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Building a bridge between assessment and practice: Risk assessment tool and RNR principles adherence in probation case plans

Although the LS/CMI was found to be a valid tool for appraising recidivism risk in community-supervised adult male and female offenders, in order to translate risk appraisal tools into the real world case plans application, probation officers require a quality field training with the application of RNR principles. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2018, Vol. 42, No. 3, 258–268

Real-World Use of the Risk–Need–Responsivity Model and the Level of Service/Case Management Inventory With Community-Supervised Offenders

Authors

Heather L. Dyck, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada and University of New Brunswick—Fredericton
Mary Ann Campbell, University of New Brunswick—Saint John
Julie L. Wershler, University of New Brunswick—Fredericton

Abstract

The risk–need–responsivity model (RNR; Bonta & Andrews, 2017) has become a leading approach for effective offender case management, but field tests of this model are still required. The present study first assessed the predictive validity of the RNR-informed Level of Service/Case Management Inventory (LS/CMI; Andrews, Bonta, & Wormith, 2004) with a sample of Atlantic Canadian male and female community-supervised provincial offenders (N = 136). Next, the case management plans prepared from these LS/CMI results were analyzed for adherence to the principles of risk, need, and responsivity. As expected, the LS/CMI was a strong predictor of general recidivism for both males (area under the curve = .75, 95% confidence interval [.66, .85]), and especially females (area under the curve = .94, 95% confidence interval [.84, 1.00]), over an average 3.42-year follow-up period. The LS/CMI was predictive of time to recidivism, with lower risk cases taking longer to reoffend than higher risk cases. Despite the robust predictive validity of the LS/CMI, case management plans developed by probation officers generally reflected poor adherence to the RNR principles. These findings highlight the need for better training on how to transfer risk appraisal information from valid risk tools to case plans to better meet the best-practice principles of risk, need, and responsivity for criminal behavior risk reduction.

Keywords

risk-need-responsivity model, case management, Level of Service/Case Management Inventory, best practices

Summary of the Research

“The risk–need–responsivity (RNR) model provides guidance for effective offender risk assessment and case management. This model reflects an integrated theory of criminal behavior drawn from personality, cognitive, and social learning approaches and contains three foundational principles: the risk, need, and responsivity principles. The risk principle states that supervision and intervention intensity should match the individual’s recidivism risk (more intensive services for high-risk offenders). The need principle calls for the identification, and targeted intervention, of criminogenic needs (e.g., procriminal thinking, substance use, family problems) driving the criminal behavior. The responsivity principle outlines guidelines for how to provide intervention services; namely by means of cognitive-behavioral skill building techniques rooted in social learning theory that are individualized to match the offender’s characteristics (e.g., age, ethnicity, learning style, motivation).” (p. 258)

“Generally, correctional programs and case plans that more strongly adhere to the RNR model show decreased levels of recidivism in males and females, youth and minority offenders, and in community and custodial settings with recidivism reductions of 10–50%. Stronger adherence to the RNR model is associated with decreases in substance abuse relapses and a variety of criminal behaviors, including nonviolent, violent, gang-related, and sexual offenses. […] Research has demonstrated that the RNR model is cost effective when compared to traditional sanctions for criminal behavior, with a $2 cost for each 1% decrease in recidivism compared with $40 for each 1% decrease when using sanctions. These results indicate that correctional services that implement a RNR model framework can significantly reduce recidivism without a significant increase in cost.” (p. 259)

“A key aspect of the RNR model and evidence-based case management is the use of risk assessment measures. Using a risk assessment instrument to inform decision-making increases the agreement in case management plans across probation officers. Contemporary risk tools are advancing into a framework that integrates the risk appraisal process with case management planning and progress assessments until discharge. The Level of Service/Case Management Inventory (LS/CMI) is one instrument that aligns with this integrative case management process. The LS/CMI is designed to assist professionals in justice, forensic, correctional and crime prevention agencies with the management, supervision, and case planning of offenders over the age of 16 years. The LS/CMI was developed as an extension of the Level of Service Inventory– Revised (LSI-R). […] The LS/CMI has demonstrated moderate to high predictive validity for general recidivism with male and female offenders in both incarcerated and community-based settings, and is moderately predictive of violence.” (p. 259)

