Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

A cognitive-behaviorally based substance abuse treatment program was implemented within a Community Supervision setting. This program included a goals group that included a contingency management component and included the probation agent as a part of treatment. This paper describes the contingency management component of the treatment and discusses, in detail, issues that arose throughout the course of the study. Possible causes and solutions to the issues are discussed from a contingency management perspective that can result in improved reinforcements to achieve better probationer outcomes.     

A qualitative investigation of treatment components for families of youth who have sexually offended

ABSTRACT

Traditional treatment approaches for youth who commit sexual crimes are generally understudied and lack consideration for youths’ evolving context and development. A holistic model is important in service delivery, whereby multiple socio-ecological risk and protective factors are targeted in treatment. Family treatment, a key component of holistic practices, has not been well-defined for families of youth who have committed sexual crimes. Better understanding of the practical techniques used in service agencies can inform family services for youth. Using an inductive grounded theory approach, this qualitative study interviews service providers (N?=?19) to understand components of family treatment. Findings suggest components including problem solving, communication skills, and working through the pain meet certain goals of restructuring and uniting families. The therapeutic relationship was a component that meets all goals of family treatment and helps families and youth overcome stigma of sexual offending. Findings have implications for developing and testing models of family treatment for sexually abusive youth.     

Comparing inmate perceptions of two residential substance abuse treatment programs

Drug and alcohol abuse by criminal offenders remains at an all time high. Residential substance abuse and treatment (RSAT) programs were developed to address the drug and alcohol treatment needs of inmates in prisons. Typically, such programs range in length from 6 to 12 months, have an Alcoholics Anonymous and/or Narcotics Anonymous component, and occur in a therapeutic community environment. Some programs also include a cognitive self-change component. Inmate participation in their programming is crucial to the success of a therapeutic community treatment environment, yet there is little research on the perceptions of RSAT inmates regarding their programming. In this research, the authors describe, compare, and contrast the perceptions of inmate clients of two RSAT programs in a rural mountain state.     

Using wilderness therapy in treating adolescent sexual offenders

Abstract

This article describes a follow-up study of 14 adolescent sexual offenders who had attended a community treatment programme. A core component of their treatment included outdoor wilderness group therapy. Interviews were conducted with adolescents and parents and tapped several areas including social skills and peer relationships, victim empathy, cognitive distortions, safety plans and coping with high risk situations, sexual offending cycle, perceived level of risk, intimacy and sexuality. The study also examined the child protection service records of the It adolescents. Data from child protection service computer records showed that none of the adolescents had reoffended. Interviews with adolescents and families focusing particularly on the wilderness component of the programme showed positive changes.     

The need for child maltreatment research and program evaluation

The knowledge base supporting child abuse treatment and prevention rests upon clinical experience and applied research. An analysis of program funding in the United States indicates that unevaluated clinical programs are funded rather than research or program evaluation projects. Grant funding patterns for the National Center on Child Abuse and Neglect were analyzed for 4 years. Overall, 66% of projects had no research or evaluation component. Without such programs, we cannot determine the effectiveness of treatment and prevention efforts that, while well intended, may have no effects on the participating parents and children, or, worse still, may have unintended negative consequences. Quality programs must be based on the maintenance of a balance between research and clinical efforts with evaluation being an important component of the latter.Portions of this paper were presented at the Seventh International Congress on Child Abuse and Neglect, Rio de Janeiro, Brazil, 27 September, 1988.     

On Being Able to Walk Twenty Metres: The Introduction of Personal Independence Payments

The Welfare Reform Act 2012 introduced Personal Independence Payments (PIPs), and in particular the enhanced‐rate mobility component (ERMC), with its twenty‐metre test to replace the more flexible fifty‐metre test for the higher‐rate mobility component of Disability Living Allowance (DLA). The government objective was to reduce the number of recipients of the benefits, which carry eligibility to the Motability scheme. Rather than modify DLA so as to cure its perceived faults, the government decided to ignore the past and start afresh. The article examines the implementation of PIP, including the treatment of the application of the author, and shows that the norms according to which DWP operates the benefit, are radically at variance with those in the Social Security (Personal Independence Payment) Regulations 2013. These developments have been central to the creation of a ‘hostile environment’ for people with disabilities.     

Family Drug Treatment Courts As Comprehensive Service Models: Cost Considerations

Literature on family drug treatment courts (FDTCs) suggests that parental participation in these courts is associated with improved substance abuse treatment and child welfare system outcomes. Despite these beneficial outcomes, FDTCs serve only 7‐10% of eligible child welfare involved families. As part of a FDTC evaluation, this FDTC site sought to provide stakeholders with information about costs and benefits. Considering the program costs alongside the cost avoidance from reduced time in foster care, this analysis determined that FDTC participation resulted in a net savings per child of $9,710. The cost component of the evaluation proved valuable, challenging, and informative.     

