New Jersey's assessment centers: Helping inmates take the final step toward release.
Assessment centers were designed to provide residents with a comprehensive assessment of their needs and an orientation to a treatment regimen prior to their transition to a halfway house. They provide inmates with a master treatment plan and a comprehensive assessment that halfway house staff can use to assist residents as they plan for their immediate future in halfway houses. This experience orients residents to the treatment process so their transition to the halfway house is smoother than if directly transferred from the prison environment. In addition, the assessment center process evaluates inmates' current risk levels, thus high-risk residents about to be released into the community can be returned to prison. Assessment centers are a new concept and no pre-existing models were used for their development. At this time, all assessment centers are located in New Jersey with some potential expansion in other states.
New Jersey's First Assessment Centers
The first New Jersey assessment center, Talbot Hall, opened in 1998 in Kearny as a 500-bed facility. In March 1999, the Bo Robinson Assessment and Treatment Center in Trenton was transformed from a halfway house to a 320-bed assessment and treatment center. Residents at Talbot Hall live at the facility for an average of 90 days, while Bo Robinson Center residents average a 60-day stay. The 30-day difference between the two centers exists because Talbot Hall staff work with men whose needs generally are more extensive than those of Bo Robinson Center residents. For example, Talbot Hall houses more residents classified as violent offenders, whereas the majority of Bo Robinson inmates have committed nonviolent offenses; approximately 50 percent of Talbot Hall residents' current offenses are categorized as violent and only 15 percent of Bo Robinson Center residents comitted violent offenses.
Assessment centers' twofold purpose -- an orientation to the treatment process and a comprehensive assessment of each resident -- uses a coordinated method in which treatment is conceptualized as a component of assessment and assessment as an element of treatment. Both assessment and treatment contribute to each other in a synergistic fashion, creating a system that is greater than the sum of its parts.
Treatment orientation is meant to expose residents to the elements of relapse prevention, change criminogenic thinking patterns and develop a set of realistic goals that residents can take with them. Residents are introduced to treatment information through lectures and small group interactions, Individual sessions with senior counselors are used to develop the initial treatment plan and the continuum of care plan. The treatment combines features of cognitive-behavior therapy, primarily Rational Emotive Behavior Therapy (REBT), a cognitive-behavioral form of psychotherapy that emphasizes changing the person's irrational thinking patterns; the principles of Alcoholics Anonymous and Narcotics Anonymous; reality therapy; and principles from the best seller, Seven Habits of Highly Effective People by Stephen Covey.
Comprehensive assessments of residents combine the ongoing, naturalistic observations of clinical staff with objective instruments that are administered and interpreted by assessment staff. The assessment process concludes with a summary report that includes residents' test scores from risk screening instruments and vocational tests, clinical staff evaluations, a comprehensive review of the official file and information from a structured interview. The assessment's purpose is to provide detailed information for the DOC's Classification Committee so DOC personnel may determine where residents should be placed. Assessment data also are used to formulate residents' master treatment plans prior to their departure from the facility.
The Assessment Process
Final recommendations for treatment and placement are based on the convergence of the information from a number of different vantage points. Residents are enlisted as active participants in the assessment and treatment process, and feedback about the assessment results are provided to residents. Residents' responses to the assessment feedback is considered a valuable source of clinical information. The following represents a breakdown of the various domains that are assessed.
Substance abuse assessment. The substance abuse assessment comes from a convergence of sources and recommendations about further treatment that are based on information from multiple sources. The assessment counselors administer the computerized version of C.A. Miller's Substance Abuse Subtle Screening Inventory-Third Version (SASSI-3) within the first five to seven days of the residents' arrival. SASSI-3 includes items that assess residents' open acknowledgment of alcohol and drug use for the six months prior to their incarceration. In addition, SASSI-3 contains items that the SASSI research team found distinguishes substance-dependent individuals from nondependent individuals even if the test-takers deny substance dependency. For example, some of the subtle items assess if the resident has committed crimes in the past and shows impulsive traits. The SASSI team designed the items in the instrument with a disease model of substance abuse in mind; in other words, without treatment, the resident's substance dep endence will be degenerative and lifelong, and even with treatment, he has to maintain a drug/alcohol-free lifestyle for the rest of his life. SASSI-3 results are sent to the assessment office where they are incorporated into the assessment report. The results also are sent to the senior counselor's office to assist with the development of each resident's initial treatment plan.
Residents' files also are considered valuable sources of substance abuse history. For example, results from the Addiction Severity Index, a test many residents were administered in prison, are incorporated into the assessment. If residents were in a prison-based therapeutic community, their files may have a progress summary. Substance abuse information also comes from a structured interview in which residents are asked direct questions about their substance abuse histories. Assessment counselors conduct the structured interview the week before residents are brought before the DOC Classification Committee hearing. Assessment counselors also gather this information from residents' senior counselors.
