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Evidence Based Practice and
Treatment Programs for
Juvenile Offenders

  Jennifer Samimi-Luu, LMSW
  Jsamimi-luu@legal-aid.org



                              1
What is EBP?
   No consensus definition
   Be skeptical
   Culturally grounded???
   Become a knowledgeable consumer of EPB
    information



                                   2
Defining EBP
   …the integration of the best research
    evidence with clinical expertise and patient
    values
    (Institute of Medicine)




                                        3
Selecting a Practice
   EBP needs to fit population ,family,
    individual
   Consistent with cultural beliefs and values




                                        4
How much “evidence” is “Evidence”?
   Effective
   Efficacious
   Not effective
   Promising
   Emerging



                           5
Fidelity

   Adopting
   Adapting
   Adopt-Validate-Adapt-Evaluate




                                    6
“Nothing Works”
   In 1975 Lipton, Martinson, & Wilks
    concluded that research could not support
    rehabilitation of juvenile offenders
   Today some effective interventions have been
    developed, but most services utilized in the
    juvenile justice system have either not been
    proven effective or not been evaluated at all

                                       7
Ineffective Programs and Policies
   Processing in juvenile justice system
       Analysis showed that processing in the juvenile
        court tends to increase criminal behavior,
        especially when compared to diversion programs
   Juveniles in criminal court
       Transfer to adult court is associated with higher
        recidivism rates among juveniles


                                               8
Ineffective Programs and Policies
   Surveillance (probation or parole, all levels)
       Current evidence is mixed regarding the effects of
        probation and parole on juvenile offending
       Used widely, but lack of strong empirical support
   Shock incarceration interventions (Scared
    Straight)
       Increase the criminal behavior of juvenile
        offenders

                                              9
Ineffective Programs and Policies
   Residential Placement
       Includes boot camps, group homes, detention
        centers, residential treatment centers, and
        wilderness camps
       Mental health, substance abuse, and educational
        needs are deficient
       Increases criminal activity


                                             10
EPB’s with Strong JJ Outcomes
   Parent Training
   Family Therapy
   Cognitive Behavioral Therapy
   Mentoring
   Out of Home Care (not placement)



                                       11
Blueprints for Healthy Youth
Development
   In 1996, the
    Center for the Study and Prevention of Violence (CSPV), at
    the University of Colorado Boulder, designed and launched a
    national youth prevention initiative to identify and replicate
    violence, delinquency and drug prevention programs that
    have been demonstrated as effective.
       Each Blueprints program has been reviewed by an independent panel
        of evaluation experts and determined to meet a clear set of scientific
        standards. Programs meeting this standard have demonstrated at least
        some effectiveness for changing targeted behavior and developmental
        outcomes.
       Programs are rated as either Promising or Model. Promising
        programs meet the minimum standard of effectiveness. Model
        programs meet a higher standard and provide greater confidence in
        the program’s capacity to change behavior and developmental
        outcomes.
                                                             12
Blueprints
   MODEL PROGRAMS
       Model programs meet these additional standards:
       Evaluation Quality: A minimum of (a) two high quality
        randomized control trials or (b) one high quality
        randomized control trial plus one high quality quasi-
        experimental evaluation.
       Positive intervention impact is sustained for a minimum
        of 12 months after the program intervention ends.
   Over 1,100 programs have been evaluated – three
    meet the “model” criteria for intervening with
    juvenile offenders – FFT, MST, and MDFT
                                                   13
Functional Family Therapy (FFT)
   Blue Prints for Violence prevention model
    program
   One of the first EBP’s in the field
   www.fftinc.com




                                      14
Functional Family Therapy (FFT)
   Presenting problem is viewed as symptom of
    dysfunctional family relations
   Interventions aims to establish and maintain
    new patterns of family behavior
   Integrates behavioral (i.e. communication
    training) and cognitive behavioral (i.e.
    assertiveness training, anger management)
    interventions into treatment
                                       15
Functional Family Therapy (FFT)
   Phased-based; initially focuses on engaging
    family members, moves to extensive effors at
    individual and family behavior change,
    concludes with interventions to allow for
    sustainability
   Therapists are required to participate in
    intensive training protocol

                                      16
Multisystemic Therapy (MST)
   Blue Prints for Violence prevention model
    program
   Focuses on youth with serious clinical issues
    (violent or sexual offenses, substance use,
    serious emotional disturbance)
   Uses “person-in-environment” persepective,
    theory of social ecology

                                        17
Multisystemic Therapy (MST)
   Comprehensive and flexible interventions that
    address factors at individual, family, peer,
    school, and community levels
   Includes intensive quality assurance and
    improvement program




                                       18
Multidimensional Treatment Foster
Care (MTFC)
   Developed as a community-based foster care
    alternative to detention or group care facilities
   Intended to be used when other intensive in
    and out of home services have failed




                                          19
Multidimensional Treatment Foster
Care (MTFC)
Based on social learning theory, including
  behavioral principles
       Reward and punishment

   Uses behavioral management plans and
    cognitive behavioral techniques



                                      20
Program Components
Effective          Ineffective
   Address key risk factors             Ignore risk factors or
       (assessing family                 directly conflict with
        functioning, disassociation       research (i.e. peer
        from deviant peers)               contagion in residential
                                          settings)

                                         Interventions are outside of
   Are behavioral in nature              youth’s natural
    and are community-based               environment (residential
    and work to address                   settings, courts, probation
    problems where they occur             offices, etc.) and fail to
    (work, school, home)                  consider context of real
                                          world

                                                       21
Effective                          Ineffective
   Well specified and             Absence of supportive
    include intensive               research, even with
    support for intervention        “systematic”
    fidelity                        interventions




                                              22
Conclusion
   Despite well established evidence of effective
    services for juvenile offenders, the vast
    majority of services provided either result in
    increase criminal behavior or have not been
    evaluated.




