Midland CountyDay Treatment Program

USING DATA TO DRIVE EVIDENCE-BASED PRACTICES

Michele M. BellAssistant Director

Midland County Juvenile Care Center

ELEMENTS TO SUCCESSFUL IMPLEMENTATIONIdentify Champions and StakeholdersEducate & collaborate with community leaders &

agenciesUse data to drive program selection and

decisions targeted to the criminogenic needs and risk factors of the youth in the Court

Monitor implementation for fidelity to the modelCollect data to support the use of the evidence-

based practiceHave Patience: Change is difficult and be ready

for resistance

Timeline

2001 2002 2004 2005 2005 2008 2009

1997 2002 2003 2005 2005 2008 2008 2010 2011

Juvenile Offense Rates & Recidivism Rates are lowest since 1998

Principles of Evidence-Based Practices

Assess Risk Level:

YASI Youth Assessment Screening Instrument

MAYSI Massachusetts Assessment Screening Instrument

Youth Skill Assessment

Criminogenic Need Response

Accommodations/Anti-Social History Build non- criminal alternatives to risky situations, structure 40-60% of day

Anti-social cognitions Reduce anti-social cognition, recognize risky thinking and feelings, adopt an alternative identity

Anti-social companions Reduce association with criminals, enhance contact with pro-social peers

Anti-social personality or temperament Build problem solving, self management, anger management, and coping skills

Assess Needs & Target Interventions

The Top Four Needs

Criminogenic Need Response

Family and/or marital status Reduce conflict, build + relationships and communication, enhance monitoring/supervision

Substance abuse Reduce usage, reduce the supports for abusive behavior, enhance alternatives to abuse

Employment/School Provide employment seeking and keeping skills and Enhance performance rewards and incentives

Leisure and/or recreation Enhance involvement and satisfaction in pro-social activities

The Lesser Four Needs

Assess Needs & Target Interventions

Criminogenic Need Program/Intervention ExamplesAnti-social history Electronic Monitoring, Curfew, Community

Service Work, Restitution, Victim Impact (VIG)Anti-social Thinking MRT, VIG, ART, PX2, Thinking for a Change (CBT)Anti-social Peers MRT, Pro-social Activities, Thinking for a

Change (CBT )Anti-social Personality or Temperament MRT, VIG, CBT, Thinking for a Change (CBT), Family Stressors Common Sense Parenting, Wraparound, MST,

MST-PSB, Intensive Counseling, In Home Services, BSFT, ART interactive Sessions for Parents, Family Meetings

Substance Abuse J & A Counseling, MST, Partners in ChangeEmployment Staff driven: Job shadowing, resume

development, applications, job searchesEducation School on site, E2020 Credit Recovery, TutorsLeisure Midland Community Center, Gymnastics,

Karate, Horse Farm,

Need/Intervention Guidelines

DosageMedium Risk youth receive 100 hours of cognitive-based

interventionsHigh Risk youth receive 200 hours of treatmentAll intervention hours are trackedAll interventions challenge thinking errors, cognitive distortionsFamily Involvement: Weekly family contact, family activity, family

counseling, parenting classes, intervention meetings as neededTreatment plans reviewed informally on a weekly basis, formally

on a monthly basis with the treatment team, and reviewed with the Court every three months

   

BOY BELL DAYS IN PROGRAM Summer 1 2 3 4 5 6

DATE Program 8/29 8/30 8/31 9/1 9/2 9/6PHASE TRACKING

Made Day=1 Not Made=0 1 1 1 1 1 1Character Coupons 1 1 3 2Sanctions L1-1 Contracts CURRENT DAY 1 2 3 4 5 6Skill Assessment

GROUP TRACKING Skill streaming 44.5 1 1 1 1Anger Control 7 1 1Moral Reasoning 5 Safe Dating SITCAP VIG 21 Substance Abuse 28.5 TOTAL HOURS 106 107 109 109 109 110 112

DRUG TESTING Time Testing Personnel 12 PANEL TEST THC (ONLY) ALC PBT

Sample Day Treatment Tracking Form

Daily ScheduleMONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

8:00 - 8:15 AM Breakfast/ RRS Breakfast/RRS Breakfast /RRS Breakfast/ RRS Breakfast/ RRS

8:15 – 8:30 AM Chores Chores Chores Chores Chores

8:30 – 8:45 AM Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity Hmwk Check In/ Activity

