Juvenile Detention Alternatives Initiative Inter-site Conference Improving Conditions in Detention Centers: Recent Innovations New Incentive System
(NIS) Commonwealth of Massachusetts Department of Youth Services John Flaminio, Program of Director of Central Region Reception Center (JDAI Pilot Site) NIS - Implementation of a Positive Based Behavior Modification Incorporating Dialectical Behavior Therapy in a boys juvenile detention facility
Development All program components (Administration, Direct Care, Education and Clinical) involved in NIS development Developed for over 7 months prior to implementation Dialectical Behavior Therapy (DBT) concepts were a contributing factor for change NIS needed to address both resident accountability and the promotion of pro-social behaviors Clients need to understand the impact of their behaviors on themselves, others and their community when exhibiting positive and/or negative behaviors The programs advocacy component would be an integral part of NIS success
Guiding Principles New Incentive System Guiding Principles Balance resident accountability with staff support Provide new skills & intervention strategies Reduction in behavioral incidents, physical restraints and separation time Time Factor>Average detention stay is 17 days. Previous behavior management system took 4-5 weeks to achieve top level Eliminate points & levels (Hierarchal System) that creates a status atmosphere and entitlement issues amongst residents and staff Eliminate a system that focuses primarily on accountability & sanctions and focus more on positive behaviors Catch Them Doing Something Right! Youth will learn better ways to deal with negative emotions and conflict by practicing new behaviors with staff support
Positive Based Interventions and Support National research exists on Best Practices that indicates Positive Based Incentive Systems are more effective in reducing problematic behavior than punishment based systems (www.pbis.org). Utilize relationship building as a core strategy to manage youth behaviors. Promote Positive Youth Development through attention to youths strengths. Train youth to understand that all feedback is a means of support. Development of a positive peer culture that is realized primarily through staff role modeling pro social behaviors.
Dialectical Behavioral Therapy Why use DBT in Detention? DBT originally created for individuals who are very impulsive and have difficulty regulating their emotions The skills learned can be generalized and help them handle their stressors more effectively Goal is to promote positive change in the daily lives of youth in our care Use of DBT concepts in Detention Use of Distress Tolerance Plans at the initial Intake to then be reviewed with advocates Use of Behavior Chain Analysis Repair status overview Star Reward overview
DBT in Programming Clinicians teach DBT skills in group settings Skills are reinforced through homework assignments and Skill of the Week Advocates meet regularly with youth to review homework, provide feedback, document and report progress with skills Staff (including program administration) participate in DBT groups and encourage residents to become familiar with the skill DBT language is used on the floor and during processing DBT skills are reinforced through the programs Behavior Management System Youth are rewarded extra privileges for the use of DBT skills Youth must repair for behaviors that have disrupted others Staff are trained to recognize cues/behaviors indicating that a youth is beginning to experience emotional and behavioral difficulties Staff respond by Validating the individuals feelings, often diffusing the situation Staff then Coach or encourage youth to use DBT skills to help them tolerate difficult emotions
Staff Role and Responsibilities Learn the system through training and attend scheduled refresher sessions. Be involved. Accept change and maintain a positive attitude, especially in the developmental stage. Educate youth as an advocate. Be an active participant in daily groups. Note any inconsistencies or problems and have suggestions for improvements to the system. Maintain consistency but be flexible as well. Continuity is the key. Use and reinforce DBT skills and language. Encourage structured use of free or down time.
System Breakdown Tracks Orientation Track Applies to all new intakes/residents for first 24-72 hours Learn program rules, expectations & meet staff Sign Program Expectations Contract - See Handout Complete a Distress Tolerance - Coping Skills Sheet Program Track Applies to all residents detained for 30 days or less Know & follow program rules Active participation in all facets of daily living & activities 30+ Track Applies to residents held for 30 days or more Residents develop a Service Delivery Plan with their clinician & advocate Expectations are slightly higher with opportunities for more independence, responsibility & leadership.
System Breakdown Diary Cards/Infractions Diary Cards will replace current systems point sheets and serves as a record of resident behavior. Nine (9) universal behavior criteria per shift ( 2 active shifts ) Maintained/updated collectively by staff at the end of each shift Includes -Behavior Summaries -Incidents -Repair Status -Stars/ Rewards -( ) Checks ( ) Minuses (*) Asterisks (W) Warnings Infractions are violations of Program Rules (Residents Misbehaving) The Degree/severity of the Infraction(s) determines the degree/severity of Repair (consequences) that will be assigned
Purpose: New Incentive System System Breakdown Repairs To hold residents accountable for their behavior Ensure the safety & security of the program Teach the pro-social concept of Making up apologizing, and giving back to the community/individuals Our Goal: Help residents identify & understand the impact of their actions on others and themselves Provide residents with the skills needed to process & change their behavior. Residents on Repair are removed from the immediate general population until they complete their assignments, or they have reached their maximum time allotment (still with population, just separated from the activity ) No recreational or leisurely activities No redemption of incentive points ( STARS ) Community Service within the program (Peer Facilitator, Peer Advisor, Unit cleaning projects etc.) Cooperative behavior & completion of assignments are rewarded with early re-entry back into the program
System Breakdown Star Rewards Star Rewards Stars are used to recognize & immediately reward residents for pro-social habits and positive behaviors (Incentives, Privileges, Rewards) Each resident receives a new STAR sheet each week Staff will document justifications for STARS received, and initial the residents star sheet Ways to earn stars Earn all checkmarks ( ) for the shift (one star per shift) Exhibit a significant improvement with problematic behavior Going above and beyond expectations during daily living/activity Residents will not be awarded STARS if they ask for them Stars can be rolled over (saved) from week to week Stars cannot be redeemed if a resident is on any Repair Status Stars cannot be taken away for any reason
System Breakdown Repair Status/IP Plan Repair Status Overview Repair 1 (up to 1 active shift) Repair 2 (1 3 active shifts) Repair 3 (3 7 active shifts) Corresponds w/ Class 1 Infractions Corresponds w/ Class 2 Infractions Corresponds w/ Class 3 Infractions Individual Treatment Plan -A plan that accommodates residents with individual/specialized needs. -We recognize that some residents may need individual interventions to assist them in maintaining appropriate behaviors or stay on task
Pre- and Post DBT Behaviors 250 217 200 150 100 117 90 66 2007 2008 50 0 Total Days out Total Residents out Restraints 8 2 2007 217 90 8 2008 117 66 2 Behaviors
The End Questions????