Bernice Gershenson

Does Risk Assessment Make a Difference? Results of Implementing the SAVRY in Juvenile Probation

An effective approach to reducing recidivism is, first, to identify a youths risk of reoffending and then to match the intensity of interventions to that risk level. This pre-post quasi-experimental, prospective study compared 247 (pre) with 217 (post) adjudicated youths to examine the implementation of the Structured Assessment of Violence Risk in Youth (SAVRY) and its effects on case management practices in Louisianas Caddo parish probation office. The results indicated that placement rates dropped by 50%, use of maximum levels of supervision dropped by almost 30%, and use of community services decreased except for high-risk youths, but only after the SAVRY was properly implemented. This shift towards more appropriate allocation of resources that are matched to risk level occurred without a significant increase in reoffending. The implications for implementation and for use of risk/needs assessment in juvenile probation are discussed.

Family options for parents with mental illnesses: a developmental, mixed methods pilot study.

OBJECTIVE The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate significant improvements in well-being, functioning, and supports and resources at 6 months post-enrollment in Family Options. Mothers report help from Family Options staff consistent with the intervention as conceptualized, and high levels of satisfaction with the intervention as delivered. CONCLUSIONS Innovative study design and analytic strategies are required to build the evidence base and promote rapid dissemination of effective interventions. Findings from this study will assist purveyors in refining the intervention, and will lay the groundwork for further replication and testing to build the evidence base for parents with serious mental illnesses and their families.

Development of a measure of the latency to needing a cigarette.

PURPOSE People addicted to smoking experience a recurrent physiologic need to smoke anytime when they go too long without smoking. Our purpose was to evaluate the reliability and concurrent validity of a measure of the time elapsed between completion of smoking one cigarette and experiencing the need to smoke another (the latency to needing a cigarette-LTNC). We also investigated the relationship between the LTNC and dependence-related symptoms. METHODS An anonymous, self-administered survey was completed by 134 current adolescent smokers, and in a separate study, 32 smokers were asked to complete a retest. RESULTS A frequent need to smoke was reported by 84.3% of the current smokers. Consistent with published case histories, the duration of the LTNC varied widely between the individuals. Among subjects who reported a regular need to smoke, 48% reported that their LTNC had shortened over time. The median LTNC among subjects who had smoked <100 cigarettes was 243 hours as compared with 2 hours for those who had smoked ≥ 100 cigarettes (p < .001). Test-retest reliability was reported to be excellent (r = .85, p < .001). As expected, LTNC correlated moderately and inversely with daily cigarette consumption (ρ = -.53, p < .001). It also correlated inversely with cue-induced craving (ρ = -.64, p < .001), psychological reliance on cigarettes (ρ = -.43, p < .001), nicotine withdrawal (ρ = -.57, p < .001), and pleasure obtained from smoking (ρ = -.39, p < .001). CONCLUSION The data obtained in this study support the reliability and concurrent validity of the LTNC measure.

Developmental Issues in Risk Assessment: Implications for Juvenile Justice

Abstract This study investigated two issues in youth risk assessment that may be important to juvenile justice agencies: (1) whether there are age-related differences that might impair the predictive accuracy of risk assessment across adolescence and (2) whether dynamic risk factors provide a unique contribution to risk assessment. The study tracked new petitions over an average 14.5-month follow-up for a large sample (n = 674) of adjudicated young offenders who received the Structured Assessment of Violence Risk for Youth (SAVRY). Findings indicated that age did not moderate the association between the SAVRY and reoffending between youth age 12 and under, age 13 to 15, and age 16 to 18. Dynamic risk factors had incremental predictive validity over static factors for each type of recidivism (e.g., violent, nonviolent) except probation violations. Implications to juvenile justice agencies include the critical importance of including dynamic risk factors in risk assessment tools of youth and the generalizability of these tools across age.

The retest reliability of nicotine dependence measures

Aim: As reliable instruments are needed for longitudinal research on the development of nicotine addiction, we evaluated the test–retest reliability of eight survey measures (three scales and five individual item measures). Methods: A paper survey was administered to convenience samples of adolescents in two schools and adults in five workplaces in Argentina and re-administered 1–2 weeks later. Test–retest reliability was assessed with Pearson correlations for continuous measures and kappa statistics for dichotomous measures. Results: Both surveys were completed by 95 adolescent and 88 adult smokers. The modified Fagerström Tolerance Questionnaire (r = 0.88–0.91), the Hooked on Nicotine Checklist (r = 0.85–0.91), the Autonomy Over Smoking Scale (0.91–0.96) and items assessing latency to needing a cigarette (r = 0.85–0.94), the pleasure obtained from smoking (r = 0.84–0.94), and relaxation obtained from the first cigarette (κ = 0.63–0.67), all showed very good to excellent reliability in both populations. Items assessing experiencing the need to smoke more often than previously and the percent of time smoking because of need appear to be more reliable with adolescents (κ = 0.52 and r = 0.76, respectively) than with adults (κ = 0.32 and r = 0.51, respectively). Conclusions: This is the first study to simultaneously compare the reliability of multiple smoking measures within individual adolescent and adult smokers. All the eight measures showed adequate reliability for use in longitudinal studies with adolescents and all but one were adequate for use with adults.

Developing Family Options: Outcomes for mothers with severe mental illness at twelve months of participation

ABSTRACT Family Options is a psychiatric rehabilitation intervention for parents with severe mental illness and their children who work with family coaches to set and achieve goals. The objective of this study is to compare changes in well-being, functioning, and supports and resources achieved from enrollment to 12 months by mothers participating in Family Options (N = 22) with changes from enrollment to 6 months. Mothers’ scores are compared on standardized measures of psychological distress, trauma symptom severity, mental and physical health status, social support, and the number of services needed but not received from enrollment to 6 months, and from enrollment to 12 months. Data were also obtained about help received and satisfaction with Family Options. Mothers achieved significant improvements in well-being at 12 months, as measured in terms of reductions in psychological distress and symptom severity scores. Significant improvements in social support and services received were reported at 6 months but not at 12 months. Mothers received help obtaining services and benefits for themselves and their children and were satisfied with the intervention. Findings underscore the importance of further refinements to the intervention and larger-scale, rigorous testing of Family Options.