Offender incentives and behavioural management strategies (Full report)

Publication

  • No R-214 - Summary
  • July 2009
  • Ralph C. Serin & Laura J. Hanby

Introductory Statement

This document contains a two-part report on Offender Incentives and Behavioural Management Strategies. Part 1 contains a literature review examining the effectiveness of incentive systems in managing offender behaviour. This review sets the stage for Part 2 which contains a discussion of measurement, policy development, and implementation issues. The reports are presented in the format they were delivered to the Correctional Service of Canada. The authors retain full responsibility for the format, style and content of the report.

Ralph C. Serin & Laura J. Hanby
April 2009
Carleton University
Completed Under Contract for the Research Branch,
Correctional Service of Canada
23 March 2009

Abstract

This review juxtaposes several themes across more than three decades in an effort to highlight consensus in the published literature regarding factors that might influence offender behaviour. To reduce the occurrence of misconducts and violence in prisons, various strategies have been explored. Contingency management programs in the form of individual and systemic incentives are the focus of this discussion, with examples drawn from both correctional and non-correctional settings. It is clear that the development of behavioural management strategies is complex in that only a minority of offenders commit serious misconducts and that issues of fairness are often compromised when broad-based discipline strategies are attempted. Overall, the results regarding the effectiveness of incentive systems to manage offender behaviour is mixed. There is increasing consensus regarding what not to do but far less consensus regarding viable next steps.

This review sets the stage for discussions about effectiveness; policy development; policy implementation; and context. Liebling's (2008) paper is perhaps the most ambitious and salient among all published work in that it provides a meaningful context to appreciate the purpose and challenges of implementing a standardized incentive model in a correctional setting. Much of her comments mirror discussions that have surrounded this topic in Canada and at Correctional Service of Canada for the past decade. From that perspective, it is a useful start point for the subsequent aspects of this work (consultation, identification of offender-centric incentives, measurement of offender compliance, etc.).

Table of Contents

Offender Incentives and Behavioural Management Strategies

Similar to the patterns of criminal behaviour in the community, involvement in institutional misconduct is not evenly distributed among inmates. Instead, a small segment of the inmate population is disproportionately represented in official records of prison rule violations (Flanagan, 1983). The characteristics of offenders prone to involvement in institutional misconducts have been investigated extensively. Some of the characteristics that have been considered include age, race, antisocial attitudes and behaviour, criminal history, prior institutional behaviour, and gang affiliation. The environment may also play a role above and beyond personal characteristics in explaining rule violations and acts of violence. The occurrence of institutional misconducts and violence in prisons can be attributed in part to the impulsivity of a large proportion of the inmate population. Pharmacological strategies have been implemented as a solution to control the impulsivity of inmates, and consequently reduce violence in correctional institutions. The use of drugs to control and change behaviour has been widely criticized (e.g., Blumenthal, 2006; Wong, 2006; Wyatt & Midkiff, 2006). An alternative approach to modifying inmate behaviour is providing incentives to offenders, through the use of contingency management programs.

The purpose of this literature review is to present evidence for and against the use of incentive schemes in correctional settings. An effort was made for a fairly inclusive review in order to determine if there existed successful behavioural management strategies both within and outside the field of corrections. First, the context for implementing contingency management programs will be presented through a discussion of the issues of institutional misconducts and the use of pharmacological strategies in institutions. As well, this literature describes broad approaches to reducing misconducts that essentially fall into punishment versus incentive and treatment efforts. The latter is perhaps best exemplified in non-correctional literature (e.g., addictions, mental health) and reflects both individual incentives (i.e., tokens, vouchers, money) and systemic incentives (i.e., contingency management, levels with gradations of privileges). Presently, the results regarding the effectiveness of incentive systems to manage offender behaviour is mixed at best. Similar to offender programming, there is increasing consensus regarding what not to do but far less consensus regarding viable next steps. Lastly, the role of individual differences in the sensitivity to reinforcement will be discussed as a factor to be considered in implementation and practice.

Literature Search Strategies

Using keyword searches, a review of the literature regarding the use of incentives to manage and modify behaviour was undertaken. Two electronic databases were searched: PsycINFO and the Educational Resources Information Centre (ERIC). The reference sections of the articles chosen to be included in the review were examined to search for any other relevant studies that had not been identified in the keyword searches. Incentive programs and behavioural management strategies were searched in the areas of corrections and other clinical populations (e.g., substance abusers, mentally disordered, and low functioning individuals). The positive parenting literature was searched, although the research located was not directly relevant to incentives and behavioural management strategies. Research regarding institutional misconducts was examined at length to provide a context underlying incentive approaches to managing offender behaviour. Pharmacological strategies to control impulsivity and violence were also briefly reviewed.

Institutional Misconducts

Similar to the patterns of criminal behaviour in the community, involvement in institutional misconduct is not normally distributed among inmates. Instead, a small segment of the inmate population is disproportionately represented in official records of rule violations (Flanagan, 1983). The frequency of institutional misconducts decreases as the seriousness increases, and many fewer inmates are involved in serious forms of violent misconduct (Cunningham & Sorensen, 2007a). In a review of over 24,000 inmates in Florida in 2003, while almost half incurred some form of disciplinary report, only 14.7% were sanctioned for misconduct representing violence potential and 4.5% for an actual assault (Cunningham & Sorenson, 2007b). The notion of a "new" offender has been proposed to explain serious misconducts, one that is more aggressive and difficult to manage (Innes, 1997). This offender is defined as younger, generally African-American, urban, and before coming to prison was involved in gangs that used or sold drugs and employed violence.

