Monthly Archives: April 2015

Using Evidence-Based Assessment To Create Problem-Solving Interventions



Center for Court Innovation researcher Sarah Picard-Fritsche discusses the risk-need-responsivity model for
working with offenders and the Center’s efforts to develop a screening tool for misdemeanor offenders.

The following is a transcript

 

Raphael:
Hi. I’m Raphael Pope-Sussman at the Center for Court Innovation and in today’s podcast, we’re looking
at risk-need assessment tools for offenders. Our guest is Sarah Fritsche, associate director of research here at
the Center. Sarah, thank you for speaking with me today and welcome.

SARAH
FRITSCHE: Thanks. Happy to be here.

RAPHAEL POPE-SUSSMAN: Wonderful. What
is risk-need?

FRITSCHE:  Well, risk-need-responsivity theory is essentially
a theory of crime prevention which has three core components. The risk principle, which suggests that courts and
treatment programs that are interested in reducing the risk of offenders should focus on those individuals coming
through the system who are at the highest risk for re-offense–as opposed to what we sometimes see happening, which
is lower risk offenders, we focus our resources on them based on an idea that they deserve a second chance or that
the higher risk offender is a lost cause.

All of those ideas are quite intuitive
but actually research evidence shows us that when we focus our resources on treating and intervening with and supervising
the higher risk group, that is when we achieve risk reductions and when we are able to get people out of the revolving
door where they keep coming through the jails over and over again.

When
we focus our resources on lower risk offenders, ironically enough or perhaps it’s not really an irony, I don’t
know, but unfortunately when we do that, what happens is that we sometimes increase risk because we put folks who
have pro-social networks and not very serious drug problems who just were in the wrong place at the wrong time. We
put them into intensive treatment and that exposes them to anti-social networks, that takes them away from their
job, that takes them away from their family, and this increases their risk for future offense and future involvement
in the justice system.

POPE-SUSSMAN: What’s the origin of
this theory?

FRITSCHE:  The theory originates with two Canadian psychologists
in the late ’80s, early ’90s, James Bonta and his partner’s name was Andrews. They were actually developing
an assessment tool which is now one of the longest-used assessment tools in the field, called the “Level of Services
Inventory.” Their theories of criminal conduct are essentially psychological. Individual theories of criminal conduct
were what undergirded the assessment tool that they created. They came up with a theory– the main and most tested
principle in the theory is the risk principle, but there’s also two other components. One is the need principle,
which tells us that we should try to understand the specific needs of each individual person coming through the justice
system in order to give them the correct targeted treatment. It’s that part that is intuitive.

But without the correct assessment tools, we can’t figure out what that is. The third
component is responsivity, which means that we should develop treatment programs or therapeutic intervention programs
that respond to people’s learning styles and some clinical needs that might interfere with their ability to
recover, such as mental illness or trauma.

POPE-SUSSMAN: Can you talk a little
bit about what you’re working on in the Center and what is the Center’s focus right now in terms of risk-need
assessment?

FRITSCHE: Sure. I started working in this area about five years
ago and my interest in it grew out of one of the first studies that I did here at the Center, which was a study of
Brooklyn’s program, which they call the Universal Screening for Drug Court, for people in the criminal court
who might have the need for drug treatment. They were trying to find as many people as they could and send them into
drug court as an alternative to maybe a short-term jail sentence that they might get. They had a screening system
that was effectively just based on present charge. I guess my response to the system was that it was well intentioned
but that based on the research that I did that they probably needed a little more information to identify the individuals
that were most appropriate for drug court programming. A little more clinical information, maybe a little more criminal
history information.

I started looking around to see if anybody else had had
that idea and that’s where I ran into risk-need-responsivity theory. One of our first projects here that’s
really about this theory is testing the LSI-R, which I just described to you as one of the earliest tools in …

POPE-SUSSMAN: Just for listeners who aren’t so savvy, what does LSI-R stand for?

FRITSCHE: Oh, it stands for the Level of Services Inventory and it’s just a 54-item
assessment tool that they developed to assess individual offenders along the areas that we know may be related to
re-offense. We wrote a proposal to the National Institute of Justice to do a randomized controlled trial where we
looked at whether … we’re looking, we’re actually now analyzing and writing up the data, at whether the
treatment plans and outcomes of a drug court participant that was assessed using the LSI-R would be any different
than those where they didn’t get a standardized or RNR-based assessment. That was our first project that began
in 2010 and is ongoing and will be reported on soon.