Treatment manuals: The good,the bad and the useful

Abstract

This paper offers a commentary on the debate between Marshall and Mann on the desirability and merits of treatment manuals in the treatment of sexual offenders. Marshall offers a view of manuals as restrictive to clinical practice and as stifling to clinical innovation. Mann takes the position that manuals are a vital component in effective correctional practice. The commentary suggests that these contrary views are understandable: Marshall takes a clinical perspective and advocates best practice; Mann speaks from a realist forensic perspective in which manuals offer a practical means to deliver treatment on a large scale within prisons and probation. Of course, both positions have their merits and it is suggested that the two are perhaps not irreconcilable if the skills of the practitioner and model of treatment delivery are taken into account.     

Distress Tolerance and Intimate Partner Violence among Men in Substance Use Treatment

Intimate partner violence (IPV) is overrepresented among men in substance use treatment. Individuals who relapse following substance use treatment report greater IPV perpetration relative to individuals who remain remitted. In addition, distress tolerance has been shown to be an important treatment target in substance use treatment, with distress tolerance predicting relapse following treatment. However, we are unaware of any research that has examined the relationship between distress tolerance and IPV among men in substance use treatment, which may hold important treatment implications. The current study therefore examined this relationship in a sample of men in substance use treatment (N = 138). Results demonstrated that distress tolerance was negatively associated with physical and psychological IPV perpetration. After controlling for age and substance use and problems, distress tolerance remained associated with psychological, but not physical, IPV perpetration. These findings suggest that distress tolerance may be an important component of treatments for IPV, particularly for psychological aggression. Substance use treatment programs that target distress tolerance may concurrently reduce the risk for relapse to substance use and IPV perpetration.     

Improving violence intervention outcomes by integrating alcohol treatment

There is extensive empirical and theoretical support for a link between alcohol use and intimate partner violence. Recent innovations in the assessment of these constructs have shown a strong temporal link between alcohol use and intimate partner violence. The majority of men participating in batterer intervention programs have alcohol problems, and these men are at very high risk for violence recidivism. Research has shown substantial decreases in partner violence among alcoholics subsequent to obtaining alcohol treatment. It is likely that violence outcomes could be significantly improved by incorporating alcohol treatment as a standard component of batterer intervention programs.     

Intensive case management as a jail diversion program for people with a serious mental illness: a review of the literature

This article reviews the research on intensive case management (ICM) programs as a jail diversion intervention for people with a serious mental illness (SMI). The review includes two types of ICM programs: (a) general ICM programs that included an assessment of arrests and incarceration rates for people with an SMI and (b) ICM programs specifically implemented as a component of a jail diversion intervention for people with an SMI. Results indicate that general ICM programs (19) rarely led to reductions in jail or arrest rates over time, and these rates were similar to those found in standard mental health services. General ICM programs that included an integrated addiction treatment component (8) had mixed results but a trend toward reductions in rates of arrests and incarceration over time for individuals with an SMI and a co-occurring substance use disorder. Results were mixed for jail diversion interventions with an ICM program, but most ICM programs (8) led to significant reductions in arrests and incarcerations over time. Specific elements of effective ICM jail diversion programs are discussed.     

Treatment planning with the Psychopathy Checklist-Revised (PCL-R)

The Psychopathy Checklist-Revised (PCL-R) is an essential component of any assessment protocol within forensic and correctional settings. Both nomothetic and idiographic interpretations aid the clinician in screening and treatment planning. Whereas the PCL-R can be effective in identifying those who are at highest risk of disrupting treatment efforts and jeopardizing the safety of those around them, through item analysis, it also provides clues to the nonpsychopath's unique treatment needs. Specific recommendations are offered regarding the implementation of the PCL-R for screening and treatment planning, and illustrative case examples are provided to enliven essential points.     

