Effective Use of Contingency Management
in Juvenile Treatment Courts
Jacqueline van Wormer, Ph.D.
NCJFCJ
Washington State University
S
Learning Objectives
S Participants will review and discuss proper phase structuring for
adolescents – and why this matters in the proper use of incentives
and sanctions.
S Participants will learn about what DOES and what DOES work to
promote positive behavior change in youth.
S Participants will learn about contingency management for
adolescent’s substance abuse and use.
S Participants will learn how about contingency management
theories and they work in juvenile drug courts.
S Participants will learn how to develop behavior and activity
contracts.
What led to the Development of the JDTC
Guidelines?
S Early 1990’s: Adult drug court models were adapted for juveniles by
placing emphasis on family-based and developmentally-appropriate
services for adolescents.
S Juvenile Drug Courts: Strategies in Practice (2003). Consensus
document - served as a framework for planning, implementing, and
operating a JDC.
S Have juvenile drug courts worked?
S Overall, evaluations regarding the effectiveness of juvenile drug
courts has been inconclusive. There is a lack of rigorous
research and consistent implementation.
5
Objective 5. Implement
contingency management, case
management, and community
supervision strategies
effectively.
Part I
Building a Responsive Phase Structure
S
Responsible Practices in Juvenile
Justice
S
Do no Harm
S
Applying Adolescent Development Lens
S
Informed Use of Detention
S
Individualized
S
S
S
S
S
Treatment
S
S
S
Offender based rather than offense based – Procedural Justice
Use of Risk/Needs/Responsivity
Certain, Fair and of Appropriate Intensity
Gender and Culture competence
Occurs in the Community
With family
Use of Data
Five Critical Components
of Procedural Justice
1.
Voice: Youth has an opportunity to be heard.
2.
Respect: Person is treated with dignity and respect.
3.
Trust/Neutrality: Youth perceives decision makers as neutral and competent and their
decisions as unbiased and accurate.
4.
Understanding: Youth understands decisions including the reasons for those decisions.
5.
Helpfulness: Person perceives that decision makers have a genuine interest in their
needs and personal situation.
Do No Harm
S Delinquency/criminality is age-limited
S Most youth will desist from crime in mid-late 20’s, depending on type of
crime
S Studies vary, but only 5-9% of youth go on to long-term adult criminal
careers (depends on crime type)
S What causes desistence?
S Significant relationships
S Employment
S Brain development
S Do not saddle youth
Adolescent
Development
S
S This is not a child brain, or undeveloped adult brain. It is a biologically
unique brain characterized by the ability to change and grow (Geidd, 2015).
S Adolescence begins at puberty (biological function) and ends with a social
definition of adulthood.
S Mismatch between limbic system (emotion) and prefrontal cortex:
S Biology encourages separation of the young adolescent from
family in order to explore and recreate
S Found in all social mammals
S “What most determines teen behavior, then, is not so much the
late development of executive functioning, or the early onset of
emotional behavior, but the mismatch of timing between the two.”
Jay Geidd, 2015
Proper Use of Detention
Detention Research:
S To Summarize:
S Detention can slow or interrupt the natural aging out of delinquency
S There is no correlation between increasing amounts of time spent in
detention and future reductions in recidivism.
S Formally detained youth have reduced success in the employment
market and will earn significantly less in their life time
S 40% of incarcerated youth have learning disabilities and cannot
successfully navigate their way back into school
S Detention has a negative impact on the mental health of youth –
especially those that enter with mental health conditions
S
Source: The Dangers of Detention: Justice Policy
Institute
Continued:
S Most importantly:
S The use of detention increases the odds that youth
will continue on the path of delinquency.
S Must carefully apply detention or the juvenile court
may in fact be negatively impacting public safety
S Detention serves a vital purpose for our high-risk,
violent and serious offending youth. 70% of youth in
detention are classified as non-violent.
Individualized
S Risk/Needs/Responsivity
R-N-R
SRISK: who to treat
SNEED: what to treat
SRESPONSIVITY: how to
treat
The RISK Principle
S Because criminal behavior can be predicted,
services should be matched to each person’s
risk of reoffending
S To reduce recidivism:
S Higher risk youth need additional services
S Lower risk youth need little to no
intervention
The (Criminogenic) NEED Principle
S The Central Eight
S The Big Four (Tier I)
S antisocial personality traits, thinking, and attitudes
S criminal associations
S Tier II
S Substance abuse
S Family/marital relationships
S Education and employment
S Positive leisure activities
S
Source: Andrews & Bonta (2010) The Psychology of
Criminal Conduct
The RESPONSIVITY Principle
S Service delivery should be responsive to the
learning style and capabilities of each
individual youth
S What protective factors does the youth
possess that will assist with participation in
and completion of services?
It begins with the phase
structure
Phase Two
Phase One
Phase Three
Phase requirements for youth and family should start out small, increase,
and then decrease again after the youth work through treatment and court
related goals.
Phase Structure
Phase I: setting
the stage
Betty Gurnell
Phase Source:
II: learning
Phase III:
skills
maintaining the
change
Readiness and engagement
Involvement, stabilization
Reflection, enrichment
Focus on compliance
Beyond compliance
Maintain drug testing, court
appearance
Structure
Skill development
Expanded development
activities
Clarifying expectations,
building trust
Completing assignments
Enriching community
connections
The Four Steps
S Behavior to target
S Current behavior
S Desired behavior
S Small, achievable increments
Decision Matrix – Phase I
Phase I
Incentives
Sanctions
Behavior
*Response
Response
Attend school at least 18
out of 20 days
• Teacher signs attendance
card each day present and
acknowledges
•Small prize or coupon for
each week with no absences
• After school study hall for
each day absent over the
limit to make up all missed
work
Decision Matrix – Phase II
Phase II
Behavior
Attend regularly
Complete all
assignments
Incentives
Sanctions
*Response
*Response
•Select a book ,
notebook, pen after two
weeks of success
•Praise from teacher,
family, court
•Grades improve
•After school study hall
to complete
assignments (with help
as needed)
Decision Matrix – Phase III
Phase III
Incentives
Sanctions
Behavior
*Response
*Response
Attend regularly
Complete all
assignments
Improve grades
•Praise from teacher,
family, court for
improvement
•Certificate of
achievement
•Select school related
gift: tuition, book
•Determine if tutor is
needed
•Attend extra class or
session for help
•Tighten curfew
Part II
Incentives and Sanctions
S
Why We Want to Use
Alternatives
Probation/court monitoring, group homes, and correctional
facilities have, at best, only modest favorable effects on
subsequent recidivism. Some studies show negative effects
(Lipsey and Cullen, 2007; Petrosino, Turpin-Petrosino, and
Guckenburg, 2010).
Why We Want to Use
Alternatives
Deterrence-oriented programs that focus on discipline,
surveillance, or threat of punitive consequences (e.g., prison
visitation Scared Straight–type programs, boot camps, and
intensive probation supervision) have no effect on recidivism
and may actually increase it (Lipsey, 2009).
Because…
“Therapeutic” programs oriented toward facilitating
constructive behavior change have shown very positive
effects—even for serious offenders (Lipsey, 2009; Lipsey
and Cullen, 2007; Lipsey and Wilson, 1998).
Reasons Why JDCs Should
Implement CM
S Theories are based on cognitive behavioral therapy,
which has been proven to work with adolescents,
and is vastly used in outpatient settings
S It can be easily adapted within the JDC
S In their study of six juvenile drug courts, Henggeler
et al (2006) found stronger outcomes for those youth
who received MST AND CM then standard process
Incentives & Sanctions, Continued
S Historical CJ responses vs. modification of behavior through a
coordinated and thoughtful (research informed) process
S Punishment for a “wrong” is not the goal – behavior change is
the goal
S The JDC should use a balance of incentives, sanctions and
treatment responses
Incentives and Sanctions,
continued
S Key components:
S Immediate, certain, fair and of appropriate intensity
S Do not rely solely on standardized “lists”
S Should be proportional and balanced
S Punishment alone is least effective way to change behavior
S Be comfortable in combining incentives and sanctions
S Be cognizant of time
S Perceptions of fairness – it all begins with individualization
S Make sure youth understand their positive and negative reinforcers
Contingency Management
So how do we strengthen the use of CM in
our treatment settings, and utilize the same
methods within our Juvenile Drug Courts?
Point & Level Reward Systems
S Contract
S Reward Menu
S 3 for 3
S Most Valued Privilege
S Checkbook System
Most Valued Privilege
S This is a privilege that the youth values and will work
hard to earn
S Work with the youth and family to determine what the
MVP is, preferably a family-based reward (i.e., video
games, cell phone use, time w/ friends)
S The MVP is given or taken away with each drug screen
S IMPORTANT – youth does not earn points if there is
a positive drug screen but points that have already
been earned are not taken away
(Henggeler et al, p. 107-108)
Make it Transparent
MVP
Sally – Use of cell phone
John – Curfew extension on Saturday
night
Mary – Allowed to use Mom’s car on
Friday afternoon
Jack – Ride to school, rather than walk
Checkbook System
S Basic checkbook set up – date; transaction
description; debit/credit; and balance
S Basic personal checks that the youth can draft and
use to purchase items on the reward menu
S Make this very visual and tangible for the youth
S Consider working with a local bank to provide life
skills training on how to keep a checking account
and write checks or to provide free checkbooks
and/or personalized checks
(Henggeler et al, p. 126-127)
The Fun Theory
https://www.youtube.com/watch?v=2lXh2n
0aPyw
Program-Wide Incentives
Go First
And
Leave Early!!!
Rocket Docket
3 for 3 Program
2. Bring JTDC
Notebook
1. Pass all UAs
3. Make all
appointments
/ contacts with
case manager
Fish Bowl
Catch youth doing
something right:
• Showing respectful
behavior
• Coming to court on
time
• Saying something nice
about a loved one in
court
• An incentive that is fairly
easy to implement as a
program-wide incentive
• An incentive that creates
some positive peer
pressure
• An incentive that allows
the team to spread
resources over a longer
period of time
Positive Peer-to-Peer
Reinforcement
Special thanks to the El Paso County, TX JTDC team for this innovative
idea.
Behavior Contracts
S “Rewards for Responsible Behavior in Other Domains”
(Henggeler et al, p. 131)
S How to target specific behaviors (i.e., school
attendance)
S How to add a step-by-step process for the youth to
follow
S How to get youth working towards “things” they are
interested in
S How to engage families/guardians in the process
S How to increase communication between the youth
and judge
S And…how to implement these components in your
Behavioral Contract Example
Goal
Behaviors/
Tasks
Enroll in GED •Call or visit
program
GED center
by xxxxx date
Incentives
Noncompliance
•Praise
Failure to
•Recognition contact by
from Team
XXXX
•Appointment
Calendar
•XXXXXX
Sanction
•Increased
reporting to
PO
•Increase in
curfew
•EM
Albuquerque, New Mexico
S One of 12 Learning Collaborative sites funded by
NCJFJC/OJJDP
S Engaged in full application of 16 Strategies, use of data
to drive program and adoption of standardized screening.
S Entails intensive support to restructure program to align
with best practices
S 2nd step: To restructure phases to be more responsive to
youth and families
S Removed the “checklist” system and flipped to a reward
system.
S Youth earn points for various activities and earn their way
out of a phase.
Earning full
points
Amount
Earning partial
points
Amount
Earning Zero
points
Attend therapy
and fully
participate or
present work.
2
Attend scheduled
therapy
appointment
1
Missing an
individual or
family therapy
session
Attend school with
no absences
2
Attend school with
only one absence
1
Two or more
school absences
Check in everyday
2
Check in 6 days
1
Fail to check in
two or more days
Youth can earn points for…
Special thanks to the Bernalillo County, NM JTDC team for the sample
procedures.
Assignment
Community Service
Bonus Points
Have a family dinner
2
4
Keep planer of assignments
and appointments
2
4
Keep a daily journal
6
12
Explore alternative
education program
2
4
5
10
Using points to
promote prosocial activities
Create a resume
Special thanks to the Bernalillo County, NM JTDC team for the sample
procedures.
Reward
Cost
Credit for 1 hour of
community service
4 points
Purchasing Guidelines
No community service
assigned with in the past
week
Extend curfew on 1 day for
1 hour
10 points
Must be checking in, cannot
be on house arrest or have
a curfew violation in past 2
weeks
$10 gift card
20 points
Must be attending therapy
Rewards the youth can
purchase with earned points
Special thanks to the Bernalillo County, NM JTDC team for the sample
procedures.
Phase
Cost
Move to Phase Two
50 points
Move to Phase Three
70 points
Move to Phase Four
70 points
Graduate
40 points
Connecting the dots, using
points to “phase-up”
Special thanks to the Bernalillo County, NM JTDC team for the sample
procedures.
Recommended Reading
S Contingency Management for Adolescent Substance
Abuse: A Practitioner’s Guide, by: Scott W. Henggeler,
Phillippe B. Cunningham, Melisa D. Rowland, Sonja K.
Schoenwald and Associates
S Making Sense of Incentives and Sanctions in working with
the Substance-Abusing Youth: Answers to Frequently
Asked Questions (Juvenile & Family Justice TODAY. 2012,
Volume 21, Number 2)
S Enhancing the Effectiveness of Juvenile Drug Courts by
Integrating Evidence-Based Practices (Journal of Consulting
and Clinical Psychology. 2012, Vol. 80, No. 2, 264-275)
Questions?