“Despite the importance of evidence-based assessment for informing how best to reduce recidivism risk, risk assessment is not without its criticisms. Some scholars have noted the inherent challenges with holding someone accountable for something they “might” do in the future, for the failure of group data to apply to individuals and the risk of harm of such approaches to marginalized groups, for the failure of group data to apply to individuals and the risk of harm of such approaches to marginalized groups, and greater need for culturally informed risk assessment. Thus, the value of risk assessment must be contextualized within these concerns.” (p. 259)

“Real-world use of risk instruments and their integration into case planning is often less than ideal. […] Challenges with RNR adherence may depend on the quality of the risk assessment tool used to inform the case plan. […] Given that the RNR model was foundational to the practices of the community supervision agency assessed in the current study, we took the opportunity to examine the degree of RNR adherence in their case management plans. These plans were informed, as per policy, by completion of the LS/CMI. Thus, consistent with past research, we expected the LS/CMI to have strong predictive validity for general recidivism for males and females. Furthermore, in accordance with the RNR model, we predicted that high-risk cases would receive higher intensity intervention and support services (e.g., more sessions, longer duration) than lower risk offenders. For all offenders, regardless of risk level, it was predicted that offenders with LS/CMI identified criminogenic needs would be referred to services that appropriately targeted these needs. Finally, it was predicted that the intervention services to which offenders were referred would follow the responsivity principle— use of effective intervention strategies for offenders (e.g., cognitive–behavioral strategies) and tailored delivery to the client’s strengths and weaknesses (e.g., motivation level, cognitive ability).” (p. 259–260)

“Data were drawn from case files generated between 2007 and 2012 by a provincial community correctional service in Atlantic Canada. Cases were randomly selected for inclusion, resulting in a sample of 136 offenders (101 male, 35 female; M age = 30.0 years, SD = 9.86; age range 18.05 – 70.07 years). Most (80.1%) were sentenced to probation, 9.6% were serving a conditional sentence, 2.2% were on house arrest, and 8.1% were on a combination of community supervision types. Thirty-one percent had a preindex history of criminal behavior. The sample was primarily Caucasian (93.4%), with the remaining 6.6% comprised of African Canadian, Asian, and Indigenous persons. A majority (78.7%) completed high school and/or had more advanced training/education.[…] The total sample available for pre–post comparisons in LS/CMI scores was 78 [cases].” (p. 260)

Materials included Level of Service/Case Management Inventory (LS/CMI), Adherence to the risk–need–responsivity (RNR) model (higher intensity treatment for higher risk individuals, primary treatment goals were related to identified criminogenic needs, case plan was tailored to individual’s strengths and limitations and when evidence-based interventions were used), and Index offense and recidivism data.

“Consistent with past research, the LS/CMI was a valid predictor of general recidivism for both male and female offenders in the current study. As expected, LS/CMI-identified high-risk cases reoffended at a significantly faster and higher rate than low-risk cases. Thus, the LS/CMI is useful for appraising recidivism risk in community supervised adult offenders. […] LS/CMI total scores did not significantly change from intake to the time of reassessment for the subgroup of cases for which such data were available. Reassessment cases did not differ from clients without reassessment on age, gender or LS/CMI intake risk scores. Nevertheless, being reassessed for risk was associated with a lower risk of general recidivism (52.6%) relative to clients only assessed at intake (67.2%). Thus, although risk scores did not change, the rate of reoffending may have been impacted by the reassessment. Although causation cannot be inferred, reassessment offers the opportunity to adjust case plans to mitigate the real-world expression of the identified risk (i.e., better risk management).” (p. 264)

“Despite use of a valid risk assessment instrument, the present study’s data did reflect challenges with the transfer of assessment information into RNR-informed case management planning. Notably, only 44.1% of reviewed plans met the risk principle and only 59.6% met the need principle. Other studies also identify problems with the translation of risk assessment information into RNR-informed case plans. Collectively, these results highlight the need to provide better training to facilitate the integration of these two processes. When stronger adherence to the RNR model was achieved, the rate of general recidivism was lower in the current study, as has been found by others. Adhering to both the risk and need principles in the current sample was associated with a 26.5% rate of reoffending, whereas this rate was 60.6% when neither of these two core principles were met. However, it was the lower risk case files that received the strongest RNR adherence ratings, which may bias interpretation of these differential recidivism outcomes.” (p. 265)

