bridging the gap offender reentry · 05/03/2015 · figure 1 outlines the btg-or program logic...

Bridging the Gap Offender Reentry

Annual Evaluation Report

October 2013 through December 2014

March 5, 2015

Prepared by

Center for Applied Behavioral Health Policy

College of Public Programs

Arizona State University

Bridging the Gap Offender Re-Entry Annual Evaluation Report

Center for Applied Behavioral Health Policy Arizona State University | 2

Acknowledgements

This report was prepared by the Arizona State University, Center for Applied Behavioral Health

Policy (CABHP), under contract number AVS0210- 027348-001 with TERROS, Inc.

The authors wish to thank the staff of TERROS and Maricopa County Adult Probation

Department (MCAP) for their ongoing cooperation and assistance.

Points of view represented in this report are those of the authors, and do not necessarily represent

the official position of TERROS or MCAP.

Suggested citation:

McKay, C., Malvini Redden, S., Shafer, M. S., & Sayrs, L. (2014). Bridging the Gap

Offender Reentry: Annual Evaluation Report for the Period October 1, 2013 – November

30, 2014. Phoenix, AZ. Arizona State University.



Table of Contents EXECUTIVE SUMMARY .......................................................................................................................... 4

1. INTRODUCTION ................................................................................................................................ 6

Background ............................................................................................................................................. 6

Program Goals ........................................................................................................................................ 8

Purpose of the Report ............................................................................................................................. 8

2. METHODOLOGY ............................................................................................................................... 8

Program Setting and Location ............................................................................................................... 8

Program Participant Qualifications ...................................................................................................... 8

Program Design and Activities .............................................................................................................. 9

3. EVALUATION ................................................................................................................................... 11

Evaluation Questions ............................................................................................................................ 11

Evaluation Methods .............................................................................................................................. 12

4. FINDINGS .......................................................................................................................................... 13

Interagency Collaboration ................................................................................................................... 14

Capacity, Staffing, and Resources ....................................................................................................... 16

Service Delivery ..................................................................................................................................... 17

Participant Demographics .................................................................................................................... 20

5. SUMMARY and RECOMMENDATIONS ........................................................................................ 23

Recommendation 1. Align the Program to Better Reflect the Program Theory. ............................ 24

Recommendation 2. Work with ADC to Reduce Barriers to Peer In-Reach. ................................. 25

Recommendation 3. Develop Collaborative Engagement and Re-Engagement Strategies. ........... 26

Recommendation 4. Formalize the Practice Model and Program Policies. ..................................... 27

References ................................................................................................................................................... 28

APPENDIX A: Key Informant Interview Script ........................................................................................ 30

APPENDIX B: T4C Group Observation Fidelity Tool .............................................................................. 32

APPENDIX C: BTG-OR Program Logic Model ........................................................................................ 36

APPENDIX D: BTG-OR Program Service Diagram ................................................................................ 37

APPENDIX E: BTG-OR Participation Path Diagram ................................................................................ 38



EXECUTIVE SUMMARY

Background and Purpose – The Bridging the Gap Offender Reentry Program (BTG-OR) is a

comprehensive reentry treatment and support program for male offenders releasing from prison,

with co-occurring disorders, at medium or high risk of re-offending, and receive community

supervision from Maricopa County Adult Probation Department (MACP). This formative

evaluation report encompasses the process evaluation of BTG-OR’s first year of services, as

implemented by TERROS in partnership with MCAP. This report will describe evaluation

methods and activities conducted from October 2014 through December 2015.

Evaluation Methods - Data gathering techniques utilized for this evaluation included: key

informant interviews, meetings with TERROS and MCAP staff, T4C observation and attendance

tracking, and tracking participant data and GPRA surveys. The program implementation process

was evaluated in a mixed methods design to understand gaps and potential remedies.

Findings – The first year evaluation resulted in findings in four program areas:

Interagency collaboration appears successful and is addressing interagency issues -

TERROS and MCAP collaboration appears successful. Staff demonstrated

understanding of the program, its underlying program theory, and shared success

indicators. Many MCAP staff revealed that this is the first time they have spoken with

behavioral health service providers. They reported appreciation for the resources and

abilities of TERROS staff to provide immediate needs for participants, several MCAP

officers worried that participants might become too reliant on RSS. Reentry officers do

desire more communication on participant success. Interviews acknowledged tension

between treatment policy, probation policy, and employment. ADC background check

policy and visit protocols restrict the pool of viable RSS staff and ability to provide in-

reach.

Capacity is increasing but obstacles remain for staffing and resources - Gains were made

in capacity and sustainability building through hiring a second RSS position, opening a

third prison referral source and AHCCCS eligibility expansion. TERROS and MCAP

developed staff skills through several cross-system training activities. Obstacles to

capacity building occluded through turnover in the second RSS position and the clinical

supervisor position.

Services are delivered but program completion rates are low - BTG-OR surpassed the

initial referral and intake goals during the first program year, October 01, 2013 –

September 30, 2014. By December 31, 2014, BTG-OR provided services to 78 enrolled

participants, with 9 graduations and 24 attritions. Attritions included 7 participants

recidivating to prison, 4 cases on new offenses and 3 cases on technical probation

violations. The tension between treatment requirements, probation requirements, and

employment were observed in T4C attendance patterns.



Client Level Descriptions - The majority of participants are under the age of 35 (68%)

and have at least a high school diploma or equivalent (60%), but over 20% of participants

did not make it past middle school. Close to 20% of participants secured employment

directly upon release from prison and 40% report having parental responsibilities. There

were a high number of participants reporting the prior use of injections (19.2%) for

amphetamines and opioids, half of which reported cross contaminated injections.

Recommendations – BTG-OR saw many successes in its first year. There were also

implementation issues that highlighted areas for improvement. From these issues, four

recommendations were formed:

1. Align the Program to Better Reflect the Program Theory. Revise policy to better reflect

the program theory in the definition of successful program completion. Incorporate

employment and role responsibilities into the treatment modality. Seek participant input

on program revisions to more comprehensively meet needs of the reentry population.

2. Work with ADC to Reduce Barrier to Peer In-Reach. Align MCAP and ADC

background clearance policy in order for TERROS to provide more prison in-reach

services. Strengthen the partnership with ADC, MCAP, and TERROS to increase the

program’s capacity to expand services to more prisons.

3. Develop Collaborative Engagement and Re-Engagement Strategies. Revise engagement

strategy to recognize that probation violations may occur. Improve communication

methods to coordinate engagement strategies around group attendance and changes in

probation terms. Develop a reengagement strategy for participants that have a probation

violation

4. Formalize the Practice Model and Program Policies. As BTG-OR continues in its

second year, develop a formal BTG-OR program manual to standardize the program

theory, policies, and practices for sustaining program fidelity in BTG-OR and as BTG

expands to other agency partnerships.



1. INTRODUCTION

Background

Recidivism in the criminal justice system is costly to public funds and community safety. A

2005 Arizona Department of Corrections (ADC) study on recidivism found that 42.4% of

released offenders returned to prison during a three-year follow-up period (ADC, 2005).

