What we learned about the Opioid Crisis at the 2017 ICCA Conference in Seattle

The Opposite of Addiction is not Sobriety.  This may have been the most powerful statement we heard at the ICCA conference where researchers and practitioners of many fields and backgrounds came together to learn, share information and knowledge; pushing each other to keep learning and doing more in our pursuit to do what works best.  Community Corrections has never been short of challenges and barriers.  It is encouraging to see dedicated professionals working hard to break through.

The conference encompassed workshops surrounding some of these challenges, including the opioid crisis, relapse prevention, housing and employment, and our jails being filled with a large amount of people with significant mental illness and trauma.  While there were many outstanding workshops at the Seattle conference, in this blog we will talk about discussions and community corrections solutions with relationship to the opioid crisis.

The Opioid Crisis

Who are some of the people who have been impacted directly by this crisis? 

Our reflections of APPA 2017 from the inside, outside and beyond.

Last month we found ourselves positioned in a good space as we went about setting up our booth at APPA’s 42nd Annual Training Institute, held this year in a particularly exciting place, New York City. We were positioned on the Expo floor at a busy nexus of booths and buffet tables, and our team reconnected with and met practitioners from all over the country. Each brought their knowledge, progressive nature and passion for EBP. We attended several interesting sessions as well, which highlighted important challenges facing the corrections industry.

The Big Apple proved the perfect backdrop for APPA, and we explored some of the city’s unique places. Following are a few highlights from inside the conference, activities outside it, and challenges going forward.

Criminal Justice Reform is on the Move and 9 other things I learned at the Oregon Justice Reinvestment Summit:

one: Although the event was in Oregon, speakers from around the country made it clear that criminal justice reform is on the rise nationwide.

two: Pretrial research has uncovered that being locked up for three or more days while awaiting a hearing can cause very serious unintended repercussions for that individual, including a 4% increased risk that the person will recidivate.

three: Oregon was recently selected as one of three states to participate in the National Criminal Justice Reform Project with a focus on pretrial and a mission to reform using data driven, evidence based practices.

four: As shared in the Justice Policy Institute Report, “The vaguely understood pretrial process of bail costs the taxpayers of the United States billions of dollars and infringes on the liberty and rights of millions of Americans each year.”

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?