Moving EBPs Into Practice

Danielle S. RudesCenter for Advancing Correctional Excellence (ACE!)

George Mason UniversityDepartment of Criminology, Law and Society

Presented at OAR of Fairfax, 13 February 2013

What are EBPs?Evidence-based practices are…

Scientifically studied workplace practices that have been shown effective through rigorous research. Started in the early 1990s with the term “evidence-based medicine.”

The contemporary definition of EBP is “The integration of the best research evidence with clinical expertise and patient [client] values" (Sackett, et al. 2000, p. x).  

Slide courtesy of Dr. Faye S. Taxman

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Understanding the Science Evidence: How is it

obtained?

Translation: From another discipline (law enforcement, psychology, business, etc.) to corrections and crime prevention

Decision Making: Move away from sensationalized politics (reactionary) and gut-level decisions

Try www.crimesolutions.govSlide courtesy of Dr. Faye S. Taxman

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Ways to Create Science #1: Examine only research studies

that use randomized field experiments as the “Gold Standard”

#2: Examine ALL available research (regardless of design) on a particular topic

#3: Conduct a nonscientific review, simply say“evidence based” & then offer your own listing of best practices or use a subset of all available research based on liberal or conservative ideology.

Slide courtesy of Dr. Faye S. Taxman

Implementation is a Process,

not an EventIt is not just about an idea (EBP)It is more about:

How you take an idea and make it work (DRIVE)The people that you involve in making it work

(RELATIONSHIPS) The willingness to learn together (LEARN)The ability to set criteria to judge “impact” (FIT)The coming together to create the values and

norms within a community (GOAL SETTING)

Common EBPs in CorrectionsRisk/Needs Assessment InstrumentsMotivational InterviewingSome cognitive behavioral

programming/treatment

What Works (EBPs) vs. What We Do?

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Intensive Supervision

Boot Camp Case

Management Incarceration

Non-Directive Counseling

Directive Counseling

TASC Diversion to

Treatment (DTAP)

Treatment with Sanctions

Outpatient Treatment in

Supervision Emotional

Skills Moral

Reasoning 12-Step with

Curriculum• In-Prison Treatment & Aftercare

• Cognitive-Behavioral Interventions

• Drug Treatment Courts

• Contingency Management

• Therapeutic Communities (in prison)

• Focus on High Risk Offenders or Offenders with High NeedsSource: Taxman, 2009. Evidence-Based Practices in the United States.

The majority of correctional programs fall

into these areas.

Slide courtesy of Dr. Faye S. Taxman

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The Current EvidenceRisk & Needs Assessment Should Drive

Program Participation: High risk (not need) offenders should receive more rehabilitative programs

Sentencing & Program Placement Should Address Criminogenic Needs: Not all needs are criminogenic

Treatment Quality: Treatment and programs should be of sufficient duration and certain content to change behavior.

Procedural Justice: Clarifying expectations with clear and precise rules of program participation and rules for program completion are likely to lead to improved outcomes. Also creates trust and rapport for building commitment to change. Slide courtesy of Dr. Faye S.

Taxman

Aligning EBPs with existing system(s)

Every system has its own processesAlign, refine and fit but make sure to

Keep the core principlesKnow when “it” is no longer “it”

Ensure support from sister/collaborating agencies and other stakeholders

An example of EBP implementation: Contingency Management in a criminal justice setting

Evidence-based treatment Shape behaviors through rewardsFocus on a social contract for behaviorTechnique to replace immediate “drug using”;

structured rewards

AdaptationFit to EnvironmentInclude Sanctions

8 Main CM PrinciplesPositive incentives w/ point systemClear guidelines about earning pointsEmphasize abstinenceEarly incentivesPoint escalationIntegrating point system into existing systemBonusesFocus on no more than 3 behaviors at a time

Site Overview

Site Initial AddedOne Drug Court --Two Drug Court Reentry CourtThree Drug Court Reentry CourtFour Regular Caseload --Five Undetermined Halfway

House & Drug Court*

*Started with one ideas regarding implementing in one location/program but realized program not far enough along for CM. When program was ready they added it back into JSTEPS.

Participant teams self-design and

finalize CM protocols; TA

Feedback reports, on-site coaching

and TA

Practitioner teams consider feedback; some revised; follow-

up site-visits

Feedback reports, follow up phone

calls &emails some joint external

presentations by researchers and

participants

JSTEPS Learning

Collaborative Session

Year 1: MOU, software design, baseline site visits, org survey

Year 2:Adoption & implementation processes moving toward sustainability Study Design with

Continual Feedback Loops

Research development phases Phase 1 Phase 2 Phase 3

Adoption Implementation

Sustainability

0 6 12 18 24

Months Site

visits at S1, 2a, 2b, 3a, 4, Learning Meeting & Org survey

Site visit at S5, follow-up TA, feedback reports & telephone calls

Follow up site visits at S1, 2a/b, 3a, 4 &5; site visit S3b, TA, feedback reports & follow up phone calls

2nd learning meeting

Follow up phone calls & feedback reports

Wrap up site visits & phone calls

Site development phases

ADOPTION

0 6 12 18 24

S1 A

S2a A

S2b AS3a A S3b AS4 AS5a AS5b A

Months

What we learned from Adoption Phase…

Acceptability (unobjectionable) & Feasibility (suitable) Yes, acceptable/feasible but some challenges include: 1) too

many behaviors in CM model; 2) intra-org challenges, and 3) balancing sanctions with rewards

(Rudes et al. (2011) Journal of Substance Abuse Treatment)

Adaptability (understandable) Mostly acceptable with little difference between social &

material rewards. Female and non-PO more accepting. (Murphy, Rhodes & Taxman (2011) Journal of Substance

Abuse Treatment)

Site development phases

IMPLEMENTATION

0 6 12 18 24

S1 I S2a IS2b IS3a IS3b IS4 IS5a IS5b I

Months

What we learned from implementation phase… Probation Officer Roles

PO roles matter greatly for court and adoption/implementation processes. POs use three types of power 1) informational; 2) technical, and 3) relational to sway decisions to a certain end.

(Rudes & Portillo, 2012)

Transportability of EBPs EBP transportability is processual with front-line CJ

workers adapting EBPs by first adopting EBP language (loose coupling) with few adjustments to work activities. These processes have both positive and negative potential/implications.

(Portillo, Rudes & Taxman, in progress)

More learning from implementation phase… Judicial Roles & Decision Making in PS Courts

Role judges take affect collaboration and decision making regarding court and adoption/implementation processes.

Portillo, Rudes, Viglione, Nelson & Taxman, Victims & Offenders 2013)

Redefining the Win Problem-solving court attorneys often work to achieve

the courts’ collaborative goal using covertly adversarial processes in a therapeutic jurisprudence environment including: 1) battling; 2) insider trading; 3) silent treatment, and 4) evidence as a weapon. This action affects court and adoption/implementation processes.

(Rudes & Portillo, under review at Law & Social Inquiry)

Site development phases

SUSTAINABILITY

0 6 12 18 24

S1 S S2a S2bS3a SS3bS4 SS5aS5b S

Months

What does this all mean?Stay true to core principles of EBPsDo not use a one-size-fits-all approach,

individual organizational context mattersUse mixed method design to study both

process & outcome simultaneously and long-term

Follow implementation from adoption to implementation to sustainability

Account for fidelityWhat else?

Questions?

Thank You!

Dr. Danielle S. Rudes

drudes@gmu.edu