In the past two decades, the characteristics of offenders typically involved in institutional misconducts have been investigated. One of the consistent predictors of various types of misconducts is age. Age has been found to be inversely related to rule violations, misconduct, and violence in prisons (Berk, Kriegler, & Baek, 2006; Chapman, 1981; Cunningham & Sorensen, 2007a; Cunningham & Sorensen, 2007b; Edens, Poythress, Lilienfeld, Patrick, & Test, 2008; Flanagan, 1983; Gendreau, Goggin, & Law, 1997; Gillespie, 2003; Griffin & Hepburn, 2006; Innes, 1997; Jiang, 2005; Jiang, Fisher-Giorlando, & Mo, 2005, Steiner & Wooldredge, 2008). Race has also been examined as a predictor of institutional misconduct, with mixed findings. Innes (1997) examined whether the prevalence of the "new" offender in prisons explained the increasing number of misconducts in the U.S. This model of a new type offender, as young and African American, worked best in predicting less serious misconducts and rule violations but did poorly in predicting the most serious forms of violence. Jiang and Fisher-Giorlando (2002) found that neither race nor age was related to violent and nonviolent incidents against staff or other inmates. However, race has been found to significantly predict misconducts in a number of recent empirical studies (Berg & DeLesli, 2006; Jiang, 2005; Jiang et al., 2005, Steiner & Wooldredge, 2008).

In a meta-analysis of 39 studies that generated 695 correlations with prison misconducts, Gendreau et al. (1997) found that antisocial attitudes and behaviour were among the strongest predictors of prison misconducts, in addition to age and criminal history. These antisocial attitudes and behaviour included substance abuse, companions, prison adjustment, and interpersonal conflict. Criminal history has been found to be related to misconduct in a number of other empirical studies (Berk et al., 2006; Chapman, 1981; Cunningham & Sorensen, 2007a; Cunningham & Sorensen, 2007b; Innes, 1997; Jiang, 2005). Misconducts are significantly more likely to occur among inmates with a history of violence (Cunningham & Sorensen, 2007b; Griffin & Hepburn, 2006) and prior incarcerations (Cunningham & Sorensen, 2007a; Cunningham & Sorensen, 2007b; Griffin & Hepburn, 2006; Jiang, 2005, Steiner & Wooldredge, 2008). Related to criminal history are characteristics of the current offence that have been linked to misconduct. For example, Flanagan (1983) found that high-rate disciplinary offenders were more likely to have committed an offence other than homicide. Jiang and Fisher-Giorlando (2002) discovered that inmates convicted of a drug offence had a higher number of violent incidents than those not convicted of drug offences. A history of drug use is also correlated with both violent and non-violent misconduct (Flanagan, 1983; Jiang & Fisher-Giorlando, 2002; Jiang, 2005, Jiang et al., 2005; Steiner & Woolredge, 2008). The role of sentence length in explaining misconducts has been mixed. While Berk et al. (2006) has found that inmates sentenced to longer prison terms are more likely to engage in misconducts, Cunningham and Sorensen (2007b) found that longer sentences were related to lower rates of infractions. The time served influences misconduct due to being incarcerated for a briefer period allows less time to get into trouble, although this relationship is not linear (Innes, 1997).

Social support can enhance an inmate's moral commitment to others and to legitimate social institutions, strengthen family ties, situate them in prison, and increase self-control (Jiang et al., 2005). These effects are thought to produce a lower likelihood of violating prison rules. Jiang et al. tested this relationship, discovering that social support at both the inmate and prison levels were negatively related to overall rule violations and particularly violent and drug/property related violations. Misconducts are more likely to occur among inmates that have never been married (Chapman, 1981). Contrary to prior research, Jiang and Fisher-Giorlando (2002) found that married inmates and those with more children had a higher number of violent infractions. Less job stability prior to incarceration is also a predictor of institutional misconducts (Chapman, 1981).

Gang affiliation, both within and outside prison, has shown some association with institutional misconduct. Inmates with a history of gang activity prior to incarceration have been found to engage in more rule violations than those with no history (Berk et al., 2006; Gillespie, 2003). In particular, gang affiliation has been found to have an effect on violent misconduct during the early years of incarceration (Griffin & Hepburn, 2006). Gaes, Wallace, Gilman, Klein-Saffran, and Suppa (2002) examined the effects of prison gang affiliation on prison misconduct. Controlling for violent risk, previous history of violence and other background factors, membership was found to increase violent and almost all other forms of misconduct, including rule infractions and actual crimes. Prison gang affiliation as a predictor of violent misconduct has been replicated by Cunningham and Sorensen (2007b). Gaes and colleagues also investigated the impact of gang embeddedness, which distinguishes whether someone is a core or more peripheral member of a gang. Core members were more likely than peripheral members, and peripheral members were more likely than unaffiliated peers to commit violent misconducts.

The environment or institutional factors can also play a role in rule violations and violence committed by inmates. In the meta-analysis conducted by Gendreau and colleagues (1997), institutional factors were among the strongest predictors of misconducts. Facility-level predictors of misconduct include the proportion of inmates incarcerated for violence, proportion of inmates that use drugs prior to incarceration, proportion of inmates participating in programs, and a maximum security level of the facility (Steiner & Wooldredge, 2008). Misconducts can be predicted from security level, with a lower likelihood of violence and incidents against staff in lower security levels (Jiang & Fisher-Giorlando, 2002). However, Innes (1997) suggests the relationship between security level and misconduct is ambiguous since higher security levels have closer supervision but also a tendency to ignore minor infractions (e.g., insubordination). Camp and Gaes (2005) tested whether different security levels of institutions makes inmates more criminal while incarcerated. A sample of 561 inmates with the same level of risk to commit institutional misconducts were sent to either the lowest security level or one step down from the highest security level prisons in California. The inmates were equally likely to commit misconducts regardless of their security level assignment, not supporting the conclusion that prisons are criminogenic or that there is a relationship between security level and misconducts. In sum, Gillespie (2003) suggests that although both individual characteristics of inmates and institutional qualities affect prisonization and misconduct, institutional factors are weak predictors of behaviour. It would seem that meta-analytic reviews support the importance of institutional factors (i.e., security level) but that more specific investigations question this conclusion.

