how state, local communities and universities work together to implement evidenced based practices...
TRANSCRIPT
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How State, Local Communities and Universities Work Together To Implement Evidenced Based
Practices and Reduce Recidivism of Juvenile Offenders
WORKING TOGETHER TO GET IT RIGHT
Eric Shafer – Assistant Court Administrator – Montgomery County Juvenile Court
Barbara Keen-Marsh, MSW, LISW-S, LICDC - South Community, Inc.
Jeff M. Kretschmar, Ph.D. - Begun Center for Violence Prevention Research and Education, Jack, Joseph, and Morton Mandel School of Applied Social Sciences,
Case Western Reserve University
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Montgomery County Juvenile Court Dayton, Ohio
• Ohio’s Behavioral Health Juvenile Justice Initiative (BHJJ)
-Began in 2005 with 6 Counties-Required the introduction of Evidenced Based Practices-Funding through:
Ohio Dept. of Mental HealthOhio Dept. of Youth
Services
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Montgomery County Juvenile Court Dayton, Ohio
• Learning Independence and Family Empowerment LIFE Program
• Functional Family Therapy (FFT)
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Multiple Pathways to South Community Inc. – Function Family Therapy
• Ohio Department of Youth Services– Parole
• Nicholas Residential Treatment Center– 24 bed facility for boys 12-18– Open Setting
• Juvenile Cognitive Alternative Rehabilitation Effort– 18 bed program for boys housed within the Detention
Center– 90 Day Stay– Aggression Replacement Training (ART)
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Multiple Pathways to South Community Inc. – Function Family Therapy
• The Center for Adolescent Services– Community Correctional Facility– 44 bed facility, 34 for boys, 10 for girls
• MCJC Probation– 950 youth on Probation– 4 Dedicated Probation Officers
• MCJC Intervention Center (Diversion)– 24/7 Reception and Assessment Center– 2,900 cases diverted annually– Disproportionate Minority Contact Mediation Program
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Montgomery County Juvenile Court Dayton, Ohio
• Keys to Success– Early Involvement
• Make a connection on day one
– Opening our facilities and providing space• Become true partners with providers
– Constant Collaboration• Line Staff• Administrative staff
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LIFE ProgramLearning Independence and Family
EmpowermentLocal Partnership
ADAMHS Board of Montgomery County
Montgomery County Juvenile Court and Reclaiming Futures
South Community, Inc.
SBHI/Crisis Care
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LIFE ProgramLearning Independence and Family
EmpowermentState and Federal Partners
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REFERRAL STRUCTURE
Youth is Released from ODYS, JCARE,
Nicholas or CAS
Crisis Care Completes an Assessment
LIFE Program is Recommended
Parole, Probation Officer or Other Court Personnel Refer Family to Services
Youth Enters Into the Juvenile Court System
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LIFE PROGRAM STRUCTURETherapist Contacts Family Within 48 Hours of
Referral
Services Provided:• Home Based Family Therapy• Psychiatric Services• Intensive Probation• Case Management
Other Collaboration:• FAMILY • PROBATION/PAROLE OFFICER• INTERVENTION CENTER• NATURAL HELPER• CHILD WELFARE• OTHER SYSTEMS• CASE WESTERN UNIVERSITY• FUNCTIONAL FAMILY
THERAPY, INC.
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Why FFT?Blueprints Model – Evidenced Based Practice• Well Documented
• Highly Successful Family Intervention Program for Juvenile Offenders
Strength-based• Consistent with local and state initiatives• Focus on strengths and assists families to
recovery
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Goals:• Significant and Long-Term Reduction in Youth Re-Offending and Violent Behavior
• Low Drop-Out and High Completion Rates• Positive Impacts On Family Conflict, Family
Communication, Parenting, and Youth Problem Behavior
• Significant Reduction in Sibling Entry into High-Risk Behaviors,
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CONTINGENCY MANAGEMENT MODEL
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Macro LevelKey Concepts
Top Down Cooperation and Collaboration
Ongoing Problem Solving
Attention to Customer Service—the other agencies are Our Customers too!!
Ongoing Needs Assessment
Planning for Sustainability from Day 1 and adjusting Sustainability Plan as Program Grows
Current Challenge is Ohio’s move to an IHBT Rate
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Service with a Smile• Weekly meetings with Probation officers to maximize
collaboration and keep everyone on the same page• Including Probation Officers and Administration in FFT
Trainings• Problem Solve any interruption in the flow of referrals–
eliminate barriers and SELL SELL SELL to all links in the referral chain---Judges, Magistrates, Traditional Probation Officers, Mental Health Assessors in and out of our agency.
• Key Attitude is how can we make Our Process fit Your Process and Your Needs
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Marketing = Matching
• A site is Selling Two Things – Service (Micro Level)– Results (Macro Level)
• You have to do both in ways that MATCH a particular customer
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Demographics
• From 2006 through June 2013, 2,545 youth enrolled– average age at intake 15.6 years– 58.4% male– 52.3% Caucasian
• From July 2011 – June 2013– 67.4% male– 42.9% Caucasian
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Youth CharacteristicsQuestion Females Males
Has the child ever been physically abused? 20.5% (n=194)**
15.3% (n=208)
Has the child ever been sexually abused? 28.1% (n = 262)***
7.1% (n = 95)
Has the child ever had a problem with substance abuse, including alcohol and/ or drugs?
43.9% (n = 411)
50.3% (n = 674)**
Has the child ever talked about committing suicide?
