New treatment model beginning to show positive changes at Lincoln Hills
IRMA, Wis. (WSAW) - Staff at Lincoln Hills/Copper Lake Schools are beginning to get in-person training in dialectical behavior therapy. It is the treatment model the Wisconsin Department of Corrections, Division of Juvenile Corrections is moving to in order to improve conditions at the facility and for the lives of youth and staff outside the fence.
For the last four years, Wisconsin has tried to make changes to address the safety and security of youth and staff at the facility, which has been plagued with violence.
“We have youth that (sic) have strong impulses and have difficulty managing those impulses,” Ron Hermes said.
He took the position of DJC administrator in August 2019. By the end of that year, he was working with the monitor, who is court-ordered to see that the DOC is meeting the terms of its settlement after families of juveniles injured or neglected by staff sued the state, as well as the executive director of the Council on Juvenile Justice Administrators to determine the best practice for DJC to implement as it transitions from a traditional corrections environment to more of a treatment environment.
‘We really focused on DBT as being the approach we wanted to take,” Hermes explained. “We had some clinicians that were doing DBT work, but we had not implemented dialectical behavior therapy, DBT to its fullest extent.”
They were pointed to the practices used in Utah and Massachusetts, which have been using DBT in their juvenile facilities for one to two decades, respectively. In Dec. 2019, DJC sent a team to Utah to see what their system was all about. In January, they reached out to Dr. Lesley Baird Chapin, a licensed psychologist who has implemented DBT in smaller sections elsewhere within the DOC, to see if she would be willing to implement DBT on the full DJC scale.
She agreed and they intended to begin implementation and training in March 2020, but the pandemic delayed the effort six months. They officially contracted her in August to begin overhauling the juvenile justice system.
“DBT is a cognitive behavioral therapy, which means it addresses thoughts and it addresses behaviors in a very targeted way,” she stated.
Chapin said there are five components to DBT, those being:
1) Individual therapy
2) Skills training, which is done in a group format
3) Skills coaching, which helps people to apply the things they are learning in real-life scenarios
4) Consultation team for the DBT providers to ensure they are getting ongoing consultation and support while working with high-risk patients
5) Structuring the environment through conversations with ancillary treatment providers
Some staff members have expressed to 7 Investigates that they are skeptical of the practice because they have practiced cognitive behavioral therapy work before at LHS/CLS.
“In my mind, that’s actually a plus because we’re not starting from scratch,” Chapin responded. “A lot of people understand the concepts and the reason why some of these skills work and how to use them.”
She said DBT builds on other cognitive behavioral therapies and those add-ons are impactful. The evidence-based practice is proven to improve the overall life of those being treated as well as the treatment providers. Chapin and Hermes said DBT is just as much about improving the safety, health, and well being of the staff as it is the youth. Part of the goal is to be able to reduce the number of incidents happening at the facility and be able to help youth gain skills to manage the strong impulses they have.
Some of the examples she gave to how it builds on other cognitive-behavioral models are that it is rooted in mindfulness-based practices that require both the youth and staff member to use mindfulness skills when interacting. It also requires staff of all levels, including management, to use mindfulness when interacting with each other and is structured around having regular consultation with staff to ensure the practice is being done effectively and that the staff has support.
Most of the training for staff so far has been held virtually, but Chapin said she is beginning to conduct them in-person, providing refresher training, helping people think behaviorally, re-encouraging, reinforcing, and modeling how to have effective interactions with one another and build relationships, “because DBT works because of the relationships.”
She said because it is a transition, not every part of the implementation has gone perfectly, but she said there is a noticeable positive change in the climate at the facility. She said staff have begun to use it in their personal lives, finding benefit and even teaching it to their own children.
“That’s what the kids want to know about when you’re teaching these skills, is do you do this? How does this work, you know, how does this work for you? Who are you to tell me? And so, we’re trying to close that divide of the, like, us-them thing and say, this just works.”
Overall Chapin said it has been well-received and youth are also noticing a difference too.
The practice has not been fully implemented yet, but Hermes said pieces of it have been piloted in different living units around the facility so they can learn what works and what needs changing so that the practice works the way it is intended to work. He urged they have been very deliberate with their roll-out, moving onto more implementation when they see the staff ready to move forward to create a system of care across the state for how youth are treated in a juvenile corrections setting.
With the implementation ongoing, Hermes said it is too soon to determine the efficacy of DBT at the facility. One of the improvements noted in research about DBT elsewhere is that there is an improvement in recidivism. 7 Investigates requested current recidivism data from the DOC, however, they said that data is not tracked by facility since many individuals move within the corrections system, with some institutions designed to prepare inmates for release while others are designed for long-term sentences. Hermes said he was unsure about the existing recidivism rate for LHS/CLS youth. The DOC has had documented issues with its records system in years past. Hermes said it is possible that they will have to create a starting point with DJC recidivism data if it does not already exist.
Chapin noted they are still working on different ways to measure success with DBT implementation including using a mix of objective measures as well as survey and self-report data from youth and staff. Some of the things they want to measure include staff burnout - she said it was a big problem they are working to reduce, having youth survey their grasp of self-coping practices every six months, and collecting observational data like weekly reviews of youth progress through growth teams. Those growth teams can talk with youth about non-compliance or concerning behaviors, while also reinforcing and highlighting things that the youth is doing well. They also plan to collect objective data on staff overtime, staff assaults, youth assault, and conduct reports to see if the climate change objectives are taking hold.
“Life in the facility is, kind of, the tip of the iceberg. I mean, ultimately, what we’re wanting is for youth to leave custody feeling like they have a broader array of skills that they can use and even more than that to really feel hopeful about their future,” Chapin noted.
“Our purpose is to work with these youth so that when they are released back into the community...they can be successful and be an important part of their community,” Hermes added.
With the knowledge that youth will not remain for long at LHS/CLS as the state slowly moves to a regional model, Hermes and Chapin said DBT can move easily to wherever the youth are. Youth at LHS/CLS typically serve a little less than a year to a year’s time at the facility.
Hermes said he is hopeful that as they do this sweeping change that other areas of juvenile and adult corrections either begin to use DBT or expand its use. Chapin was presenting about DBT to the Division of Community Corrections the same day of this interview to help guide how it can be implemented outside of a facility.
Chapin also does outpatient work for adolescents and adults as the vice president and executive director for the Pauquette Center for Psychological Services, which has eight clinic locations in Wisconsin including Richland Center, Reedsburg, Baraboo, Portage, Columbus, Prairie du Sac, Madison, and Whitewater. She said they provide telehealth as needed to reach more areas of Wisconsin.
Chapin along with others are also providing a year and a half-long comprehensive DBT training for teams of mental health providers who work in Wisconsin. The goal is to provide teams with the knowledge and experience needed to provide comprehensive DBT. Applications are due June 18. To learn more and apply, click here.
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