Blog: Evidence-Based Practices

Fit for Trial in the Juvenile Justice System (and More) -- News Roundup

Your Input Needed: Building an Online Community Supporting Evidence-Based Practices and Quality Improvement in Behavioral Healthcare

adolescent-substance-abuse-treatment_construction-signsEvidence-based practices and how to implement them is a priority for many substance abuse treatment organizations, including those treating adolescent.  
To help with this priority, NIATx has launched a new project, the Building a Sustainable National Infrastructure for Research and Dissemination of Improved Behavioral Treatment Practices, funded by the National Institute on Drug Abuse (NIDA). The informal title for this project is “The Network of Practice.”
Its aim? To build an internet-based community focused on adopting evidence-based clinical practices. The resulting tool may include features such as virtual cafes, a step-by-step guide to implementing an evidence-based practice, a library of practical information, and a cost-benefit calculator.
More than 500 organizations have completed an online survey for this project (and that number is growing). You can still complete the survey (which takes about five minutes to complete) by visiting: http://www.surveymonkey.com/s/infra_survey
For more information about the project or to get involved in its development, please contact:
Anna Wheelock at anna.wheelock@chess.wisc.edu or
Kim Johnson at Kimberly.johnson@chess.wisc.edu

Survey of Police Chiefs Shows Need for Police Training to Work with Youth

juvenile-justice-system_cops-lecturing-handcuffed-youth-on-streets-ChicagoAt a  training of Massachusetts MBTA Training Academy recruits in July, a police officer said to the group, “What I am telling you today we did not get when we were in the academy. Now you’ve got a leg up in dealing with kids by knowing this stuff.” The officer had been trained in a train-the-trainer capacity building effort by Strategies for Youth. “Knowing this stuff about kids makes working with them easier and less stressful and believe me, they can be stressful,” he told the recruits.
The newly released findings of the International Association of Chiefs of Police (IACP) survey on juvenile justice and youth training needs suggest this officer is both right and unusual. Training in best practices for working with youth is helpful, but remains the exception to the rule across the country.
The IACP’s survey, the “2011 Juvenile Justice Training Needs Assessment,” found that police chiefs want training but lack funding and agency resources to provide it to their officers.  They wanted their officers to have the skills to work with the increasing and challenging demands posed by youth. The top 5 areas in which chiefs want their officers trained are:

  1. substance abuse;
  2. physical, sexual and/or emotional abuse;
  3. dealing with chronic juvenile offenders;
  4. bullying/cyber-bullying; and
  5. gangs. Other topics included internet offending, runaways, and school safety. 

The survey is notable for the unusually large size of the sample: over 672 law enforcement officers in 404 law enforcement agencies in 49 states and the District of Columbia. The agencies represented the gamut of departments, from small and rural, to suburban, to large and urban; 77% were police departments.  
Demands on  Law Enforcement:
While officers have always dealt with children and youth, arguably today they are asked to deal with them more than ever. Cuts in youth serving programs, the increased placement of officers in schools, and the common reaction of calling the police for any youth-related issue, combine to make police the first responders to incidents involving youth. 

Less Scared Straight, More 'Talk Therapy'

juvenile-justice-system_teen-staring-through-chainlink-fenceThe other day I watched the A&E program Beyond Scared Straight for the first time. I'm familiar with the original 1979 Academy Award winning documentary, Scared Straight!, that inspired many states across the country to institute similar programs in an attempt to deter juveniles already involved with the criminal justice on some level from a future life of imprisonment. These kids are taken on a tour of a jail and introduced to prisoners who recount horror stories of their time behind bars. The hope is that once given a taste of the grim reality of prison life, these 13-19 year old kids will want to go "straight" and avoid incarceration. Executive produced by the director of the original, Arnold Shapiro, this new "reality" series is the highest rated original program in A&E's history.
The show has been met with harsh criticism. In an op-ed for the Juvenile Justice Information Exchange, director of Justice Programs at Governor's Office for Children and Families in Georgia, Joe Vignati wrote: "The scared straight approach is an inappropriate and unacceptable means for disciplining children. This approach has been shown to cause short -and long-term harm and actually INCREASES the likelihood of re-offending among some participants."
A January op-ed for the Baltimore Sun titled "Scary -- and ineffective," written by Laurie O. Robinson and Jeff Slowikowski, two Justice Department officials, sites research that says those who participated in a scared straight type program were 28 percent more likely to offend than youths who had not participated. The Campaign for Youth Justice is calling for the show to be pulled from A&E.
In the episode I saw, there was a young man named Brandon who lived in Detroit. Brandon sported a tattoo on his right forearm of a skull and the word "Heartless" underneath and said he lived by the creed "MHD," which stands for "Money, Hoes, Drugs." Money brings women, and drugs bring money, Brandon explained. The worst he had ever done, he admitted, was shoot someone.