服刑人员分级处遇制度研究

分级处遏制度是行刑个性化和刑罚人道的重要内容，具有激励服刑人员改过自新的重要功能，同时也是监狱调控服刑人员改造行为建立良好监管秩序的重要手段。分级处遏制度本身具有较强的技术性和专业性，需要精巧的立法设计和科学的实施。而受旧有的行刑观念和制度的影响，我国现有的分级处遏制度还比较粗疏和薄弱，激励机制明显不足，对推动服刑人员的矫正工作相当不利。亟待从立法、运作措施和人员专业化等方面进行完善。     

The application of the transtheoretical model to offender populations: Some critical issues

Purpose. Over the past two decades, the transtheoretical model (TTM) of change has become perhaps the most widely used model of behaviour change in the treatment of addictive and/or problem behaviours. More recently, the stages of change component of the TTM has been adopted for use in forensic settings. This paper aims to review the application of the TTM model to offender populations. Arguments. The application of the TTM to offenders raises a number of issues regarding the process of behaviour change for offenders attending treatment programmes. It is argued that while the TTM has been designed to account for high frequency behaviour (e.g. smoking, alcohol misuse), offending behaviour may be less frequent and the process of change less cyclical. Moreover, it is suggested that the most important issue in a treatment context is the proper integration of the TTM constructs. There have been few empirical tests of this aspect of the model. Conclusion. While the TTM may have some value in explaining how rehabilitation programmes help offenders to change their behaviour, the stages of change construct is, by itself, unlikely to adequately explain the process by which offenders desist from offending.     

Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series

Some juveniles who engage in sexual offenses may have a paraphilia, a psychiatric disorder characterized by a pervasive pattern of deviant and impairing sexual fantasies, thoughts, and/or behaviors. Though there is no known cure for these conditions, paraphilias can be effectively managed using a multimodal treatment approach. This may include the use of psychotherapeutic and pharmacological treatment interventions, including antiandrogen medications. One such agent, leuprolide acetate (leuprolide), a luteinizing hormone-releasing-hormone agonist, has been shown to be effective in reducing paraphilic symptoms in adult patients. To date, however, there is no published data on its use and effectiveness in adolescent and young adult paraphilic patients. This study consists of a case report series of six young adult patients treated with leuprolide. All subjects had been diagnosed with at least one paraphilia (i.e., Pedophilia, Sexual Sadism, Frotteurism, and Paraphilia Not Otherwise Specified). All subjects had been refractory to treatment in a residential program for adolescent sex offenders prior to initiation of leuprolide. All six subjects reported a reduction in sexually deviant symptoms following treatment with leuprolide. Clinicians rated four as much improved and two as moderately improved. The treatment was well tolerated in all six subjects. This preliminary case series supports the conclusion that leuprolide deserves further examination as a potentially safe and effective component in the treatment of young adult patients with paraphilia.     

Alcohol-related battering: Developing treatment strategies

There is a strong association between alcohol and battering. The purpose of this paper is to examine the relationship between alcohol and battering in order to develop appropriate intervention strategies. First,studies demonstrating a correlation between alcohol and battering are reviewed. This is followed by a summary of the intoxicated aggression literature using Graham's (1980) conceptual system. It is tentatively concluded that the role of physiological and cognitive changes brought on by alcohol, the interaction of alcohol and frustration in producing aggression, and needs for personal power in men who drink and then aggress are all promising explanations for the alcohol-battering link. With this in mind, the applicability of disease model-based treatment for alcoholism, cognitive-behavioral-based treatments for alcoholism and battering, and feminist-based treatment for battering are each considered. Finally, a model for incorporating an alcohol component to a batterer treatment program is introduced.     

A meta-analysis of the effectiveness of individually oriented Cognitive Behavioral Treatment (CBT) for severe aggressive behavior in adolescents

This meta-analysis, including six studies (13 effect sizes) and 164 adolescents, examined the effectiveness of individually oriented treatment (which means that the intervention contained at least an individual component, possibly in combination with group and/or family therapy) with CBT-elements for adolescents with severe aggression problems. A large and homogeneous overall effect size was found (d = 1.139) indicating consistency across studies. The included studies examined the effect of three interventions, namely, mode deactivation therapy (MDT; four studies), stress-inoculation therapy (1), and the cell-phone program (1). This multilevel analysis demonstrated that only few individually oriented interventions have been developed and evaluated, while four of the included studies used a weak research design. Effective individually tailored interventions for youths with severe aggression problems (who are unsuitable for group treatment) are scant. There may be added value if group interventions are supplemented with more individually tailored evidence-based interventions.     

Crime victims and attitudes towards the police: the Israeli case

Crime victims are a critical component of the criminal justice system. Their evaluations of the police have been studied through victimization and public attitude surveys mainly in the US and the UK. This study, which utilizes data from a large scale community survey conducted in Israel in 2008, finds that victims’ attitudes towards the police are significantly more negative than those of non-victims regarding police treatment, performance, and trust in the police. This study is the first to compare the views of victims and non-victims in Israel, while focusing on a wider array of attitudes than previously examined.