In order to reduce misconduct behaviour, three general strategies have been proposed (French & Gendreau, 2006). First, "get tough" advocates promote a return to "no frills" prisons with fewer services, as well as a greater use of solitary confinement and lash and chain gangs. Second, prison management and situational control strategies include a broad group of strategies (i.e., crowding, prison design, staff-prison ratios) which focus on minimizing opportunities for antisocial behaviour. Lastly, the provision of treatment programs could produce roughly equivalent reductions in prison misconducts (e.g., 20% to 30%) as they do in reducing recidivism. French and Gendreau conducted a meta-analysis of 68 studies to assess the effectiveness of correctional treatment for reducing misconducts. Behavioural treatment programs produced the strongest effects (r = .26), while the number of criminogenic needs targeted and program therapeutic integrity were important moderators.

Pharmacological Strategies

Institutional misconducts and violence in prisons can be attributed in part to the impulsivity of offenders. Edens et al. (2008) investigated whether institutional misconducts, aggressive infractions, and nonaggressive infractions among male inmates could be predicted using the Psychopathic Personality Inventory (PPI). The impulsive antisociality scale of the PPI, consisting of Machiavellian egocentricity, impulsive nonconformity, carefree nonplanfulness and blame externalization, was found to predict all three outcomes. This study highlights the role of impulsivity in rule violations and violence in prisons. Impulsivity, anger and denial of problems have been cited as the clinical problems most frequently observed in mentally disordered offenders (Quinsey, Harris, Rice, & Cormier, 2006).

Pharmacological strategies have been proposed as one solution to control the impulsivity of inmates, and consequently reduce violence in prisons. The primary goal of drug treatments is to gain immediate control of the aggressor's behaviour to prevent or stop injury, destruction, and/or disruption (Rice, Harris, Varney, & Quinsey, 1989). For instance, Wilcox (1994) tested the effects of divalproex sodium (an anti-convulsant) on 35 individuals with a variety of psychiatric illnesses. The medication was found to reduce agitation, particularly in patients with bipolar illness or borderline personality disorder. Lawson and Nanos (2006) examined the effects of divalproex to treat violent and disruptive behaviour in a correctional setting. The anti-convulsant reduced behaviours directed against self in 17 jail inmates, but did not significantly reduce disruptive behaviours toward others.

Since the 1970's, there has been a declining interest in behavioural programs, as demonstrated by a drop in the number of publications on behavioural treatments (Wong, 2006). Psychotropic medications have become the treatment of choice for mental and behavioural disorders (Wyatt & Midkiff, 2006). Quinsey et al. (2006) suggest that even the occasional occurrence of aggression toward self or others within an institution is likely to mean that an individual is not considered for any intervention other than pharmacotherapy.

Blumenthal (2006) argues that billions of dollars are spent annually to control and change behaviour with drugs, as a result of claims by drug companies that the only scientific precursor to behaviour change is drugs. Many of these behaviours "could otherwise be controlled through education and training with the proper use of behaviour management and applied behaviour principles" (p.197). Rice et al. (1989) states that there is no empirical evidence that utilizing drugs for immediate behavioural control is an effective long-term strategy to reducing the future occurrence of aggression. Further, research in support of the biological causation is weaker than expected, and claims of drug effectiveness are overstated in some cases (Wyatt & Midkiff, 2006). Blumenthal maintains that teaching individuals to take ownership and control of their lives is imperative, particularly in mental health settings which may rely on pharmaceutical strategies to change behaviour. Wong (2006) suggests that stimulus control techniques in the form of shaping and token economies can be used to effectively treat problem behaviour. Corrigan, Yudofsky, and Silver (2008) recommend making intervention decisions based on three questions: 1) Is the patient currently assaultive? 2) What are the biological precipitants of aggression? and 3) What are the environmental precipitants? It can then be determined if biological strategies (e.g., antipsychotics, sedatives, anticonvulsants) and/or behavioural interventions (e.g., token economy, assertiveness training, self-controlled time out) are most appropriate. There is abundant evidence that interventions aimed at altering the social environment, such as token economies, can have a positive effect on behaviour change (Quinsey et al., 2006).

Use of Incentive Schemes in Correctional Settings

The fundamental objective of a contingency management intervention is to alter an individual's behaviour through the systematic application of reinforcement or punishment, contingent upon the performance of a desired behaviour (Burdon, Roll, Prendergast, & Rawson, 2001). A reinforcement event is delivered contingent upon the performance of a specific behaviour, with the intention of increasing the frequency of that behaviour. Contingency management systems include token economy, contingency contracting, shaping, positive reinforcement, and response cost. Positive reinforcement of prosocial and positive behaviour (e.g., punctuality, participation, completion of program tasks) is rarely used in correctional settings (Burdon, Prendergast, Eisen, & Messina, 2003). Positive reinforcement is the delivery of some form of reward upon the performance of a desired behaviour which results in an increased frequency of that behaviour. Instead, most treatment programs tend to dispense disciplinary actions against inmates who violate institutional or program rules.