“For need principle adherence, there was little indication of overintervening with low-risk offenders. The exceptions were in the criminogenic need domains of employment/education and family/marital issues where interventions tended to be provided despite being assessed as low need areas. Probation officers may have viewed these areas as strengths to build on, but this is not clear from the current data. The importance of incorporating assessment of individual strengths or protective factors into risk assessment and case planning is increasingly being recognized and advocated for in the RNR model. Although some probation officers may have considered protective factors, it was not clearly documented. In addition, the way in which individual strengths were incorporated into case plans was likely inconsistent across probation officers without a structured protocol to inform which factors to consider and how to integrate them into the case plan.” (p. 265)

“In line with RNR recommended practice, high risk offenders in the current study were referred to a significantly greater number of services than low-risk offenders.[…] It is the quality of these services that matter more to risk/need adherence than the quantity of services per se. […] We found that high-risk cases were less likely to have their criminogenic needs targeted for intervention relative to low-risk cases. It may be that probation officers had difficulty teasing apart criminogenic and noncriminogenic interventions when working with higher risk cases, and the criminogenic focused interventions may not have been prioritized appropriately. Understanding of the process of intervention and how to target criminogenic needs in supervision meetings is a new responsibility for probation officers.” (p. 265)

“The responsivity principle is the most understudied component of the three main principles of the RNR approach, but is generally viewed as a valuable component. Unfortunately, the responsivity principle could not be meaningfully examined in the present study due to the condition of the case files. Limited information relating to the responsivity principle is consistent with previous community research.” (p. 265)

“The present study provides additional evidence for the use of the LS/CMI in community-supervision environments, especially in Atlantic Canadian populations. Furthermore, it highlights the difficulty with real-world application of the RNR model. The present study also provides evidence of challenges probation officers may experience when asked to alter their roles from a focus on supervision to a therapeutic/intervention focus. Field training with ongoing mentorship and fidelity checks is essential for ensuring appropriate implementation of the RNR model.” (p. 266)

Translating Research into Practice

“Transitioning from a role in which supervision of offenders was the primary task into one that balances supervision and intervention, as advocated by the RNR model, is one that takes time for employees to achieve.” (p. 265)

“Changes in probation officers’ approach to intervention are expected to be gradual as they adapt to a new system of practice. It is through the integration of the assessment and rehabilitation processes that the strongest outcome results are obtained. […] Quality field training with the application of the RNR model is essential and should include educational workshops about the model, why adherence to it matters for risk reduction and enhanced client outcomes, and intervention skill learning (e.g., cognitive restructuring, motivational interviewing). Over time, individual mentorship, booster sessions and skill upgrading will be key as the field of evolves. The Strategic Training Initiative in Community Corrections model is an example of this type of training, with effective results for reducing criminal risk in the clients supervised by probation officers trained in this manner relative to clients supervised by untrained probation officers. Further evaluation of such training models is needed.” (p. 265–266)

Other Interesting Tidbits for Researchers and Clinicians

“A major strength of the present study was its use of offender case files that reflect the real-time practices and implementation of the RNR framework. However, using data gathered from records maintained by professionals without a focus on research has its limitations. First, although Section 1 of the LS/CMI had strong predictive validity for general recidivism events and time to first recidivism, the majority of files did not have the other LS/CMI sections completed despite being intended to inform case management and supervision practices. […] Furthermore, many files did not have a follow-up LS/CMI completed or any information on the program(s) the offender was referred to (e.g., intervention orientation, main intervention goals). […] Examining RNR adherence with a larger sample size may reveal greater nuances in practices and limitations, including the value of reassessment. Another limitation of the current study was the limited information available for the offender rehabilitation programs. […] Finally, it should be acknowledged that the sample used in the current study was modest relative to other risk prediction studies using the LS/CMI which tend to exceed 500+ cases for analyses, often into the thousands. Although our smaller sample may influence the generalizability and reliability of the current findings, our risk prediction and RNR adherence results are fairly consistent with the broader research literature on the LS/CMI and RNR adherence use in the field.” (p. 266)

“Future research should focus on the integrity of implementing the RNR principles in real world case management as these principles, and more widely the RNR model, become foundational for more organizations. The most fruitful research may come in the form of full prospective program evaluations during times of organizational transition and policy changes.” (p. 266)

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Authored by Kseniya Katsman

Kseniya Katsman is a Master’s student in Forensic Psychology program at John Jay College of Criminal Justice. Her interests include forensic application of dialectical behavior therapy, cultural competence in forensic assessment, and risk assessment, specifically suicide risk. She plans to continue her education and pursue a doctoral degree in clinical psychology.