Offenders with co-occurring mental health and substance abuse disorders have high rates of

recidivism, more so than offenders with substance abuse only (Prins and Draper, 2009). ADC

reports from its intake assessment data that 75% of inmates have significant histories of

substance abuse. Although more than 23% of inmates receive continuing mental health services

while incarcerated, this population has limited access to community resources when released due

to their offenses and involvement in the justice system. Other common reentry challenges

experienced by probationers include homelessness, lack of family and social supports,

unemployment, lack of reliable transportation, difficulty accessing public assistance. Nationally,

there is a need for community behavioral health care services and access of services by offenders

on community supervision (Feucht and Gfroerer, 2011). Providing for reentry needs promotes

successful reentry to the community, contributes to reductions in recidivism, makes communities

safer and improves the effectiveness of public spending (Feucht and Gfroerer, 2011).

From 2010 through 2012, 40% of probation terminations were due to probation revocation with

return to prison. MCAP identified the need for reentry services as an area that could positively

affect recidivism through better reentry planning and service coordination. As a result, the

Maricopa County Adult Probation Department (MCAP) created a reentry unit to improve

coordination with ADC release and the reentry transition to community supervision. The Reentry

unit at MCAP identified reentry service gaps. One substantial gap evidenced by MCAP’s risk

assessment data shows that 34% of the medium and high risk males being released from prison

to probation are in need of treatment services for co-occurring substance use and mental health

problems.. The 2008 AARIN project report supported MCAP’s findings, indicating that 3 in 10

(28.4%) arrestees in Maricopa County had a co-occurring mental health and substance abuse

problem, with less than 5% of respondents receiving community behavioral health treatment and

more than 30% identified needing services (ARRIN, 2008).

Based on these data, MCAP looked for a partner agency to adapt an interagency reentry program

for the probation population. For example, there are successful reentry programs for adults with

severe mental illness (SMI) that provide continuity of care from hospital discharge to community

integration, and SMI peer navigator programs from jail release to connecting with behavioral

health providers and reconnecting with public benefits (Mercy Maricopa, 2014). Currently, a

Maricopa community provider, TERROS utilizes a program known as “Bridging the Gap SMI”

that utilizes peer recovery support specialists (RSS) to support to SMI adults transitioning from

psychiatric hospitalization to the community. Evidence suggests that when individuals with co-

occurring disorders are released without having someone outside the hospital to assist with

treatment and community services, outcomes are not as optimal (Bologna & Pulice, 2011).

TERROS and MCAP partnered to join their reentry programs and create a new continuity of care

program for offenders with co-occurring mental health and substance use disorders as they

reentered the community from prison.



Bridging the Gap Offender Reentry

The Bridging the Gap Offender Reentry Program (BTG-OR) is a comprehensive reentry

treatment and support program for male offenders releasing from prison, with co-occurring

disorders, at medium or high risk of re-offending, and receive community supervision from

Maricopa County Adult Probation Department (MACP). TERROS, Inc. is implementing this

program, in partnership with MACP, under grant funding from Substance Abuse and Mental

Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT)

(grant # TI024867). Arizona State University, Center for Applied Behavioral Health Policy

(ASU), is contracted to conduct a process and outcome evaluation of the program during the

course of the three-years of SAMHSA funding.

Although they represent different fields, both TERROS and MCAP share a common goal in

providing effective services to clients on probation with co-occurring disorders for successful

integration into their communities. Through BTG-OR they plan to integrate reentry services to

meet the behavioral health and community supervision needs of the client and the community.

BTG-OR is a cross system reentry intervention, incorporating both organizations’ reentry models

and coordinated system collaboration. The program establishes communication between RSSs,

TERROS counselors, and MCAP officers to coordinate care and navigate challenges that

offenders may face. Figure 1 outlines the BTG-OR program logic model.

Figure 1. BTG-OR Program Logic Model, Year 1



Program Goals

The primary service goals are to 1: Reduce the criminal recidivism for BTG-OR participants, in

other words keep participants from re-offending and returning to prison, and 2: Expand the

availability of supports for individuals with co-occurring disorders through an enhanced

collaboration between MCAP and TERROS. The program is expected to serve a minimum of 48

individuals in year one, and 96 individuals in years two and three for a total of 144 program

participants.

Purpose of the Report

This formative evaluation report encompasses the process evaluation of Bridging the Gap

Offender Reentry’s first year of services, as implemented by TERROS in partnership with

MCAP. This report will describe evaluation methods and activities conducted from October

2014 through December 2015. This first annual report encompasses 15 months of

implementation activities. Participant data reflects just 12 months of service delivery as the

program began receiving referrals in November of 2013 and the first participant completed their

intake on December 5, 2014. Findings and recommendations will be presented to inform

TERROS as BTG-OR continues implementation in year two.

2. METHODOLOGY

Program Setting and Location

BTG-OR is a partnership between TERROS and MCAP. Behavioral health services are provided

by TERROS at two TERROS clinics and in the community. These two clinics are designated as

service hubs, where program staff have designated offices and group interventions are held. One

clinic serves participants living on the west side of Maricopa County and one serves participants

living on the east side of Maricopa County. Participants have the option of accessing other

outpatient treatment and groups at other TERROS locations.

Program Participant Qualifications

BTG-OR accepts adult males with co-occurring substance use and mental health disorders that

have planned releases from the ADC Florence and Lewis Prison Complexes. Participants must

have served at least 3 months in prison and received a medium or high risk score on the MCAP

Offender Screening Tool (OST) and the Field Reassessment of the Offender Screening Tool

(FROST), a validated criminogenic risk/needs assessment (Ferguson, 2002).



Program Design and Activities

TERROS and MCAP partner to provide collaborative and concurrent services to participants

who receive behavioral health services through TERROS and community supervision from

MCAP Reentry Unit. The key components of BTG-OR are illustrated in Figure 2.

Figure 2. Bridging the Gap Offender Reentry Program Diagram

Referral. MCAP assesses offenders identified for release from ADC Florence and Lewis

Prison Complexes for co-occurring disorders using the Texas Christian University Drug Screen

(TCUDS), the ADC Substance Abuse History Index, and ADC’s structured clinical mental status

exam. Offenders are assessed for risk of reoffending and probation needs using the OST.

Identified offenders that meet qualifications of male, medium to high risk OST scores, co-

occurring mental health and substance abuse problems, and English proficiency, are referred to



the program. The TERROS Director of Recovery Services accepts all referrals and assigns the

inmate to a peer Recovery Support Specialist (RSS).

In-reach. Prior to release, an RSS visits each inmate that is referred to BTG-OR to

discuss the program, participation expectations, and assess for needs. By design, the RSS is to

visit the program participant at least twice while still incarcerated. At the first visit, the inmate

can accept or reject further program services. While the inmate is still incarcerated, the RSS

works to initiate connections with inmates to family supports, necessary identification

documents, housing resources, employment services, and transportation. The RSS collaborates

with the assigned probation officer on transition planning to ensure that plans are coordinated

and available resources are maximized. The RSS also facilitates transportation support at the

time of release if the individual is in need of it to return to his residence in Maricopa County.

