1. M EASURING C RIMINAL T HINKING : T HREE D IFFERENT P ERSPECTIVES ON I MPLEMENTATION Alec Boros, Ph.D. Research Manager, Oriana House, Inc. Mike Randle Program Manager, Oriana House, Inc. Dzanela Sehic Program Coordinator, Oriana House, Inc.

2. Overview Responsivity: A Review Summary of Responsity Assessments we use A Short Inventory of Problems The Criminal Thinking Scale The Assessment Some Results from our Agency Putting the CTS to Use: A facility manager perspective Putting the CTS to Use: Caseworker perspective

3. Responsivity: A Review

4. Relationship of Targeted Interventions: Neglected Areas Responsivity Need Desired Outcome Dosage Treatment Fidelity Risk Treatment Plan

5. Responsivity: General vs. Specific General Responsivity- is associated the use of the most effective correctional programming to change the criminogenic needs of offenders Specific Responsivity Use cognitive behavioral interventions that take into account characteristics of the individual. Failure to address can hinder treatment efforts

6. Responsivity: Internal vs. External Internal Responsivity Factors Characteristics of the individual offender Demographic More difficult to assess and accommodate factors such as personality and intelligence They can contribute to the engagement of offenders into treatment and the development of therapeutic alliance

7. Responsivity: Internal vs. External External Responsivity Factors The interaction between Facility, Staff and Client characteristics Staff Facility Client

8. How can we categorize these responsivity areas? Gender Race Age Ethnicity Religion Peers Motivation Trauma Literacy Attitude/Thinking Style Family relations Personality Intelligence Communication style Learning Style Demographic Characteristics Dynamic Characteristics Static or Near-Static Characteristics Programming

9. Sample of Responsivity Assessments Used at OHI AssessmentConstructOur Recommendation Adverse Childhood Experiences (ACE) Assesses exposure to childhood emotional, physical or sexual abuse and household dysfunction Under review. Currently developing norms to examine how we can use information regarding adverse childhood experiences to guide programming. TCU Criminal Thinking Scales (TCU CTS) Measures 6 criminal thinking stylesYes. Good assessment for determining client thinking errors prior to programming. Can be used to guide programming as well as one-on-one client-staff interactions. Also, an effective measure of client change when pre and post test scores are compared TCU Family and Friends Family relationships, family drug use, peer socialization, peer criminality Under review. Currently developing norms to examine how we can use information regarding social functioning (family/friends) to guide programming. Psychological Inventory of Criminal Thinking Style (PICTS) Assesses 8 criminal thinking stylesIt depends. An excellent, well-validated assessment of pre- intervention thinking as well as pre and post test change, but maybe not be practical due to length and difficulty in scoring

10. Sample of Assessments Used at OHI AssessmentConstructOur Recommendation PTSD Diagnostic Scale (PDS) Assesses severity of Post Traumatic Stress Disorder (PTSD) Symptoms stemming from a traumatic incident Yes. Good for assessment of PTSD symptoms to determine whether client requires a referral for PTSD treatment. Also can be used as a post-test to determine changes in PTSD symptoms. Please note: self report assessment that is administered and scored by a clinician. Short Inventory of Problems (SIP) Measure 5 life areas that could be affected by drug/alcohol use in past 3 months Yes. Good assessment for determining problems related to drug and alcohol use. Can be used to provide insight into areas where client requires assistance. Also, an effective measure of client change and improvement in client functioning when pre and post test scores are compared. University of Rhode Island Change Assessment Score (URICA) Motivation to change as assessed by Transtheoretical Model of Change Yes. Good assessment for determining the client ’ s initial motivation to change. Can be adapted to address any problem. We found it is not effective as a post-test and cannot effectively be used to determine change in motivation.

11. Criminal Thinking: Selecting an Instrument

12. M AJOR C RIMINOGENIC R ISK F ACTORS : B IG F OUR & C ENTRAL E IGHT 1. Anti-social Attitudes/Thinking 2. Anti-social Peers 3. Anti-social Personality Pattern 4. History of Anti-Social Behavior Big FourBig Four CentralEightCentralEight 5. Family / Marital Factors 6. Lack of Achievement in Education/ Employment 7. Lack of Pro-social Leisure Activities 8. Substance Abuse

13. Selecting an Appropriate Responsivity Assessment

14. Criminal Thinking Scale (TCU CTS) Origins Developed from the work of Glen Walters and the Bureau of Prisons in 1996 Knight et al., development assessment in 2006 Reliability and validity of the CTS 3,266 clients from 26 programs

15. Criminal Thinking Scale (TCU CTS) TCU CTS ScalesDefinition Personal IrresponsibilityBlaming others/external factors for criminal behavior. EntitlementFeeling of privilege Power OrientationNeed for power/ control over others JustificationMinimalization of seriousness of antisocial acts Cold HeartednessCallousness Criminal RationalizationNegative attitude toward law and authority figures requires about 15 minutes to complete 36-item self-report questionnaire Each item is rated using a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = uncertain, 4 = agree, 5 = strongly agree) The scales contain an average of 6 items each Higher scores on a subscale indicate a greater tendency to exhibit the pattern of thinking being measured by that subscale

16. Criminal Thinking Scale (TCU CTS) Sample CTS questions

17. Criminal Thinking Scale (TCU CTS) Scoring Breakdown

18. Criminal Thinking Scale: Norming our Population

19. Objectives 1. To identify the standard cut-off CTS scores used in the agency 2. To illustrate pre- and post- test results of TCU CTS assessment which serves as a measure of change in criminal thinking. Why develop our own cut-off scores? TCU Norms were developed with a different population Greater Socio-economic diversity Greater diversity in problem severity Greater diversity in correctional setting Not gender specific Populations used Male and Female Halfway House, CBCF, Probationers (contract) Norming our Population at Oriana

20. N ORMING OUR P OPULATION AT O RIANA Demographic Summit Male CBCF Summit Female CBCF RCCTMRC JNRM CBCF CROSSWAEHTotal Gender (n = 1,707) Male 338 170 486 211 1205 70.6% Female 113 269 120 502 29.4% Education (n = 1,276) No GED/ High School 155 43 72 23 229 522 40.9% High School/ GED 175 64 182 51 241 713 55.9% Higher than High School/ GED 8 6 14 1 12 41 3.2% Race (n = 1,243) Caucasian 1508421232139 617 49.6% African American 168244642306 586 47.1% Other 724225 40 3.2%

21. CTS scores at intake:  Red numbers represent the highest scores in each criminal subscale.  Blue numbers represent the lowest scores in each criminal subscale. Norming our Population at Oriana

22. *Since there are some data which were not normally distributed, non-normal distributed data were transformed to the log number before running independent t-test analysis. Norming our Population at Oriana Mean and median of intake CTS scores compared by gender:

23. Norming our Population at Oriana

24. CTS norm-referenced cut-off scores: OHI Female

25. Norming our Population at Oriana CTS norm-referenced cut-off scores: OHI Male

26. N ORMING OUR P OPULATION AT O RIANA ORIANA MALE CTS Scores Q 1 (Low)Q 2 (Low-Moderate)Q 3 (Moderate-High)Q 4 (Moderate-High) Entitlement =1010 < X ≤ 11.711.7 <X ≤ 18.3X > 18.3 Justification =1010 < X ≤ 15.015.0 <X ≤ 20.0X > 20 Power Orientation 10 ≤ X ≤ 12.912.9 < X ≤ 17.217.2 <X ≤ 21.4X > 21.4 Cold Heartedness 10 ≤ X ≤ 18.018.0 < X ≤ 22.022.0 <X ≤ 26.0X > 26.0 Criminal Rationalization 10 ≤ X ≤ 15.015.0 < X ≤ 20.020.0 <X ≤ 25.0X > 25.0 Personal Irresponsibility 10 ≤ X ≤ 11.711.7 < X ≤ 15.015.0 <X ≤ 20.0X > 20.0 ORIANA FEMALE CTS scores Q 1 (Low)Q 2 (Low-Moderate)Q 3 (Moderate-High)Q 4 (Moderate-High) Entitlement =10 10 < X ≤ 15.015.0 <X ≤ 20.0 X > 20.0 Justification 10 ≤ X ≤ 11.7 11.7 < X ≤ 16.716.7 <X ≤ 20.0 X > 20.0 Power Orientation 10 ≤ X ≤ 15.7 15.7 < X ≤ 20.020.0 <X ≤ 24.3 X > 24.3 Cold Heartedness 10 ≤ X ≤ 20.0 20.0 < X ≤ 24.024.0 <X ≤ 28.0 X > 28.0 Criminal Rationalization 10 ≤ X ≤ 20.0 20.0 < X ≤ 25.025.0 <X ≤ 30.0 X > 30.0 Personal Irresponsibility 10 ≤ X ≤ 13.3 13.3 < X ≤ 18.318.3 <X ≤ 21.7 X > 21.7

27. Criminal Thinking Scale: Pre- and Post-Tests

28. Pre- and Post- CTS results Specialized Cognitive Offender Programming & Education - SCOPE - SCOPE data were analyzed from 2010 to 2012. Average Pre- and Post- CTS scores compared by gender Blue numbers represent CTS scores statistically decreased over the assessment period.

29. Pre- and Post- CTS results Specialized Cognitive Offender Programming & Education - SCOPE Average Pre- and Post CTS scores compared by year Blue numbers represent CTS scores statistically decreased over the assessment period.

30. Pre- and Post- CTS results Red numbers represent significant increase in score from pre- to post-test. Blue numbers represent significant decrease in score from pre- to post-test

31. Putting the CTS to Use: A facility manager perspective

32. J UDGE NANCY CBCF R ESULTS VariableVariable Categoriesn% Race African American31662.2 Caucasian14728.9 Hispanic153.0 Multiracial102.0 Other71.4 Education No High School Degree22945.1 High School Degree10320.3 GED15831.1 Associate Degree122.4 Bachelor’s Degree2.4 Advanced Degree10.2

33. J UDGE NANCY CBCF R ESULTS

34. January 2012-April 2013 (n = 136) May 2013-April 2014 (n = 154) Pre-testPost- test p-valuePre-testPost-testp-value Entitlement 16.7016.90.66616.80 16.06.137 Justification 16.8317.63.10617.48 16.82.188 Power Orientation 19.6320.73.015* 20.4921.47. 069* Cold Heartedness 25.3825.10.60825.77 21.48.107 Criminal Rationalization 25.2825.7339725.55 24.57.421 Personal Irresponsibility 19.4118.46.057*. 19.61 18.47.022*

35. Shared with staff Developing new programming Shared with other programs (Transitional Services) How CTS Results are used in our Facilities

36. Putting the CTS to Use: Caseworker perspective

37. U SING CTS IN C ASEWORKER MEETINGS : ENTITLEMENT What is Entitlement? Examples HOMEWORK IDEAS 1. Inventory of Wants vs. Needs 2. Before making choices list out the consequences to other people. 3. I’m a victim of others worksheet (give handout and reading) 4. “I Want it Fast and Easy” Homework 5. “Robin Hood” Homework 6. Thinking Report, Thinking Check In, Cognitive Model, Cognitive Model with Replacement Thoughts or “Thinking and Feeling” Worksheet on: Anytime you find yourself saying “I need this”, “I deserve it”, “You owe me”, “I want it now”, and “I can’t wait”, “I won’t wait” do TR Optional - evaluate is it a Want vs. Need When you feel its okay to break a small rule.

38. U SING CTS IN C ASEWORKER MEETINGS : POWER ORIENTATION What is Power Orientation? Examples HOMEWORK IDEAS 1. 3 step from T4C 2. Thinking Report, Thinking Check In, Cognitive Model, Cognitive Model with Replacement Thoughts, “Thinking and Feeling” Worksheet, or L17 Homework from T4C on: Situation where you become upset when someone tells you what to do. When you feel you are not in control When someone disrespects you Whenever you feel yourself becoming defensive or argumentative When things don’t go your way

39. U SING CTS IN C ASEWORKER MEETINGS : C RIMINAL RATIONALIZATION What is Criminal Rationalization? Examples HOMEWORK IDEAS 1. “What is the bad thing that happened to you?” Homework 2. “This happens again and again in your life and you don’t like it” Homework 3. Thinking Report, Thinking Check In, Cognitive Model, Cognitive Model with Replacement Thoughts or “Thinking and Feeling” Worksheet on: a. Situation where you begin feeling like you are being treated unfair. b. Times when you begin to think “the system”, “facility”, “staff” is unfair.

40. U SING CTS IN C ASEWORKER MEETINGS : JUSTIFICATION What is Justification? Examples HOMEWORK IDEAS 1. “I’m a victim of others” worksheet (give handout and reading) 2. Seemingly Unimportant Decisions “SUDS” Homework 3. No One Was Hurt – Ripple Effect 4. “This happens again and again in your life and you don’t like it” Worksheet 5. Choices and Consequences (self and others). Can do past or current situations 6. Thinking Report, Thinking Check In, Cognitive Model, Cognitive Model with Replacement Thoughts or “Thinking and Feeling” Worksheet on: When you find yourself wanting to do something you shouldn’t do because “Everyone else is doing it”. When you find yourself blaming other People, Places, or Things for your actions.