The Effects of Drug Testing in Schools (and More) -- News Roundup

  • Health and Human Services Awards $40 million
    Grants were awarded to 39 state agencies, community health centers, school-based organizations and non-profit groups in 23 states for efforts to identify and enroll children eligible for Medicaid and the Children's Health Insurance Program. (Hat tip to Rob Vincent.)
  • Study Finds Drug Testing in Schools Has Only Small Effect in Reducing Substance Use
    “This study sends a cautionary note to the estimated 20 percent or more of high schools that have joined the drug testing bandwagon,” study co-author Dan Romer said in a news release. “We find little evidence that this approach to minimizing teen drug use is having the deterrent effect its proponents claim.”
  • Fact Sheet: Understanding Child Welfare and the Courts
    Families involved with the child welfare system may have some involvement with the court—in most States, this occurs in a family or juvenile court. This fact sheet is designed to serve as a quick guide to the general types of court hearings that a family may experience, and it traces the steps of a child welfare case through the court system. (H/t Paul Savery.)

Teens Only Listen to One Person…Themselves: How a Child’s Own Reasons for Change Lead to the Most Success

adolescent-substance-abuse-treatment_teens-on-the-street[Please note: Reclaiming Futures and its partners are not endorsing or promoting the author's book. We are reprinting his column because it does a good job of showing how the principles of Motivational Interviewing (an evidence-based practice) can be used to help youth make positive changes. Though written for parents with teens using alcohol and drugs, it also applies to juvenile probation officers and other professionals who work with youth to help them change their behavior -- all sorts of behavior, not just alcohol and drug use. --Ed.]
Imagine you are in the Emergency Department (ED) with your 16-year-old daughter, who was brought in for her second episode of alcohol poisoning in six months. The doctor is about to discharge her because, medically, she’s fine, but you know she’s going to go right back to heavy drinking if you don’t do something. You and your husband feel you’ve tried everything to help your daughter, but you also believe that there has to be some way to take advantage of this dire emergency to motivate her to get into treatment and to stop drinking.
I’ve seen hundreds of families in this very situation and their dilemma is always the same: they all want to influence their child to get on a better path, but they don’t know that there is a quick, easy and scientifically-proven way of getting the job done. The approach I’m referring to is called “Instant Influence.” It’s based on Motivational Interviewing (which in its briefest form has been shown to reduce substance use among adolescents and young adults seen in the ED) and my 20 years of experience motivating some of the most resistant-to-change substance abusing children and adults in a wide variety of settings.
People tend to only listen to one person — themselves. And, as a result, they’re only influenced by one person … again — themselves. So, as frustrating as this may be for a parent who would like to sternly say, “You have to stop!” and to have that be enough, the real trick to motivating someone is to get them to convince themselves to make a change for their own good reasons.

"Beyond 'Scared Straight'" Program “Incoherent” According to Conflict Management Expert

juvenile-justice-reform_beyond-scared-straight-North-CarolinaThe premier episode of the new season of the controversial reality show, “Beyond Scared Straight,” adheres to the themes that made it A&E’s most watched show: a small group of at-risk youth spend the day in prison where they are yelled at, intimidated and humiliated by sheriff’s deputies and inmates alike. The screaming and threats of prison rape are followed by emotional conversations with the inmates as they describe to the teens where they went wrong and how the teens can avoid the same fate.

The episode features Mecklenburg County, N.C.’s “Reality Program,” created by Sheriff Daniel “Chipp” Bailey.
“Our Reality Program stresses education, not intimidation,” Bailey is quoted as saying on the program’s website.
According to the website, the mission of the program is to “provide the community with a program which will help educate young people about the long-term effects of participating in criminal activity.”
After watching the show, non-violent communication and conflict management expert Dr. Heather Pincock was baffled.
“There is no coherent approach in the diversion program,” Pincock said. “Most of the episode they [the deputies] were there to intimidate the youth or break the youth down or humiliate them. Then they suddenly start saying. ‘We’re your friends, we’re here to help you.’ There are very mixed messages around their role. It doesn’t make any sense.”

