The impact of a brief RNR-based training on Turkish juvenile probation officers' punitive and rehabilitative attitudes and recidivism risk perceptions

The present quasi-experimental study examined the impact of a brief training program based on the risk–need–responsivity (RNR) model on Turkish juvenile probation officers' (JPOs) punitive and rehabilitative attitudes toward justice-involved youth and recidivism risk perceptions. Fifty-nine JPOs were recruited through three probation offices in Istanbul, Turkey. Thirty-six JPOs, who received a 1-day training in the RNR model of offending behavior, were compared to JPOs in a wait-list control condition (n = 23). Participants in both conditions completed surveys at baseline and 1-week posttraining. Mixed-factorial analysis of variances revealed a significantly higher decrease in JPOs' punitive attitudes from pre- to posttest, in the training condition compared to the control group, with a medium effect size. Rehabilitative attitudes decreased in both conditions, while recidivism risk perceptions did not change from pre- to posttest in either condition. Future research could expand on these promising results using a more intensive training program and a randomized-controlled design in a larger sample of JPOs.     

An evaluation of a juvenile court volunteer program

A longitudinal study of the impact of three separate volunteer programs working with juvenile delinquents was undertaken at one juvenile court. The youth were followed for a period of one year with measures of official and unofficial delinquent behavior obtained four times during that year. Other data were also collected. The study results indicated two of the programs (i.e., volunteer probation officer and group counseling) had a negligible effect on reducing probationers' delinquent behavior compared to a control group. Youth who participated in the third group, a volunteer tutor program, actually increased their delinquent behavior when compared to a control group within the first 6 months of their probation. However, one year after probation, the differences were negligible. Recommendations are made which include divesting the juvenile court of client responsibility for providing volunteer services.     

Perceived Relationships With Parents Among Adolescent Inpatients With Depressive Preoccupations and Depressed Mood

Examines the impact of a program aimed at reducing re-offending among juveniles transferred to adult court in Miami-Dade County, Florida. Initiated in 1998, the Juvenile Sentencing Advocacy Project (JSAP) worked to increase the degree to which defense lawyers, prosecutors, judges, and police officers considered the developmental status of youth charged with crimes, as well as the contextual basis for their behavior and their potential for rehabilitation. Through such activities, the goal was to increase the use of juvenile sanctions, rather than traditional adult sentences. Based on previous research, it was predicted that increased use of juvenile sanctions would be associated with fewer youth re-offending. This article examines 162 youth who were transferred to and sentenced in adult court during 1999. Re-offense patterns were monitored through June 2001. Analyses using epidemiological measures of effect found that the use of juvenile sanctions significantly increased following implementation of JSAP and that youth receiving adult probation or boot camp were 1.74 to 2.29 times more likely to re-offend than were youth receiving juvenile sanctions. The increased use of juvenile sanctions following implementation of JSAP corresponded to an 11.2% to 15.3% decrease in the number of youth one would have anticipated would re-offend had previous patterns of sentencing continued.     

The differential impact of work-oriented vs. communication-oriented juvenile correction programs upon recidivism rates in delinquent males.

This study examined recidivism rates in work-oriented (N = 30) and communication-oriented (N = 30) juvenile delinquency programs for males. Both groups were matched for age, ethnic origin, educational achievement, and reading scores. Chi-square analyses indicated significant differences in recidivism rates between groups in both residential (chi2 - 6.71, df = 1, p less than .01) and aftercare (chi2 = 3.89, df = 1, p less than .05) programs. In each phase of the treatment program, recidivism was highest in the work-oriented group. The results suggested that (a) facilitation of family interaction and communication is related closely to successful treatment of the delinquent and consequent recidivism; (b) group counseling that provides the youth and parents an opportunity to learn better communication skills appears to improve family cohesion and solidarity; and (c) newer therapeutic approaches in delinquency should concentrate on filial and family-type therapies.     

