Transcript Menu of Programs - Organization of American States

Research-based Intervention for
Offenders – Part III
Elements of Effective Programming




Empirically supported model
Effective methods for intervention
Multimodal approach to intervention
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 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
Relapse Prevention


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
Effective Methods
The intervention is most effective
when it is:
• Structured
• Has built in reinforcement,
modelling and skills acquisition
through role-plays, graduated
approximations and extinction
• Responsivity factors are identified
and addressed
Effective Methods

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
Harm reduction model
Multi-modal Interventions






Assertion training
Social skills
training
Problem solving
Controlled drinking
strategies
Methadone
maintenance
Employment
training






Recognition of high
risk situations
Relapse prevention
Behavioural selfcontrol
Stress
management
Marital
Aftercare
CSC’s Integrated Model of Change






Psychology of Criminal Conduct
(Andrews & Bonta)
Social Cognitive Theory (Bandura)
Cognitive Behavioural
Relapse Prevention Therapy (Parks &
Marlatt)
Coping Model of Criminal Recidivism
(Zamble & Quinsey)
Transtheoretical Model of Change
Integrated Model


Crime because learning and skills 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
Change patterns of substance abuse to
decrease relapse and recidivism
Motivational enhancement necessary to
facilitate change
Integrated Model in Action



Timeline – substance abuse and
crime link
Pathway to crime
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
Programming starts at the beginning
of the sentence, where warranted
Aftercare is mandatory
Program Timing
Assessed
Level of
Need
Institution
High
NSAP
High
Moderate
NSAP
Mod
Low
M
A
I
N
T
E
N
A
N
C
E
Community
PreRelease
Booster
NSAP
low
M
A
I
N
T
E
N
A
N
C
E
Menu of Programs
CSC’s application of Effective
Program Methods





Programs are structured with a “scripted”
manual for facilitators to follow
Programs based on the principles of adult
learning
Offenders guided to see personal
relevance of the content
All skills are introduced, modelled and
reinforced and frequently practiced
Facilitators sensitised to responsivity
factors and given guidance to address
Skills in CSC’s Programs









Self-control training: self-monitoring,
goal setting,
Identification of high risk situations
Problem solving to deal with 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
Behavioural coping:
Craving, slip and relapse management
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
Where it fits
Self
Monitoring
+
Assessment
High Risk
Situation
Analysis of
Relapses
Efficacy
Enhancing
Imagery
+
Emotional
Regulation
Ineffective
Coping
Competency
Assessment
+
Skills Training
+
Relapse
Prevention
Rehearsal
Limit use
+
Slip
Management
Decreased
Self Efficacy
+
POE
Decision
Matrix
+
Lt vs. ST
Effects
LAPSE
Violation
Effect
Emergency Cognitive
Relapse Restructuring
Plan
Program Phases
All NSAP intensities have same phases
 Phase I: Deciding What I would Like
to Change
 Phase II: Improving the Odds
 Phase III: Learning the tools for
Change
 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
Personal goal setting
Identification of obstacles and selfmanagement deficiencies
Self-monitoring
POE related to crime and drugs
basic social and intrapersonal skills
Coping with cravings and urges
Phase II






Goal is to have participants recognise their
internal and external risk factors
Use Inventory of Drug/Drinking Situations
to identify HRS
Marlatt’s model of Relapse Prevention
How triggers effect them (T-D-G) and how
they build (G-Y-R)
Development of integrated crime and
substance abuse 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)
Using Cognitive and Behavioural Coping to
develop
• Better relationships: intimate partners, friends, others
authority
• Feeling good – enhancing sense of self, emotion
management, mental health
• Personal control and freedom – putting in place things to
stop the return to substance misuse
• Satisfying life
Phase IV




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
Evaluate RP and life area plans
Set goals for continued change and
monitoring