MI Implementation in Juvenile Justice: A Case Report

Motivational interviewing (MI) is a communication style focused on enhancing clients’ own motivation towards change. In the justice system MI has evidence to support that it enhances communication and change behaviors in youth. As most MI training is designed for healthcare settings training and implementation of MI must be adapted to fit the juvenile justice model. This includes both rehabilitation and restorative justice. Here we describe the details that allowed one county small county in Pennsylvania to roll out MI training and initial skills review in less than 6 months. The case reviews the details of planning, trainings, and timing of activities. We then discuss what elements of those details fit into a greater implementation plan that may be applied elsewhere. Four key elements were instrumental to implementation: 1) appreciation of JPO time constraints, 2) cost containment 3) using blending to enhance JPO flexibility with MI use, and 4) policies that normalize use of MI. This outline may assist other courts in their own implementation efforts.     

The Relational Principle of Trust and Confidence

This article seeks to explain why, in terms of Iain Macneil'srelational theory of contract, the implied mutual duty of trustand confidence can be described as a quintessentially relationalnorm. The role played by the duty in the development of a relationalapproach to variation of the employment contract is examined.The potential for the trust duty to become a relational principleinforming the content of the employment contract is explored.The impact of litigation based on the trust duty in creatinga relational approach to employees’ contractual remediesat common law, which have traditionally been dominated by thenotice rule, is assessed. Finally, the potential for there todevelop a relational principle of trust and confidence capableof, to some extent, unifying the contractual, statutory andtortious elements of the law of the employment relationshipis examined.     

Introduction

ABSTRACT

This article argues for the analysis of the flow of ideological discourse through society within and across three distinct but interrelated levels: (1) the canonically defined, or macro level, (2) the intermediate or meso level of competitive political appeals, political relevant public discourse and cultural criticism, and (3) the everyday or micro level of conceptual use by non-experts. This differentiation among levels of ideological action and influence helps us to clarify the objects and appropriate methods of ideological analysis. Methods applied in specific cases must facilitate an effective focus on phenomena on one of these levels while still allowing recognition of the complex forms of direct and indirect conceptual influence and connection between the levels. The article also serves as an introduction to the volume, giving a brief account of the analysis and argument of each contribution.     

The congressional foundations of agency performance

When Congress delegates a policy mandate to a regulatory agency, Congress acts as a principal, choosing the institutional arrangements, or the ‘rules of the game’ for agency decision making. Individuals in the agency, acting as agents, take the rules of the game as given and do the best they can within these institutional arrangements. In this paper we develop a simple model that relates the congressional choice of institutional arrangements to two underlying environmental factors — uncertainty and conflict. We suggest that uncertainty and conflict of interest lead Congress, in delegating, to prescribe a greater scope of permissable regulatory activity, a wider array of regulatory instruments, and more confining regulatory procedures. Increased scope and stronger instruments tend to broaden the overall discretionary authority of the agency, while more confining procedures tend to narrow it. We conjecture that with increased uncertainty or conflict the narrowing tendency more than offsets the broadening tendency, for a net decrease in the agency's overall discretionary authority. Lastly, we argue that the performance of a regulatory agency in fulfilling its mandate is determined in large measure by the foundations Congress constructs for the implementation of delegated authority.     

Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Detection of deception with fMRI: Are we there yet?

A decade of spectacular progress in functional magnetic resonance imaging (fMRI) technology and systems neuroscience research has so far yielded few changes in our daily lives. The dearth of clinical applications of this prolific and academically promising research tool began raising the eyebrows of the public and the research funding agencies. This may be one of the reasons for the enthusiasm and interest paid to the growing body of literature suggesting that blood oxygenation level‐dependent (BOLD) fMRI of the brain could be sensitive to the differences between lie and truth. The word ‘differences’ is critical here since it refers to the often‐ignored core concept of BOLD fMRI: it is only sensitive to differences between two brain states. Thus, available studies report using fMRI to discriminate between lie and truth or some other comparative state rather than to positively identify deception. This nuance is an example of the extent to which applied neuroscience research does not lend itself to the type of over‐simplification that has plagued the interpretation of fMRI‐based lie detection by the popular press and the increasingly vocal academic critics. As an early contributor to the modest stream of data on fMRI‐based lie detection, I was asked by Dr Aldert Vrij to write a piece in favour of fMRI‐based lie detection, to be contrasted with a piece by Dr Sean Spence presenting an opposite point of view ( Spence, 2008 ). This seemingly straightforward task presented two hurdles: having to respond to the popular as well as scientific view of what lie detection with fMRI is and present a wholly positive view of evolving experimental data.     

The politics of flatland

A version of the median-voter theorem holds for two-dimensional spatial models in which voters regard the two dimensions as economic goods or goodlike activities and in which the set of feasible outcomes is constrained by budget or technology. Although mathematically trivial, this fact has widespread analytical uses. After arguing that our two-dimensional model, with its stability property, fits a number of important and general policy areas, we use our analysis to address some prominent theoretical issues.