What’s Wrong With Court-Ordered Behavioral Education Programs?  Just About Everything

 

by

 

Peter J. Favaro, Ph.D.

Executive Director, SmartParenting, The Family Center

CEO, New York City Conflict Resolution Services

pfavaro@aol.com

www.nicerny.com

www.behavioranalytics.net

 

This conference originally had the words "Behavior Modification" in the title. Technically, that misused the term.  “Behavior Modification,” is a very specific set of techniques, designed to increase or decrease the frequency of behavior through various types of rewards or punishments. Chances are, and this is only because I am a psychologist who favors behavior modification (my area of training and expertise), if we relied more on behavior modification, we would probably get much further with the people whose lives we try to bend and shape when they do bad things, or more frequently when they do stupid things, because after thirty years of experience, it is my conclusion that the people we serve are more often foolish than evil.

 

But let’s stop at bending and shaping for a second, so that I might remind everyone in the former Soviet Union when people comported themselves in ways that were objectionable to society they were referred to asylums for behavioral correction. Behavioral correction was routinely ordered for criminal behavior, delinquency, and drug and alcoholism. (1)

 

Therapeutic methods were often not very humanistic, and quite punitive. Yet despite what most would consider some rather draconian attempts to persuade people to conduct themselves in more mentally healthy ways, those problems were often seen with great frequency, both in the society itself and in the relapse rates of past offenders. And so, the best way to cure these problems were just to kill them out of people, or send people to very cold, very far away places to contemplate the consequences of their actions. These dispositions are not really readily available to us in the here and now.

 

Thinking further still, we don’t have to stand on the shores of the Baltic Sea, holding hands with Sarah Palin and squinting toward what is not communist Russia anymore, we merely need to look over our shoulders and into our own pasts right here in this country to remember the days when we lobotomized people who misbehaved, poisoned them with toxic chemicals, drilled holes in their heads or burned them at the stake.

 

Conclusion: we really don’t like it when people misbehave. But better the disposition to an anger management program than to a session of evil spirit banishment through the swiss cheesing of someone’s head. However, the research seems to indicate that efficacy is a problem, despite which technique is used. We have become more civilized and humane in what we tell people they must do, but probably not a bit more effective when it comes to education and prevention.

 

I attended a program by invitation of one of the smartest and nicest judges I have ever encountered, Judge Evelyn Frazee, in Albany, quite a few years back. The idea was to create a standardized parenting program and this sounded like something I was interested hearing more about. As it turns out participating was just not my cup of tea because the state was insisting on the provision of service at a very low fee and with the demand that anyone who couldn’t pay had to be given a sliding scale. I saw the sliding scale part as an administrative nightmare, and in my practice I already take on about a quarter of a million dollars in pro bono work annually. But the principles behind the construction of the programs were sound.  It required among other things, submission of the curriculum to a panel of peer reviewers, a team of experts in both court process and parenting to teach various modules of the course, and a level of accountability for the people who took the courses.

 

My ultimate choice not to participate in the program leads us to the first and largest problem we encounter – there are very few places to send people for court ordered behavioral intervention programs. Absence of providers, I have found, almost always paves the way for program providers with dubious to no credentials to bottom feed off of the court appointed circuit because as long as there is a place to send people, referrals will be made. Secondly, as long as referrals are taken by the service provider, referrals will come by the droves. It makes the path of least resistance, even less resistible.

 

For licensed professionals like psychiatrists, psychologists and social workers the issue of over referring is generally not a problem. Generally speaking most licensed professionals who went to school for many years and worked hard for their licenses, won’t take ten bucks an hour to do work. Only the most crazy providers will take ten bucks and hour to work with a population as difficult as the population we service.

 

Some professionals will take a portion of their practice in this arena as a loss leader for the provision of other more lucrative types of referrals. I for one am not ashamed to say that I have offered certain services like supervised visitation at a very low fee because I know it leads to the referral of more forensic evaluation and parenting coordination cases, which bring in more income. My business model has always been one of given take so performing the amount of pro bono services that I do is easy because it is balanced by more lucrative referrals. I could not do all pro bono work because I can’t afford to, and I could not maintain a living of all “good paying” cases with a clear conscience. The point is, I get to choose.

 

There are unlicensed, unregulated court service providers who perform high volume, low cost services and I believe this is a problem on many levels, but the one I will highlight is lack of consumer protection. Licensed professionals must always answer to the State Board of Regents who provides administrative oversight in the form of the Office of Professional Discipline, which reviews complaints as matters of consumer protection.

 

Unlicensed practitioners who go by the titles, “educator,” “therapist,” “trainer,” “psychotherapist” all very legitimate sounding credentials, are unlicensed. The only licensed mental health professionals in the State of New York are “psychiatrist,” “psychologist,” “social work,” and “licensed counselor.” As a side note, you can’t combine the words by calling yourself a “psychological therapist.” In my profession, by law you cannot call yourself a “psychological educator,” or a “psychological trainer.”

 

Also, you should be wary of licensed practitioners who oversee but who do not provide service. In my practice, we only use licensed social workers, licensed psychologists, and in very limited roles, approved psychological interns to do work. When consumer complaints are filed involving people who work for the professional who runs the place, it is the owner/operator who gets called onto the carpet and asked whether the actual service provider was licensed.

