTATIONIdentify Champions and StakeholdersEducate & collaborate with community leaders &
agenciesUse data to drive program selection and
decisions targeted to the criminogenic needs and risk factors of the youth in the Court
Monitor implementation for fidelity to the modelCollect data to support the use of the evidence-
based practiceHave Patience: Change is difficult and be ready
for resistance
Timeline
2001 2002 2004 2005 2005 2008 2009
1997 2002 2003 2005 2005 2008 2008 2010 2011
Juvenile Offense Rates & Recidivism Rates are lowest since 1998
Principles of Evidence-Based Practices
Assess Risk Level:
YASI Youth Assessment Screening Instrument
MAYSI Massachusetts Assessment Screening Instrument
Youth Skill Assessment
Criminogenic Need Response
Accommodations/Anti-Social History Build non- criminal alternatives to risky situations, structure 40-60% of day
Anti-social cognitions Reduce anti-social cognition, recognize risky thinking and feelings, adopt an alternative identity
Anti-social companions Reduce association with criminals, enhance contact with pro-social peers
Anti-social personality or temperament Build problem solving, self management, anger management, and coping skills
Assess Needs & Target Interventions
The Top Four Needs
Criminogenic Need Response
Family and/or marital status Reduce conflict, build + relationships and communication, enhance monitoring/supervision
Substance abuse Reduce usage, reduce the supports for abusive behavior, enhance alternatives to abuse
Employment/School Provide employment seeking and keeping skills and Enhance performance rewards and incentives
Leisure and/or recreation Enhance involvement and satisfaction in pro-social activities
The Lesser Four Needs
Assess Needs & Target Interventions
Criminogenic Need Program/Intervention ExamplesAnti-social history Electronic Monitoring, Curfew, Community
Service Work, Restitution, Victim Impact (VIG)Anti-social Thinking MRT, VIG, ART, PX2, Thinking for a Change (CBT)Anti-social Peers MRT, Pro-social Activities, Thinking for a
Change (CBT )Anti-social Personality or Temperament MRT, VIG, CBT, Thinking for a Change (CBT), Family Stressors Common Sense Parenting, Wraparound, MST,
MST-PSB, Intensive Counseling, In Home Services, BSFT, ART interactive Sessions for Parents, Family Meetings
Substance Abuse J & A Counseling, MST, Partners in ChangeEmployment Staff driven: Job shadowing, resume
development, applications, job searchesEducation School on site, E2020 Credit Recovery, TutorsLeisure Midland Community Center, Gymnastics,
Karate, Horse Farm,
Need/Intervention Guidelines
DosageMedium Risk youth receive 100 hours of cognitive-based
interventionsHigh Risk youth receive 200 hours of treatmentAll intervention hours are trackedAll interventions challenge thinking errors, cognitive distortionsFamily Involvement: Weekly family contact, family activity, family
counseling, parenting classes, intervention meetings as neededTreatment plans reviewed informally on a weekly basis, formally
on a monthly basis with the treatment team, and reviewed with the Court every three months
BOY BELL DAYS IN PROGRAM Summer 1 2 3 4 5 6
DATE Program 8/29 8/30 8/31 9/1 9/2 9/6PHASE TRACKING
Made Day=1 Not Made=0 1 1 1 1 1 1Character Coupons 1 1 3 2Sanctions L1-1 Contracts CURRENT DAY 1 2 3 4 5 6Skill Assessment
GROUP TRACKING Skill streaming 44.5 1 1 1 1Anger Control 7 1 1Moral Reasoning 5 Safe Dating SITCAP VIG 21 Substance Abuse 28.5 TOTAL HOURS 106 107 109 109 109 110 112
DRUG TESTING Time Testing Personnel 12 PANEL TEST THC (ONLY) ALC PBT
Sample Day Treatment Tracking Form
Daily ScheduleMONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
8:00 - 8:15 AM Breakfast/ RRS Breakfast/RRS Breakfast /RRS Breakfast/ RRS Breakfast/ RRS
8:15 – 8:30 AM Chores Chores Chores Chores Chores
8:30 – 8:45 AM Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity
8:45 – 10:15 PM Class Class Class Class Class
10:15 – 10:30 AM
Review Skill of the Week/ Break
Review Skill of the Week/ Break
Review Skill of the Week/ Break
Review Skill of the Week/ Break
Review Skill of the Week/ Break
10:30 – 12:00 PM
Class Class Class Class Class
12:00 - 12:20 PM Lunch Lunch Lunch Lunch Lunch
12:20 - 12:30 PM Chores Chores Chores Chores Chores
12:30 - 12:40 PM Free Time Free Time Free Time Free Time Free Time
12:40 - 2:05 PM Class Class Class Class Class
2:05 - 2:10 PM Break Break Break Break Break
2:10 - 3:15 PM Class Class Class (Aftercare Boost) Class Class
