Transcript Sanctions and Incentives

Responses to Client
Behavior:
Rethinking Incentives and Sanctions
LADCP
April 13th, 2012
Hon. Peggy Fulton Hora (Ret.)
Based on Work by Greg Little, Ed.D., Hon. William G. Meyer (Ret.), West Huddleston
and Jane Pfeifer for the National Drug Court Institute
Why don’t they just change?
• Why can’t people just change when it is obvious that
change is needed?
•Change is hard!
For the alcoholic/addict
• Remaining addicted becomes easier than trying to
change
• Recovery from addiction is a journey that takes time
and effort and is often filled with false starts and
failed attempts
• Our goal is to aid the alcoholic/addict to promote
change through incentives, sanctions and
motivational interviewing
Target Behaviors
Initial Behaviors and Attitudes:
•
•
•
•
•
•
Defiant, Uncooperative, Suspicious
Positive Tests
Denial
Stage of change: pre-contemplative or
contemplative
Withdrawn/ non-communicative
Low self-esteem/confidence
Target Behaviors
Behaviors and attitudes near end of program:
 Communicative
 Self-Aware
 Improved self-esteem
 Maintenance Stage of change
 Aim to Please
 Open
 Greatest folks in the world
What are our Expectations?
•
•
•
•
•
•
•
•
Abstain from drug and alcohol use
Show up to Court
Go to Treatment
Take Random Urine Tests
See Probation and/or Case Manager.
Pay for some of the above
Job
Literacy—GED
• Positive Attitude
Proximal and Distal Behavior
Do we emphasize certain target behaviors during
different phases of the program?
•
•
•
What Behaviors?
Why?
How do we respond to show that emphasis?
The purpose of sanctions and
incentives is to keep participants…
Engaged in Treatment
• Length of time is key: The longer
a patient stays in treatment, the
better they do
• Coerced patients tend to stay in
treatment longer
Judicial Toolkit
Back to the future
• Researchers have found only nineteen incidents of
incarceration in the roughly 120-year period
between 1691 and 1776
Friedman, Lawrence M. 1992. Crime and punishment in American history. New York, NY: Basic Books
• 18th C. America turned to imprisonment because
alternative punishments had lost their ability to
shame
• 20th C. America turned to alternative punishments
because imprisonment has lost its ability to deter
and rehabilitate
Kahan, Dan. 1996. What do alternative punishments mean? University of Chicago Law Review 63: 631
Punishment is not the goal in
the imposition of sanctions;
Changing behavior is.
Drug Court Participant:
• “It’s a learning experience for me. You just
learn what to do. When you see somebody
doin’ right and they get patted on the back,
you think, ‘I want to be like that next time I
come.’ Or when you see someone get the
cuffs slapped on them, you thinking like, ‘Oh, I
ain’t going to do that. I don’t want to be that
person’.”
San Bernardino Drug Court participant focus group
Drug Court responses to
participant behavior:
Incentives
Sanctions
Treatment Responses
Types of Sanctions
Punishment
“Any consequences of a specific behavior that
reduces the likelihood that the behavior will
be repeated, or repeated at the same rate, in
the future” (Marlowe, 1999).
Negative Reinforcement
“The removal of an earned sanction contingent
on a target behavior, which has the effect of
increasing that behavior” (Marlowe,1999).
Negative Reinforcement differs fundamentally
from punishment in that negative
reinforcement focuses on increasing desirable
behavior rather than on decreasing
undesirable behavior.
Pre-trial or pre-sentencing
diversionary programs exemplifies negative
reinforcement, and not punishment.
Incentives Promote Abstinence
• Addiction changes the brain in ways that make
individuals more responsive to short-term rewards
and less able to forego them in the interest of longer
term benefits
• Incentives weaken over time but can show benefits
for 1-2 years
• Adding a “fish bowl” increased success 4xs for
stimulant abusers attaining 12 weeks of continuous
abstinence. Cost is $200 per participant.
Volkow, Nora D., M.D., “Incentives Promote Abstinence,” NIDA Notes 23:3 (2011)
What Does Advanced Behavioral Research Tell
Us About Motivating Behavior Change?
