This blog is a continuation of the EBP Practice Models blog series started by this blog’s author Evan C. Crist, Psy.D. and other industry leading authorities on practice models, Brad Bogue, Matt Moore and Tom O’Connor.

When Brad Bogue first suggested we work on a “practice model” I was embarrassed to admit I had no idea what he was talking about. After a bit of research I realized that, while the term was foreign to me, the concept was not that complicated and was a logical extension of our agency’s evidence-based practices (EBP) training. I learned that practice models structure the use of various EBPs into a logical, coherent process to help practitioners identify the next necessary step in the intervention sequence.

Armed with lots of knowledge about EBP, but without a framework to identify and organize what techniques to use when, we recognized we did, indeed, need a practice model. Since I am writing this blog during the Christmas season, it seemed that we had lots of ornaments and tinsel but no tree on which to hang them. It became clear that without a practice model we would remain knowledgeable about EBP but unskilled in their delivery.

I looked at several of the prepackaged practice models available but found all of them lacking. They were either incongruous with my clinical experience (e.g., the importance of building motivation was essentially ignored) or contradicted my philosophy of the change process (e.g., they followed a manual but left little room for situational flexibility). With Brad at my side challenging my assumptions every step of the way, we decided to develop a practice model in house. We facilitated the process while our capable staff of case managers merged research with their experience and theory with reality.

It was a vital learning experience for me. I thought I needed to teach the case managers to think; turns out, I simply needed to create the space and let them think.

We started with the necessary requirements for the practice model:

1. It must include a variety of interventions.
2. It must include evidence-based, evidence-informed or promising practices.
3. It must be coherent.
4. It must be simple but powerful.
5. It must include situational flexibility.

Note from the editor: This blog is a continuation of the EBP Practice Models blog series started by this blog’s author Evan C. Crist, Psy.D. and other industry leading authorities on practice models, Brad Bogue, Matt Moore and Tom O’Connor.

This blog has two parts.

Part I, The Changing Function of a Case Manager, paints a picture of how the role of community corrections practitioners is constantly changing as the field and its stakeholder’s expectations evolve and expand.

Part II, More Effective Treatment, explains the need for a coherent intervention strategy based on logic and research to help case managers do the treatment oriented work we are expecting more and more from them. We suggest Practice Models are the answer to our need for this intervention strategy. Although EBP has been viewed by some as a nuisance, adding more work to already overloaded case managers, read below to see how we think differently.

PART I – The Changing Function of a Case Manager

Case Manager or Psychologist? Or both?

As a participant of community corrections for the better part of two decades, I’ve noticed an interesting and predictable shift in the industry. Yes, it is becoming more treatment oriented, but the change that I find more interesting is the shift to teaching paraprofessionals to deliver specialized services generally allotted for master’s level or doctoral level therapists.

I’ve seen this happen throughout my psychologist career and I don’t think it is good or bad, rather a normal progression of a maturing industry that needs to provide more services to a larger population without the benefit of a significant increase in government funded resources.

But why?

Getting to the Point

The top of a pyramid is what makes it identifiable as a pyramid. This apex is known as the capstone. On ancient pyramids, capstones were given special care and sometimes made of gold. Kings had their names etched in them. Pyramids are architectural marvels. While many mysteries and legends abound, experts agree that the building of the pyramids took hundreds of workers hundreds of years to complete.

While pyramids served many purposes (some were quite elaborate on the inside with bakeries, tombs and hallways aplenty) the outward symbol of success was to get to the point, the capstone. Once the builders completed the point of the pyramid, it was complete. Any shortcuts would certainly be noticed and mar the elegance of these ancient structures. If the work crews had rushed to get to the point, it is unlikely that these landmarks would still be standing. 

My 15-year-old daughter has her driver’s permit. She is attentive and cautious, but sometimes being in the car with a learning driver is a bit harrowing. She is slowly becoming more comfortable and confident but still needs guidance at times and frequent feedback for assurance. She will have her license soon, but, for now, this learners’ permit experience serves a great transition from being an unlicensed driver who still needs Dad to play taxi driver to a licensed driver who believes she needs nothing from no one.

Learning the necessary skills to earn that freedom is not without stress for driver and passenger, but imagining what the roads would be like without such a transition period is certainly far more frightening.

Transition Clients Back into the Community

Thoughtful planning, basic skills training and the freedom to make some mistakes are vital aspects of a good transition for community corrections offenders too. In fact, it can be argued that the lack of such a process is largely to blame for our unacceptably high recidivism rate.

As the father of two teenage girls, any article about parenting tends to catch my attention. I found this article Parenting Style and Its Correlates by Nancy Darling particularly interesting both as a parent and as an administrator for a community corrections facility. While there is not much new information in this article about which parenting style typically results in well-adjusted children, it is a great summary. What was new for me in reading this article is the parallel that I see in working with offenders.

A Couple Key Definitions

Parenting: It is assumed that the primary role of all parents is to influence, teach, and control their children. A parenting style is the overall pattern of the extent and focus of control.

Psychological control: "You should adapt my values, goals, and judgments."

Behavioral control: "You are expected to play by the rules of this family."

Parental responsiveness refers to "the extent to which parents intentionally foster individuality, self-regulation, and self-assertion by being attuned, supportive, and acquiescent to children's special needs and demands."[i] I refer to this characteristic in the table below as “fosters psychological independence.”

Parental demandingness refers to "the claims parents make on children to become integrated into the family whole, by their maturity demands, supervision, disciplinary efforts and willingness to confront the child who disobeys."[ii] I refer to this characteristic in the table below as “demands behavioral compliance.”

Can you start to see the parallel between parenting and our work in supervising offenders?