Research-based Intervention for Offenders – Part III Elements of Effective Programming Empirically supported model Empirically supported model Effective methods for intervention Effective methods for intervention Multimodal approach to intervention Multimodal approach to intervention CSC’s Substance Abuse Programs CSC’s Substance Abuse Programs

Empirically Supported Model Cognitive-Behavioural Model Addictive behaviours are as a result of the interaction between biological, psychological and sociocultural factors Addictive behaviours are as a result of the interaction between biological, psychological and sociocultural factors Addictive behaviours are maladaptive because they are the central or sole means to feel pleasure and to deal with life’s demands Addictive behaviours are maladaptive because they are the central or sole means to feel pleasure and to deal with life’s demands Changing behaviour and thinking will modify existing patterns Changing behaviour and thinking will modify existing patterns Relapse Prevention Most people don’t successfully change behaviour on first effort Most people don’t successfully change behaviour on first effort Individuals identify their risk factors and broaden ways to cope in order to decrease likelihood of lapsing or relapsing into old patterns Individuals identify their risk factors and broaden ways to cope in order to decrease likelihood of lapsing or relapsing into old patterns

Effective Methods The intervention is most effective when it is: StructuredStructured Has built in reinforcement, modelling and skills acquisition through role-plays, graduated approximations and extinctionHas built in reinforcement, modelling and skills acquisition through role-plays, graduated approximations and extinction Responsivity factors are identified and addressedResponsivity factors are identified and addressed

Same processes that maintain substance abusing behaviours are used in treatment to change patterns (Reinforcement, modelling, skill acquisition through role-play and graduated approximations, cognitive restructuring) Same processes that maintain substance abusing behaviours are used in treatment to change patterns (Reinforcement, modelling, skill acquisition through role-play and graduated approximations, cognitive restructuring) Motivational enhancement strategies Motivational enhancement strategies Harm reduction model Harm reduction model Effective Methods

Assertion training Assertion training Social skills training Social skills training Problem solving Problem solving Controlled drinking strategies Controlled drinking strategies Methadone maintenance Methadone maintenance Employment training Employment training Recognition of high risk situations Recognition of high risk situations Relapse prevention Relapse prevention Behavioural self- control Behavioural self- control Stress management Stress management Marital Marital Aftercare Aftercare Multi-modal Interventions

Psychology of Criminal Conduct (Andrews & Bonta) Psychology of Criminal Conduct (Andrews & Bonta) Social Cognitive Theory (Bandura) Social Cognitive Theory (Bandura) Cognitive Behavioural Cognitive Behavioural Relapse Prevention Therapy (Parks & Marlatt) Relapse Prevention Therapy (Parks & Marlatt) Coping Model of Criminal Recidivism (Zamble & Quinsey) Coping Model of Criminal Recidivism (Zamble & Quinsey) Transtheoretical Model of Change Transtheoretical Model of Change CSC’s Integrated Model of Change

Integrated Model Crime because learning and skills deficits Crime because learning and skills deficits Substance abuse because of learning, dependency and deficits Substance abuse because of learning, dependency and deficits Beh’r is maintained by past learning, including peer modeling, reinforcement contingencies, cognitive expectations, and biological influences Substance abuse and crime linked Substance abuse and crime linked Change patterns of substance abuse to decrease relapse and recidivism Change patterns of substance abuse to decrease relapse and recidivism Motivational enhancement necessary to facilitate change Motivational enhancement necessary to facilitate change

Integrated Model in Action Timeline – substance abuse and crime link Timeline – substance abuse and crime link Pathway to crime Pathway to crime Relapse Prevention Path and Planning Relapse Prevention Path and Planning

CSC’s National Substance Abuse Programs (NSAP) There are three levels of program intensity to address differing severity of problem – high, moderate and low There are three levels of program intensity to address differing severity of problem – high, moderate and low Programming starts at the beginning of the sentence, where warranted Programming starts at the beginning of the sentence, where warranted Aftercare is mandatory Aftercare is mandatory

Program Timing Assessed Level of Need InstitutionCommunity High Moderate Low NSAP High NSAP Mod Pre- Release Booster MAINTENANCEMAINTENANCE MAINTENANCEMAINTENANCE NSAP low

