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•–

–

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See also:

(Lamberti, 2007) (Andrews, 2006)

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(adapted from Lamberti, 2007)

Economic Pressure

•

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–

•–

Even for those “enrolled in state of the art treatment programs,

arrests and other encounters with the legal system are regular

occurrences for persons with dual disorders”

Clark, Ricketts, & McHugo (1999, p. 546)

•

AZ

S001

S002

CA

S004

S006

S007

S022

S031

S032

S067

S083

CO

S033

CT

S094

FL

S035

IL

S081

IA

S071

S008

MD

S009 MO

S010

S037

S068

NJ

S068

NM

S057

NY

S011

OH

S012

S082

S059

S013

S014

S060

S025

S026

OR

S040

S027

PA

S069

S073

S028

S078

S041

S084

S042

S043

S017

S061

S044

TX

S074

S046

S075

S018

S047

S048

S049

S050

S019

S029

S062

S051

S063

S052

S020

S030

S064

UT

S02

WA

S065

WI

S070

S054

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–

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-

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Small subgroup

Everyone else

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See also:

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•

Prob

Solv /+ Sanction

/-

Talked with you to figure out the reasons for any problems...listened .77 Tried to convince you that you would feel better if you stayed out of trouble… .76 Talked with you to help find a solution to a problem that you agreed on... .75 Reminded you of the conditions of probation or… .54 .34Praised or rewarded you when you've followed the rules .52 Told you that if you followed the rules, you wouldn't have to meet… .41 Met with you and your therapist or case manager to try to solve… .32 Asked or got the judge to put in jail for a short time .73Asked or got the judge to revoke your probation .70Scolded or punished you when you've broken the rules .66Took you in for a court appearance to show that you could go to jail if … .55Told you that if you didn't follow the rules, you would go to jail or prison. .25 .47Made you report (meet with him/her) more often .45Tried to get you hospitalized .27

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What to do - Systems

– Cross-agency collaboration

• Info-sharing

• Coordination of services

– Proper Program Implementation

• Workforce Quality/Capacity

• Organizational capacity/program fidelity

• Outcome evaluations/performance measures

– Performance-based contracting/funding

– Organizational culture and leadership

Thank You

Fred Osher, M.D.

Director, Health Systems

and Services Policy

fosher@csg.org

Jennifer Skeem, Ph.D

Associate Professor,

Department of Psychology and Social

Behavior, UC Irvine

skeem@uci.edu