1. Rethinking Evidence-Based Practice for Women and Girls
Barbara E. Bloom, Ph.D., M.S.W.
Stephanie S. Covington, Ph.D., L.C.S.W.
Center for Gender and Justice
AJFO Conference
Jackson, MS
October 11, 2009

2. History Martinson – Nothing works What works – Canadian research
Evidence-based practice vs. gender- responsive approaches
© S. Covington, 2009

3. Evidence-Based Principles for Effective Interventions
Assess actuarial risk/needs
Enhance intrinsic motivation
Target interventions (risk, need, responsivity, dosage, treatment)
Skill train with directed practice (cognitive behavioral treatment methods)
Increase positive reinforcement
Engage ongoing support in communities
Measure relevant processes/practices
Provide measurement feedback
© S. Covington, 2009

4. Evidence-Based Practice in Criminal Justice Settings
Assessment tools address:
Risk - Predict likelihood of reoffending
Need - Treatment and services target “criminogenic” needs
Responsivity - Matching services to the learning styles and abilities of offenders
© S. Covington, 2009

5. Current Concerns Risk/need assessments
Cognitive-behavioral programming
© S. Covington, 2009

6. Risk/needs Assessment
Risk assessments assume that risk can be predicted
Focus is on offender deficits rather than strengths
“The gender problem” – Risk/needs assessment advocates assert that men and women share similar risk and need factors
Feminist literature – Growing body of research that critiques the sameness argument
© S. Covington, 2009

7. “The Big Four” Criminal history Criminal associates
Criminal personality
Criminal thinking
© S. Covington, 2009

8. Risk
Holtfreter, Reisig & Morash (2004) found that poverty status was a more powerful predictor of recidivism among women offenders than the combined summary risk index of the LSI-R.
The authors suggested that the LSI-R fails to take into account the economic marginality of women offenders.
© S. Covington, 2009

9. Risk and Needs Assessment Instruments
Level of Service Inventory Revised (LSI-R)
Correctional Offender Management Profiling for Alternative Sanctions (COMPAS)
© S. Covington, 2009

10. Cognitive-Behavioral Programming
Guided by Social Learning Theory
Assumes that one size fits all
Ignores “gendered pathways”
© S. Covington, 2009

11. Current Concerns (cont.)
Trauma
Lack of therapeutic environment
Mental health
Lack of services
DSM not evidence-based
© S. Covington, 2009

12. Creating the Bridge
National Institute of Corrections – Integration of EBP and Gender Responsive Principles
Pat Van Voorhis – Development of a gender- responsive trailer
Canadian Research – Kelley Blanchette
Development of a gender-informed risk/needs assessment tool
© S. Covington, 2009

13. Gender-Informed Risk Assessment
Blanchette and Taylor question the value and appropriateness of moving forward with gender-neutral risk assessment instruments.
They argue for a “gender-informed” assessment approach including a tool developed “from the ground up.”
© S. Covington, 2009

14. A Shift from What Works to What is the Work?
Prevention
Do no harm
Gender-responsive services
Reentry to community
© S. Covington, 2009

15. Definition: Gender-Responsiveness
Creating an environment through site selection, staff selection, program development, content, and material that reflects an understanding of the realities of the lives of women and girls and that addresses and responds to their strengths and challenges.
(Covington and Bloom)
© S. Covington, 2009

16. Definition of Gender-specific Services/Approaches
…are those that intentionally allow research and knowledge on female socialization and development and girls’ risks, strengths and needs to affect and guide ALL aspects of program and system design, processes, and services…
(DCF/CSSD Guidelines 2008)
Connecticut
© S. Covington, 2009

17. Guiding Principles for Gender-Responsive Services
Environment
Relationships
Integrated Services
Economic & Social Status
Community
© S. Covington, 2009

18. Guiding Principles Gender: Acknowledge that gender makes a difference.
Environment: Create an environment based on safety, respect, and dignity.
© S. Covington, 2009

19. Guiding Principles (cont.)
Relationships: Develop policies, practices, and programs that are relational and promote healthy connections to children, family, significant others, and the community.
Services: Address substance abuse, trauma, and mental health issues through comprehensive, integrated, and culturally relevant services.
© S. Covington, 2009