                                        23

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Evidence based practice for Juvenile Justice

  • 1. Evidence Based Practice and Treatment Programs for Juvenile Offenders Jennifer Samimi-Luu, LMSW Jsamimi-luu@legal-aid.org 1
  • 2. What is EBP?  No consensus definition  Be skeptical  Culturally grounded???  Become a knowledgeable consumer of EPB information 2
  • 3. Defining EBP  …the integration of the best research evidence with clinical expertise and patient values (Institute of Medicine) 3
  • 4. Selecting a Practice  EBP needs to fit population ,family, individual  Consistent with cultural beliefs and values 4
  • 5. How much “evidence” is “Evidence”?  Effective  Efficacious  Not effective  Promising  Emerging 5
  • 6. Fidelity  Adopting  Adapting  Adopt-Validate-Adapt-Evaluate 6
  • 7. “Nothing Works”  In 1975 Lipton, Martinson, & Wilks concluded that research could not support rehabilitation of juvenile offenders  Today some effective interventions have been developed, but most services utilized in the juvenile justice system have either not been proven effective or not been evaluated at all 7
  • 8. Ineffective Programs and Policies  Processing in juvenile justice system  Analysis showed that processing in the juvenile court tends to increase criminal behavior, especially when compared to diversion programs  Juveniles in criminal court  Transfer to adult court is associated with higher recidivism rates among juveniles 8
  • 9. Ineffective Programs and Policies  Surveillance (probation or parole, all levels)  Current evidence is mixed regarding the effects of probation and parole on juvenile offending  Used widely, but lack of strong empirical support  Shock incarceration interventions (Scared Straight)  Increase the criminal behavior of juvenile offenders 9
  • 10. Ineffective Programs and Policies  Residential Placement  Includes boot camps, group homes, detention centers, residential treatment centers, and wilderness camps  Mental health, substance abuse, and educational needs are deficient  Increases criminal activity 10
  • 11. EPB’s with Strong JJ Outcomes  Parent Training  Family Therapy  Cognitive Behavioral Therapy  Mentoring  Out of Home Care (not placement) 11
  • 12. Blueprints for Healthy Youth Development  In 1996, the Center for the Study and Prevention of Violence (CSPV), at the University of Colorado Boulder, designed and launched a national youth prevention initiative to identify and replicate violence, delinquency and drug prevention programs that have been demonstrated as effective.  Each Blueprints program has been reviewed by an independent panel of evaluation experts and determined to meet a clear set of scientific standards. Programs meeting this standard have demonstrated at least some effectiveness for changing targeted behavior and developmental outcomes.  Programs are rated as either Promising or Model. Promising programs meet the minimum standard of effectiveness. Model programs meet a higher standard and provide greater confidence in the program’s capacity to change behavior and developmental outcomes. 12
  • 13. Blueprints  MODEL PROGRAMS  Model programs meet these additional standards:  Evaluation Quality: A minimum of (a) two high quality randomized control trials or (b) one high quality randomized control trial plus one high quality quasi- experimental evaluation.  Positive intervention impact is sustained for a minimum of 12 months after the program intervention ends.  Over 1,100 programs have been evaluated – three meet the “model” criteria for intervening with juvenile offenders – FFT, MST, and MDFT 13
  • 14. Functional Family Therapy (FFT)  Blue Prints for Violence prevention model program  One of the first EBP’s in the field  www.fftinc.com 14
  • 15. Functional Family Therapy (FFT)  Presenting problem is viewed as symptom of dysfunctional family relations  Interventions aims to establish and maintain new patterns of family behavior  Integrates behavioral (i.e. communication training) and cognitive behavioral (i.e. assertiveness training, anger management) interventions into treatment 15
  • 16. Functional Family Therapy (FFT)  Phased-based; initially focuses on engaging family members, moves to extensive effors at individual and family behavior change, concludes with interventions to allow for sustainability  Therapists are required to participate in intensive training protocol 16
  • 17. Multisystemic Therapy (MST)  Blue Prints for Violence prevention model program  Focuses on youth with serious clinical issues (violent or sexual offenses, substance use, serious emotional disturbance)  Uses “person-in-environment” persepective, theory of social ecology 17
  • 18. Multisystemic Therapy (MST)  Comprehensive and flexible interventions that address factors at individual, family, peer, school, and community levels  Includes intensive quality assurance and improvement program 18
  • 19. Multidimensional Treatment Foster Care (MTFC)  Developed as a community-based foster care alternative to detention or group care facilities  Intended to be used when other intensive in and out of home services have failed 19
  • 20. Multidimensional Treatment Foster Care (MTFC) Based on social learning theory, including behavioral principles  Reward and punishment  Uses behavioral management plans and cognitive behavioral techniques 20
  • 21. Program Components Effective Ineffective  Address key risk factors  Ignore risk factors or  (assessing family directly conflict with functioning, disassociation research (i.e. peer from deviant peers) contagion in residential settings)  Interventions are outside of  Are behavioral in nature youth’s natural and are community-based environment (residential and work to address settings, courts, probation problems where they occur offices, etc.) and fail to (work, school, home) consider context of real world 21
  • 22. Effective Ineffective  Well specified and  Absence of supportive include intensive research, even with support for intervention “systematic” fidelity interventions 22
  • 23. Conclusion  Despite well established evidence of effective services for juvenile offenders, the vast majority of services provided either result in increase criminal behavior or have not been evaluated. 23