Poll: Drug Abuse a Top Health Concern for Kids (and More) -- News Roundup

  • Selecting and Implementing Evidence-Based Practices
    Treatment funding is being increasingly tied to outcomes, a trend expected to continue as the integration of behavioral health with primary care moves forward in the context of healthcare reform. Learn more from the Addiction Technology Transfer Center of New England about achieving desired client outcomes in part 2 of a 3-part series.
  • Poll: Drug Abuse Equals Childhood Obesity as Top Health Concern for Kids
    On Aug. 15th, the University of Michigan C.S. Mott Children’s Hospital released the results of its 5th annual national poll, in which Americans rated drug abuse and childhood obesity as the number one health concern for our nation’s youth. This is important news because it shows that drug abuse is now on the radar screens of people throughout the country and that Americans are very concerned about this issue. Community Anti-Drug Coalitions of America issues a statement in response. (Hat tip to Christa Myers.)

"Beyond 'Scared Straight'" Returns to Promote a Discredited Juvenile Justice Intervention (Roundup)

juvenile-justice-system_scared-teenMuch to our dismay, A&E Network will air a second season of "Beyond 'Scared Straight,'" its hit reality-TV show, beginning August 18, 2011. As you may know, the program exposes a group of teens who've committed offenses to a group of adult prison inmates who scream, yell, and talk tough, in an effort to convince the kids to "going straight." 
There's a lot of problems with this approach, but the chief one is this: it doesn't work. There's not a single piece of independent research that indicates it's effective, and quite a lot that shows it isn't -- in fact, an overview of nine studies shows that youth who participate are more likely to commit crimes than kids who don't.  That may make for great television, but it's not good for the kids or our communities. 
We've given a lot of coverage in the past to why "Scared Straight" is a bad idea, so I'll just link to it here:

Photo: anna gutermuth under a Creative Commons license.

VIDEO: Dr. Howard Liddle on Engaging and Changing Troubled Youth

adolescent-substance-abuse-treatment_Howard-LiddleBack in 1974, sociologist Robert Martinson reviewed the research and concluded that "nothing worked" when it came to rehabilitating offenders. Then, in the mid-1990s, when fears about rising juvenile crime rates were at their peak, John DiIulio of Princeton predicted an onslaught of teens in trouble with the law, whom he dubbed "super-predators," creating a toxic political environment for those who knew from experience that youth in the justice system were overwhelmingly capable of positive change and rehabilitation. 
Martinson and DiIulio were wrong. Most importantly, Martinson's research was flawed, and he admitted his errors in print. [For this history and much more, see "Juvenile Justice: Lessons for a New Era."]
But the myths remain -- and they get in the way of our ability to take advantage of new, evidence-based treatments that are exceptionally effective.
So argues Dr. Howard Liddle, of the Center for Treatment Research on Adolescent Drug Abuse (CTRADA) at the University of Miami, in the brief video below:

How to Find Effective Adolescent Substance Abuse Treatment + How to Train Treatment Counselors

adolescent-substance-abuse-treatment_cool-stuff-neon-signHere's four great resources for finding effective adolescent substance abuse treatment programs (emphasis on residential), plus one on how to train clinicians in evidence-based treatment:

  1. How to Find the Best Drug Treatment for Teens: A Guide for Parents -- This guide from TIME magazine is excellent to pass on to parents struggling with their teens' drug and alcohol issues. Among other things, it includes a link to Time to Get Help, an excellent website developed and hosted by The Partnership at Drug-Free.org. (I'm glad TIME got the word about about this -- while Steve Pasierb, CEO of the Partnership, did a post for us about Time to Get Help way back in December, there's no denying that TIME gets a little more traffic than we do. And I was unaware of the next two resources before I read the TIME article.)
  2. Questions for Parents to Ask Before Entering a Youth in a Residential Program - these questions were developed by the Federal Trade Commission and apply to all sorts of residential programs, not just alcohol and drug treatment programs.
     
  3. Ten Important Questions to Ask Teen Substance Abuse Treatment Program
  4. Questions for Youth to Ask When Entering a Treatment Program - Imagine a set of questions youth might ask themselves and others before agreeing to enter a residential program. Questions that could help them adjust to treatment faster.  Now, you don't have to imagine, thanks to the Building Bridges Initiative of the Substance Abuse and Mental Health Services Administration (SAMHSA).  You can see similar tip sheets for parents and recommendations for treatment providers and adolescent substance abuse policy officials at the state level on how to use and disseminate them here. 
  5. Strategies for Training Counselors in Evidence-Based Treatments - What's the most effective way to insure that your clinicians learn to implement evidence-based treatments?  Learn the answer(s) in this article, authored by Steve Martino of Yale University School of Medicine, which appeared in the December 2010 issue of Addiction Science and Clnical Practice. (Hat tip to Paul Savery.)

 
NOTE: This is an updated  version of a post that appeared in February 2011. 

Photo: hometownzero.

