Treatment Flashcards
Sechrest definition of treatmetn
result of any planned intervention that reduces an offender’s further criminal activity
-> no mention of mental health outcomes
- primary goal is reducing recidivism
what is the levels of intervention based on?
public health model
- the number of people to get treatment with each type of prevention equal to size of the lvl (t smallest and p largest)
primary preventions
stop it before it ever happens
- required good knowledge of development and rf
head start program
identify struggling kids academically and find protective effect
- PPP
secondary prevention
lets nip it in the bud
- for those showing early signs of criminal involvment but no formal charges
- identified by family court, school guidance offices, social services
-> EJS (extrajudicial sanctions)
what is secondary prevention available for?
minor infractions
- difficult to eval bc of nature limits supervision and kids more involved in crime than infraction suggests
gang monitoring uses which model
spergal model
- leaders held responsible for actions of under members
- opportunities given
- hard to get information
tertiary prevention
formal treatment
purpose of formal treatment
reduce and prevent future crimes by targeting individuals already criminally invovled (convicted)
- most restrictive, costly and least effective
is formal treatment always avail?
no its based on legal circumstances
what is preferable and why?
early intervention
produce better outcomes than later intervention
what are the 2 goals
rehab
punishment
rehab goal, method, agent
produce productive citizen - make you stronger so less likely to recidivate
treatment - offender or someone you care about then rehab
enable training/therapy
punishment goal, method, agent
stop crime - already victimized by crome then want punishment more
incarceration
restrict isolation/deprivation
**sentencing theory CCC s. 718
fundamental purpose of sentencing is to contribute, along with crime prevention initiatives, to respect for the law and the maintenance of a just, peaceful and safe society by imposing just sanctions that have one or more of:
- denouce unlawful conduct
- deter offender
- separate offender from society
- assist in rehab
- reparations to victim
- responsibility to offender and acknowledge harm to victim (L side of continuum)
difference between goals of treatment and sentencing?
sentencing goals are much broader
- no denouncement or public protection or restitution
- hoped-for outcomes
what are not mutually exclusive?
rehab and punishment
- enviro tends to strongly favor one or other
what is the most left side of continuum?
rehab
enviro and situational validity
what is cheaper and more effective than institutional and inpatient approaches?
community based interventions
what is used in community based intervention?
tridactic model
- third party present along with patient and therapist
what are special consideration of community treatment?
- community secuirt
- interagency coordination
- difficult managing contingencies
- community may oppose
- natural home then family may undermine
- therapist safety
interagency coordination
try tor ehabilitate people that are gonna screw up initially and if its not big then doesnt make sense to criminally punish them - guide them instead
scared straight
scare youth that have minimal conflict with law for the shock value
- ineffective
- take them to high secuirty facility but the problem is that its based on intensity, not the probability of punishment
- it doesnt happen to me so im not scared
outward bound
foster self-esteem
- based on isolation
- teach interdependence and self-reliance
- if you have self-confidence then lower risk to commit bc you have the ability to solve issues
EJS
estrajudicial services
- community service
what is the behavioral principle of EJS?
overcorrection
- if you show that the short cut is inconvenient and more work then theyll do it right
who is EJS effective for?
less serious offenders who will comply
- community service
street corner program
approach kid son street and did intervention: diff reinforcement of prosocial statement
- you reward them for everything but the thing you are trying to stamp out
- mod effect
shape program
delivered in community housing and hostel setting
- taught survival skills
achievement place
houseparent model - usually married
- functional home
- direct and incidental teaching of prosocial skills
- token economy then adds merit and homeward bound (discharge planning)
what do criminals need?
routine that can be generalized outside of model home
what were the effects of shape program?
need for transition programs
- prosocial skills not adaptive
- outcomes not as good as expected
parent management training
teach parents rudiments of behavior theory and contingency contracting
- kiss of death is when the paretns follow inconsistent rules so the kid learns which parent is better to go to for what they want
what do other systems use?
ABS and DRO
- teach social skills, time out from pos reinforcment, role plays
systems work effectively for who and why?
younger, less delinq bc parents have control over contingencies
functional family therapy based on?
family systems theory - immediate fam
- work to improve style and quality of interactions and learn effective problem solving
deviant behavior consequence of?
pathological community styles
what functional family therapy effect?
group members committer fewer major crimes BUT MORE MINOR
- MORE THAN 2X more likely
why was there more minor offences than major?
regression to the mean effect ( sig higher or lower than mean likely to be closer to mean when measured again)
- exposure to more serious offenders
MST
multisystemic therapy
- MOST promising
- avail 24/7 to clients
- scheduled and non visits
- assist with RT crisis intervention
-> takes a village to raise a child
- practical training of skills
- high effect and cost efficient
- generalization is maximized bc in real enviro
role of therapy in pris on is two-fold_____
lower recidivism if you incarcerate them then the range of victims is less
assess and relieve distress
Kazdin found that most institutional treamt was ___ to practioner and ____
unique
not empirically grounded or formally evaluated
what was cali rehab strip?
silly con valley
why is inpatient therapy a mess?
not dealing with the worried well
- little evidence for efficacy of humanisitic and psychodynamic approach to pop
significant or no difference b/w mandatory counseling, voluntary and control?