41. U SING CTS IN C ASEWORKER MEETINGS : COLD - HEARTEDNESS ' What is Cold-heartedness? Examples HOMEWORK IDEAS 1.Choices and Consequences (self only) Both positive and negative (Decisions worksheet) 2.List out who is important in your life. Have client then list out consequences to that person for their actions

42. U SING CTS IN C ASEWORKER MEETINGS : PERSONAL IRRESPONSIBILITY What is Personal Irresponsibility? Examples HOMEWORK IDEAS 1.If a client receives a rule violation have them take a look at how they played a role in the situation. (Cog Model) 2.“What is the bad thing that happened to you?” Homework 3.“This happens again and again in your life and you don’t like it” Homework 4. Thinking Report, Thinking Check In, Cognitive Model, Cognitive Model with Replacement Thoughts or “Thinking and Feeling” Worksheet on: “ism” – Favoritism, racism, sexism -- have client do TR.

43. C OGNITIVE M ODEL

48. C OGNITIVE M ODEL WITH R EPLACEMENT T HOUGHTS

49. T HINKING AND F EELING W ORKSHEET T HOUGHTS T HE S ITUATION F EELINGS

50. CTS results distributed to assigned caseworker Caseworker begins EPICS II process with client: Role Clarification Explaining Behavioral Analysis Processing Behavioral Analysis Once caseworker processes the Behavioral Analysis, those targets, as well as the identified CTS domains, are placed on the RACE document to track and determine direction Based on the collaboration between client and caseworker, a single target from the RACE document is chosen Appropriate homework will be assigned to address the chosen target Using the CTS in conjunction with EPICS II

51. Recognize Learn to recognize high-risk situations Avoid Can you avoid? Plan to avoid Cope If you cannot avoid, plan to manage Evaluate How can you better handle the scenario? What did you do well? Need to feel in control; Feeling disrespected Personal Irresponsibility Feeling entitled to certain things; Wanting fast and easy way Specific peer Lack of self control This form is designed to help you keep track of situations (people, places, things) that increase your risk of getting into trouble. List the situations that you have recognized as being high-risk for you, how you plan to avoid them, if you can’t avoid them how you will cope with them, and finally, how your avoidance and coping strategies have worked if you have tried them out. Think of ways you can improve your avoidance and coping skills each time you try one. Last, be sure to use self-reinforcement when you avoid or cope successfully!

52. Personal Irresponsibility  Cognitive model (how they played a role in the situation)  What is this bad thing homework  This happens again and again  Thinking Report, Thinking Check in, Cognitive model with or without replacement thoughts: favoritism, racism, sexism Lack of self control  Social skill: using self control  Choices and consequences list: times they’ve not used self control and the consequences that occurred  Cognitive model or thinking report on specific situation Specific peer  Avoidance plan  Coping plan

53. Collaborative approach to initiate change ORAS results Targets identified via use of EPICS II CTS results Client’s Self-Report and Insight

54. Cognitive Skills Specialists receive CTS results for clients with a Very High ORAS risk score CTS results are utilized during Very High Risk Group sessions by implementing previously established curricula for Thinking Errors in order to process those identified targets During Very High Risk Individual sessions, staff tailors approach based on CTS results Consistent communication and collaboration between caseworker and assigned Cognitive Skills Specialist on client’s progress Currently, above process in place only for VHR clients U SING THE CTS IN C OGNITIVE P ROGRAMMING

55. Intake ORAS results reviewed Pre-Test CTS administered EPICS II Behavioral Analysis processed CTS results sent to assigned caseworker Targets identified and tracked on RACE document Single target chosen and addressed CTS results for VHR clients sent to Cognitive Programming staff VHR Group sessions held to address identified CTS domains CTS results incorporated in VHR Individual sessions Communication with caseworker regarding progress

56. Lessons Learned and Discussion

57. Some Lessons Learned An assessment is useless unless you make plans on how it will be integrated within your program. Be sure to use a tracking method that is right for your project, staff and resources CQI: fidelity of assessment and application of assessment

58. Questions?