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WW Module 04 Modified - NYS-word version

1. Case Planning

1.1 What Works in Changing Offender Behavior: Case Planning

Notes:

Welcome to the e-learning training module on What Works in Changing Offender Behavior with a focus on case planning. In this module, you will be introduced to various concepts associated with case planning. We will be discussing strategies for identifying and addressing criminogenic needs in case/supervision plans.

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1.2 How to Use This Module

Notes:

Before we begin, please take a few moments to review how the presentation works. The core concepts and visuals in this module are intended for use with accompanying in-depth explanations of each slide topic. The in-depth information can be accessed in three ways, depending on learner preference: Module Notes, Audio, and Module Script. Each option contains the same information. Once the audio for each slide has ended, use the navigational buttons at the bottom of the module presentation window to advance to the next slide.


1.3 Table of Contents

Notes:

This module will present an array of methods aimed at case management.

First, we will discuss the importance of case planning. Then we will examine the principles of effective intervention and how they relates to case planning. Next, we will explore different opportunities for case management. These include case planning that is assessment-driven, the components of case management, special populations, and discharge planning. Finally, we will review the learning objectives to recapture an overview of the module.


1.4 Learning Objectives

Notes:

Learning objectives for this course include learning the difference between case planning and case management and reviewing the principles of effective intervention. Next, we’ll discuss role clarification during the case planning process and examine approaches for identifying and addressing criminogenic needs in case plans. Finally, we’ll discuss how to develop a clear understanding of discharge planning.


1.5 Section 1

Notes:

The first section of this module focuses on the importance of case planning with participants. Many concepts referenced in section 1 will be further discussed and expanded on throughout this module.

1.6 Case Management and Case Planning

Notes:


When you entered this field, you may have done so for a particular reason. Many of us say that we entered the field because we want to help people or we want to work to protect our communities. Regardless of your personal reason, you may find yourself asking the question, “What works to change the behavior of the individuals under my supervision?”, or “What issues do I address?”, or “What should I prioritize?”, or “How do I address these issues through programming or treatment sessions?”. Individuals under supervision often have an assortment of problems and issues to address. Sometimes these issues seem incredibly difficult to identify and address and can be extremely overwhelming. Agencies often try and help through the development of a case plan or through case management practices.

The terms case management and case planning are used interchangeably in the field of corrections. However, the two terms are different concepts. Case planning creates strategies of what needs to be done. In other words, we are using the results of the risk/need assessment to create an individualized treatment plan for each participant. This plan should reflect their risk level and recommended interventions based on specific criminogenic needs. Case management, on the other hand, involves the actual delivery of services. This includes checking in on their progress and providing ongoing feedback to the participant. With case planning and case management, we want to ensure that we are matching participants to the services and programs which address risk factors and accommodate for barriers related to responsivity. When this occurs, agencies are getting the most use of the available resources.


1.7 Why Case Plan?

Notes:

Case plans are key because they provide a structured approach to case management. Case plans clearly and specifically identify a participant’s criminogenic risks and needs, accompanied by risk reduction strategies and plans of action, with timelines. The case plan is the roadmap for a participant, referencing risks and needs and linking them to specific programs in which they will participate. This allows one to organize and prioritize what and how criminogenic needs should be targeted. Case plans also document and track progress through the various phases of interventions that are recommended and provided to a participant. Case plans are dynamic instruments that organize a participant’s behavioral expectations and are adapted according to his or her actions while on supervision. Case planning also helps guide decision-making. For example, if the participants have been shown to be have high needs in the criminal thinking and attitudes domain, we want to look for interventions and programs that will target the needs and make referral and treatment decisions around the need.


1.8 Section 2

Notes:

Section 2 of this module provides a brief overview of the principles of effective intervention. These principles help criminal justice agencies prioritize services and make determinations about persons under supervision. In the “What Works in Changing Offender Behavior” module, we discussed these principles in extensive detail. As a quick review, the next few slides will provide a brief description of each of these principles.


1.9 Principles of Effective Intervention: Risk

Notes:

The risk principle tells us who to target. More specifically, interventions should be matched by risk level, reserving the most intensive treatment and programming for higher risk participants. This is the group we are most concerned about and where we should place most of our efforts. Recall, studies have shown that placing lower risk participants into intensive programs and higher levels of supervision can actually increase their failure rates.


1.10 Major Set of Risk/Need Factors

Notes:

This slide shows the eight major risk/need factors, or correlates of criminal conduct. The first risk factor is having antisocial or procriminal attitudes, values, and beliefs. This risk factor manifests itself in several ways: negative expressions about the law, about self-management of behavior, and a lack of empathy and sensitivity toward others. The second major risk factor is having antisocial friends and a lack of prosocial friends and acquaintances.

The third major risk factor is one that is often ignored in assessment; temperamental and personality factors. This includes weak socialization, impulsivity, egocentricism and having a taste for risk. The fourth major risk factor is criminal history and other antisocial behavior. Criminal history is a very strong predictor of future behavior. The fifth major risk factor involves family factors, including criminal behavior in the immediate family, and a number of other problems such as low levels of affection, poor parental supervision, and out right neglect and abuse.