Then shortly following
that project, the world of evidence-based assessment, evidence-based practice just however coincidentally really
exploded and a lot of the federal government agencies that we worked with and other non-profit organizations that
work in the justice system became very interested in some of these concepts– whether we could use evidence-based
validated assessments to learn more about what keeps offenders caught in this revolving door of being incarcerated
and re-offending very quickly. And whether we could then use that information or evidence to develop better programs
that are therapeutic interventions. The Center has a long history of trying to create therapeutic or problem-solving
interventions for offenders. This foray into this field was very natural for us.

Since
the evidence-based assessment research in the drug court started, we have picked up several new projects that are
in this area. At the moment, we are looking at a different assessment tool that’s similar to the LSI-R called
the COMPAS. Don’t ask me what that stands for because nobody really knows, but it’s a similar tool and
we’re looking at that specifically in a sub-population of mentally ill offenders because there’s a lot
of questions in the field as to whether these validated assessments that have been historically used to predict outcomes
for general felony populations will work in some of the sub-populations that are important in the justice system,
mentally ill offenders being one of them.

Then the other project that’s
very important in this field that we’re doing right now began specifically from misdemeanor offenders, which
is another important and understudied subgroup. We have, nationally in our justice system, about 10 million individuals
per year that come through our criminal courts on misdemeanor charges. We have a very underdeveloped understanding
or comprehension of what the clinical and social service needs and criminal risk of these individuals is. That gap
in the research is what brought us to develop and seek funding for the Misdemeanor Assessment Project, which is a
two-part project. First, to develop an assessment tool that can accurately give us a profile of the risk and needs
of misdemeanor offenders rooted in risk-need-responsivity theory, and secondly to develop an intervention that we
hope will effectively reduce risk for re-arrest in this population. Because the misdemeanor population is also quite
tricky in terms of therapeutic intervention because they may have very high needs. They may have very serious drug
problems. They may have mental illness. They may be traumatized. They may have long rap sheets. Their current charge
will not allow you to put them in a two-year drug treatment program such as a drug court no matter how badly they
may need it. We have to maintain legal proportionality.

The second part of
the Misdemeanor Assessment Project is specifically to develop short-term interventions including evidence-based cognitive
behavioral treatments for this population that we hope will at least advance the ball for them somewhat in terms
of reducing the clinical and social structural factors that cause them to come back into the system so quickly.

POPE-SUSSMAN: Are there specific projects that we’re rolling out?

FRITSCHE:Yes.
The Misdemeanor Assessment Project is a specific project. We’re at a stage now where we have developed a short
screening tool that we feel is feasible for people in criminal courts here in New York City and nationally to try
to get an idea of what the profile of their low-level offender population is in terms of risk and needs. This short
screening tool is currently being used in Cook County, which is essentially Chicago, with a pilot test of a program
they have for misdemeanor offenders who have been diverted from jail from traditional processing, court processing,
and are given some level of treatment. Based on our screening tool, they’re going to make an assessment of whether
to give them a high level of treatment because they’re high risk, or something a little less if they’re
a moderate risk, or basically just refer them to services if they’re low risk. In Cook County, we’re using
this tool as a test of the risk principle, basically.

The same short assessment
tool is being rolled out in New York City, in Brooklyn and Manhattan criminal courts as a part of a larger research
study to re-validate whether the items and domains that we think are predicting re-arrest in this population in New
York City … we’re going to test them again. We tested them once last year and we’re going to test them
again. That’s one product that we have that we’re refining but we’re also giving to the field to use
and test and then at the same time, we’re developing a short-term intervention for misdemeanor offenders that
we’re going to pilot test in the community courts in Manhattan, the Bronx, and Brooklyn over the next six months.

POPE-SUSSMAN: Great. Longer term on the horizon, are there any further plans?

FRITSCHE: Yes. I think it’s sometimes a little hard to see past the next six months
especially for those of us who do research because we’re oftentimes quite reticent to make claims. I think that
there’s definitely a demand on the ground for concrete tools, curriculums, assessment instruments that can help
people move the needle from their default response to a lot of criminal behavior and overloaded criminal dockets–which
is to put people into short-term stays and detention–to having more evidence-based responses to this kind of crime
that have the potential to reduce risk.

I think that it’s a very timely
field not just for practitioners but politically and especially socially here in the United States, that there’s
currently a public debate about whether incarceration is an effective response to crime, especially low-level crime.
I think that our focus on these issues is really going to become … I hope it will become a part of practical solutions
and a part of the national conversation on alternatives to incarceration.

POPE-SUSSMAN:
That’s very exciting. Well, thank you so much for talking to me today. I’m Raphael Pope-Sussman. I’ve
been speaking with Sarah Fritsche, associate director of research at the Center for Court Innovation about risk/need
assessment tools. To learn more about the Center for Court Innovation, please visit www.courtinnovation.org. Thank
you for listening.

