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Principle 3b: Collaborate on a Treatment Plan

Consider what it is like to be an offender who has been in multiple incarceration and treatment environments. In most cases, the intake process starts with a barrage of questions and then someone tells you what your problems are, what treatment is required and the total of the monthly fees required to keep you out of jail. The entire first few days is largely out of your control and your opinion is rarely asked, much less actually valued. Worse, it feels like your identity is summarized as a set of problems. That is the way you’ve felt for a long time, but it is disconcerting for a professional to reinforce the idea.

Conversely, imagine expecting the above experience and instead being pleasantly surprised when the treatment plan process begins with, “Let’s begin with what you value most; what is most important to you.” This process changes the entire interaction, the attitude and even the environment immediately, doesn’t it? Instead of beginning a “treatment plan” that is based on a history of failure and critically poor choices, you get defined by what is important to you and who you want to become. You get defined by potential rather than problems. Feeling more motivated already? That is the idea.

This is the 5th of a 12 part series on Evidence Based Principles.  Subscribe to our blog and get the series delivered right to your inbox.

Principle 3a: Target Interventions 

In the progression of "ready", "aim", "fire", the relationship, assessment, and motivation collectively provide the "ready". Focusing the "aim" is the next step. The assessment results, formal and informal, provide the foundation, but putting all the ingredients together can be a challenge. With a collaborative relationship and sufficient motivation, deciding what to target may involve some negotiation, but that is a logical and reasonable part of the process. While public safety must come first, even the most resistant clients goals and values should be reflected in the game plan to some extent.

The most important concept is that the assessment is not just a set of documents to check off and file away. Developing the plan is part art and part science. 

This is the 4th of a 12 part series on Evidence Based Principles.  Subscribe to our blog and get the series delivered right to your inbox.

Principle 2: Enhance Intrinsic Motivation 

Which of the two statements feels more inspiring to you? 

• I have a good relationship with my son again 
• I haven’t been incarcerated for six months

It is critical to understand that there are two different types of motivation. Most offenders come to us motivated to “stay out of prison” or “not use drugs.” While both are admirable goals, it is vital to help the client tap into what they are motivated FOR. There is a significant difference between being motivated to say “no” to something and being motivated to say “yes” to something. In general, motivation to achieve something (e.g., be a better parent) is stronger than motivation to avoid something (e.g., stop using drugs). After all, getting up every day to work toward something is much more inspiring than getting up with the hope of avoiding something. Help the client define WHO THEY ARE vs. WHO THEY ARE NOT. 

This is the 3rd of a 12 part series on Evidence Based Principles.  Subscribe to our blog and get the series delivered right to your inbox.  

Principle 1b: Assess Actuarial Risk/Need and Responsivity

Principle 1a: Build the Therapeutic Relationship

The change process is a journey. It has its ups and downs and often feels scary and out of control. It is always easier to approach the unknown with a partner, particularly a partner who has been there before. Most offenders have a long history of failure and are well acquainted with betrayal. Their first question is, “Can I trust this person?” Answering this question can, for some, be a time-consuming process. When you have a long history of hurt, it is wise to be hesitant to trust again. 

“Is this person going to listen to me or just tell me what to do?” “Do they really care about me or are they just going through the motions?” “If I decide to take this leap and start this journey with them, will they be a reliable and supportive partner along the way?” While there is likely to be some testing of the relationship and commitment, no real progress starts until these questions have been answered. One of the reasons that Motivational Interviewing (MI) is so popular with this population is that, done well, MI quickly creates an environment and relationship that allows the client to answer these questions quickly and affirmatively.