8:45 – 10:15 PM Class Class Class Class Class

10:15 – 10:30 AM

Review Skill of the Week/ Break

Review Skill of the Week/ Break

Review Skill of the Week/ Break

Review Skill of the Week/ Break

Review Skill of the Week/ Break

10:30 – 12:00 PM

Class Class Class Class Class

12:00 - 12:20 PM Lunch Lunch Lunch Lunch Lunch

12:20 - 12:30 PM Chores Chores Chores Chores Chores

12:30 - 12:40 PM Free Time Free Time Free Time Free Time Free Time

12:40 - 2:05 PM Class Class Class Class Class

2:05 - 2:10 PM Break Break Break Break Break

2:10 - 3:15 PM Class Class Class (Aftercare Boost) Class Class

3:15 - 3:30 PM Snack/Break Snack/Break Snack/Break Snack/Break Snack/Break

3:30 – 5:00 PM Group-Weekend Review Group-Substance Abuse Group -Safe Dating Group-Victim Impact Group-LAP/Incentive Time

5:00 – 5:20 PM Dinner Dinner Dinner Dinner Dinner

5:20 – 5:30 PM Chores Chores Chores Chores Chores

5:30 PM – 6:30 PM

GroupSkillstreaming 1

GroupSkillstreaming 1 Continued

GroupAnger Control (MRT Target 11/23)

GroupAnger Control Continued

GroupSkills for Weekend

6:30 – 6:45 PM Review “Made My Day” Review “Made My Day” Review “Made My Day” Review “Made My Day” Review “Made My Day”6:45 – 7:15 PM “Made My Day” Free

Time or Skill Group“Made My Day” Free Time or Skill Group

“Made My Day” Free Time or Skill Group

“Made My Day” Free Time or Skill Group

“Made My Day” Free Time or Skill Group

7:15 PM Home Home Home Home Home

Cognitive Based InterventionsA.R.T.: AGGRESSION REPLACEMENT TRAINING Cornerstone Program for Day Treatment

Three Components:SkillstreamingAnger ControlMoral ReasoningUsed for all behavior interventions (role plays)

BOOSTER SESSIONS for Transitioning YouthVICTIM IMPACTSAFE DATESMST-PSBSUBSTANCE ABUSE GROUP

Family FocusedCommon Sense Parenting (Trained Staff)MST-PSB (CMH) Multi-Systemic TherapyBSFT (CMH) Brief Strategic Family TherapyHome-Based and Wraparound (CMH)Intensive family outpatient (J & A Counseling)Interactive Skillstreaming NightsTeam Meetings

Trained Staff A.R.T. – Aggression Replacement TherapyCommon Sense ParentingCollaborative Problem SolvingVictim ImpactNext Steps for Training:

Thinking for a ChangeMotivational Interviewing

Interventions: CBT, Educational, and Strength Based Skill Streaming Anger Control Moral Reasoning Victim Impact Group Substance Abuse Group Dialectical Behavior Therapy Multi Systemic Therapy & Problem Sexual Behavior Counseling Trauma & Loss Group PX2 MITI Safe Dates Parenting Support / CSP Midland Mentors Healthy Teens Life Skills Midland Community Center Leadership Adventure Program Horse Sport Camp E2020 Credit Recovery Bay Arenac Skill Center MiTech Construction Camp

Increase Positive Reinforcement

RESPECT, RESPONSIBILITY & SAFETY emphasized in every activityused in student evaluations for “Making Their Day”

Verbal Praise 4:1Daily, weekly, monthly incentives for “Made My Day” and Character

CouponsStaff DrawingPhase Incentives

Earn increasing time in structured activity outside the programGoing to high school ½ day classes

School Friday Fun DayEncourages homework completion, good behaviors, parent support,etc.

Working with parents on positive responses to youth’s increased positive behaviors or accomplishments (weekly reports to the parents)

ConsequencesSanctions GridContracts for patterned negative behavior Parents join youth in evening for homework

time

Level 1 Violations

Behaviors:Following staff requestsAppropriate languageRespect own propertyHygiene/ daily routine

TransitioningNon-physical horseplay

Dress CodeWearing seatbelt incorrectly(3rd time violation = move to

Level 2 sanction)

Level 2Violations

Behaviors:Respect to others

Participation in programming

Physical boundariesCompliance with Program

Responsibilities (RRS)Approved items policyNot wearing seatbelt

Repeated Level 1Behaviors (3rd time violation = move

to Level 3 sanction)

Level 3Violations

Behaviors:Gang related activities(non-

violent)Verbal aggression

Respect for personal safetyRespect for other’s

propertySafe expectation

GamblingRepeated Level 2Behaviors(3rd time violation = move

to Level 4 sanction)

Level 4Violations

Behaviors:Violation of safety and security expectations

Major destruction of property (>$300)

Contraband policy Escape (attempted)

Assault and battery/ fightingSexually acting out

Repeated Level 3BehaviorsFailed Drug/ Alcohol Test

Violations

SanctionsSanction issued at time of infraction

RedirectionStaff reminder of expectation

Determine SS and RRS applicable. Review with staff and role play.

15 minute privilege restriction at time of infraction

And one of the following MAY be added: Collect cigarette butts in park (if related

to smoking) No free time until homework done

Shower at Center Do an extra chore

Apology to group leader Make reparation

Behavior Specific ConsequenceDress Code:

Call parent to bring in clothing Change into Detention blues

Behaviors on Van: Sit in front seat of the van

Return to Center for parent pick up Picked up first on van the next day

SanctionsSanction issued at time of infraction

Lose privileges for the dayRequires Thinking Report

Determine SS and RRS applicable. Review with staff and role play.

And one of the following MAY be added: Written explanation of which RRS are

violated Make up time lost in group or activity

(if applicable) Do extra chore for person who

violated Suspend time period to earn bonus

points Clean grounds of Park, JCC, Animal

Control Separated from the group for 24

hours Do all dinner chores for the day

Call parent for a meeting Youth present skill to group/ role

play/ presentation Youth decides sanction using

Collaborative Problem Solving and presents to staff for approval

Choose job from job jar Behavior Specific Consequence

Contraband confiscated for 5 passing days

Parent to come in and stay late with youth to work on homework if

homework not completedBehaviors Related to Transportation:

Stay late one day if missed ride/ late for van and clean vans and parent

pick up

SanctionsSanction issued at time of infraction after

team meeting (same day)Loss of privileges for 1-3 days

Loss of social skill credit for that day (for in group infraction)

Requires Thinking ReportRequires “Freeze” for one day or until day is

“Made”Determine SS and RRS applicable. Review with

staff and role play.And one of the following MAY be added:

Report to PO Stay late and do chores

Call parent for meeting and stay late until takes place

Written Contract Choose job from job jar

Youth present skill to group/ role play/ presentation

Youth decides sanction using Collaborative Problem Solving and

presents to staff for approval Behavior Specific Consequence

Behaviors Related to Transportation: Parent has to transport to and from

the Center the next day

SanctionsSanction issued at time of infraction after team

meeting (same day)Loss of privileges for 1-3 days

Requires Thinking ReportRequires “Freeze” until determined by team

Determine SS and RRS applicable. Review with staff and role play.

And one of the following MAY be added: Potential Detainment

Contraband confiscated Letter of apology to person(s) violated

Restitution for damaged property

Sanctions

Measure Progress, Practices & Feedback

Daily youth evaluation for demonstration, interaction, participation (RRS) for “Made My Day” or not

Youth skill assessment and demonstration of skills for phase advancement

YASI (completed every three months by PO)Participation in outside activities: Evaluate ability to generalize

learned skillsFamily and professional staff team meetings to evaluate goalsWeekly contact with parentsExit interviewsTransition meetings with schoolsRecidivism measurement

Analysis of recidivism rates proves that the local rehabilitative programs that have been put into place over the last three years are working. Recidivism has dropped significantly in the Day Treatment Program from 59% (1997-2007) to 17% (2008-2010)

Recidivism Rates

No Re-Offense 0-6 Months No Re-Offense 0-12

Months No Re-Offense 0-18 Months

0%10%20%30%40%50%60%70%80%90%

100%

70%

50%41%

91%84%

83%

1997-20072008-2010

Day TreatmentHabitat for Humanity

Midland Community Center

Midland Public Schools

Bay Arenac Skill Center

MITECH

J and A Counseling

Janis Duke

Humane Society

Delta College

Shelterhouse

Michigan Works

Family and Children’s Services

Community Mental Health

Partners in Change

Boy Scouts

Midland Mentors

The Rock

Horse Sports Center

Donors: The Herbert H and Grace A Dow Foundation, The Midland Community Foundation, Rebecca Cox, Richard and Donna Gross,

Various individual donations

The Legacy Center

Community Support

EducationMPS Classes

E2020Bay Arenac Skill Center

TutorsCredit Recovery

Service ProjectsHumane Society

MCC Leadership AdventureCollaborate with Kiwanis

Dog RunShelterhouse

Habitat for HumanityHorse Farm

ParentsWeekly Phone Updates

Team MeetingsParent Intervention Meetings

Interactive Skillstreaming NightsEducation Classes

Newsletter

Youth TreatmentVictim Impact

Trauma and Loss GroupART Programs

Individual and FamilyCounseling

Substance AbuseDBT

MST-PSB

Education GroupsSafe Dates

Cooking ClassesBotvin Life Skills

Job Shadowing/Job SearchPX2 and MITI

Ongoing Skills for Life TrainingArt Projects

Substance AbuseSee Family and Youth

TreatmentYoga and Mindfulness TrainingFamily Treatment

“Common Sense Parenting”In-Home Counseling

WraparoundMST and MST-PSB

BSFTIntensive Outpatient

Substance Abuse Family Treatment

Pro-Social SkillsMidland Mentors

MCC Leadership Adventure Program MCC ClassesWork Groups

MCC Summer CampBoy Scouts Venture Crew

Muy Thai KickboxingKarate

Volunteering Gymnastics

SportsThe Rock

Day Treatment Youth

Day Treatment Targeted Programs for High Risk Areas for Youth