The Incentives and Earned Privileges Scheme (IEPS) is a prison incentive scheme established in the United Kingdom in 1995 (Liebling, Muir, Rose, & Bottoms, 1999). The main aim of the policy is "to ensure that prisoners earn privileges by responsible behaviour and participation in hard work and other constructive activity" (Liebling, 2008, p. 30). The underlying theory is that favourable behaviour will be repeated if it is reinforced by rewards and unacceptable behaviour will not be repeated if it leads to a negative response (Prison Reform Trust, 1999). The scheme provides three levels of incentives based on an inmate's behaviour, willingness to cooperate, participation in hard work, and other constructive activity. The privileges available under the IEPS include access to private cash, extra visits, enhanced earning schemes, community visits, own clothes, time out of cell for association, and in-cell television. An evaluation of the IEPS by the Prison Reform Trust suggests a number of weaknesses with the system. For instance, the majority of inmates felt that although the principles of the scheme were fair, the policy sometimes operated unfairly. There were also no significant improvements observed in prison behaviour. There were reductions in favourable perceptions of staff fairness, relations with staff, regime fairness, consistency of treatment, and progress in prison. However, staff reported increased confidence, feeling less intimidated by prisoners, and better able to communicate with and motivate prisoners. An evaluation by Liebling (2008) produced similar findings. There were few improvements in prisoner behaviour or order and significant losses in staff-prisoner relations, perceived fairness, and perceptions of procedural justice. To improve practice, the Prison Reform Trust advised that prisoners who lose privileges should be told clearly what they have done wrong and what they can do to regain their former status. Warning systems should be put in place to allow inmates the opportunity to improve their behaviour or performance. Lastly, privileges should be valuable enough to ensure inmates are responsive to the scheme and motivated to make progress. Incentives and earned privileges are valuable in contemporary prison regimes but need to be administered fairly, individually, and constructively (Liebling, 2008).

On an intensive behaviour therapy unit (IBTU) in a maximum-security female prison, incentives are distributed based on adherence to a daily checklist of personal hygiene, sanitation, and socialization activities. The goal of the IBTU is to promote prosocial behaviour and extinguish problem behaviour. The IBTU consists of levels of privileges (e.g., phone calls, recreation time) in which inmates can advance or be demoted. An inmate must demonstrate a significant period of stability in behaviour change before being integrated back into the general prison population. A pilot study testing the efficacy of the program suggests that inmates had fewer disciplinary reports in the three months after release from the IBTU than in the three months prior to admission (Daniel, Jackson, & Watkins, 2003). Further, the coordinator and consultants rated a greater number of inmates as improved than would be expected by chance.

Ellis (1993) describes a contingency management work squad program for inmates in administrative segregation. Only inmates who demonstrated good institutional behaviour (e.g., follow prison rules, behave courteously and display good hygiene) were eligible to participate in the program. Inmates earned one point per week and could be exchanged for a warden's reclassification review once three points have been accumulated. Inmates who did not maintain good behaviour were dismissed from the squad. Participation in the work squad program was found to reduce the frequency of violent and assaultive behaviour in the majority (8 out of 10) of the participants.

An early prison release incentive impacted inmates' perception of drug treatment (Raney, Magaletta & Hubbert, 2005). The study compared inmates in their first, third, or sixth month of residential drug treatment who were eligible (n = 71) or ineligible (n = 16) for the early release incentive. Eligible inmates endorsed a greater number of learning areas and skills that they wanted to focus on in treatment. Inmates who were eligible for the early release incentive had an overall higher satisfaction in and greater perceived helpfulness of the treatment program than those who were ineligible. Thus, the early release incentive served to encourage treatment engagement.

Kandel, Ayllon, and Roberts (1976) investigated the effects of different incentive reinforcement schedules on the academic performance of two prison inmates. The academic performance of the inmates was compared when a fixed number of points were earned for each skill level completed (standard schedule of reinforcement) to a variable number of points earned depending on the amount of time between passing tests (enriched schedule of reinforcement). The enriched schedule of reinforcement produced high rates of academic performance in both inmates who had a long history of academic failure and were unmotivated to engage in academic work.

Geller, Johnson, Hamlin, and Kennedy (1977) identified the issues that arose in implementing a large-scale contingency management program in the Virginia correctional system. This program combined token economy procedures with progressive living through four stages. Restrictions successively decreased and response opportunities increased as inmates moved through the stages. Greater privileges and educational opportunities were available in each progressive stage. Tokens could be spent only by the individual who earned them to avoid undesirable behaviour such as stealing and gambling. A number of problems were encountered in implementing the program, including a lack of sufficient training and supervision for the counsellors and guards, limited finances and manpower, and external pressure cause by political, economic, and administrative considerations. Further, the program was labelled as 'brainwashing' and 'lobotomy' by guards, reducing the credibility and ability to develop rapport.

While positive reinforcement involves rewarding desirable behaviour, negative reinforcement consists of taking away a sanction in exchange for desired behaviour. Although positive reinforcement is generally the most effective, it may incite some resistance in a criminal justice setting on the ground that "it is inequitable to reward antisocial individuals for doing what is minimally expected of most citizens" (Marlowe, 2006, p. 131). Negative reinforcement, on the other hand, avoids the adverse effects of punishment while also being acceptable to stakeholders (Marlowe, 2006). Alternatively, positive reinforcement could be used to initially engage offenders in treatment, and negative reinforcement could subsequently be used to maintain adherence over time (Marlowe, 2006).

Rewarding appropriate behaviours among inmates can serve to promote motivation and engagement in treatment program activities when they are properly structured and administered (Burdon et al., 2003). Behavioural reinforcement of treatment attendance has been found to increase treatment retention, reduce unexplained absences, and improve employment and social adjustment while decreasing criminal behaviour (Burdon et al., 2003).

Contingency Management in Drug and Alcohol Treatment

Contingency management strategies have been used at length in drug and alcohol treatment (see Higgins & Silverman, 1999 for an extensive review). Contingency management in the treatment of drug and alcohol abuse has been found to be successful in various populations. This includes adolescents (Corby, Roll, Ledgerwood, & Schuster, 2000; Kamon, Budney, & Stanger, 2005), women (Svikis, Lee, Haug, & Stitzer, 1997), and in particular, pregnant women (Elk, Mangus, Rhoades, Andres, & Grabowski, 1998; Jones, Haug, Silverman, Stitzer, & Svikis, 2001). Most of the contingency management programs currently in use to treat substance abuse rely on reinforcement rather than punishment due to the likelihood of treatment attrition if participants are punished (Burdon et al., 2001). Positive reinforcers tend to be more efficacious in retaining clients in treatment than negative reinforcers (Petry, 2000). Incentives utilize the same behavioural processes of reinforcement to foster recovery which play a role in drug dependence and abuse (Higgins, Alessi, & Dantona, 2002). For instance, cocaine use is an operant behaviour that delivers positive reinforcing effects (Higgins, 1997). Therefore by increasing the availability of alternative non-drug reinforcers, cocaine use and abuse can be significantly reduced. The efficacy of various types of reinforcers have been tested and compared, from goods and services to monetary vouchers and prizes. Typically drug or alcohol consumption is used as the target behaviour, although treatment attendance and activities have also been examined. Incentive programs have been successful in both decreasing maladaptive behaviour and increasing productive behaviour.

