Evidence-based practices (EBPs) – interventions that have been shown through scientific research to produce positive outcomes—are becoming increasingly common in justice systems and behavioral health settings to influence behavior change and help people make lasting positive changes.
EBP is not a new concept. We rely on evidence every day. We wear a seatbelt because studies have shown that it decreases the likelihood of automobile-related injury or death. We brush our teeth because we know from research that it gets rid of bacteria that build up overnight. We wash our hands because we have evidence that it prevents the spread of germs.
8 Core Principles for Evidence-Based Practices
According to the National Institute of Corrections, 8 core principles underly evidence-based practices in justice and behavioral health settings:
- Use Actuarial Assessments
Each person in the justice or behavioral health system is different; similarly, the paths that lead them into and out of each system are different. Knowing the factors that lie beneath their behavior and the strengths they have to work on those factors will improve outcomes. Studies have shown that the most accurate way to determine a person’s strengths, challenges, and the likelihood of success is through the use of actuarial assessments. These assessments are more accurate than using professional judgment alone.
- Enhance Motivation to Change
While some people in justice and behavioral health settings will be motivated to change, others will not be…or they may not be yet. Research shows that there are five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Some people may still be in the precontemplation or contemplation stage; movement to the action stage is needed to be successful. One of the key ways to increase motivation to change is by developing a professional alliance, or rapport, with the person. Being strength-based, attentive, empathetic, non-judgmental, and empowering all help increase rapport. The use of motivational interviewing is also key: using active listening; recognizing, eliciting, and reinforcing change talk; and responding to resistance.
- Target Interventions
Research indicates that to help a person succeed, interventions should focus on those factors that most contribute to the person’s behavior—the factors identified using an assessment. And, the more factors targeted, the better—but not all at once. That would be far too overwhelming. There may be other challenges that would be helpful to address but working on these would usually not lead to the behavior change that would most benefit the person.
- Skill Train with Directed Practice
Often a lack of skills is behind a person’s harmful behavior. For example, they may have difficulty problem solving, coping with stressful situations, controlling emotions, recognizing unhealthy friendships, or resolving conflict. Helping people build those skills is crucial to assist them in changing their behavior. One of the most effective ways to teach and learn a skill is through “social learning”: modeling the skill for the person, practicing it together, reinforcing their efforts, increasing the difficulty of the practice, and encouraging the person to transfer their learning to their day-to-day environment.
- Increase Positive Reinforcements
We are good—maybe too good—at responding to noncompliance. A more effective way to encourage and reinforce positive behavior is to use incentives and rewards. In fact, studies have shown that a combination of reinforcements and responses to noncompliance is the most effective way to encourage positive behavior—with rewards outnumbering responses to noncompliance by a ratio of at least 4:1. Reinforcements can be extrinsic—words of praise, certificates of accomplishment, gift cards—or they can be intrinsic, for example, a person’s knowledge that they have worked hard toward a goal. We also know that rewards are most effective when genuine, immediate, customized, specific, and meaningful to the person.
- Engage Ongoing Family and Community Support
The time that justice system and behavioral health professionals spend with someone and the information they learn about them from assessments paint only part of the picture. Family—whether a person’s nuclear family, extended family, close friends, or community members who offer support—can provide additional insight that helps those working with them better understand and support them. Family and community members can be a positive influence in a person’s life, for example, helping them practice new skills, reinforcing their positive behavior, and working with them to address issues such as housing, employment, transportation, and child care—all of which can be barriers to people’s participation in treatment and programming.
- Ensure Fidelity to Processes and Practices
Outcomes improve when processes and practices are implemented as intended—that is, with fidelity. Conversely, when implementation is flawed or “drift”—the process of slowly departing from an endorsed, proven procedure—occurs, desired outcomes are less likely to be achieved. Putting in place quality assurance (QA) and continuous quality improvement (CQI) processes helps ensure fidelity. With QA, an agency looks back in time to determine whether practices have been delivered as intended; with CQI, an agency uses feedback to facilitate incremental improvements in staff performance and organizational processes. To effectively implement QA and CQI—to determine if the evidence-based practices agencies have adopted are producing the desired results—data is needed. But first, agencies must determine the specific areas for which they want to collect data and define performance measures for those areas.
- Use Data as a Guide
It isn’t enough to gather data; the data has to be analyzed, shared, and used to identify the specific improvements needed and to develop an improvement plan. More staff may have to be recruited; training for new staff, booster sessions for experienced staff, and coaching for all staff may need to be a greater focus; technological advancements may be required. And, once improvements are in place, it’s important for agencies to continue tracking performance data to ensure the improvements are successful.
Implement Evidence-Based Practices with the Help of Carey Group
Decades of experience demonstrate that aligning justice and behavioral health systems around evidence-based policies and practices offers the greatest promise of success. Using evidence-based practices will help organizations achieve their mission, improve their outcomes, and maximize their investment.
Carey Group is a leader in the implementation of EBPs and has worked with more than 200 agencies from across the U.S. to develop and maintain an evidence-based framework.
Carey Group’s evidence-based training and consulting services address the needs of justice system and behavioral health professionals. Training is an essential tool for keeping staff, supervisors, leadership, and stakeholders up to date with emerging knowledge and expectations for improved outcomes. Carey Group offers in-person, online, and self-directed courses on evidence-based practices, motivational interviewing, core professional competencies, case planning and management, continuous quality improvement, coaching, and the use of behavior-change tools and supervisor resources.
Carey Group also collaborates with agencies to identify ideas for improvement, develop strategic action plans, coach leadership, and facilitate change.
Carey Group (Consulting and Publishing) is a national consulting and publishing firm that equips justice system and behavioral health professionals with knowledge, skills, and tools that improve the lives of clients. We make this possible by providing an array of staff training, organizational consulting services, and evidence-informed intervention tools. Contact us today to learn more about our evidence-based training and consulting services.