Aftercare programs for reducing recidivism among juvenile and young adult offenders: A meta-analytic review

The aim of this meta-analytic study, including 22 studies and 5764 participants, was to examine the effects of aftercare programs on recidivism in juvenile and young adult offenders released from correctional institutions. The studies had to be (quasi-)experimental, with the control group receiving ‘care as usual’ or no treatment. Recidivism was measured by re-arrests and/or reconvictions and was based on official reports. Although the overall effect size for aftercare programs was generally small (d = .12), moderator analyses indicated more substantial effects and showed that aftercare is most effective if it is well-implemented and consists of individual instead of group treatment, and if it is aimed at older and high-risk youth. Whereas the treatment duration and moment of starting the aftercare program were not related to the program's effectiveness, more intensive aftercare programs were associated with lower recidivism rates.     

Relationship between the social and demographic characteristics of post-sentence offenders and the outcomes of forensic psychiatric referrals

Examined the relationship between the social and demographic characteristics of post-sentence offenders (N = 240) and outcome of outpatient forensic psychiatric referrals using multiple regression analysis. The referral process was divided into three stages: Decision to refer, compliance with referral, and outcome of referral, and the following research questions were explored: (1) whether there were differences between the social and demographic characteristics of offenders who were referred by court order of the sentencing judge and those referred by their probation officer; (2) the the relationship between socioeconomic status and completion of referral; (3) the relationship between socioeconomic status and recommendation for further mental health services; and (4) the relationship between source of referral and recommendation for mental health services. Results suggest that the relationship between social and demographic variables and the offender's interaction with a forensic mental health system is markedly different from the voluntary clients and mental health resources studied in earlier research.     

An independent effectiveness trial of multisystemic therapy with juvenile justice youth.

This study examines the effectiveness of an evidence-based practice, multisystemic therapy (MST), conducted in a real-world mental health setting with juvenile justice involved youth and their families. Importantly, this is the first randomized clinical trial of MST with juvenile offenders in the United States conducted without direct oversight by the model developers. This study reports outcomes achieved for 93 youth randomly assigned to MST or treatment as usual (TAU) services through 18-month follow-up posttreatment for offense data and 6-month follow-up posttreatment for ratings of the Child and Adolescent Functional Assessment Scale (CAFAS). Outcomes include significant reduction in rearrest and improvement in 4 areas of functioning measured by the CAFAS for youth who received MST. Implications for delivery of empirically supported treatments in real-world settings are discussed.     

A meta‐analytic review of the efficacy of psychological treatments for violent offenders in correctional and forensic mental health settings

This meta‐analysis examined whether psychological treatments with adult violent offenders in correctional and forensic mental health settings are effective in preventing community recidivism and institutional (hospital/prison) misconduct. A total of 27 controlled studies containing 7,062 violent offenders were obtained via a comprehensive search strategy that yielded more than 13,000 records. Overall, treatments with violent offenders significantly reduced violent and general/nonviolent recidivism. The average effect for violent and general/nonviolent institutional misconduct did not attain statistical significance. Moderator analyses indicated numerous trends; however, most effects were nonsignificant following alpha‐level corrections. Findings regarding the impact of psychological treatments are promising and suggest that multimodal treatments are associated with the strongest treatment effects. However, the extant evidence base is limited by a small number of well‐controlled outcome studies and inconsistent/incomplete reporting of the evaluations. More high‐quality research is needed to investigate the effectiveness of violent offender treatment on outcomes and mechanisms of action, and to determine which treatment components are effective, in what combination, and for which offenders.     

Sexually abusive youth: a review of recidivism studies and methodological issues for future research

This paper is a critical review of the recidivism studies on sexually abusive youth. Recidivism studies looking at sexually abusive youth have only appeared in the literature in the last 10 to 15 years and the small number of published studies, along with difficulties in defining recidivism, have affected the quality of outcome data. The most consistent criteria for recidivism applied in the literature uses official records to determine subsequent arrests and/or convictions for sexual and/or non-sexual offences. However, official records are conservative and so will underestimate recidivism rates. Recidivism rates for sexually abusive youth who have received treatment for sexual re-offending are approximately 10%, though rates vary greatly (0% to 42%), while recidivism rates for non-sexual offending are higher (ranging between 8% and 52%). Research indicates that comparison groups of untreated sexually abusive youth have higher rates of sexual and non-sexual re-offending than those who have received treatment. Specific recommendations are made for strengthening research design in future studies. These include using multiple sources to determine recidivism (e.g. official records, self-report, family report and standardised psychological tools), having comparison groups of treatment dropouts and untreated sexually abusive youth and including long-term, longitudinal follow-up of youth.     

