effective strategies for individual...
TRANSCRIPT
Effective Strategies for Individual Interventions
An in-depth look at the skills in the EPICS Model
Myrinda Schweitzer Smith, Ph.D. University of Cincinnati
Corrections Institute
Presented at the Fall Substance Abuse Conference St. George, Utah
September 21, 2017
What is EPICS? PURPOSE • This model strives to more fully utilize POs as agents of change
and ensure clients receive a consistent message throughout the continuum of correctional services
• The EPICS model is not intended to replace more intense cognitive-behavioral treatments that address specific domains
What is EPICS? DESIGN • Applies the RNR framework to one-on-one settings
• Trains staff on core correctional practices • Trains staff to intervene where the offender is deficient in making
decisions (Behavior Chain)
• Includes measures of fidelity and coaching sessions
What is EPICS?
RISK
WHO
Deliver more intense intervention
to higher risk offenders
NEED
WHAT
Target criminogenic needs to reduce risk
for recidivism
RESPONSIVITY
HOW
Use CBT approaches
Match mode/style of service to offender
Why EPICS? IMPORTANCE OF THE TRAINING • Bonta et al. (2010) have been collecting data in Canada after
implementation of the Strategic Training Initiative in Community Supervision (STICS)
• Results indicated that trained officers had 12% higher retention
rates in comparison with untrained officers at six months
Why EPICS?
Bonta et al. (2010) The Strategic Training Initiative in Community Supervision: Risk-Need-Responsivity in the Real World. Public Safety Canada.
Why EPICS?
IMPORTANCE OF THE TRAINING • Strategic Techniques Aimed at Reducing Re-Arrest (STARR) • Results indicated that the application of core correctional
practices and adherence to the RNR model can improve offender outcomes (Robinson et al., 2011)
Why EPICS?
0"5"
10"15"20"25"30"35"40"45"
Moderate"Risk" High"Risk"
Control"Experimental"
Robinson, Vanbenschoten, Alexander, and Lowenkamp, Forthcoming, Federal Probation, Sept. 2011.
Why EPICS?
EPICS PILOT RESEARCH
• Effective Practices in Community Supervision (EPICS)
• Results indicated that staff trained in the EPICS model demonstrated more consistent use of core correctional practices
• Trained staff also became more proficient in their use of the skills over time as a result of participation in additional practice sessions
Smith et al. (2012) 9
Why EPICS?
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0 10 20 30 40 50 60 70 80 90
100
Session 1 Session 2 Session 3 Total
Trained
Untrained
% of audiotapes
Trained staff were more likely to spend time discussing criminogenic needs
0 10 20 30 40 50 60 70 80 90
100
Session 1 Session 2 Session 3 Total
Trained Untrained
% of audiotapes
Trained staff were more likely to make effective use of social reinforcement
Why EPICS?
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0 10 20 30 40 50 60 70 80 90
100
Session 1 Session 2 Session 3 Total
Trained Untrained
% of audiotapes
Trained staff were far more likely to identify antisocial thinking
Why EPICS?
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Why EPICS?
EPICS RESEARCH
• Evaluation of EPICS in Ohio
• Involved 21 trained and 20 untrained staff and 272 offenders
• Staff trained in EPICS outperformed untrained staff in the use of core correctional practices during contact sessions
• High risk offenders assigned to high fidelity staff had significantly lower incarceration rates than high risk offenders assigned to low fidelity staff
13 Latessa et al. (2013)
Why EPICS?
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0
10
20
30
40
50
60
Use of Core Correc;onal Prac;ces
Treatment Control Pe
rcen
tage
EPICS RESEARCH
Latessa et al. (2013)
Why EPICS?
0
5
10
15
20
25
30
35
Incarcera;on
High Fidelity/High Risk
Low Fidelity/High Risk
15
EPICS RESEARCH
Latessa et al. (2013)
Percen
tage
WHAT CAN COMMUNITY SUPERVISION LEARN FROM THESE STUDIES? Adhere to the principles of effective Intervention:
• Assess risk and need levels • Target moderate and high risk offenders • Target criminogenic needs • Use cognitive behavioral interventions
Use core correctional practices: • Quality collaborative relationship • Reinforcement, Disapproval, Use of Authority • Cognitive restructuring • Structured skill building • Problem solving skills
Why EPICS?
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What Does EPICS Look Like?
