Practical Application of Incentives and Sanctions for Behavior Change in the Court System
This resource discusses the practical application of incentives and sanctions in behavior change within the context of drug courts. It covers the purpose of sanctions and incentives, reliable detection methods like urine drug testing, and includes real-life examples such as phone transcripts from court sessions to highlight the importance of supervision in natural social environments. The content emphasizes the need for a structured approach to implementing incentives and sanctions effectively in the court system.
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Presentation Transcript
Incentives and Sanctions: Practical Application of the Science of Behavior Change Shannon M. Carey, Ph.D. Based on a Need to Know Fact Sheet by Doug Marlowe, J.D. Ph.D./NDCI
Purpose Purpose What is the purpose of Sanctions? What is the purpose of Incentives? What other court responses are there?
Overview Overview Brief review of the science of behavior change Research on application in drug courts Sample incentives, sanctions and treatment responses (guidelines) Implementing incentives and sanctions (Review and discuss videos)
Certainty Certainty 1:1 Schedule for initiation Reliable detection Trust but verify
Reliable detection Reliable detection Urine drug testing at least twice per week* Do not decrease frequency of testing until last phase Do tests with short detection windows in field Random testing all 7 days Extend supervision into natural social environment (work, home, school, street, cell phones) Include law enforcement on the team *Or use continuous detection methods
Reliable detection Reliable detection Cell Phone Transcript from Phone during Court Session - 1 SF B Chic Nov 18 3:29pm R u getting anything in la? SF B Chic Nov 18 3:35pm Can we go in on the deal. If I got 4 would u get 2 so we could do the 540 SF B Chich Nov 18 3:45pm Toats
Reliable detection Reliable detection Cell Phone Transcript from Phone during Court Session - 2 ?? Nov 18 6:47pm If you need a source for tina Hit up 714-647-0410 Tell them dan sent ya..Good stuff AM Nov 18 6:48pm How lomng doles xaanax stay in system ?? Nov 18 6:48pm 72hrs to a week AM Nov 18 6:49pm anyway to clear em out ?? Nov 18 6:49pm Do you ever get swabbed!!!??????? AM Nov 18 6:50pm Occasionally ans I no it doesn t test for that ?? Nov 18 6:50pm Well if ur dirty dirty.. Always check urself into the ER for a panic attack or something.. do that day of probation..Walk outta there with a hospital/dr ltr
Reliable detection Reliable detection Participant in his outpatient substance abuse group AM Nov 18 6:22pm Plzbring tibaasement pLII AM Nov 18 6:23pm Theyre randomly testing me tnite AM Nov 18 6:25pm IM in grop AM Nov 18 6:27pm Plese bring to basement bathroom AM Nov 18 6:27pm Plzzzzzzzzzzzzz S Nov 18 6:29pm Ok AM Nov 18 6:29pmHit me up when ur down there ill walk out AM Nov 18 6:30pm How long bro S Nov 18 6:30pm Like 20 AM Nov 18 6:34pm Im in the bathroom in the basement plz hurry im trippin out S Nov 18 6:35pm Leavin hollies rite now AM Nov 18 6:36pm Shit whats ur eta from there
Reliable detection Reliable detection Participant in his outpatient substance abuse group (cont) S Nov 18 6:37pm 15 S Nov 18 6:38pm Shuld I wait in basement bathroom AM Nov 18 6:38pm Plz tell me u gotta vial to pissi in S Nov 18 6:38pm Ya AM Nov 18 6:42pm Put the vial of piss in bathrroom trashcan AM Nov 18 6:42pm I gotta go bak to geoup9 hit me up when its dun S Nov 18 6:54pm Its in the trash
Timing is Everything Timing is Everything http://sixpacktech.com/wp-content/uploads/2012/11/A-swing-and-a-miss..jpg
Timing is Everything Timing is Everything Effects degrade exponentially New behaviors interfere Status hearings every two weeks the first few months Bring non compliant participants in sooner Catch them doing something right, provide incentive sooner Continue hearings monthly until participants have engaged in continuing/after care plans
Keep Centered Keep Centered Effective Zone Habituation Ceiling Effects Effects EFFECTIVENESS SEVERE MINIMAL MODERATE
Keep Centered Keep Centered NDCI Handout NDCI Handout http://ndcrc.org/content/list-incentives-and-sanctions
Do Due Process Do Due Process (Procedural Fairness) (Procedural Fairness) Allow participants to explain Explain judge/team decision Be respectful (and expect respect) Have written incentive/sanction guidelines Allow reasonable discretion The brain and decisions about punishment
Sanctions or Treatment Sanctions or Treatment Responses? Responses? Abuse or dependence (mild, moderate or severe substance use disorder)? Proximal or distal behaviors
Needs Needs Substance Dependence or Addiction }Abstinence is a distal goal 1. 2. 3. Binge pattern Cravings or compulsions Withdrawal symptoms
Needs Needs Substance Dependence or Addiction }Abstinence is a distal goal 1. 2. 3. Binge pattern Cravings or compulsions Withdrawal symptoms Substance Abuse
Needs Needs Substance Dependence or Addiction }Abstinence is a distal goal } 1. 2. 3. Binge pattern Cravings or compulsions Withdrawal symptoms Substance Abuse Abstinence is a proximal goal 1. Still enjoyable 2. No Cravings or compulsions 3. No withdrawal symptoms
Needs Needs Substance Dependence or Addiction }Abstinence is a distal goal } 1. 2. 3. Binge pattern Cravings or compulsions Withdrawal symptoms Substance Abuse Abstinence is a proximal goal Collateral needs Dual diagnosis Chronic medical condition (e.g., HIV+, HCV, diabetes) Homelessness, chronic unemployment
Needs Needs Substance Dependence or Addiction }Abstinence is a distal goal } }Regimen compliance is proximal 1. 2. 3. Binge pattern Cravings or compulsions Withdrawal symptoms Substance Abuse Abstinence is a proximal goal Collateral needs Dual diagnosis Chronic medical condition (e.g., HIV+, HCV, diabetes) Homelessness, chronic unemployment
Sanctions or Treatment Sanctions or Treatment Responses? Responses? Abuse or dependence (mild, moderate or severe substance use disorder)? Proximal or distal behaviors Dependent: Expectations change over time (Phases) Abuser: Higher level sanctions sooner Separate status hearings Rely on clinical expertise
Targeting Targeting
Targeting Targeting Define behavior clearly (both bad and good) Point direction (describe positive behavior you are looking for) Target the behavior not the person (be respectful)
Targeting Targeting Don t expect too much Learned helplessness and ratio burden Don t expect too little Habituation Proximal vs. distal goals Phase specificity What was once distal becomes proximal
Phase Regression Phase Regression An example of response cost Often a sign that services were withdrawn prematurely Temporary regression and remedial plan (accelerated redemption) Avoid the Abstinence Violation Effect (A.V.E.)