Evaluation of a selective medical school admissions policy to increase the number of family physicians in rural and underserved areas

Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974; this program preferentially admits medical school applicants from rural backgrounds who intend to practice family medicine in rural and underserved areas. Evaluation of the program has shown that PSAP graduates from the classes of 1978 to 1985 have performed slightly less well than their peers (non-PSAP) during medical school, although there was no difference in attrition between the two groups. Nor did the performance of PSAP and non-PSAP graduates differ during their postgraduate training. PSAP graduates from the classes of 1978 to 1981 were almost five times as likely as non-PSAP graduates to practice family medicine (59.6 vs. 12.6 percent, P less than 0.001), three times as likely to practice in rural areas (37.8 to 42.2 percent vs. 10.0 to 11.8 percent, P less than 0.001), and two four times as likely to practice in areas where there is a physician shortage (26.7 to 40.0 percent vs. 9.2 to 11.2 percent, P less than 0.01). They were 7 to 10 times as likely as their peers to combine a career in family medicine with practice in a rural or underserved area (24.4 to 31.1 percent vs. 3.1 to 3.9 percent, P less than 0.001), thereby fulfilling the goals of the PSAP. This study concludes that the medical school admissions process can have a major influence on the specialty choice and geographic practice location of physicians, and suggests one mechanism for increasing the number of family physicians in rural and underserved areas.     

Clinically Referred Children and Adolescents: Fathers,Family Constellations,and Other Demographic Factors

Investigated the likelihood that clinically referred youth have contact with their biological father. Family demographics such as family constellation, race/ethnicity, and socioeconomic status were also explored. Based on 356 consecutive therapy and assessment referrals to an outpatient clinic, slightly less than half (42.4%) of the children and adolescents referred due to psychological problems and more than half (67.8%) of the youth referred due to learning difficulties lived with both their biological mother and biological father. For those who did not live with both of their biological parents, 40.0% and 56.0%, respectively, had regular face-to-face contact with both biological parents. These figures suggest that, although the percentages of intact families are somewhat lower in treatment samples than in the general population or in a sample referred for learning difficulties, close to half of clinically referred youth continue to live with both of their biological parents. Future directions for the inclusion of fathers in clinical research are discussed.     

Long-term follow-up to a randomized clinical trial of multisystemic therapy with serious and violent juvenile offenders

In this study, the authors examined the long-term criminal activity of 176 youths who had participated in either multisystemic therapy (MST) or individual therapy (IT) in a randomized clinical trial (C. M. Borduin et al., 1995). Arrest and incarceration data were obtained on average 13.7 (range = 10.2-15.9) years later when participants were on average 28.8 years old. Results show that MST participants had significantly lower recidivism rates at follow-up than did their counterparts who participated in IT (50% vs. 81%, respectively). Moreover, MST participants had 54% fewer arrests and 57% fewer days of confinement in adult detention facilities. This investigation represents the longest follow-up to date of a MST clinical trial and suggests that MST is relatively effective in reducing criminal activity among serious and violent juvenile offenders.     

Is evidence‐based treatment helping my patient? Utilizing modified Brinley plots to measure clinical change

Using both group (nomothetic) and individual (idiographic) approaches to measuring clinical change may provide more information about the effectiveness of an intervention than either approach alone. The current study re‐examined previously published data from two randomized clinical trials of omega‐3 fatty acids and Individual‐Family Psychoeducational Psychotherapy as treatment for mood disorders in youth, using modified Brinley plots, a method of illustrating individuals’ treatment response in the context of group information. Although the original nomothetic approach provided information about the average effect of treatment, modified Brinley plots gave more information about individual children's outcomes. Practicing clinicians in particular could use modified Brinley plots to track treatment trajectories and outcomes for specific clients and subsequently use these data to inform treatment planning.     