FRITSCHE: Thanks.


Babies in the Child Welfare System to Get More Help in the Bronx, Along with Their Families



Dr. Susan Chinitz, a psychologist with specialties in the areas of infant mental health and developmental disabilities
in infancy and early childhood, and a Professor of Clinical Pediatrics at the Albert Einstein College of Medicine,
discusses the new Strong Starts Court Initiative, which will enhance the capacity of Family Court to bring positive
changes to court-involved babies and their families. (April 2015)

The
following is a transcript

SARAH SCHWEIG:
Hi, I’m Sarah Schweig of the Center for Court Innovation and today I’m speaking with Dr. Susan Chinitz,
a psychologist with specialties in the areas of infant mental health and developmental disabilities in infancy and
early childhood. Professor of clinical pediatrics at the Albert Einstein College of

Medicine
here in New York, she has extensive experience in child and infant mental health and recently she teamed up with
the Center for Court Innovation to craft what’s called the Bronx Infant Court, which aims to enhance the capacity
of Family Court to bring positive changes to court-involved babies and their families. Thanks for speaking with me
today and welcome.

SUSAN CHINITZ: Thank
you, Sarah. Thank you.

SCHWEIG: First off, you’re
a psychologist and an expert in infancy studies. What made you start thinking about the justice system and infants?
Can you talk a bit about what drove you to look at how court cases handle infants–cases involving infants or families
with infants.

CHINITZ: I direct a center up at
Einstein, as you said. It’s a therapy program for children under five years of age and many of the children
that we work with, a very large proportion of them are child welfare system involved. Children come to attention
at such a young age when something pretty significant or dramatic has happened to them and, certainly, that’s
the story of young children in the child welfare system. Our clinical population at Einstein has always had a very
robust number of children who have had allegations of neglect or abuse, who are in foster care, or otherwise under
court supervision. I’ve just had lots and lots of day-to-day experience with these children and their birth
parents and their foster parents.

Though the children struggle in their home
environments, which I guess by definition is true when they’re child welfare system involved, it also seemed
that the courts and the foster care agencies could be more protective of these children if they knew more about babies.
Sometimes in the absence of that knowledge, and totally inadvertently of course, the courts or the child welfare
system can inflict more harm on the children. So it seemed very important while we were working with the children
clinically, to also bring expertise to the systems that are making decisions about them every day.

SCHWEIG: Of course Family Court sees children of all ages. Could
you talk a little bit about what makes cases involving infants particularly different or difficult for courts to
handle?

CHINITZ: A lot of things–hard to know
even where to start but I’ll start with the fact that brain development is happening very, very rapidly during
these early stages of development, and we’ve learned through recent developmental neuroscience that children’s
brains’ development is very influenced by the environment and the context in which they live. In fact, in the field
we say that the brain recruits experience into its developing architecture. Children who have been removed from their
parents lose the biggest protection that children have; that bond with a committed and available caregiver. And we
know that that loss of a primary caregiver brings with it all kinds of risks to brain development.

It’s really out of nurture and security and engagement of a committed caregiver that
we see the brain develops. These children are struggling with attachment disruptions. Sometimes they’re struggling
with attachment disorders. If the interaction has been problematic, then they’re subject to exposure to violence
very often, instability in their care-giving as they move from caregiver to caregiver. There are just many, many
things that go on in the life of a young child during the stage of development of critical capacities; mediated by
brain development. It’s also a very important time for the consolidation of a secure attachment, so the whole
process of removing babies and moving them around in care is very detrimental to their development.

SCHWEIG: Maybe you can describe the traditional options available
for the court and dealing with cases involving infants and then how this new project is aiming to fill the gaps.

CHINITZ: Very interestingly, despite the fact that most
children become known to the courts because of abuse or neglect, or exposure to violence, there’s often very
little recommendation for relational parent-infant repair work. The typical interventions available through the courts
have been parenting classes, which means the parents attend a series of lectures about child development. But we’re
not identifying what went wrong in this particular dyad. Was it maternal depression? Was the child just so difficult
to manage that a parent just didn’t have enough support?

We have to really
understand what was the cause of the need to intervene with child welfare system intervention and then try to remediate
that, or even if we can’t remediate all of it, help the parent develop more safe and nurturing parenting skills
and help them learn to be with each other in ways that are healing to the child. We remove children but we don’t
do the critical work to repair what exactly went wrong. We’re trying to do that. We’re trying to evaluate
babies and parents and their relationship through this new project, so that the interventions that are court-mandated
will address the particular problems.

