Dear Colleague: For this month, the NEARI Press newsletter article looks at the research behind the dosage of treatment. This study explores the ques

   
NEARI Press Masthead with Photos

Dear Colleague:
For this month, the NEARI Press newsletter article looks at the research behind the dosage of treatment. This study explores the question of how much more treatment services or supervision to provide, especially to higher risk clients. The research seems to indicate that providing high dosage of treatment (200 hours) to higher risk offenders shows substantial reductions in recidivism. That said, this research also suggests that when clinicians make these decisions based on thoughtful and individualized assessments, we may enhance both safety and treatment success.

As always, if you have any other questions or suggestions for future newsletter topics, please don't hesitate to contact us.

Sincerely, Joan Tabachnick and Steven Bengis

***

What Is the Right Amount of Treatment for the Level of Risk?

by Steven Bengis, David S. Prescott, and Joan Tabachnick

The Question
How much treatment is enough to have a significant impact?

The Research
Kimberly Sperber, Edward Latessa, and Matthew Makarios examined the impact of treatment dosage (measured by the number of hours in treatment) on recidivism at different risk levels. Although the study examined 689 adult male offenders, the findings suggest that further exploration of the risk principle for those working with youth as a key characteristic of effective programs is important. The risk principle holds that the amount of services provided should be commensurate with the amount of risk posed. In other words, high-risk clients require high-intensity interventions.

Until recently, there were few studies that would provide individual clinicians, residential programs, or correctional facilities with the practical guidance to decide on the treatment dosage. This study explores the question of how much more treatment services or supervision to provide, especially to higher risk clients.

One previous meta-analysis of 200 studies on juvenile (mostly non-sexual) offenders found that treatment programs that lasted for a minimum of six months (100 hours of programming) demonstrated significant reductions in recidivism (Lipsey, 1999). These findings held for both institutional and non-institutional programs. Sperber et al.’s study showed a 38% reduction in recidivism for high-risk cases receiving 200 or more hours of treatment. The study also found a 13% reduction in recidivism for low risk cases when dosage increased from minimal (less than 100 hours) to moderate (100-200 hours) of treatment.

Overall, the study suggests a relationship between treatment dosage and risk level. The most efficient use of resources lies in providing more treatment services to those who truly pose the highest risk. Although this study examined adult offenders, it demonstrates the need for further research with adolescents to provide the same practical guidance needed for the field.

Bottom Line: Providing high dosage of treatment (200 hours) to higher risk adult offenders shows substantial reductions in recidivism.

Implications for Professionals
This research provides some benchmarks for clinicians to consider when making treatment dosage decisions. However, as our understanding of risk in adolescents expands into individualized approaches that are both contextual and developmental, this research raises questions of dosage as well as the identifying the correct treatment needs to focus on. With a “more is better” guideline for higher risk clients and “less is more” with lower risk clients, the additional work is individualizing the treatment plan to address the safety and treatment needs for the best outcomes.

Implications for the Field
Practical information about dosage is a valuable step in research that helps ground our work with adolescents in research-based practice. Future research will focus on accurate identification of risk management strategies, individualized research-based treatment approaches, and cost efficient use of limited intervention resources. With this research we start to answer key questions such as: How much, for whom, with what methodologies, with what fidelity to implementation of research-based approaches will replicate positive outcomes? That said, this research suggests that when we make these decisions based on thoughtful and individualized assessments, we may enhance both safety and treatment success.

Abstract
The risk principle suggests that effective correctional interventions should vary the intensity of treatment by offender risk, with higher risk offenders receiving more intense services than lower risk offenders. Although much research indicates that programs that target higher risk cases are more likely to be effective, relatively little research has examined the impact of varying levels of treatment dosage by risk. Consequently, this study seeks to identify the number of hours of treatment that are necessary to reduce recidivism in a sample of offenders placed in a residential community corrections facility. The sample for this study includes 689 adult male offenders successfully discharged from a Community-Based Correctional Facility in Ohio. The results provide support for providing higher levels of dosage to high-risk offenders, with substantial reductions in recidivism for high-risk offenders receiving 200 or more hours of treatment.

Citation
Sperber, K.G., Latessa, E.J., & Makarios, M.D. (2013). Examining the interaction between level of risk and dosage of treatment. Criminal Justice and Behavior. Vol. 40, No. 3. 338-348.

To print a pdf of this article, click NEARI NEWS.

***

BECOME A WEBINAR SERIES SPONSOR

Neari 2014 Catalog thumb

NEW 2014-2015 Catalog

Please consider becoming a sponsor of NEARIPress.org's exciting new 2015-2016 NEARI Press Webinar series. We will continue to feature nationally recognized authors including, but not limited to: Cordelia Anderson, David Prescott, Jane Silovsky, and Jill Stinson, among many others.

For $98 as an individual or $250 as an organization, we will guarantee your seat in the webinar AND offer you CE credits. We do all of the work to sign you up each month, and, as a thank you for your essential support, we offer you two free NEARI Press books - Current Perspectives and Current Applications, both edited by David Prescott and Robert Longo. We think that this is really a win-win situation for all of us.

For more information or to sign up, visit our website at info@nearipress.org or contact Diane Langelier at 413.540.0712 x14 or email her at info@nearipress.org.

***

FEATURED NEARI RESOURCES

assessingyouth

Assessing Youth Who Have Sexually Abused: A Primer

by David S. Prescott

Assessing Youth introduces program and clinical staff to the goals and principles, techniques and instruments, and accomplishments and pitfalls of assessing young people who have sexually abused. This primer provides an overview of many of the instruments currently in use for assessing youth and addresses areas of risk that can serve as treatment goals. It further provides considerations for the developmental needs of youth, brief suggestions for interviewing, and links to new resources. Assessing Youth is the most user-friendly primer on adolescent assessment available.

ISBN: 978-1-929657-27-8
Cost: $23 plus shipping and handling

Upcoming Training with Dr. Phil Rich: Assessment of Juvenile Sexual Risk: 3-Day Certification

Presented by: Phil Rich, Ed.D, LICSW
Date: June 2-4, 2015
Location: Marlboro, Massachusetts

This three-day course will provide instruction and practice experience in administration of sexual risk assessment for juveniles who have previously engaged in sexually abusive behavior. The course will cover the process of risk assessment, from theory, method, and instrumentation to case study and applied practice, including case formulation.

CE credits: 3 days of CE credits are available for Social Workers and Psychologists through a competency-based process.

For a downloadable flyer, click here.

For more information or to sign up, please contact Diane Langelier at 413.540.0712 x14 or at info@nearipress.org.

***

DONATE NOW TO NEARI PRESS

NEARI Press is a nonprofit and depends upon the support of professionals like you to continue our work. Please consider giving a donation to NEARI Press.

Click here to make a donation of any amount. Thank you!

***

QUESTIONS/FEEDBACK

Please email us at info@nearipress.org or call us at 413.540.0712, x14 to let us know if you have a question or a topic you would like us to cover.

If at any time you no longer want the e-newsletter, just let us know and we will remove your name from our list. We value your trust. We will not sell or give your contact information to any other organization.

Volume 8, Issue 5: May 2015

1px