 

Be wary of “specialty monikers” used by unlicensed professionals who make themselves sound like highly trained professionals but who carry no license or educational credentials. “Sex abuse specialist” and “validator” are examples of this con job, perpetrated in many jurisdictions. All you would have to do to make a living as a court specialist who makes money through court referrals is to:

 

1.      Invent an official sounding title for yourself, like “sex abuse expert,” or “validator” or “parenting educator.”

2.      Build a resume by offering free lectures or “in service training” programs to government agencies or programs.

3.      In less than two years time you would surely sucker in enough police departments, schools and others who don’t have the budgets to pay for the service from someone with real credentials and most lay people can’t tell the difference between real credentials and fake ones anyway.

4.      Print your resume and offer it to the court system.

5.      Rake in the referrals.

6.      Then hold yourself out for the real money which comes when people pay you for expert testimony.

 

It is at this last step when things get really dicey. The case law tells us that experts don’t need licenses. All they need is experience. Most judges don’t listen carefully enough to the credentials of the people who testify, and most lawyers are not skilled enough at voir dire to uncover their con artist path to expertise, so abuses and misrepresentations abound, right under our very noses, and quality control becomes a mere pipe dream.

 

This set of dynamics have led to debacles of proportions significant enough to free wrongly convicted sex offenders and ruining the lives and reputations of many people ravaged by these abuses.

 

So whether it is for the purpose of providing a service, or providing testimony which leads to the referral for service, let’s be mindful of the operations out there, and let us demand a quality of service that is overseen by a regulatory agency.

 

The system suffers from a guilty conscience and often operates on the principal that “something is better than nothing and we don’t have enough room in jail for all the people who do bad things so let’s send them for behavior education,” with an unlicensed, unregulated educator, such as an “anger management educator”. Once again, the consumer is unprotected. But what about people like me, licensed and professional, who run anger management programs and other psychoeducational programs? I am licensed and I am regulated, but I can’t prove that anything I do works to reduce the relapse rates of people who are referred to me for anger management. The research shows that anger management education does not reduce the rate of domestic violence incidents. What is the solution here? Do we just stop trying to put our efforts into educating people about anger? I don’t think so, but I do think we look toward developing what are called “evidence based practice” parameters, where individual practitioners become accountable for proving that what they do works and how often it works. This is where my practice is heading more and more these days. For instance, while I can’t tell you about anger management referrals yet, I can tell you, thanks to the doctoral students who pour through my data what the success rate is for people who are referred to my office for what we call reconciliation counseling. This is a program designed to address the problem of what happens when children are estranged from parents during and after divorce – the cases where kids refuse to see their parents for visitation and effectively model the parents behavior by “divorcing” one of them. We have a structured therapeutic protocol for this and I can tell you how often this protocol succeeds and at what ages it succeeds more or less.

 

It is not enough to send people somewhere to pay money for an exercise that does nothing to change behavior. It is time to place demands on practitioners for minimum levels of credentialing and training, and it is time to do some research. You know the Ph.D. is a scientist/practitioner degree. When you get a Ph.D. you are supposed to be able to evaluate what you do. I can’t think of a more important setting than the court setting to at least try to keep track of how well you do the things you get paid to do.

 

The solution to these problems and the other fifty or so that I don’t have time to mention today is innovation. We need the ability to provide low cost, consumer protected, well-researched programs to people.

 

I wear a second hat, and that hat has to do with technology, which I see as having great potential in assisting practitioners in delivery and measuring the efficacy of services of all kinds.  I will give you one example:

 

People are referred to me for conflict resolution. My New York City office, New York City Conflict Resolution Services deals with this type of referral almost exclusively. High conflict divorce litigants need conflict resolution assistance. However, there are several problems associated with this type of referral.

 

What if there is an Order of Protection?

 

What if when people get in the same room all they do is argue and act like they are trying their cases?

 

What if the conflict escalates because of eye rolling, sarcastic commentary, aggressive posturing and body language?

 

What if one or the other parties stalks one another on the trip home?

 

To address these issues I created something called “internet based moderated communication,” which is a piece of technology that works like a chat room. Three people share a common screen and each can type at their keyboards and what they type will appear on the common screen. It is a discussion via text which I like for a number of reasons including that when people have to write what they are thinking they tend to censor a little more than if they are spewing in an angry rage. But let’s say the people you are providing service to are lawyers (or psychologists) and they are bad at censoring things…that’s when the moderated part comes in. Before the text is sent to the screen it must be approved by the moderator, so if there is anger, threats, hostility, sarcasm, criticism, bad language, etc., the moderator can send it back to the speaker and even suggest a more civilized way of saying what they were intending to say.  The net-net of moderation is that people only see civilized language, they learn the skills of expressing themselves in a civilized way, the anger and hostility is not reinforced either, and problems get solved.

 

The icing on the cake is that the entire interaction is memorialized. It can be rated, counted, plugged into an empirical methodology, examined for its effectiveness. For behavior counters such as myself this is exciting and stimulates other creative, innovative ideas about modifying people’s behavior.

 

Is technology the be-all/end-all solution for creating more effective dispositional outcomes? No, nothing can be, but it is a great jumping off point for discussing change, and that’s why I am delighted to have been part of this program.

 

 

 

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(1) Deviance in Soviet Society. Crime, Delinquency, and Alcoholism. WALTER D. CONNOR. Columbia University Press, New York, 1972

 

 

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Last updated January 11, 2011

 

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