Predictors of psychological treatment noncompletion among sexual offenders

Research indicates that sexual offenders who do not complete their treatment are more likely to reoffend than are those who do complete it (Hanson et al., 2002; Losël & Schmucker, 2005). Several investigators have attempted to identify the characteristics of those individuals who do not complete treatment, most likely with the aim of preventing recidivism and the disastrous consequences that offenders' behavior has for their victims and for society at large. The objective of the present article is to review studies of treatment noncompletion among sexual offenders. We found that between 15% and 86% of sexual offenders do not complete treatment. In addition, results of the 18 studies reviewed diverge to the point where it is difficult to draw unequivocal conclusions about the variables related to the phenomenon. Only antisocial personality disorder and certain features of antisocial personality disorder appear to be related consistently and significantly to the discontinuation of treatment. These features are conceptualized under the three principles of effective treatment for general offenders. We present an analysis of the methodological limitations common to all of the studies reviewed in order to explain why confusion seems to reign supreme in the literature in this area at the present time, and we offer recommendations for future research in light of these limitations.     

Classification of severe male juvenile offenders using the MACI clinical and personality scales.

Classifications for severe juvenile offenders and ones that include mental health needs are lacking. Thus, in this study, adolescent male offenders (N = 652) committed to a residential facility were clustered on personality and clinical scales of the Millon Adolescent Clinical Inventory (Millon, 1993) into 5 groups (including 4 found in other typologies). As expected, the impulsive/reactive and psychopathy groups had more severe criminal histories and the impulsive/reactive and anxious/inhibited groups had increased suicidal behaviors and poor psychosocial functioning. The impulsive/reactive group showed expected verbal deficits. The unremarkable group lacked discernable personality/clinical problems and was unremarkable on dependent variables. A conforming group emerged that may be unique to severe juvenile offender populations. Future studies should examine institutional adjustment and outcomes among the identified groups.     

The Appalachian Preceptorship: over two decades of an integrated clinical-classroom experience of rural medicine and Appalachian culture.

There is a need to encourage careers in rural medicine and to prepare potential rural physicians for life in rural communities. The authors describe a program that addresses this need, the Appalachian Preceptorship Program, and report the program's experience from 1985 to 2004. The Appalachian Preceptorship is a four-week summer elective conducted by the Department of Family Medicine of East Tennessee State University (ETSU) that offers students clinical preceptorships in rural areas of southern Appalachia. By the conclusion of the 2004 preceptorships, the program had served 225 medical students from 95 medical schools across the country and abroad. The program combines an individual community-based preceptorship with an interactive group instructional block, emphasizes rural medicine, and provides students an understanding of the interface between culture and medicine in southern Appalachia. Follow-up of Appalachian Preceptorship students during the 18-year period studied demonstrates that 82% of the 157 participants who matched before 2004 had selected residencies in primary care, with 60% entering family medicine. Those completing the program were more than three times as likely to practice in a rural community compared with the national average. Fifty-six percent of their practice settings carry multiple rural or underserved designations. The program has helped transform a legislative mandate to train doctors for rural communities into an institutional culture leading to more extensive programs and a greater recognition of ETSU's rural mission. The authors encourage other medical schools to develop combined clinical/classroom electives that reflect their institutional priorities and that can address a wide variety of clinical interests.     

Family preservation using multisystemic therapy: an effective alternative to incarcerating serious juvenile offenders.

Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by a Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration. In comparison with youths who received usual services, youths who received MST had fewer arrests and self-reported offenses and spent an average of 10 fewer weeks incarcerated. In addition, families in the MST condition reported increased family cohesion and decreased youth aggression in peer relations. The relative effectiveness of MST was neither moderated by demographic characteristics nor mediated by psychosocial variables.     