Corby et al. (2000) tested the effects of a contingency management intervention with adolescent smokers. The participants received payment noncontingently during the first and third week of the experiment, and contingent on not smoking during the second week. The intervention was successful in increasing the total number of abstinences from smoking. Providing contingent payment with verbal feedback has also been found to be effective in lowering drug use (Hall, Bass, Hargreaves, & Loeb, 1979). Outpatient heroin detoxification patients receiving the contingency had significantly lower illegal drug rates and longer sequences of drug-free days than a control group receiving standard treatment. Refundable deposits have been used as an incentive for participation in behavioural programs to treat alcohol abuse. Participants in a group treatment program for driving under the influence of alcohol who were required to place a $50 refundable deposit at the beginning of treatment had fewer unexcused absences and were more efficient in completing treatment forms than those who did not place a deposit (Ersner-Hershfield, Connors, & Maisto, 1981). However, no differences were found in the number of sessions attended.

Voucher-based reinforcement has been found to be an efficacious method of increasing drug abstinence, medication compliance, and participation in treatment programs (Silverman, Preston, Stitzer, & Schuster, 1999). Generally vouchers exchangeable for retail items are provided to participants contingent upon submitted drug-free urine samples, while a control group receives standard treatment. Higgins et al. (1994) found that cocaine-dependent adults eligible for vouchers were more likely to complete treatment and had longer durations of continuous cocaine abstinence than those receiving only the standard treatment. Budney, Higgins, Radonovich, and Novy (2000) compared the outcomes of individuals with marijuana dependence receiving motivational enhancement (ME), ME plus behavioural coping skills therapy (BCS), or ME plus BCS plus voucher-based incentives. Adding voucher-based incentives was more effective in increasing marijuana abstinence than either of the other treatments. The efficacy of voucher-based reinforcement has been replicated in a number of studies (Downey, Helmus, & Schuster, 2000; Higgins et al. (2002), Iguchi, Belding, Morral, Lamb, & Husband, 1997; Jones et al., 2001; Kirby, Marlowe, Festinger, Lamb, & Platt, 1998).

Because vouchers take into account individual preferences, they hold promise for special populations of substance abusers such as pregnant and recently postpartum women, adolescents, and those with serious mental illness (Higgins et al., 2002). A successful contingency management plan for illicit drug use requires the use of a multidisciplinary team, staff supervision, policies developed by staff as a whole, and the belief by staff that the system works (Calsyn & Saxon, 1987). A well-designed and well-implemented voucher-based approach improves compliance and reduces recidivism (Burdon et al., 2001). Although a contingency management system may pay for itself in this sense, the savings may not be realized by the same funding sources that provide treatment. The use of vouchers, for instance, may not be acceptable to all stakeholders involved in correctional practice. For the general public that believes that criminal should be punished, vouchers may be viewed as 'paying criminals to be good' (Burdon et al., 2001). Lastly, it may be difficult to integrate a contingency management protocol into existing correctional practice.

Although voucher-based reinforcement in drug and alcohol treatment is widely employed and evaluated, alternative reinforcers can be used to effectively approximate the target behaviour. Silverman et al. (2002) investigated the efficacy of providing access to a 'therapeutic workplace' (employment or training) in heroin- and cocaine-dependent, unemployed, treatment-resistant young mothers. Participants were required to provide drug-free urine samples before permission was granted to be paid to work or train. Over the course of three years, participants in the workplace program had increased cocaine and opiate abstinence on a continuous basis relative to a control group receiving standard care. Miller (1975) examined a behavioural intervention program for offenders with chronic public drunkenness charges. The positive contingency management system entailed the provision of goods and services that participants required (e.g., housing, employment, medical care, clothing, meals, cigarettes, and counselling) contingent upon their sobriety. Participants in the program substantially decreased their number of public drunkenness arrests and their alcohol consumption, and increased their number of hours employed. No such changes were observed in a control group receiving services on a noncontingent basis.

Providing the opportunity for take-home methadone privileges has been investigated in methadone maintenance patients. Stitzer, Iguchi, and Felter (1992) compared the outcomes of patients receiving take-home methadone either contingent upon two weeks of drug-free urine samples or noncontingently. Participants in the contingent group were more likely to produce at least four weeks of abstinence (32% vs. 8%). Subsequent to the initial testing period, 28% of the participants receiving take-home privileges noncontingently achieved abstinence once shifting to the contingent procedure. Glosser (1983) discovered that methadone maintenance patients that received points for drug-free urinalysis reports that could be redeemed to obtain methadone had lower illicit drug use after six months than patients receiving traditional treatment. Although take-home medication is valuable to methadone patients, alone it may be incapable of competing with some patients' motivation for supplemental drug use (Magura, Casriel, Goldsmith, Strug, & Lipton, 1998). Silverman, Robles, Mudric, Bigelow, and Stitzer (2004) conducted a similar study with methadone-maintenance patients, but included a third group which received take home-methadone doses plus up to $5800 in vouchers. Both of the abstinence-reinforcement groups had higher abstinence from cocaine, but the addition of voucher incentives resulted in the largest and most sustained abstinence.