49.6% (n = 468)***
31.3% (n = 425)
Has the child ever attempted suicide? 22.2% (n = 207)***
9.6% (n = 129)
Has the child ever been exposed to domestic violence or spousal abuse, of which the child was not the direct target?
43.8% (n = 414)*
39.4% (n = 536)
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*p = .05, ** p < .01, *** p < .001
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Youth CharacteristicsQuestion Females Males
Has anyone in the child’s biological family ever been diagnosed with depression or shown signs of depression?
68.2% (n = 626)***
60.3% (n = 793)
Has anyone in the child’s biological family had a mental illness, other than depression?
47.8% (n = 440)***
39.7% (n = 511)
Has the child ever lived in a household in which someone was convicted of a crime?
40.6% (n = 372)
40.9% (n = 540)
Has anyone in the child’s biological family had a drinking or drug problem?
43.9% (n = 439)**
57.2% (n = 480)
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*p = .05, ** p < .01, *** p < .001
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Juvenile Court History
County Youth with Felony Charges in the 12 Months prior to BHJJ
EnrollmentCuyahoga (Cleveland) 35/156 (22.4%)Franklin (Columbus) 147/221 (66.5%)Montgomery (Dayton) 124/634 (19.6%)Hamilton (Cincinnati) 30/90 (33.3%)Lucas (Toledo) 33/59 (55.9%)Summit (Akron) 46/49 (93.9%)Total 415/1209 (34.3%)
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OYAS Risk
• Ohio Youth Assessment System (OYAS) – Criminogenic risk tool designed to assist juvenile
court staff with placement and treatment decisions
– Helps identify likelihood to re-offend
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Risk Level Low Moderate High
24% (n = 59) 48% (n = 118) 28% (n = 67)
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DSM Axis I Diagnoses
DSM-IV Axis I Diagnosis Females MalesOppositional Defiant Disorder 41.3% (n = 419) 38.9% (n = 553)Cannabis-related Disorders 27.5% (n = 279) 35.3% (n = 501)***
Attention Deficit Hyperactivity Disorder 26.5% (n = 269) 42.5% (n = 604)***
Depressive Disorders 23.0% (n = 233)*** 12.5% (n = 178)Alcohol-related Disorders 13.3% (n = 135)** 9.9% (n = 140)Bipolar Disorder 10.3% (n = 105)* 7.5% (n = 106)Conduct Disorder 9.7% (n = 98) 21.2% (n = 301)***
Post-traumatic Stress Disorder 9.4% (n = 95)*** 5.3% (n = 75)Adjustment Disorder 7.2% (n = 73)* 5.1% (n = 72)Mood Disorder 11.1% (n = 113) 9.1% (n = 130)Disruptive Behavior Disorder 6.6% (n = 67) 7.8% (n = 111)
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*p < .05, ** p < .01, *** p < .001
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Trauma
Intake Termination0
1
2
3
4
5
6
7
8
9
10
TSCC Scores from Intake to Termination
AnxietyDepressionAngerPosttraumatic StressDissociationSexual Concerns
Scal
e Sc
ores
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* all comparisons significant at the p < .01 level; effect sizes between .30 - .60.
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Ohio Scales Problem Severity
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Ohio Scales Functioning
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Substance Use
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Substance UseSelf-Reported Previous 6 Month Substance Use from Intake to Termination for Females
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Termination Information
Termination Reason All Youth Youth Enrolled from July 2011 through June
2013Successfully Completed Services
65.1% (n = 1315) 71.9% (n = 323)
Client Did Not Return/Rejected Services
6.2% (n = 125) 2.9% (n = 13)
Out of Home Placement 7.3% (n = 148) 8.0% (n = 36)
Client/Family Moved 3.0% (n = 60) 2.4% (n = 11)
Client Withdrawn 6.9% (n = 139) 5.6% (n = 25)
Client AWOL 2.9% (n = 58) 3.6% (n = 16)
Client Incarcerated 3.2% (n = 65) 3.6% (n = 16)
Other 5.4% (n = 109) 2.0% (n = 9)
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Termination Information• 2,019 youth terminated from BHJJ services (918 from Montgomery)• ALOS = 209 days (147 days in Montgomery)
– 224 days successful completers– 180 days for unsuccessful completers
• ALOS from July 2011 – June 2013 = 163 days (131 days in Montgomery)– 174 days for successful completers– 135 days for unsuccessful completers
• At intake, 47.9% of youth were identified as at risk for out of home placement
• At termination, 24.0% of youth were identified as at risk for out of home placement – 7.3% of successful completers– 56.7% of unsuccessful completers
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Recidivism• At termination, police contacts for 68% of youth had been
reduced – Police contacts for 24% of youth remained the same
• One year after termination, 10% of successful completers and 19% of unsuccessful completers had new felony charges
• Eighty-nine (89) youth (3.5%) enrolled in BHJJ for whom we had recidivism data were sent to an ODYS facility at any time following their enrollment in BHJJ, including after a youth’s termination from BHJJ. – 24/1040 (2.3%) in Montgomery County
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Financial Considerations
• Using only the direct State contribution to BHJJ of $8.4 million from 2006 - 2011, the average cost per youth enrolled in BHJJ was $4778. The FY11 per diem to house a youth at an ODYS institution was $442 and the average length of stay was 12.6 months. Based on these numbers, the estimated cost of housing the average youth at an ODYS facility in FY11 was $167,960.
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Contact Information
Eric ShaferMontgomery County Juvenile Court
Jeff KretschmarBegun Center for Violence Prevention Research and Education
Case Western Reserve University216-368-2305
[email protected] Keen-Marsh
South Community, Inc.937-534-1325