Not every family becomes child welfare
involved for the same reason, yet we’ve had one intervention of parenting classes. We want to tailor the interventions
to much better meet the needs of the babies and the parents. We have to help monitor these babies; there’s a
very high level of developmental delay and disability in children known to the foster care system and the courts
haven’t always known how to perform developmental surveillance, watching children’s development. What systems
are available to remediate that. You have to bring all kinds of expertise to the court in order for the court to
be a therapeutic agent that we think it can be through its authority and its involvement with the kids and families.

SCHWEIG: Wonderful. I hear you saying that we’re moving
towards looking at the individual relationships between the infant and the parent, instead of just a catch-all approach.

CHINITZ: Right, exactly. Even babies have their own parenting
load. There are some easy babies and there are some very, very hard babies. We have to help identify what the baby
brings into the interaction in addition to what the parent does.

SCHWEIG:
Right. Maybe you could talk a little bit about the mechanism that’s being introduced here to Family Court and
how that’s going to work.

CHINITZ: The referrals
are going to, at least at the beginning until we are really up and running and see how this all works, the referrals
are going to come just through the particular judge who’s been selected through her usual intake process. As
she picks up new cases, we will look for the babies under three. In this project we’re going to target children
under three. We’ve been asked by our various stakeholders to work with babies who are in foster care but also
babies who have not been removed from their parents but are under court supervision due to concerns. We will be looking
for children under three whether or not they’re still home with their parents.

Then,
we’re going to have an Infant Court team coordinator. A full-time infant practitioner who’s going to work
in the Family Court in partnership with the judge. So there will then be already in-house expertise full-time on
infant development. This clinician or practitioner will help with the assessments of the babies and the parents,
and I should use this opportunity to say that we have very two generational focus in this project. We’re looking
to help the life trajectory and life outcomes of the parents as well as the children because children will only do
as well as their parents are able to do.

The infant practitioner will help
with the evaluation of the parent and the child and will assist the other people planning on the case; the foster
agency case worker, and others who do some planning in recommending particular interventions that the court and child
welfare system may not be as cognizant of as infant practitioners are. As examples, we have early Head Sart programs
that are very, very rich in child development resources. We have home visiting programs, which we know improve the
life trajectory of vulnerable children, yet we don’t see courts or foster agencies getting children involved
in a early Head Start or involved in home visiting, but an infant practitioner will have a broader array of the knowledge
of what’s out there for babies.

The infant coordinator will help with
assessment. She will help with referrals. Then we hope to have very frequent team conferences about these children
and families that will include the lawyers but will also include the community providers that were working with the
families. We’re hoping to get everybody together on a monthly basis to help monitor progress; particularly,
to help solve problems so that families are really getting what they need to get. There are no barriers to their
getting what they get. That we can keep a close eye on the case and hopefully move a little bit more quickly than
usual towards permanency because we’re really front-loading services and we’re giving a lot of attention
to the cases early on.

We’re hoping, also, to develop a more collaborative
approach and to try to leave some of the adversarial approach behind as everybody puts their heads together to think
about how to better serve babies and their families.

SCHWEIG:
As a last takeaway, what would you hope to see a few years down the line with this project? Would you like to see
it replicated, would you like to see it expanded outside of the Bronx? What’s your vision?

CHINITZ:
Babies are such a large presence in the child welfare system and in the courts. In 2013, which is the last year that
we’ve got numbers for, there was 711 just in the Bronx alone; babies under two, just in the Bronx alone. That’s
a lot of children who are living in very vulnerable situations. Young children remain the largest cohort of kids
who become court-involved every year. Yeah, we’d like to see infant expertise in all of the Family Courts. It’s
a system that does intervene every day in the life of these children and they should be imbued with expertise.

It should be a place where judges have access to the best information they can have
about babies. Yeah, my dream is that we’re in every borough of the city bringing infant expertise to judges
and helping evaluate babies so that they get the right service. Like we said, keeping a close eye on cases, moving
children to permanency as quickly as possible. That’s really important. A child has to have security with at
least one ongoing primary caregiver. We see enormous pain and suffering when children are in limbo. Year after year
if they start to have behavior problems, they can’t catch up with their learning problems, we need to bring
permanency and security.

Those things; bringing expertise, so decisions are
good decisions. Bringing resources to these families as soon as the case becomes identified, so the court can be
an agent in positive change and resolving the permanency as early as possible.

SCHWEIG:
Wonderful. Well, thanks so much for speaking with me today.

CHINITZ:
Thank you.

SCHWEIG: I’m Sarah Schweig of the Center for Court
Innovation, and I’ve been speaking with Dr. Susan Chinitz about the complexities of infancy and infants who
become involved in family court cases. To learn more about the Bronx Infant Court or the Center for Court Innovation,
visit www.courtinnovation.org. Thanks for listening.