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Structured Decision-Making Improves Quality of Offender Supervision

Forensic Training AcademyThe quality of case management plans for supervised offenders is better when risk/needs assessments and structured decision-making tools are utilized. This is the bottom line of a recently published article in Psychology, Public Policy, and Law. Below is a summary of the research and findings as well as a translation of this research into practice.

 

Psychology, Public Policy and LawFeatured Article | Psychology, Public Policy, and Law | 2016, Vol. 22, No. 2, 221-233

 

Finding the Right Focus: Improving the Link Between Risk/Needs Assessment and Case Management in Probation

 

Authors

Jacqueline Bosker, University of Applied Sciences Utrecht

Cilia Witteman, Radbound University Nijmegen

 

Abstract

In this article, the authors report a study into the Dutch probation service about the question whether structured decision making about case management plans does or does not improve the quality of these plans, and subsequently improves the effectiveness of offender supervision. Two samples of nearly 300 case management plans each were compared. In the first sample a tool for risk/needs assessment was used to assess the risks and needs but decision making about the subsequent case management plan was not structured (RISc2-sample). In the second sample professionals used the same tool for risk and needs assessment but now it also contained a section for structured decision making about the case management plan (RISc3-sample). Results showed that in the RISc3-sample the quality of the plans was significantly better than in the RISc2-sample: a better match between criminogenic needs and goals, a better match between goals of the offender and goals in the plan, more focus on strengthening social bonds, and a better match between risk of recidivism and intensity of the plan. Some significant correlations between the quality of the plans and the effectiveness of offender supervision were found, indicating that improving case management plans by structured decision support indeed can contribute to probation practice.

Keywords

Structured decision-making, risk/needs assessment, case management, probation, task separation

Summary of the Research

“Correctional professionals such as probation officers support offenders to desist from crime and become prosocial members of society. There is a growing body of empirical evidence that helps probation officers to perform that task. Research about what works in reducing recidivism has led to some stable and usable insights for correctional practice. Andrews and Bonta transformed this knowledge into a working model for correctional practice that contains a number of principles for effective practice, the Risk–Need–Responsivity (RNR) model. According to the needs principle treatment services should focus on dynamic risk factors (criminogenic needs) that are associated with recidivism. In several studies significant correlations have been found between the number of criminogenic needs targeted during case management and recidivism” (p. 221).

“Often, a probation officers’ first step in working with an offender is to develop a case management plan that describes the desired change and the actions to realize that change, formulated in goals and interventions such as behavioral treatment or practical support. The last decennia it has become generally accepted that instruments for risk and needs assessment should be used for decision making about these plans. Such instruments contain a checklist of risk factors (and in some instruments protective factors) for criminal behavior, meant to help correctional practitioners assess the risk of recidivism and the criminogenic needs” (p. 222).

“The Dutch probation service uses an instrument for structured risk and needs assessment called the Recidive Inschattings Schalen (Recidivism Assessment Scales, RISc), that has been developed from a third generation into a fourth-generation risk/needs assessment… RISc contains the following 12 criminogenic needs: (a) offending history, (b) current offense, (c) accommodation, (d) education and employment, (e) income and financial management, (f) relationships with partner, family, and relatives, (g) relationships with friends and acquaintances, (h) drug abuse, (i) alcohol abuse, (j) emotional well-being, (k) thinking and behavior, and (l) attitudes” (p. 223).