Contingency management programs in drug and alcohol treatment tend to be costly to employ and manage (Higgins et al., 2002). Recently, procedures aiming to provide contingent reinforcement in a cost-effective manner have been developed. The "fishbowl technique" is an intermittent reinforcement schedule which provides participants opportunities for reinforcement (i.e., drawing a voucher from a fishbowl) for attending treatment or for providing drug-free urine samples (Marlowe, 2006). Petry and Martin (2002) investigated the efficacy of a prize reinforcement procedure for methadone patients. Longer durations of continuous cocaine and opiate abstinence were observed in 23 patients that drew a voucher (prizes ranging from $1 to $100) from a bowl for submitting negative urine samples than 19 patients receiving standard treatment with no contingency management component. These effects were maintained throughout a 6-month follow-up period. Similar findings were observed in alcohol-dependent veterans offered the chance to win prizes for submitting negative Breathalyzer samples (Petry, Martin, Cooney, & Kranzler, 2000). While 85% of the contingency management participants were retained in treatment for an 8-week period, only 22% of participants receiving standard treatment were retained. Sixty nine percent of the contingency management participants maintained abstinence until the end of treatment, while 62% of the other participants had used alcohol. Petry, Alessi, Marx, Austin, and Tardif (2005) compared contingency management interventions with the use of vouchers or prizes as incentives for substance abusers in community settings. Participants in both contingency management conditions remained in treatment longer and achieved greater durations of abstinence than patients receiving standard treatment.

Importantly, there were no significant differences between vouchers and prizes.

In the vast majority of studies examining contingency management interventions in drug and alcohol treatment, abstinence is the target behaviour. Iguchi et al. (1996) compared the effectiveness of reinforcing two different types of target behaviours in a methadone maintenance program. Take-home medication was provided contingent on either drug abstinence or attendance of interpersonal problem solving training. The participants reinforced for abstinence showed greater improvements in rates of abstinence from drugs, suggesting that contingency management interventions should target drug-using behaviour specifically. Petry et al. (2006) also found that reinforcement of abstinence resulted in better outcomes than the reinforcement of adhering to goal-related activities, although there were no differences by group in abstinence at 6- and 9-month follow-up periods. Both groups of contingency management patients remained in substance abuse treatment longer and achieved more treatment than a control group receiving standard treatment. Conversely, Iguchi et al. (1997) found that reinforcing alternative behaviours other than abstinence to be an effective method of decreasing unauthorized substance use. Providing vouchers to reinforce the completion of treatment plan-related tasks resulted in higher abstinence than the provision of urine samples testing negative for illicit drug use. Petry (2000) suggests that reinforcing activity completion may reduce drug use, improve the therapeutic alliance, and improve psychosocial functioning. Reinforcing treatment attendance can also enhance treatment participation.

Contingency management interventions in drug and alcohol treatment appear to be successful in reducing maladaptive behaviour and encouraging productive behaviour. It is clear that for the most part, these interventions are successful in reducing drug use (Budney et al., 2000; Downey et al., 2000; Glosser, 1983; Griffith, Rowan-Szal, Roark, & Simpson, 2000; Hall et al., 1979; Higgins et al., 1994; Iguchi et al., 1996; Iguchi et al., 1997; Jones et al., 2001; Kirby et al., 1998; Liebson, Tommasello, & Bigelow, 1978; Milby, Garrett, English, Fritschi, & Clark, 1978; Petry & Martin, 2002; Silverman et al., 2002; Stitzer et al., 1992) and alcohol consumption (Miller, 1975; Petry et al., 2000). In the past, contingency management strategies have been found to decrease arrest rates (Liebson, 1978; Miller, 1975). Lastly, these strategies have resulted in increased employment (Liebson, 1978; Miller, 1975), treatment attendance (Elk et al., 1998; Ersner-Herschfield et al., 1981), and treatment completion (Higgins et al., 1994).

Kidorf and Stitzer (1999) suggest that reinforcers are most effective when they are modified by amount or frequency, administered repeatedly, and applied proximately to the target behaviour. The more certain and swift are the rewards, the greater the effects on behaviour change (Marlowe, 2006). Incentives, such as vouchers which are objective and quantitative, can be manipulated in search of optimal efficiency and effectiveness (Silverman et al., 1999). The desired behaviour should be monitored on a regular basis, such that appropriate behaviours can be reinforced frequently and consistently (Petry, 2000). Iguchi et al. (1997) advise that the reinforcement of behavioural tasks targeted toward long-term goals increases involvement in behaviours inconsistent with drug use. This method of shaping allows participants to approximate target behaviours, with smaller and more achievable goals. On a similar note, Petry (2000) recommends reinforcing successive approximations toward abstinence, reinforcing other behaviours that facilitate abstinence, and using incentives that are of sufficient value to offset the reinforcement received from using substances.

Preston, Umbricht, Wong, and Epstein (2001) compared a shaping contingency to a standard contingency in cocaine-using methadone-maintenance patients. The experimental group received vouchers for a 25% decrease in cocaine metabolite in each of their urine samples, while the control group received vouchers for any cocaine-negative urine sample. Rewarding patients for successive approximations of the target behaviour appeared to better prepare them for abstinence, as demonstrated by lower cocaine use in the shaping group. When the response requirement was changed to abstinence for both groups, the former shaping participants maintained a higher rate of abstinence than those participants that were required to display abstinence all along. This finding demonstrates that a target behaviour induced by escalating-value reinforcers can be maintained by a non-escalating schedule.

Kirby et al. (1998) examined whether the schedule of reinforcement had an effect on the initiation of abstinence in cocaine-dependent adults receiving behavioural counselling. Participants were provided either 1) high vouchers at the beginning with increased requirements for earning vouchers, 2) low vouchers at the beginning and an increasing value of vouchers throughout the course of treatment, or 3) no vouchers. The high voucher group had significantly longer durations of cocaine abstinence than the low voucher group, while the low voucher group did not differ from the group receiving no vouchers. Roll and Higgins (2000) compared three schedules of reinforcement for promoting and sustaining short-term drug abstinence: 1) fixed magnitude of reinforcement for abstinence, 2) a progressive increase in magnitude of reinforcement for abstinence with a reset contingency for drug use, and 3) a progressive increase in magnitude of reinforcement for abstinence without a reset contingency. The progressive magnitude with a reset schedule was more effective than the other two schedules in sustaining an initial period of abstinence in 18 cigarette smokers.

