Moral Reconation Therapy

Moral Reconation TherapyThe Honorable John R. Roach, Jr.296th Judicial District Court

Alyse Ferguson, Esq.Attorney Director, MHMC ProgramWe Need a ChangeHigh Recidivism RatesHigh Jail PopulationOvercrowded CourtsIncrease in MI and ID Inmates

MRT How it Came to our AttentionMRT was initially mentioned in medical contract negotiations We found out that probation had simultaneously discovered MRT as well Discussed the conceptVisited MRT program in Pueblo

What is MRT ?MRT : Moral Reconation Therapy the nameConation was a word used in the 30s before ego, meaning the conscious process of decision making - a purposeful behaviorMoral Reasoning represents how a person makes decisions about what he or she should or should not do in a given situationUnderlying Goal with MRT was to change conscious decision-making to higher levels of moral reasoning = Moral ReconationDefinition of Stupidity4MRTDeveloped in 1985 by Gregory Little, Ed.D and Kenneth Robinson, Ed.DMore than 120 published reports documenting significantly lower recidivism for MRT treated offenders for periods as long as 20 years afterUsed in 49 States and 7 CountriesCognitive Behavioral ApproachCombines:EducationGroup and individual counselingStructured exercises designed to foster moral development in treatment-resistant clients

Notes: as long as clients judgments about right and wrong are made from low levels of moral reasoning, counseling them, training them in job skills and even punishing them will have little long-lasting impact on their behavior. They must be confronted with the consequences of their behavior and the effect on their family, friends and community. Poor moral reasoning is common within at-risk populations.Designed to alter how clients think and make judgments about what is right and wrongMoral does not refer to religious concept but represents how a person makes decisions about what he or she should or should not do in a given situation

6Who Can Benefit from MRTInitially developed in the prison-based therapeutic community, it was then tested and widely implemented in general inmate populationJuvenile OffendersParole and probation settingsIn community correctionsIn hospital and OP programsEducational settingsDrug CourtsUsed with both gendersPersons with Mental Illness Diagnosis Persons with TBIWhy We Were InterestedImpact on RecidivismLow CostPotential to help the MI populationHigh Recidivism

Particpants with a serious mental illness can and do learn from this program, MI cases costly8Pueblo, Colorado ProgramPueblo, CO has established MRT in the jailsUse Assessment Tools to screen for eligible participantsLow to medium risk - inmates with at least 30-day stayGroups facilitated by deputiesPart of inmate Behavior ModificationMeeting with participantsMeetings with Deputy Facilitators and Jail AdministrationProgram informationPueblo Told Us We Would See:Requests for class admissionRequests to stay in jail to completeRequests to Return to jail for classes

10AttributesTargets issues specific to offender populationDesigned to address issues of treatment-resistant populationReduce recidivism 30%-50% for periods up to 20 years after releaseEffectively used in different programs at many sitesImproves offender compliance to rules in custody and while under supervision in the communityOpen-ended groupsIncrease moral reasoningDecrease dropout ratesIncrease sense of purposeReduce antisocial thinking and behaviorContinuum of care when implemented in a variety of settingsDoes not require a high reading levelmaximize resources

many illiterate complete successfully-examples11Difference from Other ProgramsPeer DrivenParticipants own the groupAccountabilityThe group members hold each other accountable

not led by someone not seen as a peer or having been in the same spot12WORKBOOKObjectively-defined steps focusing on seven basic treatment issuesConfrontation of beliefs, attitudes and behaviorsAssessment of current relationshipsReinforcement of positive behavior and habitsPositive identity formationEnhancement of self-conceptDecrease in hedonism and development of frustration toleranceDevelopment of higher stages of moral reasoningDrawingsalready have predefined terms. Drawings force rethinking 13The BasicsThe classes are open-endedLearning from OthersPeer DrivenGroups usually have 12-15 participantsBasic MRT has 12 stepsEach step has a general written discussion and homework exercises and requirementsAdditional steps to 16Classes are 1-2 times per weekFacilitators are all trained the exact way allowing facilitators to step easily into a groupSense of pride developsparticipants do not have to wait for a new class they can begin any time

As a result of the open ended class participants are on different steps. Those on higher steps become mentors and become more vested

The groups have a facilitator that helps keep it on track, but the peers are really driving the progress and the group learning. Instead of an instructor that cant possible understand where they have been the peers are judging the assignment and calling them out on lies and lack of honesty

sometimes larger in the jail populations

facilitators in the jail typically detention officers reduce disciplinary infractions14How Implemented:Multiple Prong - SimultaneousPhase 1 TrainingMulti-department Training Sheriffs Office Detention Staff, Juvenile Detention Staff, Community Treatment Providers and Counseling Providers for Court Programs, ProbationDemand for Additional TrainingExplanation of SCORE

Juvenile Court staff and Drug Court Staff

Detention Staff, Juvenile Staff, MH Court Case Manager, Community Treatment Providers15Phase 2-Identification and Implementation of Jail-based classesMH Population: MalesExpanded to FemalesGeneral Population ClassesAdded additional classesBegan with counselor-facilitated classes - added detention officer facilitatorsin the jail we had to split by sexes. Started in separate housing, moved to one POD-benefit that they would be together throughout the day as well as for classesDivide facilitators and split

16Step 3 Implementation of ClassesProbation/CourtsSCORECommunityJuvenile

Transition for those who started classes in jailCourt ordered participantsPre disposition

17IssuesInitial StartupDeciding on the criteriaJail Population/CommunityWho will you targetHow will you identifyWill they be housed togetherBooks$$started with only the MH population- time constraints, number of factors, required approval for rehousing etc delay with getting books, issues housing together.

risk level, time in custody, prior history, initially maximize use of resources

started with mh population and would screen-must be competent and stable enough to benefit, discus and review with client for interest, review security and cch for appropriateness, est time in custody.

initially started just transferring for class, then same cell, same pod, goal cluster-minimize staff transfer time dont want it to be a hassle, in same pod not always need for extra staff

some programs charge the participant the $50 for books-vested, in custody use commissary book goes with them to outside group. Outside groups community help- lower cost or offer payments.18Issues(continued)Buy InDevelop a planGeneral education meetingMeet with community providersMeetings with the JudgesEveryone should agree to keep dataThe NumbersTrainingit has to be ordered, there has to be somewhere to go

for implementation in phases

include commissioners, probation, DA, ADAs community providers, defense attorneys, set a goal

many agreed to have pilot class at no cost, sliding fee scale, or 0 if needed, contract with probation, , talked to DSHS about paymentonly ACT

explain program-criteria for admission, process for referral

use the same collection sheets for all- we want to be able to show it is successful. When participants change groups the info is needed to let the new group know what step they are on.

must have enough to get the classes going, would have one released and a delay before another would be released so delays left time for disposition or person to lose interest.

have to keep people trained, ongoing staffing expand, new trainings

19What HappenedJust as predicted by Pueblo:We have had inmates ask to stay in jail to completeAsk to enter the programAsk to return to the jail for classes

20Cost AnalysisToo early in our program to show numbers but we know we save..

21OngoingContinued expansion of the classesFinal step presented to the Court

Questions?