Title: Douglas B. Marlowe, J.D., Ph.D.
1Targeting Dispositions by Risks Needs
- Douglas B. Marlowe, J.D., Ph.D.
-
Treatment Research Institute at the University of
Pennsylvania
2Dispositions for Drug Offenders
Psychosocial Functioning
Costs
Public Safety Risks
Diversion (ARD)
Incarceration
Drug / DWI Courts
Probation w/o verdict
Intermediate sanctions
3Prognostic 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
4Criminogenic Needs
- Substance Dependence or Addiction
5Criminogenic Needs
- Substance Dependence or Addiction
- Binge pattern
- Cravings or compulsions
- Withdrawal symptoms
-
6Criminogenic Needs
Abstinence is a distal goal
- Substance Dependence or Addiction
- Binge pattern
- Cravings or compulsions
- Withdrawal symptoms
-
7Criminogenic Needs
Abstinence is a distal goal
- Substance Dependence or Addiction
- Binge pattern
- Cravings or compulsions
- Withdrawal symptoms
- Substance Abuse
-
8Criminogenic Needs
Abstinence is a distal goal
- Substance Dependence or Addiction
- Binge pattern
- Cravings or compulsions
- Withdrawal symptoms
- Substance Abuse
-
- Abstinence is a proximal goal
9Criminogenic 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
10Criminogenic 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
11Risk Needs Matrix
High Risk
Low Risk
High Needs
Low Needs
12Risk Needs Matrix
High Risk
Low Risk
Accountability, Treatment Habilitation
High Needs
Low Needs
13Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Low Needs
14Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Accountability Habilitation
Low Needs
15Risk Needs Matrix
High Risk
Low Risk
Treatment Habilitation
Accountability, Treatment Habilitation
High Needs
Prevention
Accountability Habilitation
Low Needs
16Practice 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
17Dispositions 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