Blog: Evidence-Based Practices

OJJDP’s October Juvenile Justice Bulletin examines underage drinking and offers evidence-based guidelines for screening and treating teen drinkers. OJJDP’s interest in promoting better treatment for underage drinking isn’t new--they’ve long understood the physical, neurological and legal consequences of underage drinking.
The Underage Drinking Bulletin series was created to help educate practitioners and policymakers about these issues and to provide evidence-based guidelines. Highlights from the 10 guidelines from this bulletin are included below:

• Youth should be screened for alcohol problems regularly throughout their supervision. If they are found to be at risk for such problems, a substance abuse specialist should conduct a thorough assessment. Other assess­ments should identify youths’ risks, needs and assets.
• Justice professionals should develop an individualized case plan for each youth.
• Professionals should match interventions with a youth’s needs and assets. Youth’s progress and participation in programs should be monitored.
• Family and social networks must support youth.
• Youth should receive swift and certain sanctions for noncompliance with supervision conditions but should also receive positive reinforcement for constructive behaviors.

OJJDP posted findings from an underage drinking literature review in their September Juvenile Justice Bulletin. The review focuses on how drinking can affect teens’ mental and physical well being--highlights from the bulletin are included below (emphasis mine):

• The human brain continues to develop until a person is around age 25. Underage drinking may impair this neurological development, causing youth to make irresponsible decisions, encounter memory lapses, or process and send neural impulses more slowly.
• Underage drinking cost society $68 billion in 2007, or $1 for every drink consumed. This includes medical bills, income loss, and costs from pain and suffering.
• In 2009, 19 percent of drivers ages 16–20 who were involved in fatal crashes had a blood alcohol concentration over the legal adult limit (0.08).
• Alcohol use encourages risky sexual behavior. Youth who drink may be more likely to have sex, become pregnant, or contract sexually transmitted diseases.

Evelyn M. Kappeler was appointed Monday from "acting" to permanent Director of the Health and Human Services Office of Adolescent Health.
Ms. Kappeler was first appointed in 2010 by the Assistant Secretary for Health to build and lead -- in an acting capacity --the newly funded Office of Adolescent Health (OAH). She established the office and implemented its signature $110 million grant program aimed at reducing teen pregnancy through the replication of evidence-based program models and research and demonstration projects.
Ms. Kappeler convened the Health and Human Services-wide Adolescent Health Working Group, a first of its kind collaboration among the many agencies and offices with interest in ensuring the health of adolescents and young adults.
The group focuses on their shared interests in promoting healthy social, emotional and physical development during adolescence to help teens grow into productive, healthy adults and reaching adolescents who are most in need of integrated, coordinated services and care.

The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) released a new five-year national study on addiction treatment, finding that despite overwhelming evidence that addiction is a disease, treatment options don’t follow the same methodologies that we currently use to treat other diseases like cancer, diabetes and heart conditions. Treatments for each of these diseases of course differ, but doctors still use the same process of evidence-based diagnosis followed by appropriate treatment.
Although addiction to nicotine, alcohol and other substances affects over 40 million Americans--more than cancer, diabetes and heart conditions--most medical professionals aren’t qualified to treat addiction. The study found youth who begin smoking, drinking, or using other drugs before the age of 21 are at higher risk for addiction. In 96.5 percent of cases, addiction originated with substance use before the age of 21 when the brain is still developing. Via the press release:

“The report finds that while doctors routinely screen for a broad range of health problems like high blood pressure or high cholesterol, they rarely screen for risky substance use or signs of addiction and instead treat a long list of health problems that result, including accidents, unintended pregnancies, heart disease, cancers and many other costly conditions without examining the root cause.”

Shay Bilchik (founder and Director of the Center for Juvenile Justice Reform at Georgetown University's Public Policy Institute) is at Portland State University this afternoon to discuss the juvenile justice system. I'll be liveblogging his talk here, so tune in!
"If We Knew Then, What We Know Now: Implications for Juvenile Justice Policy in America"
4:45pm Dr. David Springer (upcoming Dean of PSU's School of Social Work): I've had the pleasure of serving with Shay on a juvenile justice panel in Austin about a year ago, and we're all in for a real treat.
4:50pm Bilchik: We're launching work with Multnomah and Marion counties' juvenile justice systems...
Oregon has demonstrated a vision that shows the possibility of serving children and families in a great way. The multi-system juvenile justice system here is the best in the country. 
4:55pm Bilchik: We're primed to build a better and smarter juvenile justice system. It's no longer just the juvenile justice field, youth development field, education fields.. we're now working across systems. As Dr. Laura Nissen says, "these are boundary founders" who are working across multiple fields. To put it simply, we want to provide love, opportunity and hope to the children who come in contact with the juvenile justice system.
5:05pm Bilchik: We need to make sure that none of our children fall through the cracks and too often we don't do that. Too often these kids are without power (living in impoverished communities) and kids of color.
So what would we have done differently if we knew then what we know now?

