1. Managing Participant Behavior in Treatment Courts: Maximizing the available tools Cary Heck, Ph.D. University of Wyoming and Denver District Adult Drug court

2. Why people don’t just change? What causes deviant behavior? Risk and Need factors Social disorganization Life course offenders Sub-cultural norms Mental health issues Economic issues Family and peers Drugs and alcohol feel good

3. What about addiction? Dopamine, Serotonin, and the changes in the brain NEGATIVE CONSEQUENCES Tolerance Withdrawal Symptoms Substance Abuse is the same thing basically without the physical symptoms of withdrawal.

4. Behavior Modification The goal of treatment court behavior modification is to create positive, pro- social change that lasts. The targeted behavior goes beyond substance abuse issues and includes numerous other domains in the lives of program participants. B.F. Skinner (rewards and sanctions) Common sense

5. Important Considerations for Incentives and Sanctions Behavior can be taught Celerity Certainty Appropriateness – Ceiling Effects – Habituation Effects Warnings? Ratios of Incentives to Sanctions Do we treat phase 3 people like phase 1 people?

6. Celerity Not a vegetable Behavior and consequence have to be linked in time. The effects of the consequence diminish exponentially with the passage of time. This is particularly true of children and those with stunted emotional growth. Principle #1: Be speedy Principle #2: If you can’t be speedy be honest.

7. Certainty  Part of the “Rational Calculus.”  Accountability  Response ratios  Drug testing policies (maintain testing levels throughout program)  But life just isn’t certain!!!!  Principle #3: Use all the means available to you to ensure that you are monitoring behavior.  Principle #4: Provide participants with clear expectations.  Principle #5: Follow through!!!

8. Appropriateness NOT Severity Determine the level of sanction or incentive needed to change behavior. Graduated sanctions and incentives. Do NOT “Make an example” of someone. Habituation Effects Ceiling Effects Principle #6: Make the sanction or incentive fit the behavior you are trying to change or reinforce.

9. Fair and Just Why do drug court sessions include the whole group? The perception of fairness is important. Individualize the programmatic responses to the extent possible. You have to get to know your participants. Do NOT be a source of discouragement. Principle #7: Be open with participants about decisions you make to the extent possible. Principle #8: Try to be fair and don’t have favorites.

10. Should we give warnings? Think about the benefits of warnings Now think about the costs Who really benefits from a warning? What are we teaching with warnings? Are they ever appropriate?

11. Desired Ratios and Why 3 or 4 Incentives to every Sanction seems to provide the best motivational effects. What if they just won’t act right? Think about meanings of actions. Possible negative outcomes. Principle #9: Be liberal with incentives and cautious with sanctions.

12. How do we implement the model? Rethink the chart. Brainstorm a list of available incentives and sanctions. Keep that list on hand when discussing participant behavior. Get to know your participants. Be open in court whenever possible. Use therapeutic responses when participants are not responding to treatment interventions Principle #10: Be thoughtful and consistent so that participants know what to expect.

13. Conclusion The science of Behavior Management is clear about the benefits of a model of graduated sanctions and incentives. A careful and complete supervision strategy (including frequent and random drug testing) is imperative for the model to be effective. This science has also been studied with drug court and substance abusing populations. Thanks so much for your time.

14. References Marlowe & Fox (2013) Adult Drug Court Best Practice Standards, Vol I. NADPC, Alexandria, VA Burdon, Roll, Pendergrast, & Rawson (2001) “Drug courts and contingency management.” Journal of Drug Issues. 31(1) 73-90. Carey, Mackin, & Finigan (2012) “What Works? The Ten Key Components of Drug Court: Research-based best practices.” Drug Court Review 8(1), 6-42.