Release Activities

Reentry support. Within 48 hours of release the RSS is supposed to have face-to-face

contact with the participant and begin assistance with engaging in TERROS services. The RSS

provides support services as inmates are released from the correctional facility, throughout the

transition to the community, during the BTG-OR group interventions, until the offender is

established in the community. The RSS supports participants with their access to and

engagement in treatment for SMI or co-occurring disorders. Services also include minimizing

barriers to community reentry, such as providing assistance with:

Obtaining birth certificates and identification,

Verifying citizenship,

Applying for benefits, including Arizona Health Care Cost Containment System

(AHCCCS),

Locating appropriate treatment services,

Collaboration with MCAP,

Accessing housing

Referring to vocational providers, primary care physicians,

Engaging family and supports

Enrolled in BTG-OR

Intake and assessment. Within two weeks of release the participant completes intake

procedures with MCAP and TERROS. The RSS and BTG-OR program supervisor, with the

participant, coordinate the TERROS intake appointment. At the intake appointment, the program

supervisor completes a full biopsychosocial, screen for SMI and psychiatric evaluation needs,

along with intake Government Performance Reporting Act (GPRA) surveys required by

SAMSHA. These surveys are designed to track participants’ demographics, substance use

behavior, life events, and behavioral health service histories.

The RSS and participant also meet with the MCAP reentry officer to complete MCAP intake.

The MCAP reentry officer completes the offender screening tool (FROST), an assessment of the

participant’s risk of reoffending and criminogenic needs. Based on the combined MCAP and



TERROS assessment results, the participant is matched to the level of programming that is

consistent with their unique needs.

Psychiatric evaluation and medication services. If need is identified through the intake

screen, the RSS assists the participant with scheduling an appointment with a licensed M.D.,

D.O., N.P., or P.A.

Group interventions. Participants are enrolled in two group interventions, Thinking for

Change (T4C) and the Co-occurring Reentry Group (CORE). T4C is a closed cognitive

behavioral based skills group developed in the criminal justice system with 25 lessons and

facilitated by an RSS and MCAP Probation Officer. CORE is an open group that uses 20 lessons

from the Criminal Conduct and Substance Abuse Treatment model, a cognitive behavioral group

therapy intervention that focuses on recovery from co-occurring disorders for clients involved in

the criminal justice system, and is facilitated by the program supervisor.

Post BTG-OR Activities

Continuing care. After the participant completes T4C and CORE, the program

supervisor, RSS and reentry officer meets the participant to establish a continuing care plan.

Continuing care options include addressing SMI, the impact of trauma, relapse prevention,

further community integration, and symptom management.

3. EVALUATION

This process evaluation focuses on whether the program is functioning as planned, monitors any

planned or unplanned changes in program implementation, and assesses the outputs of program

delivery. During the second year of the program, the evaluation plan will incorporate an outcome

analysis, as more participants have the opportunity to graduate from BTG-OR, creating a larger

sample size for analysis.

Evaluation Questions

1. Did BTG-OR achieve the process and outcome objectives and goals proposed in the

SAMHSA grant?

Process evaluation will address engagement attempts, timely service plans,

expansion of services, orientation services, in-reach services, benefits services,

resource connection, and health care.

Outcome evaluation will address recidivism and program completion.

2. How is program theory articulated, consensus formed, and implemented? Does this effect

process and outcomes?

3. How does program fidelity effect/influence participant outcomes?



Evaluation Methods

Using a mixed methods success case method design (Brinkerhoff, 2003), information was

gathered to assess the degree and quality TERROS and MCAP had implemented the program,

including the program’s consistency with the original proposal. The data collection plan for this

study was reviewed and approved by the Arizona State University Institutional Review Board

(IRB) prior to the implementation of any data collection processes. The data sources used in this

evaluation study are summarized below:

Master list. ASU and TERROS collaborate on a master-list of client names and unique

identifiers from the GPRA data, tracking important program services and probation case

information. TERROS maintains the master-list with all identifying information and coordinates

MCAP’s data contribution through quarterly inquiry on assessment scores, current probation

status, and probation outcomes. ASU works with TERROS monthly to track referrals, intakes,

and discharges.

Government Performance Reporting Act (GPRA) surveys. TERROS staff collect

participant information in accordance with Federal funding specifications required through the

Government Performance Reporting Act (GPRA). These data are captured at three points of time

by TERROS clinical staff: Intake, 6 Month Follow-Up, and Discharge. ASU analyzes the data,

providing reports for TERROS. During the year one evaluation, analysis focused on descriptions

of participants at intake. In the second year, analysis related to outcomes and follow-

up/discharge surveys will be conducted. Table 1 tracks the monthly GPRA collection, entered by

the TERROS data specialist.

Table 1. Monthly GPRA Survey Collection

Month Intake Surveys Discharge Surveys 6 Month Surveys

Dec 2013 6 - -

Jan 2014 6 - -

Feb 2014 5 - -

Mar 2014 4 - -

Apr 2014 3 - -

May 2014 7 2 4

Jun 2014 9 1 2

Jul 2014 7 1 4

Aug 2014 5 3 1

Sep 2014 6 6 9

Oct 2014 8 7 7

Nov 2014 4 4 2

Dec 2014 8 9 4

Total 78 33 33

Key informant interviews. A semi-structured interview protocol was developed to

gather information from TERROS and MCAP key informants, regarding program theory,

concordance and discordance, purpose, roles and responsibilities, and institutional cultures. Four



groups of key informants were identified – TERROS leadership, clinical staff, MCAP leadership,

and probation officers. The interview questions addressed solicited information about staffs’

experience with the program proposal, implementation, sustainability, program changes,

relationships between MCAP and TERROS, and comparing the mission of the program to what

the program does. [See Appendix A: Key Informant Interview Script].

From February 18 to April 4, 2014, 20 interviews were completed, each lasting approximately 45

minutes on average. Seven interviews were conducted with TERROS directors, supervisors,

clinicians, and a data specialist. Thirteen interviews were conducted with MCAP probation

officers, supervisors, and a director. Interviews concentrated on investigating key informants’

understandings of agency missions, program missions, interagency problem solving,

understanding of agency and staff roles, and goals for the program. Interviews were transcribed,

coded, and analysis was completed using Nvivo software.

Group observation and attendance tracking. A fidelity instrument was developed and

piloted to monitor the Thinking For Change (T4C) group’s adherence to program guidelines of

this curriculum (Bush, Glick, & Taymans, 2011). This observation form incorporates subjective

group demographics and a12-item observer rating tool assessing 5 group management skills and

facilitation of 7 lesson activities. [See Appendix B: T4C Group Observation Fidelity Tool]. The

T4C observational fidelity instrument was piloted on 3 occasions - October 4, October 22, and

November 19, 2014. During the pilot, the attendance records for all five completed T4C groups

were reviewed for completion and attrition. TERROS tracked T4C attendance through an Excel

spreadsheet to share with ASU.

Implementation Updates from TERROS and MCAP. Formal planning meetings with

TERROS, MCAP, and ASU staff and administrators were held on August 21, 2013, October 25,

2013, and November, 19, 2013. Thereafter, monthly planning and coordination meetings have

been held with TERROS and MCAP program staff and supervisors. TERROS, and MCAP

provided updates and feedback on program implementation through informal and formal

communications. ASU attended formal planning meetings with key staff from TERROS,

MCAP. ASU facilitated evaluation meetings at TERROS on a bi-monthly schedule and

submitted quarterly progress reports to TERROS staff incorporating emergent findings.

Individual meetings with ASU and key TERROS staff included trainings on processes,

collaboration on data collection, and problem solving. ASU, TERROS, and MCAP staff also

communicated through email and phone to provide updates, clarifications, and findings.

4. FINDINGS

Each intervention the program implementation process was evaluated in a mixed methods design

to understand gaps and potential remedies. Findings are organized in order to fit the BTG-OR

logic model illustrated in Figure 1, summarized in four areas – Interagency collaboration;

Capacity, Staffing, and Resources; Service Delivery; and Client Level Descriptions.



