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Douglas B. Marlowe, J.D., Ph.D.

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Targeting Dispositions by Risks & Needs Douglas B. Marlowe, J.D., Ph.D. Treatment Research Institute at the University of Pennsylvania TRI science – PowerPoint PPT presentation

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Title: Douglas B. Marlowe, J.D., Ph.D.


1
Targeting Dispositions by Risks Needs
  • Douglas B. Marlowe, J.D., Ph.D.

Treatment Research Institute at the University of
Pennsylvania
2
Dispositions for Drug Offenders
Psychosocial Functioning

Costs
Public Safety Risks
Diversion (ARD)
Incarceration
Drug / DWI Courts
Probation w/o verdict
Intermediate sanctions
3
Prognostic Risks
  • Current age lt 25 years
  • Delinquent onset lt 16 years
  • Substance abuse onset lt 14 years
  • Prior rehabilitation failures
  • History of violence
  • Antisocial Personality Disorder
  • Psychopathy
  • Familial history of crime or addiction
  • Criminal or substance abuse associations

4
Criminogenic Needs
  • Substance Dependence or Addiction

5
Criminogenic Needs
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms

6
Criminogenic Needs
Abstinence is a distal goal
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms

7
Criminogenic Needs
Abstinence is a distal goal
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms
  • Substance Abuse

8
Criminogenic Needs
Abstinence is a distal goal
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms
  • Substance Abuse
  • Abstinence is a proximal goal

9
Criminogenic Needs
Abstinence is a distal goal
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms
  • Substance Abuse
  • Collateral needs
  • Dual diagnosis
  • Chronic medical condition (e.g., HIV, HCV,
    diabetes)
  • Homelessness, chronic unemployment
  • Abstinence is a proximal goal

10
Criminogenic Needs
Abstinence is a distal goal
  • Substance Dependence or Addiction
  • Binge pattern
  • Cravings or compulsions
  • Withdrawal symptoms
  • Substance Abuse
  • Collateral needs
  • Dual diagnosis
  • Chronic medical condition (e.g., HIV, HCV,
    diabetes)
  • Homelessness, chronic unemployment
  • Abstinence is a proximal goal

Regimen compliance is proximal

11
Risk Needs Matrix
High Risk
Low Risk
High Needs
Low Needs
12
Risk Needs Matrix
High Risk
Low Risk
Accountability, Treatment Habilitation
High Needs
Low Needs
13
Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Low Needs
14
Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Accountability Habilitation
Low Needs
15
Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Prevention
Accountability Habilitation
Low Needs
16
Practice Implications
High Risk
Low Risk
  • Noncompliance hearings
  • Treatment habilitation
  • Treatment is proximal
  • Positive reinforcement
  • Agonist medication
  • Status hearings
  • Treatment habilitation
  • Compliance is proximal
  • Restrictive consequences
  • Positive reinforcement
  • Agonist medication

High Needs
  • Secondary prevention
  • Abstinence is proximal
  • No AA or MET
  • Individual counseling
  • or stratified groups
  • v.o.p. / status calendar
  • Abstinence is proximal
  • Psychosocial habilitation
  • Restrictive consequences
  • No AA or MET
  • Antagonist medication

Low Needs
17
Dispositions for Drug Offenders

Risk of Dangerousness
High risk High needs
Low risk Low needs
High risk Low needs
Low risk High needs
Diversion (ARD)
Incarceration
Drug / DWI Courts
Probation w/o verdict
Intermediate sanctions
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