Cognitive and vocational assessment. The Wonderlic Personnel Test (WPT) is self-administered in a group format shortly after residents arrive at assessment centers. WPT assesses residents' cognitive functioning in a number of domains, including following instructions and independently solving problems. WPT is a well-known test designed as a brief measure of intelligence. Research has found that the WPT score is highly correlated with other measures of intelligence, including the Wechsler Adult Intelligence Scale. The results are used by assessment center staff in various ways, initially to assist staff in determining if residents need extra assistance in understanding the policies and procedures of the facility.
Residents who score low on WPT are assigned another resident as a "buddy" to provide extra support. Buddies are chosen by staff and are residents who have distinguished themselves as cooperative. Buddies support WPT low-scoring residents by familiarizing them with the assessment center rules and regulations. At a later date, results are used in the assessment summary to assist with vocational planning as scores can be tied into levels of cognitive functioning required for different occupations.
The Wonderlic Basic Skills Test (WBST) is a brief measure of residents' math and language skills. The WBST is administered to assess work-related math and language skills, and the scores can be tied in with the United States Government Dictionary of Occupational Titles (DOT). DOT is a reference book that has job titles and recommended levels of math and language skills for different occupations. Assessment counselors administer WBST and residents' scores are incorporated into the summary report. At a halfway house, staff members refer to DOT and find jobs that commensurate with residents' math and language skills as measured by the WBST.
Residents also are administered the Self-Directed Search (SDS), a self-administered, self-scored career interest inventory based on Holland's six-factor RIASEC (Realistic, Investigative, Artistic, Social, Enterprising and Conventional) personality theory. The theory behind SDS is that people are more likely to choose and continue a career that fits their personality. For example, a person who scores in the social and enterprising category would be interested in careers that involve interacting extensively with others. A vocation such as counseling would suit this person well. The information from WBST, WPT and SDS can be used in a halfway house for vocational planning to help match residents with jobs that align as closely as possible to their abilities as measured by these instruments.
Risk assessment. The Level of Service Inventor-Revised (LSI-R) is a risk/needs assessment instrument with strong psychometric properties that include an overall risk score that suggests the probability of recidivism and a series of recommendations based on the score. LSI-R comprises subscales that include dynamic factors such as attitudes and orientation. These subscales can assist with treatment planning. For example, a resident who scores in the very high need range for the education/employment subscale can be funneled into a vocational training program at a halfway house. Because LSI-R has a number of dynamic factors, the test can be re-administered to track residents' progress as they work their way through a program. The LSI-R total score has been shown to have good predictive properties for classifying residents into high-, medium- and low-risk categories.
Residents who have committed violent offenses, have psychiatric histories or exhibit behavioral problems at the facility are administered the Personality Assessment Inventory (PAI) to further determine their risk levels. PAI is a 344-item broadband personality inventory with 22 nonover-lapping scales. The test results include a full aggression scale, three aggression subscales (verbal, physical and attitude) and a violence potential index that is not linked to the aggression scale. Other special instruments include the Spousal Assault Risk Appraisal Guide (SARA), which is used when there is concern about domestic violence. SARA is a 20-item checklist with scoring information coming from an interview and collateral sources. The checklist includes items such as a history of violating restraining orders and attitudes that support domestic violence.
The Psychopathy Checklist: Screening Version (PCL: SV) assesses the possibility that a high-risk resident exhibits psychopathic traits. PCL: SV scores are derived from a structured interview and collateral sources. PCL: SV has 12 items including grandiosity, deceit and impulsivity. In addition, violent offenders are administered the Aggression Questionnaire (AQ), which is a 34-item specialized self-report instrument that assesses a variety of aggression domains, including physical, verbal and indirect aggression, and hostility.
In addition to the administration of instruments, a structured clinical interview and a comprehensive review of the file are carried out. The interview and file review assess a number of domains, including substance abuse, current level of risk for recidivism and the resident's family structure. During the interview, the counselor constructs a genogram, which is a schematic representation of the resident's family, with the resident. The genogram provides information such as family support and family history of domestic violence, substance abuse and criminal history, and highlights the possible generational transmission of criminogenic role modeling and substance abuse. The interview also includes questions about the resident's substance abuse history and treatment; psychiatric, medical, employment and military history; religion and hobbies/interests. The interview not only focuses on the resident's areas of need, but also on his strengths that can be used to moderate the risk factors in his life. The assessme nt counselor also notes how the resident behaved during the interview: Was he defensive with his answers? How cooperative was he with the assessment process? Was his story diametrically opposed to the file version of the current offense?
The assessment counselor also receives an evaluation form from the senior counselor that assesses the resident's progress in the facility. Senior counselors' roles include designing and implementing residents' treatment plans at the assessment center, while assessment counselors gather information to develop a comprehensive assessment of residents' current risk level and treatment needs. Senior counselors rate residents' behavior, job participation and overall program participation. Merits and demerits are attached to explain the ratings. This form provides dynamic information about the resident's behavioral status and is considered valuable assessment data. A key difference between the assessment center summary and an individual psychological assessment is that clinical and assessment staff work together to gather information about residents' needs and risk levels throughout their stays at the center. Observational data from clinical staff are considered critical for the comprehensive assessment of residents .