Crimesolutions.gov: Programs that Work for Juveniles & Adults in the Justice System, and Crime Victims

juvenile-justice-system_crime-solutions.gov-logoLooking for a credible source of information about what programs work for teens in the juvenile justice system, adults in the criminal justice system, or for crime victims?
Your search just got a little easier. Today, the Office of Justice Programs at the U.S. Department of Justice launched a new website, www.crimesolutions.gov,designed to be a "one-stop shop for programs that work in criminal justice, juvenile justice and crime victim services."
According to the OJP press release, the site "includes information on more than 150 justice-related programs and assigns "evidence ratings – effective, promising, or no effects — to indicate whether there is evidence from research that a program achieves its goals." And its searchable database includes programs for "corrections, courts, crime prevention, substance abuse, juveniles, law enforcement, technology and forensics, and victims."
The juvenile section of the site is divided into four categories:

  • Child Protection/Health
  • Children Exposed to Violence
  • Delinquency Prevention
  • Risk and Protective Factors

Looking for substance treatments for youth in the juvenile justice system? Check under "Child Protection/Health.
Besides dividing program results into "effective," "promising," and "no effect," you'll also see common -- and interesting -- questions, linked to answers.
My favorite was, "What is the national juvenile recidividism rate?" I've been in the field long enough now that it's been years since I've wondered (not seeing the forest for the trees). So I clicked on the answer and learned that there is no official national statistic for juvenile recidivism, because of the wide variability of juvenile justice systems from state to state.

Creating a Holistic Approach to Intervening with Juveniles in the Justice System

juvenile-justice-reform_hands-coming-together[Testimony given April 2011 by John Roman, Ph.D., before the Council of the District of Columbia Committee on Human Services. Reprinted with permission from The Urban Institute. -Ed.]
Good morning. My name is John Roman and I am a senior fellow in the Justice Policy Center at the Urban Institute, where I have studied innovative crime and justice policies and programs for more than a decade. Thank you for the opportunity to testify today about integrating innovative practices to better serve juveniles involved with the justice system and to improve public safety.
Using Lessons from Recent Innovations to Create a Holistic Approach to Intervening with Juveniles
Over the last decade, across the United States, there has been tremendous interest in reforming juvenile and criminal justice systems to both improve their performance and to improve public safety by reducing crime and delinquency among adjudicated youth. What I would like to describe today is how those innovative practices—the Reclaiming Futures initiative, drugs courts and other alternatives to commitment, and Project HOPE—might be integrated to maximize their effectiveness and minimize costs.
In the first phase of Reclaiming Futures, begun in 2002, multidisciplinary teams in ten communities worked collaboratively to enhance the availability and quality of substance abuse interventions for youth involved with the juvenile justice system. All ten projects relied on judicial leadership, court/community collaborations, interorganizational performance management, enhanced treatment quality, and multiagency partnerships to improve their systems of care for youthful offenders with substance abuse problems.

Juvenile Justice, Child Welfare Proceedings on Film for Research and Training, and More: A Roundup

NEW DATE - Webinar: Why and How to Work with Families of Justice-Involved Adolescents

I doubt that there is an influence on the development of antisocial behavior among young people that is stronger than that of the family. (Steinberg, 2000)[i]
 
The most successful programs are those that emphasize family interactions, probably because they focus on providing skills to the adults who are in the best position to supervise and train the child. (Greenwood, 2009)[ii]
 
adolescent-substance-abuse-treatment_compassThanks to many independent reviews, consensus documents, and meta-analyses of the evidence base on how to work effectively with juvenile offenders, there are numerous signs that the specialty has achieved a certain level of maturity.[iii]
 
A significant part of this new generation of work in the field pertains to the accumulated and rigorously derived findings about the role of families, family relationships, and parenting practices as key aspects of the creation and maintenance,[iv] as well as the reversal of antisocial and other problem behaviors.[v]
 
For some time, we’ve “known” that it can be beneficial to involve families more substantively and consistently in working with juvenile offenders, as evidenced in this quote: “In this era of an increased focus on public sector accountability, one of the important questions posed to policymakers and elected officials may be ‘Why are you waiting so long to support families?’ ” (Duchnowski, Hall, Kutash, & Friedman, 1998[vi]).

Motivational Interviewing: An Introduction to an Evidence-Based Program and Implementation Process

adolescent-substance-absue-treatment_ATTC-logoThe Addiction Technology Transfer Center (ATTC) Network hosts regular "iTrainings" in the field of addictions treatment and recovery services. Here's one you won't want to miss. "Motivational Interviewing" is a therapeutic technique that uses research on how people make behavior changes to help counselors be significantly more effective with resistant clients -- even those struggling with alcohol and drug use.
 
Adapted from the announcement:
 
Motivational Interviewing: An Introduction to an Evidence-Based Program and Implementation Process
April 21, 2011
11 am - 12:30 pm PST / 2pm - 3:30 pm EST
Hosted by: Northeast ATTC
 
This webinar will provide attendees with a brief introduction to Motivational Interviewing, its core concepts and treatment approach. In addition, strategies to insure the successful implementation of this evidence-based chemical dependency treatment model will be discussed. A question and answer period will accompany this presentation to allow participants an opportunity to gain further clarification regarding the model and a program implementation process.
 
>>Register here.

Evidence-Based Practices for Children Exposed to Violence: A Selection from Federal Databases - and More

juvenile-justice-system_peace-signSeems like youth violence -- and ways to address it -- is all over the news right now.

  1. Research: Children Exposed to or Victims of Violence More Likely to Become Violent.
  2. Evidence-Based Practices for Children Exposed to Violence: A Selection from Federal Databases.
    This publication from the U.S. Departments of Justice and Health and Human Services "summarizes findings from federal reviews of research studies and program evaluations to help communities improve outcomes for children exposed to violence. It cites evidence-based practices that practitioners and policymakers can use to implement prevention services and activities for these children." (H/t to www.findyouthinfo.gov.)

For Youth Removed From Home, Is it Helpful to Meet with Parents Not in Recovery?

juvenile-justice-system_question-mark-spray-paintedRecently, I posted a question from a juvenile justice professional about what the research said about possible harm done to youth who visit their family members in juvenile detention or prison. We got an answer to that one, but it raised a new question from someone else:

What about children who are removed by either family or the state from parents who are addicted to drugs and have previously exposed the child to unsafe situations as well as neglect? 
Is it beneficial or harmful to the child for the absent parent who is addicted to substances to allow visitation, knowing that the parent will be intoxicated at the time of visitation?  And does age make a difference?  Is it different for a 5 year old vs a 12 year old? 
Any info would be appreciated.

What do you think? Anyone know what the research says about this?  Please share, and I'll post what I learn -- leave a comment, drop me an email, or start a discussion in our LinkedIn group, "Juvenile Justice Reform and Adolescent Substance Abuse Treatment." 

Interview: Implementing Multidimensional Family Therapy for Teens in the Justice System

adolescent-substance-abuse-treatment_MDFT-coverMultidimensional Family Therapy (MDFT) is an evidence-based practice for working with adolescents struggling with substance abuse – the manual can be downloaded from SAMHSA for free. (SAMHSA is the Substance Abuse and Mental Health Services Administration.) One of five treatment protocols developed and tested in the past decade by SAMHSA, it has been shown to be clinically and cost-effective.
As it happens, the creator of MDFT, Dr. Howard A. Liddle, Ed.D., will be doing a webinar for us on family engagement on April 30, 2011, at 11 am PST / 12 pm CST / 2 pm EST. You can learn more and register for it on our webinars page.
Dr. Liddle told me recently that there was an MDFT program operating in Portland, Oregon, where I live, so I set up an interview with Deena Corso, who is a clinical supervisor in the Juvenile Treatment Services unit at the Department of Community Justice (DCJ) in Multnomah County, Oregon. (Deena and I were co-workers when I was employed there between 2000 and 2007.)
 

Benjamin: What are the top reasons to implement MDFT?
Deena: We picked MDFT as our treatment model because it's an evidence-based practice, effective at reducing substance abuse and delinquent behavior for populations that looked like ours. We’d had a Multi-Systemic Therapy [MST] program for many years with good outcomes, but budget cuts forced us to look for an alternative, and once we looked at the research, we decided on MDFT. 

JMATE 2010: Advancing Evidence-Based Programs in Juvenile Justice with Mark Lipsey

 
When I was at the Joint Meeting on Adolescent Treatment Effectiveness (JMATE) in 2010, I interviewed Dr. Mark Lipsey about a new tool he and several other colleagues developed to improve the implementation of evidence-based juvenile justice programs. Dubbed the Standardized Program Evaluation Protocol (SPEP), the tool uses a massive meta-analysis of nearly 700 evaluations to help local jurisdictions identify what they're already doing that's working, and to improve on what they've got. 
I asked Dr. Lipsey the following questions:

  1. Why did you do the meta analysis and develop this tool to improve effective programming in juvenile justice? (:20)
  2. How is the new tool different from simply implementing evidence-based programming? (2:35)
  3. How do I get my hands on it? Can I just download it? (6:36)
  4. How do I access the assistance I need to implement the SPEP? (8:57)

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