Juvenile Justice Reform

• Georgia bill would make smuggling cell phones, cigarettes into youth detention centers a felony
  JJIE
  Smuggling cellphones or cigarettes into a Georgia youth prison would become a felony under a bill approved without opposition Thursday by the Georgia Senate. Under the bill, which still must pass the House of Representatives, violators could be sentenced to up to four years in prison upon conviction.
• Kentucky Department of Juvenile Justice conducts comprehensive needs assessment
  SurfKy News Group
  The Kentucky Department of Juvenile Justice recently completed an 18-month study of its training academy, thought to be the country’s first comprehensive job task analysis and needs assessment of a juvenile justice training program.
• Los Angeles City Council unanimously approves changes to daytime curfew law
  KPCC radio
  L.A. City Council unanimously voted this morning in favor of changes to the city's daytime curfew law to improve how the city deals with its truant students.
• Opinion: Make youth justice a safer situation
  Austin Statesman
  Recent Texas Tribune-New York Times revelations of ongoing safety concerns in Texas' juvenile justice system only confirm what the leading national research shows: Secure juvenile facilities are a taxpayer burden, work against rehabilitation and can make youths' problems worse.
• California Governor Jerry Brown’s plan to end juvenile justice division faces fight San Francisco Chronicle:
  A group of criminal justice leaders are preparing to fight a plan by Gov. Jerry Brown to entirely phase out the state's Division of Juvenile Justice over the next three years and return the most violent and troubled youths to county facilities, despite support for the proposal by some experts.
• Recent increases in drug arrests were for possession, not sales
  Jeffrey A. Butts
  Between 1991 and 2006, arrests for drug sales and manufacturing actually dropped 6 percent while arrests for possession climbed 139 percent. The same pattern was observed for arrests involving offenders of different ages, but the growth in drug possession arrests was sharpest among juveniles.

Adolecscent Substance Abuse Treatment

• Teens driving under the influence of marijuana
  Join Together at Drugfree.org
  According to a recent study, nearly one in five (19 percent) of teens say they have gotten behind the wheel after smoking marijuana.

• Why Are All the Black Kids in Special Ed?
  Minority students (and especially Black students) are disproportionately diagnosed with disabilities and placed in special education or lowest-level courses. The Public Interest Law Center of Philadelphia makes the case for seeking a second opinion.
• Lasting Drop in Smoking, Delinquency, Drug Use
  Study shows that tenth-graders in towns using Communities That Care, a prevention system developed by University of Washington researchers, are less likely to have tried drinking or smoking compared with teens living in towns that had not adopted the system. Delinquent behavior, including stealing, vandalism and physical fights, decreased too.
• Kids-for-Cash Sentencing Set for November 4
  Robert J. Powell, the former co-owner of two juvenile detention centers in Pennsylvania who testified he paid kickbacks to two judges, may serve 21 to 27 months in prison for failing to report a felony and abetting tax evasion.

Evidence-based practices and how to implement them is a priority for many substance abuse treatment organizations, including those treating adolescent.  
To help with this priority, NIATx has launched a new project, the Building a Sustainable National Infrastructure for Research and Dissemination of Improved Behavioral Treatment Practices, funded by the National Institute on Drug Abuse (NIDA). The informal title for this project is “The Network of Practice.”
Its aim? To build an internet-based community focused on adopting evidence-based clinical practices. The resulting tool may include features such as virtual cafes, a step-by-step guide to implementing an evidence-based practice, a library of practical information, and a cost-benefit calculator.
More than 500 organizations have completed an online survey for this project (and that number is growing). You can still complete the survey (which takes about five minutes to complete) by visiting: http://www.surveymonkey.com/s/infra_survey
For more information about the project or to get involved in its development, please contact:
Anna Wheelock at anna.wheelock@chess.wisc.edu or
Kim Johnson at Kimberly.johnson@chess.wisc.edu

The other day I watched the A&E program Beyond Scared Straight for the first time. I'm familiar with the original 1979 Academy Award winning documentary, Scared Straight!, that inspired many states across the country to institute similar programs in an attempt to deter juveniles already involved with the criminal justice on some level from a future life of imprisonment. These kids are taken on a tour of a jail and introduced to prisoners who recount horror stories of their time behind bars. The hope is that once given a taste of the grim reality of prison life, these 13-19 year old kids will want to go "straight" and avoid incarceration. Executive produced by the director of the original, Arnold Shapiro, this new "reality" series is the highest rated original program in A&E's history.
The show has been met with harsh criticism. In an op-ed for the Juvenile Justice Information Exchange, director of Justice Programs at Governor's Office for Children and Families in Georgia, Joe Vignati wrote: "The scared straight approach is an inappropriate and unacceptable means for disciplining children. This approach has been shown to cause short -and long-term harm and actually INCREASES the likelihood of re-offending among some participants."
A January op-ed for the Baltimore Sun titled "Scary -- and ineffective," written by Laurie O. Robinson and Jeff Slowikowski, two Justice Department officials, sites research that says those who participated in a scared straight type program were 28 percent more likely to offend than youths who had not participated. The Campaign for Youth Justice is calling for the show to be pulled from A&E.
In the episode I saw, there was a young man named Brandon who lived in Detroit. Brandon sported a tattoo on his right forearm of a skull and the word "Heartless" underneath and said he lived by the creed "MHD," which stands for "Money, Hoes, Drugs." Money brings women, and drugs bring money, Brandon explained. The worst he had ever done, he admitted, was shoot someone.