Intense or "High Intensity"?

Posted by Evan C. Crist, Psy.D. on 9/28/15 9:05 PM

This is the 4th of a 7 part series on The Risk Principle Simplified.  Subscribe to our blog and get the series delivered right to your inbox.EBP RiskPrinciple High Intensity

What does "High Intensity" mean?

While the principle of matching risk level to treatment intensity level is almost universally accepted, an adequate definition of “intensity” is rarely given. The best definition is offered by Ed Latessa and Christopher Lowenkamp of the University of Cincinnati in their 2004 article titled, “Residential Community Corrections and the Risk Principle: Lessons Learned in Ohio”. The authors believe strongly in quality of treatment and have published several useful articles about its importance, but in this article they lay out a useful definition of intervention “intensity”.

  • High intensity intervention equals residential placement and low intensity treatment equals non-residential treatment.  

Along with providing, in my opinion, the best definition of “intensity,” this article also provided greater evidence of the importance of matching risk level to intervention intensity.  A central finding in the study was: 

  • When low risk offenders are placed in residential facilities, their rate of reoffending is higher than for low risk offenders who do not receive residential placement.

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When Research Meets Reality

Does the study by Latessa & Lowenkamp mean that all high risk offenders should be placed in a residential program? Is it ever appropriate for a low risk offender to be placed in a residential setting? What about moderate risk offenders? Can a non-residential supervision model provide high intensity treatment? Does the quality of treatment and monitoring in a given residential or non-residential program matter? Are my local standards for residential and non-residential similar to those in Ohio, the population studied in this article?

The nature of research is that one small answer results in a host of new questions. On average, the results of this study provide an excellent starting place for public policy. However, you do not work with averages, you work with individuals. Furthermore, the number of high risk offenders on non-residential supervision vastly outnumbers the number of available residential community corrections beds. The financial and political reality dictates that most community corrections offenders will be supervised outside of a residential setting.

The concept of “dosage” is akin to, but not exactly the same as, “intensity”. Some practitioners and scholars believe that the total number of hours of treatment is the primary concern. Others argue that the hours must fit within a given window of time. Still, others express anxiety about the momentum of the dosage concept because it threatens to take clinical judgment out of their hands. An exciting area of research, we will address “dosage” in our white paper, The Need Principle-Simplified, coming soon!

 In our next blog in this series, we will address "Why Would It Make Them Worse?".  Subscribe to our blog and get the series delivered right to your inbox.

Evaluating Risk in your clients 

To request more information or schedule an online demonstration of our Community Corrections Software, click here. We offer integrated software and support services for Probation/Parole, Residential and Reentry programs. Our Program Foundation Platform and twelve robust modules were designed by community corrections professionals to guide organizations toward a powerful EBP implementation, relieve them of strenuous paperwork and manual processes, and enable them to focus on what matters - people!

Topics: Community Corrections, Evidence Based Practices, Risk Principle

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