The sixth major risk factor includes low levels of personal educational, vocational, and financial achievement. The seventh major risk factor is low levels of involvement in prosocial leisure activities. A participant having too much idle time can be problematic. It may lead an increased risk of associating with antisocial peers in a similar situation. Filling that idle time may lead to them being involved in more criminal activities. Finally, the eighth risk factor is the abuse of alcohol and/or other drugs. This often allows for the interaction with antisocial peers, impacts social skills, and, in the case of illicit drugs, is illegal in


and of itself. The participant’s social skills and thinking patterns shift focus on how they will be obtaining alcohol or other drugs.

1.11 Principles of Effective Intervention: Need

Notes:

The need principle tells us what to target for change. More specifically, the need principle states that interventions and programs should target needs that are likely to get a person in to trouble again - those criminogenic factors from the previous slide. Remember that criminogenic need factors are dynamic, meaning that they can change when targeted properly through intervention and treatment.

Participants are not high risk for recidivism because they have one risk or need factor, but rather are high risk because they have multiple risk and need factors. Programs that target only one such need may not produce the desired effects.


1.12 Principlies of Effective Intervention: Responsivity

Notes:

The responsivity principle tells us how to target criminogenic needs to ensure that participants are successful on supervision or in a custodial setting. These are non-criminogenic factors or barriers that may impact the participant’s response to interventions. Literature differentiates two types of responsivity; specific responsivity and general responsivity. Specific responsivity tells us to match the styles and mode of services to key participant characteristics and learning styles. As the term indicates, these are barriers that may impact the specific or individual participant; in other words, what might be a barrier for one participant, is not necessarily a barrier for another participant. General responsivity refers to the fact that interventions based on social learning and cognitive behavioral models are the most effective way to teach people new behaviors regardless of the type of behavior or type of participant. Research has consistently shown that participants respond differently to treatment strategies and/or to correctional environments. For example, one participant might do well in a group treatment setting, while another participant might do better in individual sessions with their counselor, case manager, or probation officer. It is important to identify key responsivity factors for each participant, as it helps to maximize the benefits of treatment.


1.13 Principles of Effective Intervention: Fidelity

Notes:

The fidelity principle primarily focuses on how well programs properly and effectively incorporate the risk, need and responsivity principles. Fidelity measures how programs are implemented and the program’s adherence to their respective modality of treatment. When implementing an intervention, we want to ensure that it’s being delivered as closely as possible to the way it was designed. The fidelity principle demonstrates that characteristics for implementing and maintaining evidence‐based programming goes well beyond basic quality assurance standards, such as file review and case management practices. For example, fidelity can be measured and monitored during group facilitation, individual sessions and in case planning. Moreover, there is a link between program implementation and program outcomes. Specifically, programs that are implemented with fidelity have better program outcomes.


1.14 Section 3

Notes:

Section 3 of this module covers assessment-driven case planning. This section will focus on the incorporation of assessments and what to look for in those assessments while case planning.

1.15 Samantha


Notes:

Let’s begin with an example.

Samantha has been using methamphetamine on a regular basis for 6 years. She is also in an abusive relationship and has been unemployed for six months. Her friends engage in a criminal lifestyle and she lives in an area that is well known for drug dealing. Samantha explains to you the main reason for continued problems is that her teeth have rotted from the meth use and if her teeth were fixed she would be in a better place. She goes on to explain that if her teeth were fixed she would have higher self-esteem and this would help her confidence when obtaining employment and have better dating opportunities. She states she is very self-conscious about her smile and this impacts her thought process, and if she had a better smile, everything would improve. All of this seems to make sense, so you help Samantha in securing an appointment to restore her teeth offered by a local organization. Two months later, Samantha has her teeth restored and she is ecstatic about this new change; but later that week, you received information that Samantha was arrested for drug sales. What could have been done differently to help Samantha?

1.16 What is Assessment-Driven Case Management?

Notes:

There is nothing wrong with helping Samantha improve her appearance, but focusing on issues that are not crime producing take our time and energy away from the real issues. Samantha lacked skills to stop drug use. The focus was not on skills to obtain positive friendships, avoid use, and get out of an abusive


relationship. When we spend time on things that “seem” to contribute to re-offending behavior, rather than things that are not statistically relevant to future misconduct, we miss opportunities to address critical problems.As we now know, to best determine targets for change, prior to the creation of a case plan, individuals under supervision should be assessed for their level of risk and individual needs. This is important because it guides decision-making by providing more information in a systematic manner and reduces bias by following objective criteria. As already noted, good assessments help determine the likelihood of the risk to reoffend and also provide an outline for the most relevant issues to address with each person under supervision. Individuals under supervision often have multiple areas of need so sorting out what’s important to address and how to prioritize those issues is the key to being an effective change agent. Assessment-driven case management also helps prioritize services and develop goals in the case plan based on criminogenic needs. When results of the risk/need assessment are incorporated into the case plan process, re-assessment will assist in deciding the next step needed for the participant. Once re-assessed, we can figure out if a participant needs additional treatment or if we can provide fewer restrictions on this individual. An individual can be re-assessed throughout various phases of the system as needed or per the recommendations of the tool. Any time a participant is re-assessed the results should be incorporated into the case plan.

