Applying Research to Practice:Applying Research to Practice:

Using Risk and Need Factors to Determine Systems ResponsesUsing Risk and Need Factors to Determine Systems Responses

TRIscience

addiction

Presented By Cary Heck, Ph.D.

University of Wyoming/NDCI

Criminogenic Criminogenic RisksRisks

TRIscience

addiction

• Age during rehabilitation < 25 yearsAge during rehabilitation < 25 years

• Criminal onset < 16 yearsCriminal onset < 16 years

• Prior rehabilitation failuresPrior rehabilitation failures

• History of violenceHistory of violence

• Antisocial Personality DisorderAntisocial Personality Disorder

• Psychopathy Psychopathy

• Familial history of crimeFamilial history of crime

• Criminal associationsCriminal associations

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction

TRIscience

addiction

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

TRIscience

addiction

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

TRIscience

addiction

} Abstinence is a distal goal

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

Drug Abuse or MisuseDrug Abuse or Misuse

TRIscience

addiction

} Abstinence is a distal goal

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

Drug Abuse or MisuseDrug Abuse or Misuse

TRIscience

addiction

} Abstinence is a distal goal

Abstinence is a proximal goal}

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

Drug Abuse or MisuseDrug Abuse or Misuse

Collateral needsCollateral needs– E.g., dual diagnosis, HIV+E.g., dual diagnosis, HIV+

TRIscience

addiction

} Abstinence is a distal goal

Abstinence is a proximal goal}

Criminogenic Criminogenic NeedsNeeds

Drug Dependence or AddictionDrug Dependence or Addiction1.1. Binge patternBinge pattern2.2. Cravings or compulsionsCravings or compulsions3.3. Withdrawal symptomsWithdrawal symptoms

Drug Abuse or MisuseDrug Abuse or Misuse

Collateral needsCollateral needs– E.g., dual diagnosis, HIV+E.g., dual diagnosis, HIV+

TRIscience

addiction

} Abstinence is a distal goal

Abstinence is a proximal goal}

} Regimen compliance is proximal

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

AccountabilityAccountability&&

TreatmentTreatment

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

AccountabilityAccountability&&

TreatmentTreatment

TreatmentTreatment

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

AccountabilityAccountability&&

TreatmentTreatment

TreatmentTreatment

AccountabilityAccountability

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

AccountabilityAccountability&&

TreatmentTreatment

TreatmentTreatment

PreventionPrevention

AccountabilityAccountability

Risk & Needs MatrixRisk & Needs Matrix

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

AccountabilityAccountability&&

TreatmentTreatment

TreatmentTreatment

PreventionPrevention

AccountabilityAccountability

Practice ImplicationsPractice Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Status hearingsStatus hearings Intensive treatmentIntensive treatment ComplianceCompliance is proximal is proximal Restrictive sanctionsRestrictive sanctions Positive reinforcementPositive reinforcement

Intensive treatment Intensive treatment AttendanceAttendance is proximal is proximal

Positive reinforcementPositive reinforcement

Status hearingsStatus hearings

AbstinenceAbstinence is proximal is proximal Restrictive sanctionsRestrictive sanctions

Prevention Prevention AbstinenceAbstinence is proximal is proximal

Policy ImplicationsPolicy Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Policy ImplicationsPolicy Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Drug CourtDrug Court

Policy ImplicationsPolicy Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Drug CourtDrug Court

Drug CourtDrug Court

OrOrTrack 2Track 2

Policy ImplicationsPolicy Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Drug CourtDrug Court

Drug CourtDrug Court

OrOrTrack 2Track 2

TraditionalTraditional

adjudicationadjudication

Policy ImplicationsPolicy Implications

TRIscience

addiction

High RiskHigh Risk Low RiskLow Risk

High High NeedsNeeds

Low Low NeedsNeeds

Drug CourtDrug Court

Drug CourtDrug Court

OrOrTrack 2Track 2

Pre-trial Pre-trial

diversiondiversion

TraditionalTraditional

adjudicationadjudication