Menu of Programs

CSC’s application of Effective Program Methods Programs are structured with a “scripted” manual for facilitators to follow Programs are structured with a “scripted” manual for facilitators to follow Programs based on the principles of adult learning Programs based on the principles of adult learning Offenders guided to see personal relevance of the content Offenders guided to see personal relevance of the content All skills are introduced, modelled and reinforced and frequently practiced All skills are introduced, modelled and reinforced and frequently practiced Facilitators sensitised to responsivity factors and given guidance to address Facilitators sensitised to responsivity factors and given guidance to address

Skills in CSC’s Programs Self-control training : self-monitoring, goal setting, Self-control training : self-monitoring, goal setting, Identification of high risk situations Identification of high risk situations Problem solving to deal with triggers Problem solving to deal with triggers Relapse prevention strategies to manage triggers Relapse prevention strategies to manage triggers Cognitive coping : ABC model to identify risky thinking and beliefs, to counter outcome expectancies; inoculation to come up with positive coping thoughts Cognitive coping : ABC model to identify risky thinking and beliefs, to counter outcome expectancies; inoculation to come up with positive coping thoughts Behavioural coping : Behavioural coping : Craving, slip and relapse management Craving, slip and relapse management Intrapersonal control: time out, counting down, breathing techniques Intrapersonal control: time out, counting down, breathing techniques Social skills: listening, receiving feedback, assertion, negotiation, dealing with pressure, asking for help, expressing negative feelings, conflict management, empathy building, perspective taking and community building Social skills: listening, receiving feedback, assertion, negotiation, dealing with pressure, asking for help, expressing negative feelings, conflict management, empathy building, perspective taking and community building

High Risk Situation Ineffective Coping Decreased Self Efficacy + POE LAPSE Violation Effect Analysis of Relapses Self Monitoring + Assessment Competency Assessment + Skills Training + Relapse Prevention Rehearsal Decision Matrix + Lt vs. ST Effects Emergency Relapse Plan Cognitive Restructuring Efficacy Enhancing Imagery + Emotional Regulation Limit use + Slip Management Where it fits

Program Phases All NSAP intensities have same phases Phase I: Deciding What I would Like to Change Phase I: Deciding What I would Like to Change Phase II: Improving the Odds Phase II: Improving the Odds Phase III: Learning the tools for Change Phase III: Learning the tools for Change Phase IV: Using the Skills and Planning for my Future Phase IV: Using the Skills and Planning for my Future

Phase I Goal is to illustrate how participants became dependent upon substances, how it is connected with their criminal behaviour and the consequences of this across all life domains Goal is to illustrate how participants became dependent upon substances, how it is connected with their criminal behaviour and the consequences of this across all life domains Personal goal setting Personal goal setting Identification of obstacles and self- management deficiencies Identification of obstacles and self- management deficiencies Self-monitoring Self-monitoring POE related to crime and drugs POE related to crime and drugs basic social and intrapersonal skills basic social and intrapersonal skills Coping with cravings and urges Coping with cravings and urges

Phase II Goal is to have participants recognise their internal and external risk factors Goal is to have participants recognise their internal and external risk factors Use Inventory of Drug/Drinking Situations to identify HRS Use Inventory of Drug/Drinking Situations to identify HRS Marlatt’s model of Relapse Prevention Marlatt’s model of Relapse Prevention How triggers effect them (T-D-G) and how they build (G-Y-R) How triggers effect them (T-D-G) and how they build (G-Y-R) Development of integrated crime and substance abuse cycles Development of integrated crime and substance abuse cycles Problem solving steps to disrupt the cycles Problem solving steps to disrupt the cycles

Phase III Learning Coping by Thinking and Coping by Doing skills to create a different life (4 key life areas) Learning Coping by Thinking and Coping by Doing skills to create a different life (4 key life areas) Using Cognitive and Behavioural Coping to develop Using Cognitive and Behavioural Coping to develop Better relationships: intimate partners, friends, others authorityBetter relationships: intimate partners, friends, others authority Feeling good – enhancing sense of self, emotion management, mental healthFeeling good – enhancing sense of self, emotion management, mental health Personal control and freedom – putting in place things to stop the return to substance misusePersonal control and freedom – putting in place things to stop the return to substance misuse Satisfying lifeSatisfying life

Phase IV Goal is to finalize the recidivism and relapse prevention plans Goal is to finalize the recidivism and relapse prevention plans Development of life area plans for: substance use, work/school/finance, relationships, leisure, legal, health and well-being, and community building Development of life area plans for: substance use, work/school/finance, relationships, leisure, legal, health and well-being, and community building Evaluate RP and life area plans Evaluate RP and life area plans Set goals for continued change and monitoring Set goals for continued change and monitoring