1. Re-State the Principle (What)
2. Explain the rationale/theory and the
research behind the principle (Why)
3. Identify at least one way this applies to the
Drug Court model (How)
1. Sanctions Need Not Be
Painful
Humiliating
Injurious
Harrell, A., & Roman, J., (2001); Brennan P., Mednick S.,
(1994); Murphy et. al., (2001); Sherman, L.W. (1993)
2. Responses Are in the
Eye of the Behaver
Not all punishments are painful, and not
all painful events are punishing.
Petersilla, J. and Dechanes, E. (1994)
Is incarceration always perceived as
the harshest penalty by offenders?
• Contrary to expectations, incarceration is not necessarily
viewed as the harshest punishment. Offenders
preferred 12 months incarceration to:
•
halfway house (6.7%)
•
probation (12.4%)
•
day fines (24%)
Wood, P. B., & Grasmick, H. G. (1995). “Inmates Rank the Severity of Ten Alternative Sanctions
Compared to Prison.” Oklahoma Department of Corrections:
www.doc.state.ok.us/DOCS/OCJRC/OCJRC95/950725j.htm See also Petersilla, J. and Deschanes, E.,
“What Punishes? Inmates Rank the Security of Prison v. Intermediate Sanctions?” Federal
Probation, Vol. 58, No. 1 (March 1994).
Different Strokes for Different Folks
1. Similar sanctions have completely different effects depending
upon the social situation and offender type.
2. Different treatment modalities can increase or decrease
criminality depending on offenders’ personality type and the type
of treatment.
3. Criminal sanctions may decrease criminality in employed
offenders but increase it in unemployed offenders.
4. Threat of criminal sanctions deters future criminality in people
who are older and have more to lose.
See: Sherman, L. W. (1993). “Defiance, deterrence, and irrelevance: A theory of the criminal justice sanction.” Journal
of research in crime and delinquency, 30 (4), 445-473.
3. Responses Must be of Sufficient Intensity
Subjected to punishment at low to moderate
intensities, both animals and human beings
can become habituated (accustomed) to
being punished or threats of punishment.
Marlowe, B. D., Kirby, K., (1999)
Smart Sanctions
The imposition of the minimal amount
of punishment necessary to achieve
program compliance.
Graduated Sanctions
The intensity of sanctions increases with
the number and seriousness of program
non-compliance.
Although Drug Courts recognize that
individuals may relapse, AOD use is never
condoned, and there is always a response to
both compliance and non-compliance.
Relapse is part of addiction,
not recovery
Program Termination
• Threat to public or staff safety
• Virtually never appropriate for continued use
• Written in policy and procedure manuals
• Drug Courts Make Failure and Expulsion From
the Program Difficult for the Participant to
Achieve
4. Responses Should Be Delivered
for Every Infraction
The smaller the ratio of punishment to infractions, the
more consistent and enduring is the suppression of
the undesired behavior.
Azrin, N. and Holz, W., (1966)
Outcomes demonstrate that offenders who received
sanctions on a continuous schedule evidenced a
significantly lower arrest rate than those offenders
who received intermittent sanctions.
Brennan, P. and Mednick, S. “Learning Theory Approach to the Deterrence of
Criminal Recidivism.” Vol. 103, Journal of Abnormal Psychology, pp. 430-440
(1994).
The Key to Sanctions: Reliable
Monitoring
• Nothing spells disaster more for a drug court than
failing to detect and redress negative behaviors or
failing to recognize and reward positive
accomplishments.
• Urine testing that can be trusted
• Every behavior receives a response
• Off-hours supervision (87% of time not supervised)
• “Catch” them doing something right
5. Responses Should be
Delivered Immediately
Delay in imposition of sanctions can allow
other behaviors to interfere with the message
of the sanction.
Dayan, P., & Abbott, L.F. (2001); Marlowe, D., Kirby, K., (1999); Higgins, S.T., & Silverman, D., (1999)
6. Undesirable Behavior Must
be Reliably Detected
Failure to uncover an infraction is, in behavioral
terms, functionally equivalent to putting the
individual on an intermittent schedule.