1.17 Why Standardized Assessments?

Notes:

In recent years there has been a substantial amount of research on risk assessment and the development of appropriate monitoring and supervision strategies for individuals on probation and parole. When results are effectively utilized, risk assessments possess many benefits. Ultimately, an effective instrument ensures that participants are classified so that effective treatment can be administered while ensuring public safety. The assessment also helps identify which participants are most at risk for recidivating and who will need the most intervention. These results pinpoint what specific crime producing needs should be targeted and guide decision making in case planning by providing more information in a systematic manner. This helps reduce biases by following objective criteria rather than personal intuition and judgment.

When an assessment and classification process is integrated into a correctional system it can lead to better utilization of resources. When we identify the highest risk participants and make referrals based on identified needs, we can ensure that the participants are receiving appropriate levels of supervision and adequate services that can reduce criminal behavior. We can also funnel out those low-risk participants


who do not need increased levels of supervision or multiple interventions for problems they do not possess.

1.18 Treatment Effects for High Risk

Notes:

When we are case planning it is important for us to look at how the participant’s level of risk may impact treatment outcomes. This figure is an example of when the assessment and classification process was integrated into multiple correctional facilities. Doctors Chris Lowenkamp and Edward Latessa conducted a study in Ohio that tracked a total of 13,221 participants who were placed in one of 37 halfway houses and 15 community-based correctional facilities throughout the state. The figure above shows the results for high-risk participants. Not only did most programs reduce recidivism for this group, but we also have eight programs that reduce recidivism over 20% and three programs that were over 30%. If we look at Program MM and Program LL, we can see that these two programs reduce recidivism for high risk offenders over 30%. These results suggest that when risk/needs assessment results are used to determine exactly who is appropriate for the program and what needs should be addressed for each participant; the program is likely to have a substantial impact on criminal conduct. Thus, if you build your supervision case plans with this information, you can contribute to reductions in recidivism by upwards of 30%.


1.19 Section 4

Notes:

Thus far we have discussed the importance of considering the principles of effective intervention when developing and updating case plans. Section 4 of this module discusses the components of a case plan and how to apply those principles throughout everyday practice. These components will help organize the way that you manage and assist participants as they make progress on their case plan.


1.20 Knowing Where to Start

Notes:

Knowing where to start when addressing issues of persons under supervision can be challenging. Fortunately, with the help of research, we know what areas contribute to a person’s likelihood to re-offend. However, it is not that simple. There are various questions to consider prior to developing a case plan. First, what issues does the participant feel are the most significant in her/his life? 2nd and related, what area is the individual most willing to change? Third, is the motivated area an issue that can be changed? If it can be changed, what is a reasonable time frame? Considerations should be given to any legal mandates that must be fulfilled. Keep in mind that working on multiple problems at once can be overwhelming for the participant; not to mention yourself. Therefore, it is important to think of how best to prioritize the needs to be addressed as well as various ways the plan can be simplified and still address the relevant issues.


1.21 Prior to Building the Case Plan

Notes:

After reviewing the results of the assessment you should share them with the participant and engage them in the planning process. Explaining the results of the assessment allows you to begin to discuss expectations and to continue to build rapport with your participant. Results of an assessment should not be a secret. A good approach to case planning is to stay focused on the positives of the individual’s situation. For example, what successes has s/he had in the past?, what is s/he willing to do to be successful on supervision?, what does s/he believe are her/his biggest strengths that will help create success? By engaging the participant and asking questions such as these, it will help you gauge their level of motivation and how best to tailor their case plan to maximize results. Finally, it allows you to encourage and obtain a commitment to change from the participant. Not surprisingly, if you can get persons under your supervision to make commitments to change on a plan that was his or her idea, then your work gets much easier for you.


1.22 Sample Case Plan

Notes:

Now that we have talked about how to begin engaging the participant in the process, let’s take a look at a sample case management plan. As you can see there are multiple components within the case plan. We will focus on four specific components of a case plan: First, the needs component which is a brief, specific description of the issue/criminogenic need as identified by assessment; second, the goal component which is a broad aspiration for the supervision period intended to address the need area; third, the tasks component which are the small action items the individual will take toward meeting the goal; and finally, the strategies component which are the steps utilized by the supervising officer to support the goal and tasks in the plan.

On the next slide we will learn about Jonathan. Once we learn about Jonathan, we will use his case as an example to go into more detail on the components of a case plan.


1.23 Jonathan Example

Notes:

Jonathan is a 38 year old male on your caseload and is under supervision for Theft. While meeting with Jonathan he discusses what happened the day he was arrested. Jonathan states he was unemployed for 4 months at the time and has been sitting in his apartment during the day while he looked for jobs on the internet. Jonathan states there is a new building being constructed across the street from his apartment. He states that at the end of the workday the construction workers frequently leave their tools laying out and he can see them from his apartment. Jonathan stated that he recently received an eviction notice as a result of not paying his rent. He and his friends agreed that Jonathan’s problems would be solved if they all went across the street and stole some power tools and pawned them. They convinced Jonathan that they wouldn’t get caught. In a panic, Jonathan and a few of his friends went across the street and stole a bunch of power tools with the intention to pawn them off to pay his rent. Jonathan was unaware there were security cameras watching the job site and caught everything he and his friends stole on tape. He was immediately arrested. He stated that “I never pawned them off; they would’ve got them back later.” He also stated, “My friends gave me the choice to either steal and pawn the tools or live on the streets. So I picked the lesser of two evils.” Jonathan’s risk assessment indicates that he is high risk to reoffend overall and high risk in antisocial attitudes and in procriminal associates.

Jonathan has a high school diploma and has consistently worked since he was 18. Jonathan does not have a long criminal history. Most of his convictions are for Disorderly Conduct from when he was in his early 20s. He stated he is willing


to do whatever it takes to get off probation and get back to work. During this section, as we discuss the various components of a case plan, we are going to build a case plan for Jonathan.

1.24 Jonathan’s Strengths

Notes:

Upon further file review, Jonathan has many strengths that are worth noting prior to creating his individual case plan. Jonathan has a high school diploma and has consistently worked since he was 18. Jonathan does not have a long criminal history. Most of his convictions are for Disorderly Conduct from when he was in his early 20s. He stated he is willing to do whatever it takes to get off probation and get back to work. During this section, as we discuss the various components of a case plan, we are going to build a case plan for Jonathan simultaneously.


1.25 Problem/Needs

Notes:

Recall the first component of the case plan: Needs. The needs statement, or problem statement, of the case plan should concisely identify the criminogenic need determined by the assessment. When working in the needs area, we should focus on factors that are dynamic and can change with interventions such as attitudes, problem solving skills, drug use, alcohol use, or peer association. When addressing needs you should consider the individual’s input on the need area and to what degree the problem has affected the individual’s life. Remember to keep the need statement brief and specific to the criminogenic need being targeted for change. Based on the participant’s risk level, they may have multiple needs that will require targeting. Remember participants are not high risk for recidivism because they have one risk/need factor, they have multiple risk/need factors that should be addressed. In this way, a case plan needs to be completed for each criminiogenic need. Therefore, each criminogenic need will have a need statement identified. Use caution not to overwhelm the individual; addressing a few needs at a time will help to maintain an environment of self-efficacy.


1.26 Jonathan’s Case Plan

Notes:

Revisiting Jonathan’s situation, we will start building his case plan. You will recall his assessment indicated that he is high risk in antisocial attitudes and in procriminal associates. He is also willing to do what it takes to get off probation and find another job. Because he is motivated to change, and his friends are putting him at risk, one significant need area for Jonathan are his friends. So in the “Problem/Needs” box, we are going to target his procriminal associates.

Next we will look at the goal component of a case plan.


1.27 Goals

Notes:

Goals are the long-term desired outcomes of where the participant should be after s/he receives interventions. The most effective goals should be linked to risk/need assessment results, targeting the criminogenic need area identified in the Problems/Needs section of the case plan. Participants are more likely to be successful when goals are clearly outlined, realistic, and achievable. In addition, when participants are part of the goal setting process, they are more likely to take measures to achieve them.

Some examples of long-term goals include: develop and maintain healthy relationships with prosocial family members; develop and maintain prosocial peer relationships; significantly reduce or eliminate use of illicit substances and develop skills to maintain substance-free lifestyle; maintain employment in a prosocial environment; or increase ability to manage anger with prosocial coping skills. Let’s take a look at what Jonathan’s goal might be.



Notes:

We need to come up with a goal for Jonathan that will help reduce his risk associated with his risky friends. Since Jonathan stated he is “willing to do whatever it takes to get off of probation and is very motivated to get his life back on track” his long term goal is to “significantly reduce or eliminate association with criminal friends.” Now, let’s shift our focus on the next component of the case plan, tasks.


1.29 Tasks

Notes:

Tasks are short-term steps the participant will take to reach the overall goal. Tasks should be a set of sequenced, shorter range events the participant can undertake to help them accomplish their goal. A common acronym associated with the development of tasks is SMART. SMART tasks are specific, measureable, achievable, realistic and time-based. Specific tasks identify exactly what you hope to accomplish. Tasks that are measurable allow you to gauge progress along the way. Tasks should also be achievable and realistic, so keep them small to encourage greater success. Finally, you want to ensure the tasks are time-based, creating clear deadlines for each.Let’s take a look at some SMART tasks for Jonathan to work on to reduce his risky friendships.



Notes:

Now that we have thoroughly reviewed different tasks, let’s continue to develop some short-term steps Jonathan can do to reach his overall goal. Jonathan’s first task will occur during the next session, we will have Jonathan describe the history and consequences of criminal behavior with peers. The second taskis to list the reasons past attempts to end relationships with criminal friends were unsuccessful by the next session. The last task will occur over the next three months, we will have Jonathan identify, practice and implement new strategies for distancing himself from criminal peers.


1.31 Antisocial/Procriminal Attitudes

Notes:

Before moving into strategies, let’s review the first three components of the case plan. First, a good case plan identifies very concretely the area to be targeted for change. Next, the goal highlights the exact change the participant is working toward. Finally, the tasks outline the specific steps the participant is going to take in an effort to begin meeting his/her goal. To see this more, let’s look at a few different examples of a case plan with these three components completed. For participants who are high risk in the need area of antisocial thinking, you would want participants to reduce their use of antisocial thinking, while also learning how to recognize risky thinking and feelings, so to replace them with more prosocial thoughts. Examples of a participant's tasks in this area could include: participate in cognitive-behavioral programming twice a week for 12 weeks; complete thinking reports with my supervising officer and be prepared to discuss them each meeting; complete all homework assignments that are designed to help me identify risky situations, thoughts, feelings, and beliefs; role-play situations that are risky for me with my supervising officer each meeting; complete assignments that are designed to help me identify the consequences of my thoughts, feelings, and beliefs with my supervisor each meeting; outline possible alternative beliefs that may lead to better results with my supervising officer each meeting; or practice new behaviors that I will review with my supervising officer each meeting.


1.32 Famillial Factors

Notes:

For participants who are high risk in the need area of family the focus should be on reducing conflict, building positive relationships, and enhancing communication skills with family members. Examples of tasks in this area could include: list situations that have been challenging with my family members; identify alternative actions for challenging situations with family members; attend and participate in a cognitive behavioral class with my significant other; practice new skills and rehearse them with my case manager such as being assertive with my family when needed; identify family members that may interfere with my supervision plan and list strategies that can help me overcome these obstacles; write a list of 5 behaviors or issues I feel have been a barrier to my being a prosocial member of my community and family; or write a list of 10 lies I have said that have created significant conflict with my family.


1.33 Substance Abuse

Notes:

Finally, let’s review a case plan for a participant who is high in the need of substance use. For participants who are high risk in the need area of substance abuse, you want participants to reduce usage, reduce any support for abuse behavior, and develop alternative prosocial behaviors. Examples of tasks in this area could include: Participate in an assessment and complete all recommended treatment within 6 months; Enroll in treatment at “Program X” by “June 1”; Participate in random drug testing; Write a list of triggers, situations, friends, attitudes/feelings that interfere with my ability to stay clean and sober by the next group session; Identity pros and cons of continuing use by next Wednesday; or Role-play risky situations involving substances with my case manager every week; or list ten negative consequences resulting from or intensified by substance dependence.


1.34 Strategies

Notes:

The last component of the case plan is Strategy. Strategies are closely connected to the tasks so that each task on the case plan has a corresponding strategy. Strategies are the steps that staff complete to assist with participant change. Strategies for the supervision period should list the resources or methods the staff will use to encourage the participant to meet the goals noted in the plan. There are a variety of strategies available to choose from when you are developing a case plan. Three examples of strategies include supervision, referrals and in-person face to face meetings. The next slide will discuss the differences in these three concepts.


1.35 Strategies

Notes:

The first strategy available to staff is supervision. In large part this involves monitoring the participant. Some examples of this strategy include drug screens, house arrest, curfew checks, and electronic monitoring. The second strategy is the referral technique which directs the participant to various programs, interventions, or agencies for services. Some examples of referral strategies include referrals for family intervention, educational needs, mental health, vocational services, or cognitive-behavioral interventions. The last strategy, in-person or face-to-face, allows for building rapport and checking in with the participant about progress toward accomplishing goals. It also allows the staff to be an effective agent of change by utilizing motivational engagement and cognitive-behavioral strategies to target need areas. Some examples of in-person meetings strategies include providing progress updates, modeling prosocial behavior, reassessing needs, administering reinforcers, and teaching skills. It should be noted that supervision strategies support referral and face to face strategies and do not alone impact long-term change.



Notes:

Let’s add strategies and timelines to Jonathan’s case plan. In order for Jonathan to accomplish his first task, we need to identify a corresponding strategy. This involves asking Jonathan to complete a list of the consequences that resulted from each criminal act in which he engaged with his friends. The strategy associated with his second task will be for us to help him identify the triggers, ambivalence, and unclear boundaries that might have led to failure. Since the last task will occur over the next three months, the last strategy for Jonathan will be to refer him to a skill-building group. We will help him practice new skills and will monitor his progress with updates from his provider, himself, and family. It is important to have realistic timelines when developing a case plan so that the participant is not overwhelmed and knows exactly what is expected. If you are meeting with Jonathan on a weekly basis, your dates should reflect that timeline. However, be sure not to initiate the tasks/strategies all at once. We want to ensure that the participant is able to take gradual steps towards the goal. On this slide, you can also see the complete case plan. All four components are filled out and ready for implementation. As the case plan is finalized, remember to seek commitments from the participant and monitor progess so the case plan can be updated. In Jonathan’s case, as we meet with him throughout the next few months, we will continue to monitor and update this case plan accordingly.


1.37 Decision Matrix

Notes:

Another component to case planning is designing or developing a decision matrix. A decision matrix provides a framework for interventions and allows for individualization of services. A decision matrix also helps ensure supervision is based on individual risk level and treatment is based on needs. With a decision matrix, the available service options are listed along with the known criminogenic needs and risk levels. A matrix of options is then outlined for staff to follow when determining the most appropriate services for the participant based upon the results of the risk/needs assessment. On the next couple of slides, we will cover different examples of decision matrices.


1.38 Sample Decision Matrix

Notes:

Here is an example of a simple decision matrix for various risk levels. The left column of the matrix is a list of different needs provided by the results of the risk/needs assessment. Across the top are the risk levels. For each need and risk level there are different interventions that will aid in tailoring the case plan to the individual participant’s needs. This gives case planners a quick reference to what would be an appropriate treatment match for a given participant. Creating a decision matrix like this helps to streamline the case planning process and also helps to ensure that case planners are using the same approach agency wide.


1.39 Sample Decision Matrix

Notes:

This sample model is broken out by need level, rather than risk level. However, it still provides a quick way for staff to identify which services and supervision strategies are most appropriate given need area and level of need. Let’s look at this a little more closely.You can see the left side lists a variety of service agencies and supervision techniques. Across the top you’ll see the need areas and the level of need for each (low, medium, and high). The stars show us, for example, that Thinking for a Change would be appropriate for individuals who have moderate to high need levels in either the Criminal Thinking and Attitudes or Peer need areas. On the other hand, curfew and electronic monitoring techniques are both appropriate for those program participants who are moderate to high need in the areas of substance abuse, employment, education and peers. Again, working to create a matrix like this one will save you a lot of time in the long run and will help to streamline the case planning process. Remember that a document such as this will need to be updated as services change and new services become available in your community.


1.40 Transitional Planning

Notes:

In some instances, case planners will be providing transitional planning as well as case planning. In fact, when a person successfully completes a program, treatment should not stop there as this is the time when participants struggle the most due to transitioning to a new lifestyle. Correctional facilities have been known to release individuals back into society with little or no support upon exit. The lack of support and/or proper planning increases the likelihood of individuals returning to jail, mental health facilities, or relapse into addictive behaviors. Planning for individuals who are incarcerated should begin upon their admission into a facility to ensure that sufficient time is given to develop a comprehensive plan.

As transition planners, we must collaborate with other facility staff, community workers, and the participant’s family or support network. As part of the planning process, a structured relapse prevention model should be included to help the participant upon release. This plan should include the participant’s risky situations, thoughts, feelings, and behaviors, as well as the concrete strategies needed to manage or avoid them. Additionally, booster sessions can be a component of transitional planning as they allow for the participant to continue practicing skills and obtaining support upon release. Formal linkages should exist so that the participant can clearly navigate through the transition. Lastly, we want to make sure we are still adhering to the principles of effective intervention. This means focus should be placed on higher risk participant’s criminogenic needs. Lower risk participants will need much less support during the transition process.


1.41 Transition Planners Role

Notes:

One thing that does change as we begin to plan for transition and re-entry is our role. When working within a facility we are mainly responsible for casework which essentially involves a one-on-one relationship with the participant. As the participant progresses towards transition and re-entry our role as a case manager should shift to that of a transition planner.. Instead of providing services, we now help to link the participant to services in the community.

A case manager is responsible for a number of tasks including: assessing risk, needs, and responsivity; supervising and intervening; targeting criminogenic needs identified on risk assessments through case planning; providing evidence-based interventions individually and in group settings; and providing graduated incentives and consequences to reinforce and sanction behaviors.

As a broker or transition planner, the responsibilities change a bit. A broker will be accountable for: assessing risk, needs, and responsivity; supervising, intervening, and referring participants to services; targeting criminogenic needs identified on risk assessments through case planning; finding evidence-based interventions in the community; and providing graduated incentives and consequences to reinforce and sanction behaviors. You can see how this role is more of a support role by helping the participant continue his or her change work


in the community.

1.42 Case Plan Considerations

Notes:

As you are formulating a case plan, think about how you will supervise that plan. Plans should contain statements outlining your strategies to assist the individual in completing each task and to confirm progress towards accomplishing goals. If the individual is unsuccessful at achieving these tasks, then barriers should be addressed and new strategies should be added to the plan. Depending on the lack of progress, appropriate sanctions should be administered that align to the infraction. Conversely, progress should be rewarded with incentives.Obstacles with plans are inevitable. Individuals on your caseload will have challenges. Remember the principles of effective intervention. High risk participants need the most intensive services and support. Focus your efforts on those who need it most. Additionally, remember the face to face strategies available, such as motivational engagement, to encourage the participant in the change process. Including specific timeframes and details in your actual plan help to make both you and the participant aware of the expectations. It goes without saying that it is important to avoid creating the same case plan for each participant. Considering the risk/needs assessments and each person’s history, it is necessary to create a case plan that is specifically tailored to each participants’ individual needs. Finally, should challenges or conflicts arise, make every effort to respond so that the goal of long-term behavioral change is maintained.


1.43 Section 5

Notes:

We have reviewed the principles of effective intervention, key components of a case plan, transitionally planning, and now it is time to look at discharge planning. Section 5 of this module looks at this final stage of case planning. We will review the definition of discharge planning, cover best practices in discharge planning and examine the importance of completion criteria.


1.44 Defining Discharge Criteria

Notes:

Prior to being able to say that someone has successfully completed treatment and is discharged from the program, we must first know the completion criteria for that program. Defining completion criteria requires asking and answering some questions: What is the goal of the program? What do participants need to do in order to meet that goal? What are the participant’s treatment goals? What does the participant need to do to meet them? The answers to these questions will help determine the discharge criteria for a program.Discharge criteria should be based on measuring the participant’s skill acquisition and progress in changing behavior. Knowledge and skill acquisition considers the participant’s development of new knowledge and skills relevant to abstaining from criminal behavior. For example, has the participant learned how to recognize risky thinking in high risk situations? If so, what skills has the participant developed to manage these high risk situations? Moreover, does the participant regularly use these new behaviors to manage risky situations when necessary?Ultimately, the goals and tasks outlined in the case plan should have to be met as well as other program goals prior to successful discharge.Discharge should not solely be based on time served or the discretion of staff. In other words, simply getting through a 90-day program without any infractions does not constitute a successful completion; it only proves that a participant knows how to get through a program. It is what a person learns and applies in the program that is important. A participant can easily come to a group for 90 days and make no active effort to learn any new skills related to living a crime free life. This participant may not make any progress towards achieving treatment plan goals and tasks, and therefore has failed to reduce the likelihood of engaging in crime producing behaviors. Given that our ultimate goal in corrections is recidivism reduction, our discharge criteria should reflect that the participant has taken steps and reduced their risk to reoffend. Re-assessment of overall risk will help make this determination. Additional assessment tools may also be useful. For example, a change in dynamic needs such as substance-use risk may suggest the participant has reduced their risk to rely on substances again and their risk to reoffend. Finally, other intermediate measures such as negative drug screens or attendance at school or work can suggest program progress.


1.45 Measuring Progress

Notes:

The challenge in implementing discharge criteria based on treatment and goal attainment is having some way of measuring progress. The following slides provide examples of ways to measure treatment gains through knowledge tests and competency ratings. These are only examples and do not represent all of the possible ways to measure success.

A knowledge test is an administered written test much like an exam in a school setting. The goal here is simple, to see whether participants are comprehending and retaining content presented in group. Ideas include tests for identifying risky thinking, matching risky thinking to replacement thoughts, and identifying common triggers of antisocial behavior. This could be completed prior to and after the participant has completed a specific curriculum; much like a pre/post test.

For skill acquisition, the program could apply competency ratings. Competency ratings require staff to rate a participant’s competency in applying a specific skill learned during treatment. For example, the participant could be required to identify a high risk situation that could be managed by using the social skill of “Responding to Anger”. As the participant displays this skill, staff rate their level of competency. Another example is to create some sort of treatment progress rating sheet that identifies specific behaviors that the participant should be able to perform based on what is taught in the program. In a monthly meeting the


treatment team could collaborate on a final rating for the participant using a Likert scale. The scale may have a low rating indicating no use of the skill, a moderate rating indicating some use has been made but it is still largely inconsistent use, and a higher rating indicating consistent and proficient use of the skill.

1.46 Sample Competency Rating

Notes:

Here is an example of a competency rating utilizing the social skill, “Responding to Anger”, taken from the National Institute of Corrections “Thinking for a Change” curriculum. The first half of this slide provides the skill steps involved in the skill: “Responding to Anger”. The second half is the scale a staff member will use to measure the participant’s competency in performing the skill.This role play involves observing the participant utilizing this skill in an anticipated real life situation. During the skill demonstration, the staff person is measuring the participant’s use of all of the steps appropriately. Based on the observation, the staff then provides a rating of 0 to 3. Once the participant is able to consistently and confidently achieve a rating of a 3 on this skill, the staff person could increase the difficulty of the ratings by beginning to rate how well the participant uses the steps.


1.47 Measuring Progress

Notes:

Another example of measuring progress is through counselor ratings. Programs that do this often have this as a check box in the progress note. The note will identify the goal and objective being worked on that day and will describe the day’s intervention like a group or individual session. The staff will have a place to check a rating, usually on some sort of Likert scale, indicating the level of progress on that particular goal and objective.

In addition to risk/needs assessments, many agencies will utilize assessments that may be domain specific. For example, a program may administer a pre and post-assessment of antisocial attitudes using something like the How I Think Questionnaire or the TCU Criminal Thinking Scale. Completing pre/post assessments allows staff to monitor participant confidence, as well as program effectiveness, based on the participant’s scores. It also allows staff to make adjustments to case plans in order to obtain desired outcomes and better results.

Participant accomplishments are probably the quickest and easiest way to measure progress because the verification process is simple. Most results are measured on a yes or no basis. For example, we can confirm a goal of obtaining employment by contacting an employer who can verify the participant’s employment. Another example could be the goal of a participant abstaining from using substances through the results of urinalysis or an educational accomplishment can be verified through a participant obtaining their GED.


1.48 Sample Progress Note

Notes:

This is an example of a progress note created for anger management group. The goal that the participant is currently working on is learning self-control. Consequently, the notes reflect the activities of the group for that day, including a role-play using the skill of self-control. The note also includes the participant’s performance in group that day as well as an indication of his overall progress. At the completion of the note, the staff provides a rating of where the participant stands to date on his progress with the goal of learning self-control. These types of rating scales could easily be incorporated into all group participation in that specific group.


1.49 Discharge Plan

Notes:

A discharge plan or summary is a record of what a participant has completed to reduce their risk and a measure of how well they’ve completed each step. It also helps connect the dots for them between services provided, actions they have taken, progress toward achieving objectives, and any changes to reoffending. Once we’ve determined the participant’s discharge status as either being successful or unsuccessful, a discharge plan for the participant should be created. The discharge plan should contain a summary of the participant’s progress in treatment. It should include the types of services and intervention in which the participant took part. The summary of the participant’s progress should include how well the participant did in meeting treatment goals and objectives and their level of participation. Whether the participant was successfully or unsuccessfully discharged, a prognosis indicating the participant’s risk level should be included. This is important because there may be other people providing additional services to this participant and they should have this information shared with them. Recommendations for aftercare should include what the participant needs in terms of future services or for maintaining treatment gains made to date. Once the discharge plan is complete, the participant should be given a copy for their own knowledge and personal documentation.


1.50 Section 6

Notes:

This module examined the importance of case planning, reviewed the principles of effective intervention and how they relate to case planning, discussed how to conduct assessment-driven case planning, identified the components of case management and developed a clear understanding of discharge planning. Let’s now review our initial objectives and the material we presented for each objective.


1.51 Review of Learning Objectives

Notes:

Objective 1 focused on learning the difference between case planning and case management. As a reminder, case management involves the actual delivery of services while case planning creates strategies of what needs to be done. We also discussed why it’s important to case plan. Risk/need assessments assist in the creation of an individualized case plan. It points out specific areas that should be targeted in order to reduce the risk of future criminal behavior. Case plans should clearly and specifically identify a participant’s criminogenic risks and needs, accompanied by risk reduction strategies and plans of action, with timelines. Case plans are dynamic instruments and should be adjusted according to that participant’s current needs.



Notes:

Objective 2 focused on reviewing the principles of effective intervention and how it relates to case planning. The risk principle identifies “who” should be in our programs and who will benefit from the most intensive services and programming. Those who are higher risk should receive the most intensive services. Once we have identified risk, dosage tells use the amount of structured programming each participant receives based on their risk level. The need principles identifies “what” should be targeted. The what are criminogenic needs, which are highly correlated to recidivism and dynamic. The responsivity principle identifies how to target criminogenic needs. There are two parts to this principle: general and specific. General responsivity tells us to provide treatment that participants in general will respond well to, like cognitive behavioral strategies. Specific responsivity tell us to match the styles and mode of service to key participant characteristics and learning styles. Finally, fidelity measures how well the program is adhering to the modality of treatment.



Notes:

Objective 3 discussed role clarification during the case planning process. Identifying and targeting criminogenic needs are highly correlated with recidivism. Identifying long-term goals will help manage the progress of the participant. Participants are more likely to be successful when goals are clearly outlined, realistic, and achievable. Tasks for the supervision period list the resources or methods the individual will use to achieve the goals noted in the plan. These action items should include the frequency and duration of the assigned tasks and explain how the individual will verify his/her performance. Finally, strategies are the actions staff complete to help participants reach long-term goals and include supervision, referrals and in-person meetings.



Notes:

Objective 4 examined strategies for identifying and addressing criminogenic needs in case plans. Prior to the creation of a case plan, individuals under supervision should be assessed for their level of risk and individual needs using a standardized assessment tool. This is important because it guides decision-making by providing more information in a systematic manner and reduces bias by following objective criteria.

Moreover, clinical judgement is found to be less accurate than actuarial assessment. Good assessments help determine the likelihood of the risk to reoffend and also provide an outline of the most relevant issues to address with each person under supervision. When results of the risk/need assessment are incorporated into the case plan process, re-assessment will assist in deciding the next step needed for the participant.



Notes:

Objective 5 discussed discharge planning. First we discussed that discharge criteria should be established for the program. This discharge criteria should be based on demonstrating that participants met their own goals, as well as the program goals. Next, we discussed measuring program progress. We discussed the incorporation of knowledge tests, competency ratings, counselor ratings, pre/post tests and participant accomplishments. Measuring progress will help keep track of goal attainment and treatment progress. Finally, we explained that discharge plans should contain the summary of the participant’s course of treatment. Whether the participant was successfully or unsuccessfully discharged, a prognosis indicating the participant’s risk level should be included. There may be other people providing additional services to this participant and they should have this information shared with them for future planning. Recommendations for aftercare should include what the participant needs in terms of future services or for maintaining treatment gains made to date.


1.56 Thank You

Notes:

This concludes our module on case planning. Thank you so much for your interest and participation. We hope you find this information helpful to your work.


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