The contribution of Memorial University's medical school to rural physician supply

INTRODUCTION: This study identifies the characteristics and predictors of Memorial University of Newfoundland (MUN) medical graduates working in rural Canada and rural Newfoundland and Labrador (NL). METHODS: We linked data from class lists, the alumni and postgraduate databases with the Southam Medical database to determine 2004 practice locations for MUN graduates from 1973 to 1998 (26 yr, inclusive). Multiple logistic regression was used to identify predictors for each outcome. RESULTS: In 2004, 167 (12.6%) MUN graduates worked in rural Canada and 81 (6.1%) MUN graduates worked in rural NL. Those who were more likely to practise in rural Canada (when compared with graduates from urban backgrounds, those who had not done any residency training at MUN or specialists, respectively) were graduates from a rural background (odds ratio [OR] 1.95, 95% confidence interval [CI] 1.38-2.76), those who had done residency training at MUN (OR 1.56, 95% CI 1.06-2.29) and family physicians (FPs)-general practitioners (GPs) (OR 6.64, 95% CI 4.31-10.23). Those who were more likely to practise in rural NL (when compared with graduates from urban backgrounds, those who had not done any residency training at MUN, specialists or non-Newfoundlanders, respectively) were graduates from a rural background (OR 2.54, 95% CI 1.57-4.11), those who had done residency training at MUN (OR 4.12, 95% CI 1.94-8.76), FP-GPs (OR 6.39, 95% CI 3.39-12.05) and Newfoundlanders (OR 7.01, 95% CI 2.16-22.71). CONCLUSION: The MUN medical school has made a substantial contribution to rural physician supply in both NL and Canada. Increasing the number of local rural students as well as providing incentives to graduates to complete postgraduate training in family medicine in the province may increase the number of locally trained rural physicians.     

A meta-analysis of experimental studies of diversion programs for juvenile offenders

Objective

Research to establish an evidence-base for the treatment of conduct problems and delinquency in adolescence is well established; however, an evidence-base for interventions with offenders who are diverted from the juvenile justice system has yet to be synthesized. The purpose of this study was to conduct a meta-analysis of experimental studies testing juvenile diversion programs and to examine the moderating effect of program type and implementation quality.

Method

A literature search using PsycINFO, Web of Science, and the National Criminal Justice Reference Service data-bases and research institute websites yielded 28 eligible studies involving 57 experimental comparisons and 19,301 youths.

Results

Recidivism was the most common outcome reported across all studies. Overall, the effect of diversion programs on recidivism was non-significant (k = 45, OR = 0.83, 95%CI = 0.43-1.58). Of the five program types identified, including case management (k = 18, OR = 0.78), individual treatment (k = 11, OR = 0.83), family treatment (k = 4, OR = 0.57), youth court (k = 6, OR = 0.93), and restorative justice (k = 6, OR = 0.87), only family treatment led to a statistically significant reduction in recidivism. Restorative justice studies that were implemented with active involvement of researchers led to statistically significant reductions in recidivism (k = 3, OR = 0.69). Other outcomes, including frequency of offending, truancy, and psycho-social problems were reported infrequently and were not subjected to meta-analysis.

Conclusions

High levels of heterogeneity characterize diversion research. Results of this study recommend against implementation of programs limited to case management and highlight the promise of family interventions and restorative justice.     

Development of a multisystemic parent management training intervention for incarcerated parents,their children and families

The majority of men and women prison inmates are parents. Many lived with children prior to incarceration, and most have at least some contact with their children and families while serving their sentences. Because prison populations have increased in the United States, there has been a renewed interest in finding ways not only to reduce recidivism, but also to prevent incarceration in the first place, particularly among the children of incarcerated parents. Positive family interaction is related to both issues. The ongoing development of a multisystemic intervention designed to increase positive family interaction for parents and families involved in the criminal justice system is described. The intervention package currently includes a prison‐based parent management training program called Parenting Inside Out (PIO); a prison‐based therapeutic visitation program; and complementary versions of PIO designed for jail and probation and parole settings. Work on other components designed for justice‐involved parents, children and for caregivers during reunification from prison is ongoing. Program development has occurred within the context of strong support from the State department of corrections and other key governmental and non‐profit sector groups, and support systems have been established to help maintain the interventions as well as to develop complementary interventions, policies and procedures.