Interagency Collaboration

Interagency understanding program model and interventions. Overall, TERROS and

MCAP staff demonstrated a good understanding of the program, and its underlying program

theory of change. All key informant interviewees were able to confidently discuss the project, its

broad goals, and their own roles. TERROS key informants articulated a consistent programmatic

mission. MCAP leadership did articulate a similar program mission to what TERROS key

informants provided. However, MCAP reentry officers did not provide a consensus on the

program mission, with some identifying collaborative reentry support and services to improve

outcomes for probationers with co-occurring disorder and other officers only identifying the

importance of group interventions.

A tension emerged when participants discussed participants’ reliance upon RSS staff. While both

clinical and criminal justice staff spoke about the benefits that RSS support has for participants—

transportation, logistical assistance, counseling, emotional support—several MCAP officers

worried that participants might become too reliant on RSS staff to an extent that they would not

be able to function on their own. On the other hand, TERROS staff spoke about the important

role that RSS staff play in helping participants, many of whom come into the community

overwhelmed by the sudden lack of structure in their lives and without a strong support system,

get their feet under them. This tension demonstrates the need for MCAP and TERROS staff to

carefully communicate about individual cases and case plans to determine the appropriate

interventions for each participant’s treatment, and to ensure probation and treatment staff share

mutual understanding of each other’s professional perspectives.

On the whole, all interviewees deemed the program a preliminary success, although most

acknowledged that it being early in the process and they will not know about true success until

client/offender outcomes become available. Intriguingly, interviewees largely defined their

personal success in terms of participants’ community reintegration and avoiding recidivism.

Although successful integration and reduced recidivism are the primary goals of the project,

depending upon others and a vulnerable population may be a risky proposition for personal

achievement. Still, several participants discussed success as tied to the endeavor of collaboration

between TERROS and MCAP, and helping to heal individuals, families, and communities.

Interagency communication. During the key informant interviews all parties involved

shared positive opinions about their respective partner agencies. Reentry officers with more

neutral responses identified not having as much experience with counselors and case managers,

compared to officers with more experience managing special populations. For many of the

reentry officers, this is the first time they have spoken with behavioral health service providers.

Officers reported that in the past they did not have access to timely and comprehensive

information from behavioral health agencies. Significantly, several members of MCAP

mentioned having healthy communication and positive interactions with TERROS staff members

for the first time in their careers, simply by virtue of being involved in the project. Members of

leadership from both agencies also seemed committed to, and engaged with, the project.

Officers would appreciate more information on when and how the probationers are doing well,

so they can provide support and praise to the probationers regarding their good work. MCAP



staff report an appreciation for the resources and abilities of TERROS staff to provide immediate

needs for probationers that MCAP staff do not have the ability to perform. Reentry officers do

desire more communication with TERROS staff. Officers also articulated their unfamiliarity with

what TERROS clinicians do in their role.

Interagency policies and protocols. Throughout the interviews, participants identified

catalysts and challenges to the project’s success. Although most felt the project was proceeding

smoothly at the time of the interviews, a number mentioned difficulties navigating the systems of

rules at play in the collaboration (e.g., ADC, MCAP, and TERROS, respectively), especially in

regard to accessing program participants while still in prison.

Critical tensions emerged around the two RSS positions. In order to fulfill the requirements of

the grant, the RSS staff must be peers to the program participants, meaning that they must have

experience with the criminal justice system and potentially, co-occurring disorders. However,

ADC’s requirements for individuals to visit inmates in prison, requires background checks and

prohibits visitors with certain convictions. These visitor restrictions have severely restricted the

pool of viable RSS staff. As a result, only one RSS staff has been able to perform in-reach visits

to two prisons on opposite sides of the Valley. At the time of the interviews, the existing RSS

person did not discuss burnout or stress, but only 14 BTG participants were involved at that time.

TERROS staff also identified ADC protocols and logistical issues that impact in-reach. ADC’s

visitation protocol requires the RSS to be escorted by a surveillance officer to meet with inmates.

The RSS follows surveillance officers’ during rounds, which includes the surveillance officers

meeting inmates that do not qualify for BTG-OR. Due to these protocol and logistical issues

increasing the length of time for each visit, the RSS are only providing one visit to each

participant. This is a concerning issue, particularly since the grant proposal indicates that RSSs

would provide two in-reach contacts with inmates before they are released. However, leadership

interviewees at TERROS and MCAP spoke about attempting workaround solutions and getting

additional RSS employees in place as soon as possible.

Another area of tension emerged when participants discussed probation policy and program

protocol regarding employment and group participation. Participants are expected to attend five

group meetings per week including counseling and “Thinking for Change” classes, according to

the program protocol. Probation policy requires participants to find employment and pay court

fines and fees. Some reentry officers have delayed fines and fees for participants to complete

groups, but the collection of fines impacts MCAP’s budget.

Interviewed staff reported that some participants found that the program classes interfered with

their employment schedules, and forcing them to choose between keeping their jobs and meeting

the program participation requirements. TERROS staff discussed altering MCAP policies,

delaying the employment and fees requirements. In contrast, MCAP staff discussed wanting to

change BTG rules to reduce the number of required group meetings so that participants had more

time to work. At the time of this report, the two collaborating agencies had not yet resolved this

issue, placing participants in a double bind, and potentially resulting in program drop outs and/or

probation rule violations.



Capacity, Staffing, and Resources

The first year of model program implementation saw gains in capacity and sustainability

building, along with obstacles.

Capacity expansion. BTG-OR expanded its capacity through opening a second RSS

position to meet the needs from the referral and participation rates. Additionally, a third referral

source was established, ADC Prison State Complex - Eyman. A third gain came from AHCCCS

expansion in January 2014, which expanded eligibility to childless adults with income up to

133% of the poverty line (CMS, 2013). AHCCCS expansion is a crucial factor in program

capacity and sustainability after the SAMHSA grant ends. At the time of this report 36

participants have AHCCCS coverage, 29 participants did not gain AHCCCS coverage, and 9

participants are unknown due to leaving the program.

Staff and skill development. In the first year of implementation, TERROS and MCAP

completed several cross training activities. MCAP provided two formal training opportunities to

TERROS. The first training included an overview of the criminal justice systems, community

supervision, and offender populations. The second training was a three day T4C facilitator

training with certification, technical support, and follow-up observation of program clinicians.

TERROS provided cross training to MCAP officers on behavioral health systems, clinical

interventions, and populations with co-occurring disorders. The need for this cross training was

identified through the key informant interviews and requests from MCAP officers. This training

was provided by the BTG-OR supervisor in a meeting with MCAP officers.

Staff turnover. The program did experience obstacles to capacity building through

turnover in the second RSS position and the clinical supervisor position. During the first year of

services, the second RSS position experienced high turnover with three individuals being hired

for the position. Issues that led to this turnover included inability to gain clearance for prison in-

reach and difficulty finding appropriate candidates. The current hire for the position has

completed onboarding and has begun facilitating T4C groups.

The original BTG-OR clinical supervisor resigned at the end of the FFY 2014. A supervisor was

hired by December of 2014; he brings with him a background in adult probation and a master

degree in counseling. The Manager of the Community Living Program fulfilled the clinical role

of program supervisor while the position was unfilled and during the new supervisor’s

onboarding. The turnover in this position resulted in a lag in documentation and GPRA

submission, which was corrected in January 2015. The program was able to show resilience to

turnover obstacles with the relatively quick turnaround in filling the clinical supervisor position

and staff resources to cover the vacant position. All other BTG-OR positions saw stability.