Higgins, S. T., & Silverman, K., (1999); Marlowe, D., Kirby, K., (1999); Torres, S. (1998)
7. Responses Must Be Predictable
and Controllable
• Perceived certainly of response has a deterrent affect.
Perception is based not only on what does occur but
what the participant expects will occur.
Harrell, A & Romen, J (2001); Burdon, W. et al. (2001) Higgins, B.T. & Silverman, K. (1999)
8. Responses May Have Unintentional Side
Effects
Learned Helplessness
Frequency of Court Contacts
Extrinsic Rewards for Intrinsic
Motivations
Marlowe, B. D., et al., (2002); Higgins, S.T., & Silverman, K. (1999); Deci, E.L., et al., (1999)
Learned Helplessness
“Failure to specify particular behaviors that
are targeted and the consequences for noncompliance can result in a behavior
syndrome known as “learned helplessness
where a drug court participant can become
aggressive, withdrawn and/or despondent.”
Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons From Behavioral
Research.” National Drug Court Institute Review, II (1), 11-xxix.
Response Predictability
• Use of Phase Progression
• Participant Handbook
• Policy and Procedures Manuals
• Courtroom as Theater
9. Behavior Does Not Change by
Punishment Alone
Positive Reinforcement
Rewards the client in his/her natural social
environment to ‘capture’ positive behavior, (i.e.
payment vouchers).
Most of today’s clinical textbooks conclude that
positive reinforcement is far preferable for changing
behavior than punishment.
Marlowe, B.D., 1999; Higgins, S.T. & Petry, N.M. 1999; Higgins, S.T. & Silverman, K.,1999
The Carrot Is Mightier Than the Stick
• Those in reinforcement contingency stayed longer in
treatment than those in punishment-based
programs
• Effects of punishment are transitory- change ends
when punishment ends
• Punishment most effective when used with positive
reinforcement
Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington,
D.C.: American Psychological Association, p. 330
The Mighty Carrot
Incentives
• A positive consequence that is the
direct result of and is a reward for the
offender’s positive behavior.
• Reward productive activities that are
incompatible with crime and drug use.
10. Method of Delivery
• Fairness is Key
• Empathetic communication can improve
participant satisfaction
• Motivational Interviewing
Andreoni, J., et al (2001); Hubble, M.A., Duncan, B.L. & Miller, S.D. (1999)
Effective Incentives/Sanctions:
• reliably monitor participants’ behaviors
• apply sanctions and incentives with certainty
• hold frequent status hearings to ensure
consequences are imposed with immediacy
• administer a gradually escalating sequence of
intermediate-magnitude consequences
• ensure procedural fairness in the
administration of all consequences
Judicial Core Competency #2
Core Competency 2. As part of the drug court team, in
appropriate non-court settings (i.e., staffing), the
judge advocates for effective incentives and
sanctions for program compliance or lack thereof.
Incentives & Sanctions
• After input from the whole team, the judge
should decide on incentives, sanctions and treatment
responses.
• The judge must stay abreast of research on
motivational interviewing and behavioral change
literature.
• The judge delivers a coordinated response to
participants in the courtroom.
Motivating Behavioral Change
1. What is the behavior to be targeted ?
2. Does the behavior need an incentive, a sanction or
a treatment response?
5 Steps to Deliver the response
1. Explain the decision and the factors considered by
the team
2. Review severity of the participant’s substance
dependence
3. Note the behavior being responded to
4. How the behavior is important to their recovery
5. Why the particular sanction and magnitude were
selected
National Drug Court Institute, Incentives and Sanctions: Rethinking Court Responses to Client Behavior
Practice with a partner
Danny has been in drug
court for 3 months. He
has gone as long as 3
weeks without a positive
test. In staffing, you find
out he had a positive test.
Your court requires a
participant disclose use
before testing. Danny
didn’t. How do you
deliver the consequence
to Danny?
What do you say to Danny?
• Is Danny’s abstinence a proximal or distal goal?
• Is there a different response to the “dirty” test and
the lying?
• What sanctions are available and how do you
choose?