Remember that Remember that unaddressed co unaddressed co- -occurring disorders may impede the disorders may impede the client s ability to achieve client s ability to achieve abstinence abstinence occurring
Incentive and Sanction Incentive and Sanction Highlights Highlights Verbal acknowledgement The A Team (being called early/being on the A team) Fish bowl (having your name in the bowl is a reward) Being chosen as a mentor
Incentive and Sanction Incentive and Sanction Highlights Highlights A Team Video
$ $ Decision Dollars $ $
Incentive and Sanction Incentive and Sanction Highlights Highlights Thought Paper or Recording Community Service (giving back meaningfully) Curfew Jury Box Jail
Courts that use jail greater than 6 days have worse (higher) recidivism
Incentive and Sanction Incentive and Sanction Highlights Highlights For some, incarceration is NOT the worst punishment (for some it is trauma) The threat of jail works best on those who have something to lose by incarceration. Positive reinforcement works on those who have nothing to lose by incarceration. Treatment responses may be perceived as punishments-communication is the key to explaining the difference.
Incentive and Sanction Incentive and Sanction Highlights Highlights FOCUS ON THE POSITIVE BEHAVIOR People need to know what positive behaviors are - before they can perform them They know what not to do, they need to know what to do instead Bring up the participants doing well first (the A team), and ask them what they are doing that helps them succeed. (This will have the most positive impact on those watching).
Incentive and Sanction Incentive and Sanction Highlights Highlights Video 1: Highlighting the positive Video 2: The A Team Videos 3a-3d: Positive UA with jail sanction Video 4: Learning experience with thought paper
Incentive and Sanction Incentive and Sanction Highlights Highlights During video, think about whether the judge: Is Respectful Allows the participant to explain Provides a clear explanation of behavior being sanctioned Provides a clear explanation of what to do instead Provides a learning experience for other participants
Sample Incentive and Sample Incentive and Sanction Schedules Sanction Schedules http://ndcrc.org/content/list-incentives- and-sanctions http://ndcrc.org/content/incentives-and- sanctions-fact-sheet-0 Other good info on incentives and sanctions: www.drugcourtonline.org
Sample Incentive and Sample Incentive and Sanction Schedules Sanction Schedules Washington D.C. Merced, CA Kansas NDCI
Sanction Exercise Sanction Exercise Behavior First 30 days Positive for cocaine Question T2: John Abuser T1: Allen Addict Proximal or Distal? P D Sanction low, middle or high? Proximal or Distal? M/H L Missed Treatment Session P P Sanction low, middle or high? Proximal or Distal? M M Missed Court Session P P Sanction low, middle or high? M M
Incentives Exercise Incentives Exercise Behavior After 180 days Question T2: John Abuser T1: Allen Addict Negative drug tests for last 30 days Proximal or Distal? P P Incentive low, middle or high? H M Made all Treatment Session on time for last 60 days Proximal or Distal? P P Incentive low, middle or high? M M
All Behavior is followed by a consequence, and the nature of that consequence modifies the organisms tendency to repeat the behavior in the future B.F. Skinner
Patience: we are in this for the long haul. 15 months post abstinence Normal methamphetamine addict
Readings Readings Burdon WM et al (2001). Drug courts and contingency management. Journal of Drug Issues, 31, 73-90. Harrell A & Roman J (2001). Reducing drug use and crime among offenders: The impact of graduated sanctions. Journal of Drug Issues, 31, 207-232. Marlowe DB (2007). Strategies for administering rewards and sanctions. In JE Lessenger & GF Roper (Eds.), Drug courts: A new approach to treatment and rehabilitation (pp. 317-336). New York: Springer. Marlowe DB (2008). Application of sanctions. In Drug Court Quality Improvement Monograph. Alexandria, VA: NDCI. Marlowe DB & Wong CJ (2008). Contingency management in adult criminal drug courts (pp. 334-354). In ST Higgins, K Silverman & SH Heil (Eds.), Contingency management in substance abuse treatment. New York: Guilford. Marlowe DB (2011). Applying incentives and sanctions. In The drug court judicial benchbook (pp.139-157). Alexandria, VA: NDCI.
