Transcript Effective Application of Sanctions and Incentives

Effective Use of
Rewards & Sanctions
Douglas B. Marlowe, J.D., Ph.D.
Treatment Research Institute at the
University of Pennsylvania
Basic Terminology
SANCTION
GIVE
TAKE
REWARD
Punishment
Positive
Reinforcement
Negative
Reinforcement
Response Cost
Carrot and Stick
• Reduce undesirable behaviors and
increase desirable behaviors
• No thinning for punishment
• Positive vs. negative
reinforcement
Certainty
• Reliable detection is key
• Random drug testing twice per week,
including weekends and holidays
• Sufficient detection windows & panels
• Community supervision
• Last supervisory burdens
to be lifted
• Second chances
Celerity
• Timing is second most influential
• Interference from new behaviors
• Status hearings every 2 weeks until
the case has stabilized
• Noncompliance hearings
where indicated
Magnitude
EFFECTIVENESS
Habituation
Effective
Zone
Effects
MINIMAL
Ceiling
Effects
MODERATE
MAGNITUDE OF SANCTION
SEVERE
Procedural Fairness
• Clearly communicated policies
and procedures
• Presumptive consequences
with flexible application
• Opportunity to be heard
• Respect and dignity
Target Behaviors
• Don’t expect too much
– Learned helplessness and ratio burden
• Don’t expect too little
– Habituation
• Proximal vs. distal goals
• Phase specificity
Treat or Punish?
Substance Dependence or Addiction
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
}
Abstinence is a distal goal
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
Substance Abuse
}
Abstinence is a distal goal
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
Substance Abuse
}
}
Abstinence is a distal goal
Abstinence is a proximal goal
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
Substance Abuse
}
}
Abstinence is a distal goal
Abstinence is a proximal goal
Collateral needs
–
–
–
Dual diagnosis
Chronic medical condition (e.g., HIV+, HCV, diabetes)
Homelessness, chronic unemployment
Treat or Punish?
Substance Dependence or Addiction
1.
2.
3.
Triggered binge pattern
Cravings or compulsions
Withdrawal symptoms
Substance Abuse
Collateral needs
–
–
–
}
}
}
Abstinence is a distal goal
Abstinence is a proximal goal
Regimen compliance is proximal
Dual diagnosis
Chronic medical condition (e.g., HIV+, HCV, diabetes)
Homelessness, chronic unemployment
Tangible Rewards
• Most important for reinforcementstarved participants
• Fishbowl procedure
• Symbolic rewards
Readings
Burdon WM et al (2001). Drug courts and contingency management. Journal
of Drug Issues, 31, 73-90.
Harrell A & Roman J (2001). Reducing drug use and crime among offenders:
The impact of graduated sanctions. Journal of Drug Issues, 31, 207-232.
Marlowe DB (2007). Strategies for administering rewards and sanctions. In JE
Lessenger & GF Roper (Eds.), Drug courts: A new approach to treatment and
rehabilitation (pp. 317-336). New York: Springer.
Marlowe DB (2008). Application of sanctions. In Drug Court Quality
Improvement Monograph. Alexandria, VA: NDCI.
Marlowe DB & Wong CJ (2008). Contingency management in adult criminal
drug courts (pp. 334-354). In ST Higgins, K Silverman & SH Heil (Eds.),
Contingency management in substance abuse treatment. New York: Guilford.
Marlowe DB (2011). Applying incentives and sanctions. In The drug court
judicial benchbook (pp.139-157). Alexandria, VA: NDCI.