20. Guiding Principles (cont.)
Socioeconomic status: Provide women with opportunities to improve their socioeconomic conditions.
Community: Establish a system of comprehensive and collaborative community services.
(Bloom, Owen, Covington 2003)
© S. Covington, 2009

21. Women’s Integrated Treatment ( WIT ) This model is holistic, integrated and based on:
The gender-responsive definition and
guiding principles
A theoretical foundation
Interventions/strategies that are multi-
dimensional
(Covington, 2007)
© S. Covington, 2009

22. Four Theories Pathways Trauma Addiction Psychological Development
© S. Covington, 2009

23. Pathways Perspective Women’s crimes embedded in the
conditions of their lives
Examines the specific life course events
that place women at risk for offending
Triple jeopardy: The impact of race, class & gender (Bloom)
Multiple marginality: From families,
school, work (Owen)
Trauma & addiction (Covington)
© S. Covington, 2009

24. Definition of Evidence-based
Evidence-based practice (EBP) is defined as the integration of the best available research and clinical expertise within the context of patient characteristics, culture, values, and preferences.
(APA Presidential Task Force, 2005)
© S. Covington, 2009

25. Whose Evidence is It?
Most research is conducted by the founders of the approach. Up to 40% of the results are due to “allegiance effects.”
(Duncan & Miller, 2006)
© S. Covington, 2009

26. What Kind of Evidence?
Thousands of studies have found no difference among therapeutic approaches
A few studies have found favorable results (example: CBT 15 vs. 2985)
(Duncan & Miller, 2006)
© S. Covington, 2009

27. A Lot to Lose: What it Takes
Emphasis on relationship and trust
Working in partnership with participants
Flexibility with quality standards
Importance of environment
Accountability (by staff and program)
(Smyth and Schorr, 2009)
© S. Covington, 2009

28. What’s at Stake?
Risk of continuing to distort social policy priorities
Risk not being able to make reliable judgments about the effectiveness of programs due to lack of experimental design
Risk spending huge sums of money to gather information that arrives too late to inform decision-making
© S. Covington, 2009

29. What is Needed? A reexamination of what constitutes evidence
How evidence varies by circumstances
More attention and resources invested in practice-based evidence
© S. Covington, 2009

30. What the Research Says 87% of change is client factors
13% of change is therapeutic factors
(Wampold, 2000)
© S. Covington, 2009

31. Behavioral Health (examples of missing information)
Gender
Diagnostic and Statistical Manual (DSM)
What the research says
Client
Therapeutic alliance
Impact of environment
© S. Covington, 2009

32. A Culture Shift: The Core Values of Trauma-Informed Services
Fallot/Community Connections/2008
A Culture Shift: The Core Values of Trauma-Informed Services
Safety: Ensuring physical and emotional safety
Trustworthiness: Maximizing trustworthiness, making tasks clear, and maintaining appropriate boundaries
Choice: Prioritizing woman’s choice and control
Collaboration: Maximizing collaboration and sharing of power with woman
Empowerment: Prioritizing empowerment and skill-building
© S. Covington, 2009 32

33. Gender-Responsive Program Assessment Tool
Program Elements
Theoretical Foundation & Mission Statement
Site and Facility
Administration and Staffing
Program Environment/Culture
Treatment Planning
Program Development
Program Assessment
© S. Covington, 2009

34. Interactive Exercise
Safety
© S. Covington, 2009

35. Concluding Themes Gender matters
Integration of gender-informed theories will increase the efficacy of services for women and girls.
Consideration of women’s (and girls) pathways into the criminal justice system is critical to assessment and case management.
Women’s (and girls) strengths should be incorporated into any model of rehabilitation.
Multi-disciplinary approaches will yield the greatest results for women and girls.
© S. Covington, 2009

36. Emerging Paradigm Values-based Services
Gender-responsive
Trauma-informed
Culturally competent
Recovery-oriented
(SAMHSA 2009)
© S. Covington, 2009

37. Stephanie S. Covington, Ph.D.
For more information:
Barbara E. Bloom, Ph.D.
(707)
Stephanie S. Covington, Ph.D.
(858) `
© S. Covington, 2009