“After the completion of the risk and needs assessment, probation officers formulate case management plans that are the basis for a presentence report or offender supervision…RISc2 contained a section where probation officers could describe their decisions about the various domains, without being supported by the instrument. In RISc3 the decision about the case management plan has been divided into several process steps that probation officers must pass successively using a computer-based decision support tool. In the first step, the risk and needs profile is shown on screen. Probation officers then describe and prioritize the criminogenic needs that should change. When probation officers decide not to take action on a criminogenic need that was assessed to be present, they are asked to explain their decision. Next, for each criminogenic need that was given a high, medium, or low priority, the instrument makes a digital page where the goals that should be achieved and the interventions planned to realize these goals are described. The instrument gives suggestions for interventions when offenders meet the inclusion criteria. Suggestions that are overruled should be explained. Because in some cases several suggestions are given by the tool, overruling some of the suggestions may be necessary. Third, the sanction and special conditions are described, and if thought necessary it can be decided to put in specific control measures such as electronic monitoring. In the fourth step, the instrument gives a suggestion about the intensity of the supervision, based on the assessed risks of recidivism and harm, the risk of noncompliance, and the necessity for extra guidance by the supervising officer. Again, the probation officer decides about the level of intensity. Finally, an overview of the case management plan is presented” (p.223).

The Present Study

The current study examined the quality of structured decision reports on the effectiveness of offender supervision by comparing case management plans based on the RISc2 and RISc3. Two random samples of 300 cases per instrument were generated using files of offenders who were under probationer supervision and had a case management plan based on a risk needs assessment.

“The samples were taken from two cohorts of supervisions in the context of a suspended prison sentence in the Netherlands. The cases had to have an actual and complete risk assessment including a case management plan that was made between 180 days before and 90 days after the start of the supervision, and therefore could be considered an assessment that represents the offenders’ situation at the start of the supervision” (p. 224).

Results

“To assess if case management plans in the RISc3 sample were of higher quality than case management plans in the RISc2 sample, five quality criteria were formulated based on research about effective practice and desistance from crime. We found that the quality of the case management plans was better when probation officers used RISc3. The quality of the plans improved significantly for four of the five quality criteria used in this study: the match between the criminogenic needs and the goals, the match between the goals of the offender and the goals in the plan, the focus on strengthening social bonds, and the match between the risk of recidivism and the intensity of the plan. No significant

improvement was found for the match between the criminogenic

needs and interventions in the plan.  In the RISc2-sample, case management plans had a strong focus on tackling needs regarding cognitive skills and addiction. When friends, education/work, finance, and accommodation were assessed as a criminogenic need, often no goals or interventions were formulated in the plans to meet these needs. The case management plans based on RISc3 were more balanced and targeted both needs regarding individual capital (skills, attitude, addiction), social capital (relationships, work) and basic needs (accommodation, finance)” (p. 229).

Translating Research into Practice

“The findings support the use of fourth-generation risk and needs assessment tools. Such tools include a section for decision making about case management plans in order to improve the match between the assessed risks, criminogenic needs and responsivity, and the goals and interventions in the plan. Several

studies showed that in probation practice this link often is unsatisfactory, whereas a good link between risk/needs assessment and case management can contribute to the reduction of recidivism. Based on the results in this study, we think that especially formulating the targets for change per criminogenic need, as is done in RISc3, improved the quality of the case management plans and resulted in plans that are more complete and have a better match to the assessed needs” (p. 229). However, not all probation officers are receptive to the additional work structured decision-making entails.

“Second, the findings of this study underline the relevance of including the offender in the decision making about case management plans. Including offenders’ goals in the plan was found to be positively correlated to goal attainment” (p. 229).

Other Interesting Tidbits for Researchers and Clinicians

“There is hardly any evidence to show which criminogenic needs should be given priority in which case. More research on this question is needed and can help probation officers improve decision making on this matter” (p. 231).

“More research about the contribution of the quality of the case management plans to the effectiveness of offender supervision is relevant for probation practice, and may help correctional practitioners in their decision making about case management plans. The data in this study were not suitable to go into that question sufficiently. Additional research about this topic should incorporate several measures of effectiveness, such as goal attainment and recidivism, and differences in characteristics of the offender and of the probation officer should be taken into account” (p. 231).

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Authored by Sarah Hartigan

Sara Hartigan is a second year Forensic Psychology Master’s student at John Jay and hope to obtain a Ph.D. in Clinical Forensic Psychology in the future. My main areas of interest include clinical evaluations and developing treatment interventions within the forensic population.