3:15 - 3:30 PM Snack/Break Snack/Break Snack/Break Snack/Break Snack/Break
3:30 – 5:00 PM Group-Weekend Review Group-Substance Abuse Group -Safe Dating Group-Victim Impact Group-LAP/Incentive Time
5:00 – 5:20 PM Dinner Dinner Dinner Dinner Dinner
5:20 – 5:30 PM Chores Chores Chores Chores Chores
5:30 PM – 6:30 PM
GroupSkillstreaming 1
GroupSkillstreaming 1 Continued
GroupAnger Control (MRT Target 11/23)
GroupAnger Control Continued
GroupSkills for Weekend
6:30 – 6:45 PM Review “Made My Day” Review “Made My Day” Review “Made My Day” Review “Made My Day” Review “Made My Day”6:45 – 7:15 PM “Made My Day” Free
Time or Skill Group“Made My Day” Free Time or Skill Group
“Made My Day” Free Time or Skill Group
“Made My Day” Free Time or Skill Group
“Made My Day” Free Time or Skill Group
7:15 PM Home Home Home Home Home
Cognitive Based InterventionsA.R.T.: AGGRESSION REPLACEMENT TRAINING Cornerstone Program for Day Treatment
Three Components:SkillstreamingAnger ControlMoral ReasoningUsed for all behavior interventions (role plays)
BOOSTER SESSIONS for Transitioning YouthVICTIM IMPACTSAFE DATESMST-PSBSUBSTANCE ABUSE GROUP
Family FocusedCommon Sense Parenting (Trained Staff)MST-PSB (CMH) Multi-Systemic TherapyBSFT (CMH) Brief Strategic Family TherapyHome-Based and Wraparound (CMH)Intensive family outpatient (J & A Counseling)Interactive Skillstreaming NightsTeam Meetings
Trained Staff A.R.T. – Aggression Replacement TherapyCommon Sense ParentingCollaborative Problem SolvingVictim ImpactNext Steps for Training:
Thinking for a ChangeMotivational Interviewing
Interventions: CBT, Educational, and Strength Based Skill Streaming Anger Control Moral Reasoning Victim Impact Group Substance Abuse Group Dialectical Behavior Therapy Multi Systemic Therapy & Problem Sexual Behavior Counseling Trauma & Loss Group PX2 MITI Safe Dates Parenting Support / CSP Midland Mentors Healthy Teens Life Skills Midland Community Center Leadership Adventure Program Horse Sport Camp E2020 Credit Recovery Bay Arenac Skill Center MiTech Construction Camp
Increase Positive Reinforcement
RESPECT, RESPONSIBILITY & SAFETY emphasized in every activityused in student evaluations for “Making Their Day”
Verbal Praise 4:1Daily, weekly, monthly incentives for “Made My Day” and Character
CouponsStaff DrawingPhase Incentives
Earn increasing time in structured activity outside the programGoing to high school ½ day classes
School Friday Fun DayEncourages homework completion, good behaviors, parent support,etc.
Working with parents on positive responses to youth’s increased positive behaviors or accomplishments (weekly reports to the parents)
ConsequencesSanctions GridContracts for patterned negative behavior Parents join youth in evening for homework
time
Level 1 Violations
Behaviors:Following staff requestsAppropriate languageRespect own propertyHygiene/ daily routine
TransitioningNon-physical horseplay
Dress CodeWearing seatbelt incorrectly(3rd time violation = move to
Level 2 sanction)
Level 2Violations
Behaviors:Respect to others
Participation in programming
Physical boundariesCompliance with Program
Responsibilities (RRS)Approved items policyNot wearing seatbelt
Repeated Level 1Behaviors (3rd time violation = move
to Level 3 sanction)
Level 3Violations
Behaviors:Gang related activities(non-
violent)Verbal aggression
Respect for personal safetyRespect for other’s
propertySafe expectation
GamblingRepeated Level 2Behaviors(3rd time violation = move
to Level 4 sanction)
Level 4Violations
Behaviors:Violation of safety and security expectations
Major destruction of property (>$300)
Contraband policy Escape (attempted)
Assault and battery/ fightingSexually acting out
Repeated Level 3BehaviorsFailed Drug/ Alcohol Test
Violations
SanctionsSanction issued at time of infraction
RedirectionStaff reminder of expectation
Determine SS and RRS applicable. Review with staff and role play.
15 minute privilege restriction at time of infraction
And one of the following MAY be added: Collect cigarette butts in park (if related
to smoking) No free time until homework done
Shower at Center Do an extra chore
Apology to group leader Make reparation
Behavior Specific ConsequenceDress Code:
Call parent to bring in clothing Change into Detention blues
Behaviors on Van: Sit in front seat of the van
Return to Center for parent pick up Picked up first on van the next day
SanctionsSanction issued at time of infraction
Lose privileges for the dayRequires Thinking Report
Determine SS and RRS applicable. Review with staff and role play.