NO DIF
intervention in institutions
eclectic approach meaning INTEGRATED - syncretism: everyone gets same approach
results of eclectic
fewer probation violations and less re-incaracerations
problem with eclectoc
unstandardized
- difficult to isolate and produce effects again
- therapist qualities is the STRONGEST predictor of outcomes
ABA
- change enviro cues and conting
- token economy -> punish deviant and reinforce prosocial
- easy to bring behavior under control in institutions
- lack of generalization
problems with ABA
Sometimes unclear relationship between
target behaviors and crime.
Ethical constraints on what privileges can be
withheld (eg., snacks, recreation).
Fails to promote intrinsic motivation
what is predominate in canadian prisons?
CBA
- remedial ed programs bc emphasis on skills training
who are dangerous offenders?
violent
sexual
psychopathic/apd
what prohibits dangerous offenders from community treatment?
risk level
3 types of bio based treatment for sex offenders
neurosurgery - hypothalamic nuceli
orchidectomy - remove testes
antiandrogenics - lower sex drive
- fairly effective but ethics is issue
what is psychotherapy and what are the results?
identify underlying issues to lower risk
- Groth says effective
-> 2X less likely to offend
- 36 vs 19 for non
- 8 vs 16 for sexual
CBt focus
reducing deviant arousal
early CBT used
aversive shock
- Pav: deviant stimulus with shock non-contingently
- Operant: only if arousal shown on PPG
main issue with CBT
extinction effect
covert sensitization
reduce or eliminate unwanted behaviors—especially sexual deviance, substance abuse, or impulse control issues—by pairing the unwanted behavior with imagined negative consequences
shame methods
expose to clinical audience and vid - verbalize fantasiies
Satiation/Boredom therapy
Client masturbates to appropriate fantasy. Continues after orgasm, while verbalizing and tape recording deviant fantasy
OR
orgasmic reconditioning
- osborn
- masturbate to deviant tantasy
- switch to appropriate one prior to orgasm
- orgasm is reflexive
- switches earlier in subsequent sessions
relapse prevention
substance abuse literature
what happens to aggressive offenders?
more likely to be locked up
why do AO seldom seek therapy?
absence of secondary gains (side benefits like lighter sentence)
what is present in AO?
denial, blame others and refuse responsibility
when are tranq given?
PRN to manage outbursts - as needed
- chemical straight jacket
when are pharmacotherapy enduring?
agression rooted in psychosis, epd, adhd, bpd - dumb it down
what encourages non-compliance with meds?
side effects - mess with brain and body
- side effects go away only if consistency taken
3 steps to CBT
prep
skills training
practice
prep
knowledge is power
- want to better self = get the help
skills training
cog logs to see what the situation is and the symptoms and see what triggers to learn coping mechnaisms
practice
role playing and find prosocial way to deal
what is an excellent transitions support?
cbt
what is DBT designed for?
bpd
what is the primary means of treatment for AO?
DBT
- stress balance between change and acceptance
- removal of signs and symptoms that are distressing is unrealistic
purpose of DBT
tolerance of neg affective states that contribute for criminal - DISTRESS TOLERANCE behavior
- mindfulness
- meditation
- relaxation
- this too shall pass
- challenges all or nothing and catasptrohpic thinking
what is overdiagnosed in jail?
apd
- 2/3 Dx but 1/4 qualified
Carney arguement
Flawed assumption since “personality” implies enduring characteristics and therefore inflexibility
what is the problem with ASPD treatment studies?
quasi-experiments bc no random assignment
- need random assignment for good experimental results
why cant we rely on neg rf treatment effects?
apd and psychopaths not usually distressed
- no anxiety and if they do its short term
what does not work well?
punitive setting
jail 6% vs treament is 25% less crime
why is it hard to measure treatment effectiveness?
how to measure it
- not consistent
- interpretive errors
- just desserts model - Offenders deserve to be punished in proportion to the seriousness of their crime
Palmer argument for treatment effectivenss
tailored to criminogenic needs like 3rg gen tool (SPJ)
Lipsey point of an effective program
1) Longer duration, more meaningful contact.
2) Services provided outside correctional facility. - transitional and generalization
3) Programs are reviewed and adjusted regularly.
4) Cognitive-behavioral, multifaceted (everything potential risk at same time), skill oriented approach.
5) Targets higher risk offenders.
6) Includes careful discharge planning (where living, who supporting)
2 additional program points
7) Criminogenic factors are specifically targeted.
8) Treatment is matched to the learning style of the offender.
9th point
service delivered by mental health professionals
RNR
risk-needs-responsibity
- DIRECT relation b/w RNR and Tx outcome
Andrew and Bonta
Treatment interventions that do not adhere to any of the three principles (that is, they target the non-criminogenic needs of low risk offenders using non-cognitive behavioural techniques) are actually criminogenic
A and B results
all 3 points in community best
none of 3 in community worse