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Mental Health Courts adhering to the Risk-Need-Responsivity Model lower recidivism risk

Forensic-Training-AcademyThe Risk-Need-Responsivity model may be an effective case management approach for MHCs to assist with decision-making regarding admission, supervision intensity, and intervention targets. Interventions in mental health court contexts should attend to both criminogenic and mental health needs. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2015, Vol. 39, No. 5, 489-502lhb

Multidimensional Evaluation of a Mental Health Court: Adherence to the Risk-Need-Responsivity Model

Author

Mary Ann Campbell and Donaldo D. Canales University of New Brunswick-Saint John and Centre for Criminal Justice Studies, Saint John, New Brunswick, Canada
Angela E. Totten Saint John Police Force and Centre for Criminal Justice Studies, Saint John, New Brunswick, Canada
Ran Wei University of British Columbia–Okanagan
Alex C. Macaulay and Julie L. Wershler University of New Brunswick-Saint John and Centre for Criminal Justice Studies, Saint John, New Brunswick, Canada

Abstract

The current study examined the impact of a mental health court (MHC) on mental health recovery, criminogenic needs, and recidivism in a sample of 196 community-based offenders with mental illness. Using a pre–post design, mental health recovery and criminogenic needs were assessed at the time of MHC referral and discharge. File records were reviewed to score the Level of Service/Risk-Need- Responsivity instrument to capture criminogenic needs, and a coding guide was used to extract mental health recovery information at each time point. Only mental health recovery data were available at 12 months post-MHC involvement. Recidivism (i.e., charges) was recorded from police records over an average follow-up period of 40.67 months post-MHC discharge. Case management adherence to the Risk-Need-Responsivity (RNR) model of offender case management was also examined. Small but significant improvements were found for criminogenic needs and some indicators of mental health recovery for MHC completers relative to participants who were prematurely discharged or referred but not admitted to the program. MHC completers had a similar rate of general recidivism (28.6%) to cases not admitted to MHC and managed by the traditional criminal justice system (32.6%). However, MHC case plans only moderately adhered to the RNR model. Implications of these results suggest that the RNR model may be an effective case management approach for MHCs to assist with decision-making regarding admission, supervision intensity, and intervention targets, and that interventions in MHC contexts should attend to both criminogenic and mental health needs.

Keywords

case management, mental health court, mental health recovery, offenders with mental illness, Risk-Need-Responsivity (RNR) model

Summary of the Research

“Mental health courts (MHCs) are diversionary programs that redirect offenders with mental illness away from the criminal justice system and into the mental health system. Although studies have demonstrated the positive impact of MHCs on mental health and recidivism outcomes, a limitation of MHCs is that none have made use of a theoretically and empirically based risk assessment instrument to aid in case management and treatment planning, nor do they draw from models of effective correctional rehabilitation. The goal of the current study was to evaluate a Canadian MHC, the Saint John MHC, within the context of a well- validated correctional case management strategy known as the Risk-Need-Responsivity (RNR) model” (p. 489).

Mental Health Courts (MHC)

“MHCs are problem solving– oriented courts designed to reduce recidivism and meet the mental health needs of persons with mental illness who come into contact with the criminal justice system. These courts attempt to balance the legal responsibility of protecting the public with meeting the mental health needs of the accused by integrating mental health and social service interventions into the court’s operations. Although there is no prototypical model of MHCs, they have common features. MHCs use a team approach, often composed of at least legal, mental health, and public safety professionals. Cases appear on a separate docket from traditional court, and legal and treatment-oriented sanctions are imposed for noncompliance. Participation is usually voluntary, and the participant must accept responsibility for their behavior, though not necessarily in the form of a guilty plea. Completion of a MHC program usually results in a reduction or dismissal of the index criminal charges that led to the MHC referral. MHC participants have described their MHC experience in positive terms and perceive meaningful differences from traditional court environments, which tend to be more adversarial in nature” (p. 490).

“With regard to mental health recovery outcomes, MHC evaluations have generally produced positive findings. Studies have linked participation in MHCs with increased access to mental health services, enhanced capacity for independent functioning, reduced substance use, and improved mental health outcomes in its participants” (p. 490).

The Risk-Need-Responsivity (RNR) Model

“The RNR model is comprised of the three principles of risk, need, and responsivity. The risk principle states that intensive case management and intervention services should be reserved for high-risk offenders, whereas low risk offenders only require minimal services. The need principle states that to reduce recidivism risk, treatment should target criminogenic needs (i.e., risk and need factors that have an empirically demonstrated association with criminal behavior). The “Central 8” risk/need factors include a history of antisocial behavior, procriminal attitudes, antisocial peers/limited prosocial peers, antisocial personality, lack of prosocial leisure activities, lack of education/employment, family/marital problems, and substance abuse. The responsivity principle states that treatments based on cognitive- social learning methods are the most effective at reducing criminal behavior, and intervention strategies should be tailored to match the offender’s individual learning styles, motivations, and abilities (e.g., physical disabilities, mental health, low intelligence). Research has demonstrated the value of adherence to the RNR model for the purposes of risk reduction in offender populations” (p. 490-491).

“Applied to a MHC context, the RNR model would advocate for case management plans that match supervision and intervention intensity to an individual’s recidivism risk, emphasize the importance of treating criminogenic needs directly tied to criminal behavior in conjunction with mental health specific intervention, and would do so using evidence-based methods of intervention that are tailored to each client’s strengths and weaknesses. The RNR model has relevance to offenders with mental illness given that the major risk factors for general and violent recidivism are generally the same for offenders with or without mental illness. Furthermore, mental illness is only directly tied to criminal behavior in a minority of cases. Thus, a primary focus on mental health intervention while neglecting criminogenic factors and recidivism risk status will likely limit the ability of any program to reduce the risk of future criminal behavior in offenders with mental illness” (p. 491).

This Study

This study conducted a retrospective file-based review of cases that had been referred to the St. John MHC, in New Brunswick, Canada, to “(a) to evaluate the capacity of a MHC to lead to changes in mental health recovery, criminogenic needs, and recidivism risk, and (b) to examine the degree to which RNR principles were naturally embedded within the evaluated MHC program model even though this particular program had not been developed with this model in mind” (p. 491).

Results of the study revealed that “across assessment periods, completers had significant score decreases for most criminogenic needs. In contrast, partial-completers had a significant increase in Criminal History scores and there were no changes for nonstarters” (p. 495). Further, “there was a tendency for completers to have the lowest rate of recidivism relative to partial-completers and nonstarters, but these differences were not statistically significant” (p. 495). Additionally, findings suggest that at the time of discharge, issues related to mental health recovery had stabilized or improved.

“One of our core objectives was to examine whether MHC involvement facilitated recidivism risk reduction. At discharge, completers had moderate reductions in general recidivism risk and criminogenic needs, whereas partial-completers and nonstarters had little to no changes in these areas. In line with previous research, these results suggest that involvement in MHC has the potential to affect recidivism risk, with the greatest gains achieved by receiving the full dosage of the MHC program” (p. 499).

Translating Research into Practice

“The similar general recidivism patterns, particularly between completers and nonstarters, suggest that being processed through the MHC has an equivalent impact on recidivism as found by those cases processed through the traditional court system. However, our regression analyses indicated that matching needs to intervention is essential to facilitate recidivism reduction. This result highlights the need to pay closer attention to criminogenic factors and better integration of RNR principles in any program attempting to reduce criminal behavior, including MHCs” (p. 499).

Formal integration of the RNR model should be considered to bolster positive outcomes that MHCs have to offer mentally ill offenders. “The need principle of the RNR model advocates for correctional interventions that target specific dynamic criminogenic needs of the individual. The lack of attention to criminogenic risk factors in MHCs has been a noted criticism in the literature. Although addressing clinical concerns is an essential component of mental health recovery and can positively impact lifestyle factors that make one vulnerable to the influence of criminogenic risk factors, there should exist a balance between addressing mental health needs and criminogenic needs” (p. 500). “In addition, an integrated RNR and mental health recovery focused assessment and case management process may improve the capacity of MHCs to effectively achieve their dual goal of reducing the criminalization of offenders with mental illness and enhancing their functioning” (p. 501).

Other Interesting Tidbits for Researchers and Clinicians

“The benefit of the MHC intervention was primarily limited to offenders who completed the full dose of the program. Further research is needed to understand the reason why some offenders succeed in the program, but others do not” (p. 501).

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Authored by Amanda Beltrani

3Amanda Beltrani is a current graduate student in the Forensic Psychology Masters program at John Jay College of Criminal Justice in New York. Her professional interests include forensic assessments, specifically, criminal matter evaluations. Amanda plans to continue her studies in a doctoral program after completion of her Masters degree.