Restrict their situations in the community
AND
Teach clients to recognize high-risk situations
Restructure their antisocial thoughts
Teach emotional regulation skills
Teach alternative behaviors
Reinforce positive behavior
Sanction negative behavior
What Does EPICS Look Like?
SESSION OVERVIEW Each session should be structured in the following way:
1. Check-In 2. Review 3. Intervention 4. Homework
Core EPICS Skills
Relationship Skills: • Active Listening • Reflective Listening • Giving Feedback
Behavioral Modification Skills: • Effective Reinforcement • Effective Disapproval • Effective Use of Authority
Core EPICS Skills
Interventions to address antisocial thinking: • Behavior Chain • Identification of high risk thinking and new thinking • ABC Model • Thinking Report Interventions to address behavioral deficits: • Structured Skill Building • Problem Solving
Core EPICS Skills
Interventions to address motivation: • Cost-Benefit Analysis • Card Sorting
Interventions for emotional regulation: • Predetermined Counters • Structured Skill Cards
Cost-Benefit Analysis
PURPOSE • Weighs both short-term and long-term costs and
benefits of antisocial target behavior and an alternative prosocial behavior
• Helps build motivation towards changing problem behaviors
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The Behavior Chain: Examining the Thought-Behavior Link
• Examine thinking • Challenge risky thoughts • Create replacement
thoughts
27
People, places or
things that can lead to
trouble
Triggers Invitations Activating
Events Antecedents
Ways we interpret the situations
What we tell
ourselves
Present-tense
Drive
feelings and behaviors
Emotions that are
influenced by
thoughts
They influence
our behavior
Influenced by thoughts & feelings
What we choose to do
Increases likelihood a behavior will occur again
Decreases likelihood a
behavior will occur
again
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Old friend approaches me and asks
me to get high
“Smoking sounds really
good right now”
“I miss
getting high”
“It’s only one time”
“I wanna
have a good time with my
friend”
Eager
Anxious
Get high with friend
Get high
Have fun with friend
Relapse
Disappoint Family
Jail
Violation
Cognitive Restructuring
GOAL: Change behavior TO CHANGE BEHAVIOR:
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IDENTIFY ANTISOCIAL THINKING
REPLACE WITH PROSOCIAL
THINKING
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Old friend approaches me and asks
me to get high
Confident
Resolute
“I’m going to get caught if
I smoke”
“I don’t want to lose
everything I’ve worked so hard for”
“It’s really
not worth it”
Tell friend no and go home
Stay sober
No problem with
supervision
Feel proud/gain
confidence
Old friend gets mad
Don’t get relief from
getting high
Structured Skill Building
PURPOSE • Used when problem behavior is likely being caused
by a skill deficit
• Teaches prosocial behavioral responses to high risk situations
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Structured Skill Building
STEPS OF STRUCTURED SKILL BUILDING
1. Introduce the skill 2. Obtain offender buy-in 3. Teach the skill following the concrete steps 4. Model the skill 5. Role play the skill 6. Provide feedback to the offender
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Structured Skill Building
There are many skills to engage in pro-social behavior: • All skills involve steps. • Skill development involves breaking down the steps
for participants. • Steps are often not thought about—“unconscious.” • Some steps involve thinking, while others involve
action.
Structured Skill Building
It’s time to practice!!! Watch the following demonstration of how to model a skill. Select a skill you want to model. Write a script for your model ensuring you follow each step. Practice modeling your skill with your partner.
Structured Skill Building
STRUCTURED SKILL BUILDING TIPS FOR SUCCESS • Target a criminogenic need when using structured skill building
• Apply the skill being taught to a specific risky situation
• Differentiate clearly between thinking and actions steps
• Model exactly how you want the client to use the skill- always act as a realistic, prosocial model during skill building
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Problem Solving STEPS OF PROBLEM SOLVING 1. Identify your problem and goal:
Have the offender state their problem objectively. Determine what exactly the offender wants to happen in the situation and what is best for him/her and everyone involved
2. Brainstorm options and choose the best one:
Brainstorm possible solutions to the problem. Review all the alternatives generated and discuss the short-term and long-term consequences of the solutions
3. Plan and try your solution:
Develop concrete action steps in this stage and role play the plan. The offender will then use this plan to solve the problem
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EPICS In Summary… • Prioritizes higher risk offenders
• Targets criminogenic needs using cognitive-behavioral interventions
• Teaches staff core correctional practices
• Increases dosage
• Can improve agency outcomes
Thank You!
Myrinda Schweitzer Smith, PhD.
Deputy Director University of Cincinnati Corrections Institute