And one of the following MAY be added: Written explanation of which RRS are
violated Make up time lost in group or activity
(if applicable) Do extra chore for person who
violated Suspend time period to earn bonus
points Clean grounds of Park, JCC, Animal
Control Separated from the group for 24
hours Do all dinner chores for the day
Call parent for a meeting Youth present skill to group/ role
play/ presentation Youth decides sanction using
Collaborative Problem Solving and presents to staff for approval
Choose job from job jar Behavior Specific Consequence
Contraband confiscated for 5 passing days
Parent to come in and stay late with youth to work on homework if
homework not completedBehaviors Related to Transportation:
Stay late one day if missed ride/ late for van and clean vans and parent
pick up
SanctionsSanction issued at time of infraction after
team meeting (same day)Loss of privileges for 1-3 days
Loss of social skill credit for that day (for in group infraction)
Requires Thinking ReportRequires “Freeze” for one day or until day is
“Made”Determine SS and RRS applicable. Review with
staff and role play.And one of the following MAY be added:
Report to PO Stay late and do chores
Call parent for meeting and stay late until takes place
Written Contract Choose job from job jar
Youth present skill to group/ role play/ presentation
Youth decides sanction using Collaborative Problem Solving and
presents to staff for approval Behavior Specific Consequence
Behaviors Related to Transportation: Parent has to transport to and from
the Center the next day
SanctionsSanction issued at time of infraction after team
meeting (same day)Loss of privileges for 1-3 days
Requires Thinking ReportRequires “Freeze” until determined by team
Determine SS and RRS applicable. Review with staff and role play.
And one of the following MAY be added: Potential Detainment
Contraband confiscated Letter of apology to person(s) violated
Restitution for damaged property
Sanctions
Measure Progress, Practices & Feedback
Daily youth evaluation for demonstration, interaction, participation (RRS) for “Made My Day” or not
Youth skill assessment and demonstration of skills for phase advancement
YASI (completed every three months by PO)Participation in outside activities: Evaluate ability to generalize
learned skillsFamily and professional staff team meetings to evaluate goalsWeekly contact with parentsExit interviewsTransition meetings with schoolsRecidivism measurement
Analysis of recidivism rates proves that the local rehabilitative programs that have been put into place over the last three years are working. Recidivism has dropped significantly in the Day Treatment Program from 59% (1997-2007) to 17% (2008-2010)
Recidivism Rates
No Re-Offense 0-6 Months No Re-Offense 0-12
Months No Re-Offense 0-18 Months
0%10%20%30%40%50%60%70%80%90%
100%
70%
50%41%
91%84%
83%
1997-20072008-2010
Day TreatmentHabitat for Humanity
Midland Community Center
Midland Public Schools
Bay Arenac Skill Center
MITECH
J and A Counseling
Janis Duke
Humane Society
Delta College
Shelterhouse
Michigan Works
Family and Children’s Services
Community Mental Health
Partners in Change
Boy Scouts
Midland Mentors
The Rock
Horse Sports Center
Donors: The Herbert H and Grace A Dow Foundation, The Midland Community Foundation, Rebecca Cox, Richard and Donna Gross,
Various individual donations
The Legacy Center
Community Support
EducationMPS Classes
E2020Bay Arenac Skill Center
TutorsCredit Recovery
Service ProjectsHumane Society
MCC Leadership AdventureCollaborate with Kiwanis
Dog RunShelterhouse
Habitat for HumanityHorse Farm
ParentsWeekly Phone Updates
Team MeetingsParent Intervention Meetings
Interactive Skillstreaming NightsEducation Classes
Newsletter
Youth TreatmentVictim Impact
Trauma and Loss GroupART Programs
Individual and FamilyCounseling
Substance AbuseDBT
MST-PSB
Education GroupsSafe Dates
Cooking ClassesBotvin Life Skills
Job Shadowing/Job SearchPX2 and MITI
Ongoing Skills for Life TrainingArt Projects
Substance AbuseSee Family and Youth
TreatmentYoga and Mindfulness TrainingFamily Treatment
“Common Sense Parenting”In-Home Counseling
WraparoundMST and MST-PSB
BSFTIntensive Outpatient
Substance Abuse Family Treatment
Pro-Social SkillsMidland Mentors
MCC Leadership Adventure Program MCC ClassesWork Groups
MCC Summer CampBoy Scouts Venture Crew
Muy Thai KickboxingKarate
Volunteering Gymnastics
SportsThe Rock
Day Treatment Youth
Day Treatment Targeted Programs for High Risk Areas for Youth