A meta-analysis of contingency management interventions with drug use as the outcome measure produced an overall effect size of 0.25 based on 30 studies (Griffith et al., 2000). The effectiveness of contingency management interventions differed under certain conditions. The most effective reinforcers involved increases in methadone dose and methadone take-home privileges, as opposed to vouchers or money. Immediate and mixed (both immediate and delayed) intervals in the length of time to reinforcement delivery were more effective than delayed rewards alone. Larger effect sizes were demonstrated in studies in which only one drug was targeted for behavioural change, versus multiple drugs. Lastly, the frequency of monitoring of the target behaviour was also important, with more frequent urinalyses being more effective than less frequent testing.

Chutuape, Silverman, and Stitzer (1998) examined patient preferences for the types of incentives offered in methadone maintenance patients. Take-home medication was the most preferred in a sample of 111 methadone patients, followed by dose increases and counselling. A wide variety of individual differences were observed in a ranking of preference for 18 other service items (e.g., cost of living payments, medical care, vocational training). This highlights the need for contingency management plans to be tailored based on individual needs. Svikis et al. (1997) found that patients offered higher magnitude incentives ($5 and $10) attended more days of treatment than those offered no payment or $1 per day. This was only true for non-methadone patients (i.e., no effect for methadone patients).

Contingency Management in Mentally Disordered and Low Functioning Populations

Contingency management strategies have been implemented in mentally disordered and other low functioning populations dating back to the 1970s. Examples include providing coffee packets to promote good personal hygiene, music and games to reduce disciplinary infractions, and scheduled phone calls for not harassing counsellors (Seegert, 2003). Kazdin and Polster (1973) conducted a case study of token reinforcement with two male adults with mental retardation, with the goal of increasing social interaction. The removal of the contingency resulted in a dramatic decrease in the social interactions of both participants, demonstrating the control of the token reinforcement. To examine the effects of the schedule of reinforcement, token reinforcement was withdrawn after a period in which reinforcement was provided continuously to participant A and intermittently to participant B. While participant B continued to interact socially, participant A did not.

Bellus, Vergo, Kost, Stewart, and Barkstrom (1999) examined the use of token economies in conjunction with rehabilitation programming in psychiatric inpatient settings. Reinforcement was systematically provided for adaptive behaviours, while token fines were imposed to penalize maladaptive behaviours. Lower rates of aggressive and self-injurious behaviour were observed in a group of cognitively impaired, chronic psychiatric patients compared to a similar group not subject to the token economy. The authors conclude that a token economy is effective in increasing ward structure and reducing aggressive behaviour. Longo and Bisconer (2003) also observed a decrease in aggressive acts following the introduction of a behavioural plan in an adult male with schizophrenia in a psychiatric hospital. The behavioural plan was developed to provide the client with positive social interactions, social skills training, and positive reinforcement for prosocial behaviour.

The efficacy of contingency management programs in drug and alcohol treatment has also been demonstrated in patients with psychiatric problems. In a study by Sigmon, Steingard, Badger, Anthony, and Higgins (2000), monetary incentives were provided to 18 adults with serious mental illnesses (e.g. schizophrenia) to promote abstinence from marijuana use. Marijuana use was lower when monetary incentives were provided dependent on negative urinalysis tests. Monetary incentives have also been found to increase abstinence from cigarette smoking in adults with schizophrenia (Roll, Higgins, Steingard, & McGinley, 1998).

Individual Differences in Sensitivity to Incentives

Within a correctional institution, some inmates may be more sensitive to reinforcement, and thus more likely to display the targeted behaviour. For instance, Leue, Brocke, and Hoyer (2008) demonstrated that sex offenders display a greater sensitivity to continuous reward than male non-offenders. Differences in reinforcement sensitivity between subgroups of sex offenders were also found, with paraphilic and impulse control-disordered sex offenders displaying a greater sensitivity to continuous reward. Psychopaths also show a greater responsivity to reward, tending to focus on the prospect of reward under conditions of mixed incentives (i.e., possibility of both punishment and reward; Scerbo et al., 1990). Newman, Patterson, Howland, and Nichols (1990) found that psychopaths display passive avoidance deficits on tasks involving both monetary rewards and punishments, as opposed to tasks involving only monetary punishments. Newman, Kosson, and Patterson (1992) measured delay of gratification as a form of self-control in psychopathic and nonpsychopathic offenders. Low-anxious psychopaths were relatively unwilling to delay when the omission of rewards also incurred monetary punishment, suggesting that inhibitory self-control is somewhat impaired in these offenders under conditions involving both rewards and punishments. However, low-anxious psychopaths displayed superior performance when the task involved rewards only.

Prisoner differences were observed in the evaluation of the incentives and earned privileges scheme in England and Wales (Liebling, 2008). In particular, vulnerable (in terms of risk of suicide), compliant, older, and more educated prisons reacted less favourably to the policy. Prisoners at high risk of suicide reported the highest drops in staff, regime, and procedural fairness following the introduction of the policy. Finally, the perceived level of fairness was lower in the lower privilege levels.

Individual differences in reinforcement sensitivity are also evident in an analysis of delay discounting. Delay discounting consists of decreasing the value of a delayed reward as a function of delay interval. Petry and Casarella (1999) examined discounting rates in substance abusers with and without gambling problems compared to a control group. Substance abusers have higher discounting rates (i.e., choose a reward with a lower value, as opposed to delaying a reward with a higher value) than controls, while problem-gambling substance abusers have extremely high discounting rates. Although these studies are relatively specific to offender types, they demonstrate the individual differences inherent in the sensitivity to rewards and punishment.