Assessment Center Education
Residents who have not completed high school nor earned a general equivalency diploma (GED) are evaluated with the Test of Adult Basic Education, which assesses residents' reading and math levels to assist with classroom placement for GED instruction. Residents without their GEDs prepare for the test with the INVEST learning program a computerized tutorial that evaluates residents' math and language levels, It uses this information to develop an individually tailored curriculum to assist residents as they prepare for the GED, which is administered on a quarterly basis.
Residents who are not able to use INVEST due to extremely low reading or math levels are provided with small group instruction, If residents have not obtained their GEDs at the assessment center, they can take the data from their INVEST learning on a computer disk and continue their preparation at the halfway house, as long as the halfway house has INVEST at its facility. Recently, New Jersey assessment centers became certified GED testing sites, and on Sept. 18, 2000, the assessment centers conducted their first GED testing with a group of residents.
Simultaneous with the assessment process, residents also are given treatment orientation. The treatment processes, like the assessment procedures, begin when residents arrive. Initially, a significant amount of time is spent by operational and clinical staff in orienting residents to the facility, the rules and regulations. During orientation, they are given a pretest to determine their baseline level of knowledge about the treatment and relapse prevention process. An initial treatment plan is developed through an individual interview with each resident and review of the SASSI-3 results. Throughout the course of their stays, residents are exposed to information about relapse prevention and changing criminogenic thinking in a didactic and small group format. Near the end of their stays, residents are given a posttest to gauge how much they have learned about the treatment process. Residents who score low are given feedback about their knowledge deficiency areas and data from the posttest are incorporated into the master treatment plan that is sent to residents when they are transferred to halfway houses.
Other programs include a family services program to help residents stay connected and/or build connections with their families, especial]y their children. Recognizing a need for aftercare, an alumni program also was instituted to help residents find employment, apply to college and for financial aid, and access other services after they complete their sentences. All residents compile resumes to take with them on their job searches. Data are being gathered by alumni staff to determine the outcome of the job searches.
Continuum of Care
Throughout their stays, residents and their senior counselors work together to create a master treatment plan or a continuum-of-care plan. The care plan includes the following categories: health/substance abuse, anticipated recovery plan, support network, criminal relapse prevention, psychological recovery, family support, educational plans, employment history, transportation needs and vocational/educational plans. This plan represents a combination of the dynamic and static factors that will positively or negatively impact the resident's level of recidivism. The plan also includes moderating factors such as if the resident has a supportive network in the community. At the end of the plan, the senior counselor writes up a discharge summary and treatment goals. After the continuum is completed and the resident signs the form, the information is passed on to the halfway house for further review.
Near the end of their stays, residents meet with DOC staff to determine their placement. The DOC chairperson and two other DOC personnel review the resident's files and the assessment counselor summarizes his results and provides a recommendation for placement. After careful review of the information, the DOC chairperson determines placement.
Residents are placed in halfway houses that either have intensive substance abuse treatment as a component of the services or provide a less intense level of treatment. Approximately 10 percent of the residents who are presented to the classification committee are deemed inappropriate for placement because their assessment by the DOC does not support their community placement. These residents are returned to their sending institutions for placement in a minimum-security prison. The decision to return a resident to prison is the sole responsibility of DOC personnel and is based on a review of the resident's file and the results of the assessment center's feedback about the resident's current risk level.
All halfway houses have a work release component and some educational opportunities. The halfway houses are sent a copy of the resident's assessment package to assist them with initial treatment planning. Prior to leaving the assessment center, the resident signs a release of information so the material can be transferred.
The assessment centers in New Jersey operate as modified therapeutic communities to assist full-minimum status inmates as they return to society. Residents follow a highly structured regimen and participate in a series of tests, interviews and surveys that help them develop, with staff assistance, a comprehensive assessment package and continuum-of-care plan. A strong component of assessment centers is staff working together in a systematic fashion to carry out the center's goals.
Staff are in the early phases of research in an effort to provide validation of this approach as a way of reducing recidivism and enhancing the quality of life for residents as they reintegrate back into society. Data from the comprehensive assessments are being analyzed to determine possible ways to increase the effectiveness of treatment programming. Staff hope that the outcome indicates that assessment center residents have a significantly lower rate of recidivism relative to the general prison population. Staff believe that inmates who receive treatment and assessment at these centers are better prepared to adjust to the halfway house environment and ultimately their communities than inmates who are transferred directly from prison to a halfway house. Further, the assessment center period aids public safety because the assessment process identifies high-risk inmates who should not be transferred to the less restrictive halfway house environment.
Ralph Fretz, Ph.D., is assessment director for community education centers at the Bo Robinson Residential Assessment and Treatment Center in Trenton, N.J.
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|Date:||Feb 1, 2002|
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