The Andrews’ principles of risk, needs, and responsivity as applied in drug treatment programs: meta-analysis of crime and drug use outcomes

Objectives

The purpose of the present meta-analysis was to answer the question: Can the Andrews principles of risk, needs, and responsivity, originally developed for programs that treat offenders, be extended to programs that treat drug abusers?

Methods

Drawing from a dataset that included 243 independent comparisons, we conducted random-effects meta-regression and ANOVA-analog meta-analyses to test the Andrews principles by averaging crime and drug use outcomes over a diverse set of programs for drug abuse problems.

Results

For crime outcomes, in the meta-regressions, the point estimates for each of the principles were substantial, consistent with previous studies of the Andrews principles. There was also a substantial point estimate for programs exhibiting a greater number of the principles. However, almost all the 95 % confidence intervals included the zero point. For drug use outcomes, in the meta-regressions, the point estimates for each of the principles was approximately zero; however, the point estimate for programs exhibiting a greater number of the principles was somewhat positive. All the estimates for the drug use principles had confidence intervals that included the zero point.

Conclusions

This study supports previous findings from primary research studies targeting the Andrews principles that those principles are effective in reducing crime outcomes, here in meta-analytic research focused on drug treatment programs. By contrast, programs that follow the principles appear to have very little effect on drug use outcomes. Primary research studies that experimentally test the Andrews principles in drug treatment programs are recommended.     

Migration as a Tool in Development Policy: Caution Ahead?

The World Bank and UNDP have proposed that migration and mobility facilitate economic development. Yet the epidemiological and public health literature has often associated migration and population mobility with the extension and intensification of infectious diseases, most recently epitomised by the AIDS pandemic. Within the context of the well-documented negative developmental impact of AIDS, this suggests a potential clash in perspectives on the role of migration. However, if insights from public health can be incorporated into broader development perspectives, it may be possible to realise the developmental benefits of migration while mitigating or avoiding any associated health concerns.     

Consumption of modern goods and services and it's relation to fertility: A study in Taiwan

A survey in Taiwan showed that couples whose consumption patterns emphasize modem goods and services also exhibit modern fertility behaviour, i.e. they cite a somewhat lower ideal family size and are considerably more likely to be using contraception. Since the ownership of modern goods in Taiwan does not appear to be achieved at the expense of either savings or educational aspirations, a suggested hypothesis is that economic development, by fostering new wants, may encourage couples to limit family size.     

Creating a State‐Academic Partnership to Advance a Forensic Teaching Service: Benefits and Barriers

In Washington State, like many states, there is a shortage of forensically trained mental health clinicians to work with criminal justice‐involved individuals. At the direction of the state legislature, a collaborative project was undertaken by the University of Washington, the state Department of Social and Health Services, and a state psychiatric hospital to develop a proposal for a jointly sponsored forensic teaching service. The authors reviewed the literature, surveyed and interviewed forensic psychiatry and psychology training directors, and conducted site visits of selected training programs that offer multidisciplinary training or have affiliations with state hospitals. The authors conducted focus groups of additional stakeholders, including clinicians and patients in forensic settings, to better understand the needs in Washington. The authors report on several common benefits and barriers to establishing forensic teaching services. Other states and forensic programs may find this article useful in identifying common considerations for forensic mental health teaching services.     

Addressing the mental healthcare needs of foster children: perspectives of stakeholders from the child welfare system

A qualitative study was conducted to better understand the factors that contribute to psychotropic medication (PM) overuse among children in the child welfare system in Kentucky, including barriers to providing psychosocial interventions that potentially minimize the need for PM. Semi-structured interviews were conducted with personnel in the Department of Community-Based Services (DCBS). Participants identified important areas to target for system-wide quality improvement efforts, which included improved exchange of health information, training, and communications on the use of PM, and measures to improve access to non-pharmacological psychosocial interventions to address the mental healthcare needs of children in the child welfare system.