Moving EBPs Into Practice

1. Moving EBPs Into Practice Danielle S. Rudes Center for Advancing Correctional Excellence (ACE!) George Mason University Department of Criminology, Law and Society Presented at OAR of Fairfax, 13 February 2013

2. What are EBPs? • Evidence-based practices are… • Scientifically studied workplace practices that have been shown effective through rigorous research. Started in the early 1990s with the term “evidence-based medicine.” • The contemporary definition of EBP is “The integration of the best research evidence with clinical expertise and patient [client] values" (Sackett, et al. 2000, p. x).   Slide courtesy of Dr. Faye S. Taxman

3. Understanding the Science • Evidence:How is it obtained? • Translation:From another discipline (law enforcement, psychology, business, etc.) to corrections and crime prevention • Decision Making:Move away from sensationalized politics (reactionary) and gut-level decisions Try www.crimesolutions.gov Slide courtesy of Dr. Faye S. Taxman

4. Ways to Create Science • #1: Examine only research studies that use randomized field experiments as the “Gold Standard” • #2: Examine ALL available research (regardless of design) on a particular topic • #3: Conduct a nonscientific review, simply say“evidence based” & then offer your own listing of best practices or use a subset of all available research based on liberal or conservative ideology. Slide courtesy of Dr. Faye S. Taxman

5. Implementation is a Process, not an Event • It is not just about an idea (EBP) • It is more about: • How you take an idea and make it work (DRIVE) • The people that you involve in making it work (RELATIONSHIPS) • The willingness to learn together (LEARN) • The ability to set criteria to judge “impact” (FIT) • The coming together to create the values and norms within a community (GOAL SETTING)

6. Common EBPs in Corrections • Risk/Needs Assessment Instruments • Motivational Interviewing • Some cognitive behavioral programming/treatment

7. What Works (EBPs) vs. What We Do? The majority of correctional programs fall into these areas. • Intensive Supervision • Boot Camp • Case Management • Incarceration • Non-Directive Counseling • Directive Counseling • TASC • Diversion to Treatment (DTAP) • Treatment with Sanctions • Outpatient Treatment in Supervision • Emotional Skills • Moral Reasoning • 12-Step with Curriculum • In-Prison Treatment & Aftercare • Cognitive-Behavioral Interventions • Drug Treatment Courts • Contingency Management • Therapeutic Communities (in prison) • Focus on High Risk Offenders or Offenders with High Needs Slide courtesy of Dr. Faye S. Taxman Source: Taxman, 2009. Evidence-Based Practices in the United States.

8. The Current Evidence • Risk & Needs Assessment Should Drive Program Participation: High risk (not need) offenders should receive more rehabilitative programs • Sentencing & Program Placement Should Address Criminogenic Needs: Not all needs are criminogenic • Treatment Quality: Treatment and programs should be of sufficient duration and certain content to change behavior. • Procedural Justice: Clarifying expectations with clear and precise rules of program participation and rules for program completion are likely to lead to improved outcomes. Also creates trust and rapport for building commitment to change. Slide courtesy of Dr. Faye S. Taxman

9. Aligning EBPs with existing system(s) • Every system has its own processes • Align, refine and fit but make sure to • Keep the core principles • Know when “it” is no longer “it” • Ensure support from sister/collaborating agencies and other stakeholders

10. An example of EBP implementation: Contingency Management in a criminal justice setting • Evidence-based treatment • Shape behaviors through rewards • Focus on a social contract for behavior • Technique to replace immediate “drug using”; structured rewards Adaptation • Fit to Environment • Include Sanctions

11. 8 Main CM Principles • Positive incentives w/ point system • Clear guidelines about earning points • Emphasize abstinence • Early incentives • Point escalation • Integrating point system into existing system • Bonuses • Focus on no more than 3 behaviors at a time

12. Site Overview Site Initial Added One Drug Court -- Two Drug Court Reentry Court Three Drug Court Reentry Court Four Regular Caseload -- Five Undetermined Halfway House & Drug Court* *Started with one ideas regarding implementing in one location/program but realized program not far enough along for CM. When program was ready they added it back into JSTEPS.

13. Year 1: MOU, software design, baseline site visits, org survey Year 2:Adoption & implementation processes moving toward sustainability Study Design with Continual Feedback Loops

14. Research development phases Phase 1 Phase 2 Phase 3 0 6 12 18 24 Months Wrap up site visits & phone calls Site visits at S1, 2a, 2b, 3a, 4, Learning Meeting & Org survey 2nd learning meeting Follow up phone calls & feedback reports Site visit at S5, follow-up TA, feedback reports & telephone calls Follow up site visits at S1, 2a/b, 3a, 4 &5; site visit S3b, TA, feedback reports & follow up phone calls

15. Site development phases Months 0 6 12 18 24 S1A S2aA S2bA S3aA S3bA S4A S5a A S5bA

16. What we learned from Adoption Phase… • Acceptability (unobjectionable) & Feasibility (suitable) • Yes, acceptable/feasible but some challenges include: 1) too many behaviors in CM model; 2) intra-org challenges, and 3) balancing sanctions with rewards • (Rudes et al. (2011) Journal of Substance Abuse Treatment) • Adaptability (understandable) • Mostly acceptable with little difference between social & material rewards. Female and non-PO more accepting. • (Murphy, Rhodes & Taxman (2011) Journal of Substance Abuse Treatment)

17. Site development phases 0 6 12 18 24 Months S1 I S2a I S2b I S3a I S3b I S4 I S5a I S5b I

18. What we learned from implementation phase… • Probation Officer Roles • PO roles matter greatly for court and adoption/implementation processes. POs use three types of power 1) informational; 2) technical, and 3) relational to sway decisions to a certain end. • (Rudes & Portillo, 2012) • Transportability of EBPs • EBP transportability is processual with front-line CJ workers adapting EBPs by first adopting EBP language (loose coupling) with few adjustments to work activities. These processes have both positive and negative potential/implications. • (Portillo, Rudes & Taxman, in progress)

19. More learning from implementation phase… • Judicial Roles & Decision Making in PS Courts • Role judges take affect collaboration and decision making regarding court and adoption/implementation processes. • Portillo, Rudes, Viglione, Nelson & Taxman, Victims & Offenders 2013) • Redefining the Win • Problem-solving court attorneys often work to achieve the courts’ collaborative goal using covertly adversarial processes in a therapeutic jurisprudence environment including: 1) battling; 2) insider trading; 3) silent treatment, and 4) evidence as a weapon. This action affects court and adoption/implementation processes. • (Rudes & Portillo, under review at Law & Social Inquiry)

20. Site development phases 0 6 12 18 24 Months S1S S2a S2b S3aS S3b S4S S5a S5bS

21. What does this all mean? • Stay true to core principles of EBPs • Do not use a one-size-fits-all approach, individual organizational context matters • Use mixed method design to study both process & outcome simultaneously and long-term • Follow implementation from adoption to implementation to sustainability • Account for fidelity • What else?

22. Questions? Dr. Danielle S. Rudes drudes@gmu.edu Thank You!