Further analysis of capacity factors will be conducted in the second and third year evaluations.



Modifications to the BTG-OR Model Program. A number of program adaptations and

alterations from the originally submitted proposal have occurred during this first year of program

implementation. These have included:

1. Reduction in In-reach Visits. ADC policy and protocol for in-reach has led TERROS

to reduce services to one in-reach per participant.

2. Modification in Group Curriculum Delivery. CORE and T4C group interventions

shifted from concurrent delivery to consecutive delivery. This adaptation reduced weekly

group attendance requirements from three weekly 2 hour groups, at total of six hours per

week, to two weekly two hour groups, four hours weekly.

3. Company Vehicle Use for RSS. TERROS provided company owned vehicles for the

RSS's use, many applicants for the RSS position lack reliable transportation.

4. Referral Prison Expansion. Referral sources expanded from the initial two ADC

prisons (Florence and Lewis Prison Complexes) to a third prison (Eyman Prison

Complex)

5. Diagnostic Eligibility Expansion. The program expanded from general mental

disorders to include participants with SMI status.

Service Delivery Referral and Intakes. The program’s initial first year goal was to serve 48 participants

between October 1, 2013 and September 30, 2014. The program surpassed its initial goal with 58

participants completing intake during the first program year. This achievement was remarkable,

considering that there was a delay in initiating services as the three agencies implemented new

policies, procedures, contracts, and memoranda of understanding. These process hindrances

resulted in the first referrals from MCAP being submitted in November 2013 and the first client

completing intake on December 5, 2013. The program coverage goal has adjusted to serve 60

participants per year.

Because of the delay in program implementation, the evaluation report will focus on program

activities and participants who completed intake by December 30, 2014. From December 1, 2013

to December 30, 2014, 78 participants completed intake. The collection of GPRA forms in

Table 1 illustrates monthly BTG-OR intakes.



Program participation and engagement. By December 31, 2014, BTG-OR provided

services to 78 enrolled participants, with 9 graduations and 24 attritions. The path diagram in

Figure 2 summarizes the major milestones and pathways of service for the 78 participants served

year to date.

Figure 2. BTG-OR Participation Path Diagram

Program attrition. Thirty-three (33) cases were closed between December 1, 2013 and

December 31, 2014. Of these closed cases, only 9 were due to program graduation (27.3%) with

the balance of 24 participants close due to attrition (72.7%).



Among the participants who left without completing BTG-OR (n=24), 7 participants (29.2% of

attrition cases) received probation violations and lost contact with the program. These

participants are still on community probation and do not appear to be receiving any behavioral

health services. An additional 7 participants (29.2% of closed cases) recidivated to prison with

probations revocations, 4 cases (57.1% of recidivates) on new offenses and 3 cases (42.9% of

recidivates) on technical probation violations. One program graduate recidivated with a technical

violation, while the other 6 recidivates had not completed the program.

T4C attendance. In reviewing the attendance logs and the situations that led clients to

leave group, there appears to be a conflict with meeting the T4C group attendance requirements

and employment obligations. Table 2 shows the number of TERROS clients that initially

enrolled in each T4C groups and the final completion counts and rates. With T4C being a key

component of BTG-OR, this attrition seems to be affecting the program graduation rate. This

tension between treatment requirements, probation requirements, and employment was also

found in the key informant interviews.

Table 2. T4C Census

Location Start Date End Date T4C Group Participation

Started Completed

East Feb 18, 2014 May 15, 2014 6 4 (66.7%)

West Feb 26, 2014 May 24, 2014 14 5 (35.7%)

West May 28, 2014 Aug 20, 2014 11 3 (27.7%)

East Jul 22, 2014 Oct 7, 2014 11 4 (36.4%)

West Sep 13, 2014 Dec 6, 2014 16 2 (12.5%)

Note: These counts include BTG-OR participants and non-BTG-OR participants.

Further evaluation into the attendance and completion of T4C and CORE are needed to

investigate if the current group implementation is appropriate for program and participants’

needs. At this time, a fidelity evaluation for T4C may not be the best utilization of evaluation

resources.



Participant Demographics

Participant demographics are collected through the GPRA intake survey and the master tracking

list. Table 3 summarizes participants’ age, educational backgrounds, and ethnic and racial

identity. The program has a younger population of adults with co-occurring disorders, with the

majority of participants under the age of 35 (68%). This is an undereducated population, with a

slight majority of participants have received at least a high school diploma or equivalent (57.8%)

but over 20% of participants did not make it past middle school. The GPRA survey allows for

participants to identify multiple races and ethnicities. The participants’ self-identified ethnicity

and race are representative of Arizona, Maricopa County, and MCAP racial and ethnic diversity

(U.S. Census Bureau, 2011; ADC, 2013; White, 2012). To note, three participants reported

former military service, with none being deployed or receiving veteran status.

Table 3. Participant Demographics at Intake

[N=78] f %

Age Group, in years 18 – 24 25 – 34 35 – 44 45 – 54 55 – 64

25 28 19 3 3

32.1 35.9 24.4 3.8 3.8

Education, highest level Seventh Grade

Eighth Grade Ninth Grade Tenth Grade

Eleventh Grade High School Diploma or Equivalent

1st year of college completed 2nd year of college completed 3rd year of college completed

Bachelor degree (BA, BS) or higher

1 9 6 7 9

35 7 1 1 1

1.3

11.5 7.7 9.0

11.5 44.9 9.0 1.3 1.3 1.3

Ethnicity and Race* Hispanic

Caucasian/White African-American/Black

American Indian/Native American

25 53 16 5

32.1% 67.9% 20.5% 6.4%

* Survey options are not mutually exclusive, respondents may select multiple values.



Resources and responsibilities. As reflected in Table 4, 19.2% of participants secured

part time or fulltime employment directly upon release from prison. This rate of employment

compare favorably with the 20% employment rate that had been targeted in the original proposal.

One half of the participants reported fathering at least one child, while 40% reported custodial

parent responsibilities. A relatively small proportion of these program participants meet

diagnostic criteria as seriously mentally ill, while nearly half (48.8%) meet eligibility criteria for

and enrolled in Medicaid funded health and behavioral health care services (AHCCCS). Nine

participants left the program before SMI status and AHCCCS coverage were tracked on the

master list. These factors will be followed in the year two evaluation, to investigate their

relationship to program participation and outcomes.

Table 4. Participant Resources and Responsibilities

[N=78] f %

Employed Fulltime

Part-time Unemployed

12 3

63

15.4 3.8

80.8

Children* Fathered Child(ren)

Custodial Parent

39 31

50.0 39.8

AHCCCS Funding Title XIX

Non-Title XIX NA

38 31 9

48.8 39.7 11.5

SMI Status No Yes NA

60 9 9

77.0 11.5 11.5




Substance use. When examining the participants’ reported substance use prior to

incarceration, there are interesting revelations in substance choice and methods of use. Table 5

shows illegal drug use (75.6%) use was more common than alcohol use (42.3%), with one third

of participants using both. Of alcohol users, about 94% reported drinking to intoxication. The

most common illegal drugs of choice were marijuana (51.3%), amphetamines (38.5%), and

Opioids (23.1%). A health concern for participants arose regarding the methods of substance

use. There were a high number of participants reporting the use of injections (19.2%), almost

half of these participants (7 participants) reported cross contaminated injections by sharing

needles, syringes, cotton, and/or rinsing water with someone else. Participants reported using

injections for opioids and amphetamines.

Table 5. Participant Substance Abuse Prior to Incarceration

[N=78] f %

Substance Use, past 90 days*

Alcohol

Alcohol to Intoxication

Illegal Drugs

Alcohol and Illegal Drugs

Marijuana

Amphetamine

Opioids (Heroin, Oxycodone, etc.)

Cocaine

Hallucinogens

Other Illegal Drugs: “Spice”

Benzodiazepines

Route, past 90 days

Injection

Cross Contaminated Injection

33

31

59

26

40

30

18

8

7

3

2

15

7

42.3

39.7

75.6

33.3

51.3

38.5

23.1

10.3

9.0

3.8

2.6

19.2

9.0




5. SUMMARY and RECOMMENDATIONS

The purpose of this report is to summarize results, findings, and recommendations from

formative evaluation processes of the BTG-OR program. It is the intent of these evaluation

findings to offer the project management team objective indicators of program performance,

achievement, and actionable information on areas of under-performance and project slippage.

During its first year of operation, the program saw many immediate successes, implementing a

collaborative program between two system partners serve the same target population. The first

year successes and issues are summarized in Table 6.

Table 6. Bridging the Gap Offender Reentry Implementation Issues Implementation Area Identified Success Identified Issue/Problem

Interagency Collaboration

Service team cohesion

Shared understanding of program theory, vision, and goals

Mutual respect for both professional fields

Both agencies identify mutual goals for client and community outcomes

ADC policy and protocol has hindered the ability comply with two peer in-reaches

Probation and treatment policies conflict on employment and program participation requirements

Capacity, Staffing & Resources

Expansion to a third ADC prison, Eyman

Planning for third RSS position

Treatment staff trained for group interventions

Cross system skills trainings for probation and treatment professionals

Turnover of clinical staff affected service delivery, specifically issues with hiring qualified RSS staff for in-reach

No formalized program manual has been developed

Service Delivery

Surpassed first year goal for number of participants served

Effective communication for initial engagement strategies

Group delivery shifted from concurrent to consecutive to meet needs of participants.

In-reach is occurring once per participant

Low graduation and high attrition, compromising program fidelity o Graduation policy requires completion

of T4C and CORE, not overall improvement and stability

o Rigid group attendance policy results in group attrition

o Group attendance is prioritized over employment and family responsibilities

Lack of communication between probation and treatment for reengaging participants after probation violations and release from jail



Table 6. Bridging the Gap Offender Reentry Implementation Issues

Client Level

Client demographics are representative of the population

Close to 20% have employment at release

Half of the participants receive AHCCCS

Under educated population

Family and employment responsibilities may conflict with group attendance

20% of participants used injections prior to incarceration and 10% of participants reported contaminated injections.

Based on these findings, four areas of improvement are offered for program management to

consider as the program matures in year two and moves toward sustainability in year 3.

Recommendation 1. Align the Program to Better Reflect the Program Theory.

Program policy defines participant success too narrowly. Currently successful

program completion is defined as the completion of two group interventions, CORE and T4C.

T4C is a closed group that requires consecutive attendance of at least 22 of 25 semiweekly

lessons. CORE is an open group that requires a minimum of 20 sessions. However attrition is

high and completion is low. Maricopa County Justice System Planning and Information

Department (MCJSPI) also found similar attrition issues with their T4C probation groups,

although they are still developing their recommendations (B. Frenzel and M. Kovacs, personal

communication, January 21, 2015). Rigid attendance policies have the unintended consequence

of prioritizing group participation over other valuable program outcomes, such as employment,

fulfilling family obligations, and community stability. Research shows that reentering offenders

who gain stable employment and maintain ties to their families are less likely to recidivate (Berg

& Huebner, 2011). As a result, participants that are gainfully employed and leading productive

lives in the community do not qualify as a successful participants nor as successful completing

BTG-OR. Exacerbating this problem is that there are only two physical locations to complete

the required group interventions. As a consequence of limited locations, program participants

may have to travel long distances to participate and/or complete. Coupled with other obligations

such as work or family, the geographical limitations may cause serious impacts on program

completion. Program completion is measured too narrowly when measured exclusively by group

attendance. In fact, the program theory focuses on peer reentry support with groups being

offered as a component. In this regard the priority interventions may include 1) peer RSS in-

reach and reentry support and 2) the communication and coordination of care with MCAP, as

opposed to participant attendance in the two specific groups. Program success measurements

should consider other measures of success, for example peer engagement and coordination of

reentry services. Because the goal of this program is to reduce recidivism and increase services

to reentering probationers, the measurement of successful program completion should be aligned

with these goals.



Steps to improvement. To improve completion rates, reduce attrition, and improve

program success, TERROS should take the following steps:

Revise policy to better reflect the program theory in the definition of successful

program completion

Increase the number of available group sites to offer more group treatment

opportunities

Develop a process that allows participants to substitute other interventions to meet

the participants’ identified needs

Incorporate employment and role responsibilities into the treatment modality

Seek participant input on program revisions to more comprehensively meet needs

of the reentry population

Update the program logic model as successful completion and treatment

modalities are revised

Support in shifting output and outcome measures. ASU is prepared to work with

TERROS and MCAP on instituting a strategic adaptation to T4C that will maintain fidelity to the

intervention theory. Documentation and analysis of change in outputs and outcomes with the

adaption can be incorporated in the BTG-OR evaluation activities for year two and three. If this

adaption improves outputs and outcomes, dissemination of the findings to the field would benefit

service delivery in the corrections and behavioral health systems, a goal of BTG-OR.

Recommendation 2. Work with ADC to Reduce Barriers to Peer In-Reach.

Peer in-reach is an essential component of BTG-OR. Currently the program is out of

compliance, providing one in-reach per participant, while the proposal cites an aim of providing

at least two in-reaches. In the first year, only one RSS has access to prison in-reach and could

only provide one in-reach meeting per participant. Overall, the policy differences may be

creating an unintended effect on system capacity. Best practices show in-reach occurring

multiple times throughout the last three months of incarceration to provide peer support services

as the participant prepares for reentry. In addition, multiple contacts create connections valuable

for peer-to-peer support (Randall & Ligon, 2014). The limited peer-to-peer in reach can be

attributed to policy differences between MCAP and ADO. Currently, MCAP policy is out of

alignment with ADC policy regarding specific background clearances and escorts for RSSs to

meet with inmates in the prisons. In the first year of the program, two RSS candidates passed

TERROS and MCAP background checks but failed ADC background checks. However, ADC

was unable or unwilling to provide sufficient explanation for why these candidates failed. As a

result, MCAP and TERROS are not in a position to improve their hiring practices and align their

hiring policies to successfully fill these RSS positions. The lack of policy alignment may put a

critical component of the program, namely peer-to-peer support at risk. Although there is an

agreement in place at support peer in-reach activities in ADC prisons, it has been ineffective in

addressing the RSS hiring policy difference. If this agreement does not address these policy

differences, the parties should consider revising the document to include this issue. If the

memorandum does cover this issue, the parties should collaborate to better align the policies.



Steps to improvement. To improve compliance, increase peer in-reach, develop the

program, TERROS, MCAP, and ADC should take the following steps:

Align MCAP and ADC background clearance policy in order for TERROS to return to

compliance and meet best practice regarding this core component of the program.

Clarify ADC’s minimum background clearance criteria to incorporate into TERROS

hiring practices.

Include these policies and organization roles in the program guide and updated as needed.

Strengthening ADC, MCAP, and TERROS’s partnership to increase the program’s

capacity to expand services to more prisons.

Recommendation 3. Develop Collaborative Engagement and Re-Engagement Strategies.

Currently participants that violate the conditions of their probation and receive jail time are

closed out of the BTG-OR program, with no opportunity to re-enroll. Seven of the thirty three

participants that were closed in the first year where closed due to probation violations. However,

all seven returned to community supervision after their short jail time which ranged from a week

to six months. In addition to contributing to the program’s low completion rate and high attrition

rate, these participants remain in the community without peer recovery support. MCAP

acknowledges that probation violations are expected as part of the community supervision

process when working with high and medium risk offenders. The expectation of probation

violation was not adequately planned for as part of the program goals. Without a reengagement

track for probation violators, many potentially successful probationers who could achieve

successful reentry are not served by BTG-OR.

Steps to improvement. To improve reduce attrition and improve program completion

rates, TERROS and MCAP should take the following steps:

Revise engagement strategy to recognize that probation violations may occur

Improve communication methods to coordinate engagement strategies around group

attendance and changes in probation terms

Develop a reengagement strategy for participants that have a probation violation

Focus on positive reinforcement as a reentry strategy. Reentry officers identified the

need for engagement strategies that are focused on positive reinforcement. This requires the

development of a pathway for treatment staff to easily share participants’ positive behavior and

recovery milestones with probation. Positive reinforcement from both probation and treatment

systems would provide a united message of recovery support to participants. This

communication would also provide more information to the courts regarding the participants’

positive community behavior, further benefiting participants as they complete probation and

treatment.



Recommendation 4. Formalize the Practice Model and Program Policies.

As BTG-OR continues in its second year, developing a formal BTG-OR guide would benefit the

program by standardizing the program theory, policies, and practices to sustain program fidelity

in BTG-OR and as BTG expands. This formalization in the form of a program manual would

also provide structure for training new staff and providing cross training to staff from

collaborating organizations, in promoting stakeholder and staff awareness, staff training, and

supervision. This formalized program guide would also alleviate resource strain with training

new staff. This guide should be updated as the program is implemented, incorporating lessons

learned to inform future implementation. The guide should address articulation of roles and

policies, along with clarifying the theory of change within each collaborating organization and

associated professional practices to achieve desired behavioral changes. The guide might also

include a section on effective collaborative strategies” to formalize and enhance existing

collaborative tools and techniques among system partners, along with specific steps for

identifying and leveraging shared resources.



References

Arizona Department of Corrections. (2005). Arizona inmate recidivism study: Executive

summary. Retrieved Feb 1, 2015 from

https://corrections.az.gov/sites/default/files/recidivism_2005.pdf

Arizona Department of Corrections. (2013). Arizona Department of Corrections two-year prison

population trend report. Retrieved Dec 09, 2013 from

http://www.azcorrections.gov/adc/reports/stats_2YearTrend.aspx

Arizona Department of Corrections. (2013). Corrections at a glance: February 2013. Retrieved

Dec 09, 2013 from http://www.azcorrections.gov/adc/reports/CAG/2013/CAGFeb13.pdf

Berg, M.T. & Huebner, B.M. (2011). Reentry and the ties that bind: An examination of social

ties, employment, and recidivism. Justice Quarterly, 28(2), 382-410.

Bologna, M. J., & Pulice, R.T. (2011). Evaluation of a peer-run hospital diversion program: A

descriptive study. American Journal of Psychiatric Rehabilitation, 14(4): 272-286.

Brinkerhoff, R. (2003). The Success Case Method: Find Out Quickly What’s Working and

What’s Not. San Francisco, CA: Berrett-Koehler Publishers.

Bush, J., Glick, B., & Taymans, J. (2011). Thinking for a Change: Integrated Cognitive Behavior

Change Program. Longmont, CO: National Institute of Corrections. Retrieved from

http://nicic.gov/t4c

Centers for Medicare & Medicaid Services. (2013). Arizona. Retrieved from

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/arizona.html

Ferguson, J. L. (2002). Putting the “What Works” Research into Practice An Organizational

Perspective. Criminal Justice and Behavior, 29(4), 472-492.

Feucht, T. E., & Gfroerer, J. (2011). Mental and substance use disorders among adult men on

probation or parole: Some success against a persistent challenge. Substance Abuse and

Mental Health Services Administration Data Review.

Mercy Maricopa Integrated Care. (2014). Non-Title 19 resource guide for persons determined

to have a serious mental illness (SMI). Phoenix, AZ: MercyMaricopa. Retrieved from

http://www.mercymaricopa.org/assets/pdf/members/directories-guides/mmic-nt19-smi-

guide-eng-508.pdf

Prins, S. J., & Draper, L. (2009). Improving outcomes for people with mental illnesses under

community corrections supervision: A guide to research-informed policy and practice.

New York: Council of State Governments Justice Center.

Randall, M. & Ligon, K. (2014). From recidivism to recovery: The case for peer support in

Texas correctional facilities. Austin, TX: Center for Public Policy Priorities. Retrieved

from http://forabettertexas.org/images/HC_2014_07_RE_PeerSupport.pdf

United States Census Bureau. (2011). Maricopa County, Arizona. Retrieved Dec 09, 2013 from

http://quickfacts.census.gov/qfd/states/04/04013.html

https://corrections.az.gov/sites/default/files/recidivism_2005.pdf

http://www.azcorrections.gov/adc/reports/stats_2YearTrend.aspx

http://www.azcorrections.gov/adc/reports/CAG/2013/CAGFeb13.pdf

http://nicic.gov/t4c

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/arizona.html

http://www.mercymaricopa.org/assets/pdf/members/directories-guides/mmic-nt19-smi-guide-eng-508.pdf

http://www.mercymaricopa.org/assets/pdf/members/directories-guides/mmic-nt19-smi-guide-eng-508.pdf

http://forabettertexas.org/images/HC_2014_07_RE_PeerSupport.pdf

http://quickfacts.census.gov/qfd/states/04/04013.html



White, M. (2012). Arizona Arrestee Reporting Information Network: 2012 Maricopa County

Adult Probation Department report. Phoenix, AZ: Center for Violence Prevention &

Community Safety, Arizona State University. Retrieved from

http://cvpcs.asu.edu/sites/default/files/content/products/AARIN_Adult_Probation_final.p

df

http://cvpcs.asu.edu/sites/default/files/content/products/AARIN_Adult_Probation_final.pdf

http://cvpcs.asu.edu/sites/default/files/content/products/AARIN_Adult_Probation_final.pdf



APPENDIX A: Key Informant Interview Script

Questions for BTG Clinical Team

Organizational Information

I’d like to start by having a discussion about some of your experiences working with

clients/probationers. Have you worked with this population? In what capacity and how often?

1. Please describe your organization.

a. How would you describe the mission?

c. Who do you serve? How would you describe your clients?

2. How would you describe your job? What is your job? How long have you worked here?

What are your responsibilities?

3. What education and training have you received on serving offender re-entering the

community from prison? On offenders with co-occurring disorders?

Program Description and Program Theory

You are on the new BTG team that is funded through a SAMHSA grant that TERROS received

to provide assistance to men re-entering the Phoenix community from prison who also have co-

occurring disorders of mental illness and substance abuse.

1. In your own words, how would you describe BTG? What it does? What is the mission?

2. How would you describe your involvement in the design and conceptualization of the

SAMHSA proposal of BTG’s?

3. In your own words, what are the goals and the objectives of BTG?

4. What do you think of those goals and objectives? (good:bad; easy:hard;

realistic:unrealistic; important:unimportant; simple:complex)

5. What is your role in achieving these goals and objectives?

6. What will success look like for BTG as a program? What will success look like for your

organization? What will success look like for the participants of BTG? What might be

the indicators of your personal success for your role in BTG?

7. What do you anticipate to be the greatest challenges in implementing this project? For

your organization? For you and your role?



8. What challenges or problems have you encountered thus far in implementing this project?

How have those challenges been addressed?

9. How do you perceive the implementation of the program is going?

a. What is working?

b. What could be improved? How?

10. What has surprised you the most about BTG? The program implementation? The

collaboration between agencies?

TERROS Staff: Perceptions Regarding Probation

1. Can you describe to me what experiences you have had in providing services to clients

under probation supervision?

a. What role did Probation take in the client’s services?

b. What did you feel was expected of you as a clinician?

2. How is probation helpful to you in your work? How so?

3. Describe some common challenges you face in working with Probation and DOC?

4. What would you most like to see change in your work with Probation?

5. How would you describe the relationship with Probation? What could improve these

relationships and communication between your organizations?

6. What do you think would be most effective at creating or strengthening the relationship between

your organization and the TERROS/MCAPD?

7. Is there anything else I have not asked you about that you feel would be important for me to

know?



APPENDIX B: T4C Group Observation Fidelity Tool T4C Group Fidelity Observation Rating Instructions v.1

T4C Lesson Organization and Evaluation Plan

Lesson Units Theme Evaluation Plan Notes

1-5 Introduction to T4C and Group Skills

Attend Mesa, Lesson #__

Cycle 3 starts Jan 2015

6-10 Cognitive Self Change Attend Mesa, Lesson #__

Cycle 3 starts Jan 2015, Include skills from 1-5 in the fidelity eval

11-15 Social Skills Attend West PHX, Lesson # 13

Include skills from 1-5 in the fidelity eval

16-23 Problem Solving Attend West PHX, Lesson # 21

Include skills from 1-5 in the fidelity eval

Note: The same lessons will be observed for each cycle, starting with cycle 3. Each cycle will have four observations, one observation for each theme. Two observations per cycle at each location, Mesa and West Phoenix. Currently the same lessons will be observed at the same locations.

Adherence Measure Response Option

Score Description Guidelines

0 Facilitator(s) does not cover this at all

The section was not discussed or behavior not observed

1 Facilitator(s) makes cursory reference to this, not fully completed

The section was not adequately covered, behavior attempted but inadequate, or no client inclusion addressed.

2 Facilitator(s) adequately covers the section or behavior

The Facilitator(s) reviewed all the material and engages the group in the discussion. Tip: If a Facilitator(s) follows questions that elicit collaboration in the “leader tips,” questions should be genuinely asked instead of reviewed quickly.

3 Facilitator(s) covers the section thoroughly, beyond adequate.

The section was covered with a good amount of interaction with group, incorporating feedback and . This code is available for only some of the session elements that allow for more thorough coverage.

9 Not Applicable This code is used when it is not appropriate to code adherence for a particular item.



T4C Group Fidelity Observation Rating Form v.1

Group Demographics

Date: Time: Location:

Observations:

Group/Cycle: Lesson: Group Census: # Attendees: # BTG-OR:

Group/Cycle Norms and Expectations:

Observations:

Facilitator 1: Facilitator 2: Observer:

Observations:

Individual Adherence Coding Guide

Topic Criteria for a 2 rating Criteria for a 3 rating Rating and Observations

1. Preparedness Supplements, handouts, and presentation materials are prepared before group. Clinician has read the module before group.

NA

2. Staffing 2 facilitators present. 2 facilitators present and actively engaged in facilitation of group conversation and process.

3. Structure

Facilitator(s) follow group manual, completes lesson.

NA

4. Feedback Facilitator(s) provided and maintained objectivity in feedback.

Facilitator(s) provided and maintained objectivity in feedback, providing constructive criticism and further discussion among clients.

5. Attendee Management

Facilitator(s) address disruptive behavior and noncompliance during group to keep group on target.

Facilitator(s) appropriately address disruptive behavior, noncompliance, and prosocial behavior in group.

6. Activity 1: Homework/Last Skill Review

Facilitator(s) engaged all clients and allowed then to share answers

Facilitator(s) additionally provided own experiences after clients shared answers



(insert last group’s homework topic)

7. Activity 2: What is Apologizing? Introduce concepts, definitions, and objectives of module

Facilitator(s) reviewed all content material and asked clients to share their experiences and answers to the questions.

Facilitator(s) reviewed all of the content material and actively engaged clients in sharing their own experience, encouraged clients to reflect on their own experience to gain insight, and summarized the comments so that apologizing was normalized (e.g., “Everyone in this group has experienced apologizing”) and linked to why the clients are attending the group.

8. Activity 3: Modeling skill

Facilitator(s) model new skill appropriately.

Facilitator(s) model new skill appropriately and engaged clients in active listening.

9. Activity 4: Discuss Modeling Display

Facilitator(s) reviewed all material and asked questions after each section.

Facilitator(s) reviewed all parts of the practice and engaged clients in exploring their responses to the practice.

10. Activity 5: Group Members Role Play Skill

Facilitator(s) has volunteers role play.

Facilitator(s) has volunteers role play. Facilitator(s) provided feedback that engaged clients in further discussion. Facilitator(s) should also have checked in with clients about why they did not do their practice (if applicable).



11. Activity 6: Discuss Role Play Feedback is conducted at the end of each session, gathering input from clients about their impressions of the session. While Facilitator(s) may gather feedback throughout the session, this item codes how well they facilitate feedback at the end of the session.

Facilitator(s) asked group members about what was helpful and what was unhelpful/difficult/ etc.

Facilitator(s) asked these two questions and engaged clients further, using follow-up questions (e.g., Why was that helpful to you?).

12. Activity 7: Repeat 5 and 6 with all Group Members

Facilitator(s) has all clients participate in the role play with a peer and provided feedback.

Facilitator(s) has all clients participate in the role play with a peer and provided feedback. Facilitator(s) used open ended questions to engage further discussion and exploration of applying the new skill.

11. Activity 8: Assign Homework

Each client chooses a situation to apply the new skill and describes the steps for application. Handouts are addressed and explained if part of the lesson.

Facilitator(s) checked in with clients about applying new skill and feasibility/appropriateness of the application. Facilitator(s) have clients address how they will complete the homework.

12. Activity 9: Wrap-up

Facilitator(s) read aloud the key messages and asked for any comments.

NA



APPENDIX C: BTG-OR Program Logic Model



APPENDIX D: BTG-OR Program Service Diagram



APPENDIX E: BTG-OR Participation Path Diagram

bridging the gap offender reentry · 05/03/2015 · figure 1 outlines the btg-or program logic...

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