While some individuals are especially sensitive to reinforcement, voucher-based reinforcement methods are not effective in producing a change in all individuals (Silverman et al., 1999). Some offenders may be resistant to a contingency management intervention, and consequently fail to display substantial amounts of the target behaviour. Kidorf, Stitzer, and Brooner (1994) examined the differences between patients in methadone maintenance treatment who achieved a drug-free status and those patients who failed to meet take-home criteria during a one-year assessment period. The patients who earned take-home incentives were more often employed, less likely to have a cohabitating partner who used illicit drugs, and had less baseline cocaine and heroin use. Individuals who might succeed in an incentive program may be identified since there are characteristics that differentiate those who respond to incentives and those who do not.

In implementing a contingency management intervention, a behavioural contract is essential (Petry, 2000). This contract should define specific behaviours to be monitored, a schedule of monitoring, and contingencies to be imposed. Behaviours that are reinforced need to be objectively quantified and the contract should be explicit and unambiguous. Calsyn and Saxon (1987) suggest this contract should encourage the patient in a supportive, empathic, non-punitive manner in order to enhance his or her involvement in treatment.

Role of the Date of Publication

Contingency management strategies and the corresponding research have evolved from the 1970s to the present. The types of incentives offered have moved from monetary incentives to voucher-based incentives, particularly in drug and alcohol treatment in which there is the concern that participants will purchase substances if money is awarded. Attempts have also been made to develop cost-effective incentive programs, such as the fishbowl technique and other prize reinforcements. These methods show promise in reducing substance use and abuse (Marlowe, 2006; Petry & Martin, 2002; Petry et al., 2000; Petry et al., 2005).

In recent years, the samples used in research have expanded to include adolescents (e.g., Corby et al., 2000; Kamon et al., 2005) and women (e.g., Daniel et al., 2003; Elk et al., 1998; Jones et al., 2001; Svikis et al., 1997). Contingency management interventions are being explored more in mentally disordered populations than in the past (e.g., Bellus et al., 1999; Sigmon et al., 2000). In the 1970s, research often took the form of case studies (e.g., Kandel et al., 1976; Kazdin & Polster, 1973) as opposed to the experimental and quasi-experimental studies conducted in contemporary research.

Conclusion

The existence of rule violations, misconducts, and acts of violence in prisons necessitates interventions to control and change behaviour. Strategies such as "no frills" prisons, treatment programs, and drug treatments have been proposed and/or implemented. Contingency management programs have also received varying levels of attention over the past three decades. The United Kingdom in particular has focused their efforts on developing incentive schemes in correctional institutions. It is evident that there are numerous problems and weaknesses with the practices and policies of the Incentives and Earned Privileges Scheme. Lessons can be learned from the UK experience and from other contingency management programs in prisons. Liebling's (2008) paper is perhaps the most ambitious and salient among all published work in that it provides a meaningful context to appreciate the purpose and challenges of implementing a standardized incentive model in a correctional setting. Further, individual incentives and systemic incentives have shown some promise in non-correctional settings including drug and alcohol treatment and mental health treatment.

It is clear that the development of behavioural management strategies is complex in that only a minority of offenders commit serious misconducts and that issues of fairness are often compromised when broad-based discipline strategies are attempted. Such approaches invariably do not yield improved behavioural management, despites staff's belief to the contrary. Overall, the results regarding the effectiveness of incentive systems to manage offender behaviour is mixed. Similar to offender programming, there is increasing consensus regarding what not to do but far less consensus regarding viable next steps.

References

Offender Incentives and Behavioural Management Strategies Part II (Consultation)

Ralph C. Serin & Laura J. Hanby

Carleton University

Completed Under Contract for the Research Branch,
Correctional Service of Canada

31 March 2009

References

Appendix A

Behavioural Rating of Offender Engagement

Please rate the participant from 0 to 2 on the following general offender competencies. A rating of 1 indicates that the participant somewhat displays the given behaviour. You must score 0, 1, or 2; you cannot assign partial ratings. Where possible, ratings should be completed after 1-2 sessions to ensure sufficient awareness of the offender. Consultation with other staff (PO, CO) is recommended but not essential.

1. Ability to interact with other offenders

2. Ability to follow rules

3. Respectful of staff

4. Respectful of other offenders

5. Engagement in Correctional Plan

a) Stated motivation

b) Consistency

c) Acceptance of responsibility

6. Gang affiliation

7. Predatory behaviour

8. Substance abuse

Appendix B

Overview of Effective Staff Skills

Appendix C

Rewards & Punishers

(unpublished offender ratings; Goddard & Gendreau, 1992)

Rewards (listed from most to least rewarding)

Parole
Temporary absences
Family visits
Family days
Pay raises
Better jobs
Programs
Special food
Able to decorate cell
Better recreation

Punishers (listed from most to least punitive)

No family visits
Transfer to higher security
Being in a double cell
Failure to earn remission
Pay cuts
Solitary confinement
Loss of food
Earlier lock-up
Earlier wake-up

Appendix D

Behavioural Rating Scale of Desistance Competencies

(Serin & Hanby, 2009)

Please rate the participant from 0 to 4 on the following general offender competencies. A rating of 1 indicates that the participant somewhat displays the given behaviour. You must assign a score based on these levels; you cannot assign partial ratings. Where possible, ratings should be completed after 1-2 sessions to ensure sufficient awareness of the offender. Consultation with other staff (PO, CO) is recommended but not essential.

1. Need for change

2. Knowledge

3. Cognitive flexibility

4. Inhibitory control

5. Personal Accountability

Footnotes

Footnote 1

Presently this is implicit but the proposed Offender Management System might consider making this explicit.

Return to footnote 1 referrer

Page details

Date modified: