T I P 44 Edited

  • 582 views
Uploaded on

NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at …

NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
582
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
6
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. TIP 44: Adults in the Criminal Justice System
    Dr. Dawn-Elise Snipes, PhD, LMHC, CRC, NCC
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 2. Screening and Assessment
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 3. Screening
    Purpose
    Screen out offenders who do not need treatment
    Assess the extent of offenders’ treatment needs
    Gather information for wrap-around referrals
    Determine eligibility and suitability
    Information sources
    Booking records
    Interview
    Instruments
    Correctional records/presentence investigations
    Past treatment records
    Police reports
    Drug Tests
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 4. Screening Areas of Concern
    Accuracy of information
    Continuity and system-wide sharing of information
    The importance of re-screening and re-assessing
    Timing of screening and assessment
    Drug testing
    Detoxification needs
    Readiness for treatment
    History of trauma
    Psychopathy
    Risk for violence
    Recidivism
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 5. Diagnosis Pitfalls
    Stigma
    Inaccuracy due to withdrawal
    SA diagnosis may preclude from MH treatment
    SA diagnosis may limit offenders access to work assignments or vocational training/rehab
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 6. Reasons for Diagnosis
    Reimbursement
    To support pharmacological interventions
    When psychiatric concerns emerge
    Clarification of co-occurring disorders
    Research/evaluation
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 7. De-stigmatizing Diagnosis
    Explain that diagnosis is just short hand
    Review presenting issues and discuss differential diagnosis
    Normalize diagnoses
    Google “Famous people with…”
    Do an “All About Me” worksheet
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 8. Screening Instruments
    Instruments with adequate reliability and validity with incarcerated populations
    Reproduced in appendix C of TIP 44
    Addiction Severity Index–Alcohol Use subscale (ASI-Alcohol)
    ASI–Drug Use subscale (ASI-Drug)
    Drug Abuse Screening Test (DAST-20)
    Michigan Alcoholism Screening Test (MAST)
    Simple Screening Instrument for Substance Abuse (SSI-SA)—Reproduced in TIP 42 (CSAT 2005)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 9. Assessment Instruments: ASI
    Addictions Severity Index
    reproduced in TIP 38, Integrating (CSAT 2000)
    structured interview format (75 minutes)
    examines the following areas of functioning:
    Drug/alcohol use
    Relationships
    Employment
    Legal involvement
    Physical health
    Mental health
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 10. Assessment Areas
    SA
    Substance use history
    Motivation
    Severity and frequency of use
    Detoxification needs
    Treatment history
    Criminal Involvement
    Criminal thinking
    Current and prior offense(s) types and numbers
    Prior successful completion of probation for drug use offenses
    Prior involvement in diversionary programs
    History of diagnosis of any personality disorder
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 11. Assessment Areas cont…
    Health
    Intoxication
    Infectious disease
    Pregnancy
    General health
    Acute conditions
    MH
    Suicidality
    MH diagnosis and treatment history
    Acute symptoms
    Current medications
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 12. Assessment Areas cont…
    Special Considerations
    Educational level
    Reading level/literacy
    Language/cultural barriers
    Physical disability
    Developmental disability
    Learning/cognitive disability
    Housing
    Dependants/family issues
    History of abuse (victim or perp)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 13. Triage and Placement
    Continuum of services
    Pretreatment (Detoxification)
    Outpatient
    Inpatient
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 14. Triage and Placement cont…
    Key staff preparations
    Develop a treatment resource database
    Define eligibility and suitability for each program
    Document referral process to each program
    MOU including
    information to be shared
    supervision and treatment responsibilities of each party
    evaluate effectiveness of offender matching (ongoing)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 15. Placement Strategies
    Target offenders with moderate to high risk of recidivism
    Criminal history
    Poor employment history
    Poor support environment
    Homelessness
    Antisocial traits (impulsivity, lack empathy, anger issues, entitlement)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 16. Placement Strategies cont…
    Moderate to severe substance abuse problems
    Substance dependence
    SA related arrests
    History of SA with or without treatment
    Positive drug tests
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 17. Placement Strategies cont…
    Moderate to severe mental health issues
    Suicidal or violent behaviors
    Acute symptoms
    Cognitive impairment (concentration, problem solving)
    Social impairment (interpersonal skills, frustration tolerance
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 18. Offender characteristics
    Perceived severity of problems (Readiness for change)
    Motivation (SOCRATES*, TIP 35)
    Prior evidence of attempts to improve
    Perceived importance of treatment
    *Stages of Change, Readiness, and Treatment Eagerness Scale
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 19. Implementing Treatment
    Offender involvement in treatment planning
    Motivational interviewing
    Coordination with “team”
    Plan updates at status changes
    Community based linkages at re-entry
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 20. Implementing Treatment cont…
    Outreach and low-intensity interventions
    Provided to all offenders
    Entrance
    As part of daily activities (webcast via TV)
    Exit/Re-entry
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 21. General CJ Treatment Issues
    Components of criminality
    Criminal thinking
    Criminal code (inmate value system)
    Manipulation
    Criminal Thinking
    Learned behavior
    Help offenders recognize thinking errors and understand how they can lead to behavior
    CBT and Staff/Peer confrontation
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 22. General CJ Treatment Issues cont…
    Criminal Code
    Refusal to cooperate with authority
    Refusal to confront negative behavior
    Participation in treatment viewed as weakness
    “Snitch syndrome”
    Manipulation
    Throwing focus
    Team splitting
    Demeaning others (Power plays)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 23. General CJ Treatment Issues cont…
    Addressing manipulation
    Identifying the primary thinking errors observed
    Instructing the client to begin self-monitoring when these occur (journaling)
    Providing regular feedback to the client, usually from peers in a treatment group
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 24. General CJ Treatment Issues cont…
    Excuse making
    Blaming
    Justifying
    Throwing focus
    “I think; therefore it is,” permits function according to what he wants, rather than according to the facts
    Lying: commission/omission
    Making Fools Of : pulling the wool
    Build-up: focus on positives and bring down others
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 25. General CJ Treatment Issues cont…
    Assuming
    I'm unique / It doesn’t apply to me
    Ingratiating : phony manipulation
    Fragmented Personality Behaviors are inconsistent
    Minimizing / Exaggerating
    Vagueness / Non-committal
    Anger
    Power plays
    Victim playing
    Closed channel : unreceptive, undisclosing
    Ownership / lack of awareness of other’s boundaries
    Image cowboy or victim
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 26. Addressing Anger and Hostility
    Identifying the feeling(s)—other feelings may be involved, such as embarrassment or guilt
    Understanding clearly where the feeling is coming from
    Identifying the goals the anger is serving (e.g., deflecting attention)
    Identifying the goals the anger is undermining (e.g., staying out of jail or keeping a job)
    Working toward taking the longer view (e.g., beginning to use a positive/pro-social thought process to manage the anger)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 27. Barriers to Effective Treatment
    Assessment: inaccurate placements
    Poor staff training
    Staff transition
    Overreliance on institutional sanctions instead of letting peers pressure for internal controls
    Aftercare availability and compliance
    Coercion
    Treatment competes with other facility opportunities
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 28. Sentencing Alternatives
    Pretrial Diversion
    Supervision in lieu of detention
    Treatment in lieu of prosecution
    Maintain a client’s confidentiality
    Avoid discussing the client’s criminal case
    the client is presumed innocent before trial
    Be realistic about the responsibilities that a client is capable of handling
    Avoid allowing individuals to be inadvertently penalized for enrolling in treatment
    Be aware that clients may be more focused on “beating the case” than on recovery
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 29. Drug Courts
    10 Components
    Drug courts integrate alcohol and drug treatment services with justice system case processing.
    Using a non-adversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process.
    Eligible participants are identified early and promptly placed in the drug court program.
    Drug courts provide access to a continuum of co-occurring disorders treatment.
    Abstinence is monitored by drug testing.
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 30. Drug Courts cont…
    A coordinated strategy governs drug court responses to participants’ compliance.
    Ongoing judicial interaction with each drug court participant is essential.
    Monitoring and evaluating achievement of program goals is necessary to gauge effectiveness.
    Continuing interdisciplinary education promotes effective drug court planning, implementation, and operations.
    Forging partnerships among drug courts, public agencies and community-based organizations generates local support and enhances drug court program effectiveness.
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 31. Treatment Accountability for Safer Communities (TASC)
    TASC programs provide a bridge between treatment providers and the CJ system
    Provide a range of services
    Screening and assessment
    Referral to community-based services
    Monitoring of treatment
    Case management
    Court liaison
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 32. Interventions
    Brief (TIP 34)
    Motivational (TIP 35)
    Behavior contacts
    Phased treatment
    Substance abuse education
    Detoxification
    Day reporting
    Drugtesting
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 33. Interventions cont…
    Criminal thinking assessment and treatment (video feedback)
    Coping skills training
    Relapse prevention tools
    Strengths building
    Communication skills enhancement
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 34. Wrap Around Services
    Vocational
    Job readiness assessment and preparation
    Liaison with employer
    Literacy assessment and referral
    Anger management training
    HIV education/testing/counseling
    Assistance in accessing public assistance
    Self-help programs
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 35. Treatment Issues in Jails
    Most treatment is involuntary
    Scheduling constraints: treatment or…something else
    Gang affiliation
    Confidentiality
    Trauma
    Hopelessness (esp. prisons)
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 36. Special Issues: Community Supervision
    Therapeutic community
    Intensive outpatient
    Half-way houses
    Day reporting
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 37. Special Issues: Women
    Mental health issues
    Abuse history
    HIV positive
    Poorer employment histories
    Child custody issues
    Lower educational level
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 38. Special Population: Elderly
    Many have spent most of their life in and out of “the system”
    Prison rules and mores are the norm
    Developmental milestones (marriage, raising children, career, education, etc.) are absent leading to disculturation
    Engage them by having them help others
    Special Issues
    Increased health problems
    Slow response to directions
    Physical issues presenting as MH
    Lack of assertiveness allowing them to slip through the cracks
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
  • 39. Summary
    Persons in the CJ system have a unique set of learned behaviors
    Consider the drawbacks as well as the benefits to giving up criminality
    Work with the client
    Set and consistently enforce clear boundaries and rules
    Identify biopsychosocial issues and their influence on treatment and recovery
    Ensure clients have a seamless transition into the community
    Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC