Building a Private Practice in Criminal Justice Establishing and growing a successful private practice is perhaps one of the most difficult jobs possible for counselors and psychologists. Yet it can be one of the most rewarding and important things a counseling professional can do. The provision of specialized criminal justice services is often overlooked as a possible source of clients for a private practice. But every county in the United States has a court system that requires a host of offenders to enter and complete a specific treatment for a specific problem. Offenders are routinely assigned to complete drug and alcohol treatment, anger management, DUI schools, relapse prevention, classes for shoplifters and parenting, programs for underage drinkers, criminal impersonation, failure to pay family support, and sex offender relapse prevention. Many jurisdictions do not have treatment options for these offenders. Counselors in private practice can fill this gap. Before we explore this further, it's important that you examine your motives. The reason is that your answers to a few key questions can predict how successful you will be in working with criminal justice clients. Is money one of your primary motives? Do you believe that treating criminal justice clients can be a springboard for your private practice? Do you think that treating criminal justice clients will give you the opportunity to test and develop new treatments? Do you already have a preferred method to treat criminal justice clients? Do you prefer intense, one-on-one counseling sessions where you can explore the causes of problem behavior? Do you like helping clients explore their feelings and have deeper understanding of themselves? If you answered "yes" to any of the above questions, you'll experience difficulty in establishing a successful practice with criminal justice clients. If you answered "yes" to more than one of the above questions, it's wise to not proceed further until something changes in you. The most appropriate motivations in working with offenders are closely tied to specific attitudes about treatment. A desire to help an often neglected and underserved group is a starting point. A desire to be part of a solution to a major dilemma facing society is helpful. Complete acceptance of the first two rules of helping relationships is not only helpful, but required. The first rule is do no harm. If you came to the realization that your favored counseling approach actually harmed offenders, would you change? You are probably stumped on the idea of "the second major rule." Lots of counselors never learn it. It's this: do the best you can with the resources available to you. In reality, the second rule covers a lot of territory. It means that rather than complaining about what you can't do, you do the best you can with all the resources you have. It also means that you utilize the most effective treatment available for specific problems. In medicine, no one drug is used for all disorders. There are different medications for different problems. The same is true in counseling. Providing treatment services to criminal justice clients is quite different than traditional private practice. You have to understand what the courts want, what the probation/parole officers want, and what the client wants. Judges want service providers to be accountable and to use systematic treatment methods that directly address the client's problem. Shoplifters, for example, should be placed in a group that uses a quantifiable treatment approach directly addressing the issues associated with that crime. Judges want to be informed of client failure and success. Criminal justice clients sign a special release of information form that not only allows professionals to inform the judge and probation officers, but it requires it. In addition, you have to have defendable, objective criteria that are used to determine how and when a specific client completes treatment. You must understand how to approach the court system and how to communicate with supervising authorities (probation/parole officers), attorneys, and offenders. All of these groups want to know why they should assign clients to you. What is it you can do to treat specialized groups of offenders? Talk-oriented, feelings focused, intense one-on-one counseling sessions are not only ineffective with offender groups, in many cases this approach leads to increased recidivism. How can we be sure of this statement? Numerous research studies have taken populations of offenders convicted of the same crime and then randomly placed them into groups. For example, let's say the study is performed to determine the effects of different treatments on sex offenders. One group of sex offenders simply does their time (receiving no treatment), another group receives Client-Centered counseling, a third group receives structured cognitive-behavioral counseling. At specific time intervals after each client's release (6-months, 12-months, 24-months) rearrest data is collected. Combining rearrest data will give a 6-, 12-, and 24-month recidivism rate. Under these conditions, which group do you believe will have the highest rearrest rate at all the time periods: the nontreatment group, the cognitive-behavioral group, or the Client-Centered group? Hopefully you know the answer—Client Centered treatment will almost always show the highest recidivism. It is generally significantly higher than no treatment at all. In recent years, America's criminal justice system has required the use of cognitive-behavioral programs that have been recognized as evidence-based. Each category of offender (shoplifter, road rage, domestic violence, underage drinking, etc.) is typically assigned to an offense-specific, ongoing group. The vast majority of offenders assigned to the private sector for treatment participate in cognitive-behavioral groups numbering from 5-10 participants. A private provider in Tennessee, for example, has a weekend shoplifter class about twice a month. Up to 70 individuals have participated in a single class. The clients pay a reasonable fee in advance (never waived) of about $75. They attend class for a total of 8 hours. In class, each client receives a brief workbook that is sequentially completed from one program module to the next. At the end of each module, each client shares his or her written work with the rest of the group. Each client either completes the program—or doesn't. The same provider conducts an 8-week, 2 hours a week program for individuals arrested for underage drinking and criminal impersonation. All of the participants are between ages 18 to just under 21. Many of the participants are in the military and the majority of the others are college students. Groups average around 10 participants. In some locations, this crime presents a large problem for the court system. Judges can't ignore the arrest, but at the same time they want to give the offender a chance. The availability of a class that addresses underage drinking gives judges the option of having offenders complete the program as a diversion. In addition, the Nashville provider conducts ongoing classes for domestic violence perpetrators, drug treatment, relapse prevention, and DUI/DWI offenders. All of these programs—except a DUI School—use a cognitive-behavioral workbook that was designed for specific offense categories. How Do You Start? There are many ways to start the process of working with criminal justice, but as mentioned earlier there are a few things you have to consider about yourself before you proceed. First, understand that criminal justice clients are often different than the general population. They will often present an inexperienced provider with a host of reasons why they shouldn't have to complete treatment. Yet the courts have required it! Can you adapt an appropriate attitude toward this? What will you do in that circumstance? In general, it's always a good idea to throw the burden back onto the offender. How? Simply say something like, "OK, I'll notify the judge that you are refusing treatment because you say you don't need it." You also have to be prepared for "tests" from clients. The easiest way to deal with such situations is to establish stiff rules and procedures. You have to set limits on what late for group means, how many sessions a client can miss, and simple things like "forgetting a workbook." Are these things you can do? Finally, are you devoted to a particular treatment approach? Or are you devoted to providing the best possible treatment for specialized problems? In summary, if you haven't worked with offender populations, it is wise to educate yourself about the offender population in general, the typical characteristics of offenders who commit certain crimes, and typical diagnoses. If You Are Still Interested A step-by-step guideline will be presented here to simply point out some of the things that have to be done to establish a criminal justice practice. You can do these in any way or manner you wish. Within a few months an inexpensive book on this issue will be available, but for now, here are a few steps to take. 1. Learn about your local courts, probation, and parole system. How many annual cases are handled in your local court system? How do these cases break down into meaningful categories? How is your local system handling treatment needs now? 2. Meet with local judges and ask them what they wish they had available in terms of treatment options. Have a list of possible options along with you. The judges will know how many potential clients they might have for each type of specialized group. 3. Talk to a probation supervisor for both the state and county. Ask them the same questions that you ask the judges. 4. Be prepared to tell these professionals that all services will be funded by reasonable client-paid fees. A typical outpatient drug treatment group session fee can be $10-$25. Specific programs such as shoplifting usually have a set fee, paid in advance by the client. The fee can range from $50-$200. 5. When you have an idea of the local potential, make a decision on what program options you will offer first. In general, if you are starting from zero, it's best to choose only one or two treatment options. Note that some programs such as substance abuse treatment and domestic violence treatment often require a specialized license. 6. Obtain whatever treatment materials and training you might need for the specialized treatment problems you have chosen. Make certain that the groups can be open-ended (so a new client can always enter an ongoing group). Make certain that you have objective treatment materials—workbooks. These are more important than you might realize. 7. Decide on the days, times, and number of sessions your program will require of clients. Many of the available workbooks already have these details built-in their structure. Finalize a fee structure and method of payment from clients. Note that it is not a good idea to have a pocketfull of cash at the beginning or end of a group session. 8. Put together all the forms and materials you will need. These include informational brochures for attorneys, judges, and probation/parole officers. These should include a description of the services, when and where the services are performed, the referral procedure, and contact information. Each program you offer should have a simple, one-page description that tells what it is, how a person enters, when it meets, how long it takes, and what it costs. If defense attorneys have copies of these descriptions, they will work with prosecutors and judges to assign appropriate offenders to it as a probation stipulation. You need an intake form for clients, an assessment tool if your treatment requires it, a copy of rules, procedures, and client expectations and rights. You need a criminal justice release of information form for clients to sign. Finally, you need a report form for the judge or supervising authority as well as client program completion certificates. 8. When all of the prior details are completed, you announce your availability. There are several ways to do this, but the best relies on legwork. Go to all the relevant judges, prosecutors, defense attorneys, probation & parole officers and drop off a brochure. Probation and parole authorities, prosecutors, and defense attorneys should be given several copies of the one-page descrition of each program as well as referral forms. Get to know these people as they are your source of clients. But keep in mind that they will judge you by your consistency, attitude, ability to handle the clients, and how well you perform. 9. The best thing you can do to really build your business is to be in court from time-to-time. If your face is seen, you'll get referrals. 10. On an ongoing basis, there is a simple way to assess how you are doing and how well you will probably do. If you are presenting problems and dilemmas to the criminal justice system, your business won't do well. If you are complaining to the system, you won't do well. If you are solving problems, you'll be seen as an asset. Our Program Resources One of the major reasons this webpage exists, is that all the people involved with MRT are dedicated to helping criminal justice treatment professionals and offenders. It is our LifeWork. In so doing, it helps the greater good. The choice of programs you use is up to you. As we become aware of important gaps in the treatment system or ineffective programs, we thoroughly research the problem. We then develop a specific treatment resource for it and test it. Effective substance abuse treatment for offenders was the initial problem we faced, and MRT was developed as a result. Treatment of domestic violence perpetrators was next. Below is a list of certain categories of criminal offenses. Next to the offense category is a possible cognitive-behavioral resource that directly addresses it. All of these are designed to be used in groups. Substance Abuse—Adults CBT Option: MRT — workbook: How To Escape Your Prison Also available in Spanish. Description: Step-by-step program that has clients complete homework and present homework in group. Objective criteria employed to assess client completion of each homework assignment. Used in all levels of criminal justice. Groups typically meet 1-2 times a week. Length of Program—Varies depending on location. Training required? Yes. Training Cost: $500 Workbook Cost: $25. Bulk discounts available. Also available: both English and Spanish versions available on tape. Substance Abuse—Juveniles CBT Option: MRT. Workbook: Juvenile MRT—How To Escape Your Prison Also available in Spanish. Description: Step-by-step program that has clients complete homework and present homework in group. Objective criteria employed to assess client completion of each homework assignment. Used in all levels of criminal justice. Length of Program—Varies depending on location. Training required? Yes. Training Cost: $500 Workbook Cost: $25. Bulk discounts available. Anger Management—Adults & Juveniles CBT Option: Coping With Anger Also available in Spanish. Description: Comprehensive 8 group session program supplemented with one-to-one sessions with counselor. Complete program has a variety of methods employed. Used in all levels of criminal justice. Training required? No. A training DVD and CD is available along with other treatment materials including tapes for relaxation and visualizations. Training Cost: na Workbook Cost: $10. Bulk discounts available. Relapse Prevention—Adults & Juveniles CBT Option: Staying Quit program. Workbook: Staying Quit Description: Eight module program primarily conducted in groups. Supplemented by a few private sessions with counselor built-in to specific modules. Often used with parolees who went through treatment in prison. Also used as the final component of substance abuse treatment. Length of Program—Minimum of 8 group sessions. Few clients complete all assignments in 8 meetings. Training required? No. (Facilitator's Guide available.) Training Cost: na Workbook Cost: $10. Bulk discounts available. Also available: Book on tape, relaxation and visualization exercises on tape. Shoplifting—Adults & Juveniles CBT Workbook Option: Something For Nothing Also available in Spanish. Description: Six-module program that has clients complete homework in group and then present it in group. Used in probation as a diversion program or as probation stipulation. Groups can be large and held on a single weekend. Length of Program—8 hours. Training required? No. (Facilitator's Guide available.) Training Cost: na Workbook Cost: $10. Bulk discounts available. Also available: both English and Spanish versions available on tape. Bad Checks, Repeat Traffic Offenders, Petty Larceny—Adults & Juveniles CBT Workbook Option: Responsible Living Description: Eight session group workbook with modules on rules, relationships, values, etc. Length of Program—8 sessions, 12 hours. Training required? No. Training Cost: na Workbook Cost: $10. Bulk discounts available. Parenting CBT Workbook Option: Parenting & Family Values Description: 12-session group workbook aimed at assisting parents and caregivers to discover and develop effective and appropriate parenting behaviors. Length of Program—12sessions, 18 hours. Training required? No. Training Cost: na Workbook Cost: $15. Bulk discounts available. Underage Drinking & Criminal Impersonation (False ID) CBT Workbook Option: Rules Are Made to be Followed Description: 4 session, 8 hour workbook used for those arrested for underage drinking and/or criminal impersonation. Training required? No. Training Cost: na Workbook Cost: $10. Bulk discounts available. Poor Job Habits & Poor Work Attitudes (Adult & Juvenile) CBT Workbook Option: Job Readiness Description: 6 module, 9 hour program. Training required? No. Training Cost: na Workbook Cost: $9. Bulk discounts available. Failure to Pay Child Support CBT Workbook Option: Family Support Description: Eight sessions designed to be completed in 8 hours og group. Training required? No. Training Cost: na Workbook Cost: $9. Bulk discounts available. Sex Offender Treatment Follow-up CBT Workbook Option: Making Changes for Good Description: 10 program modules addressing key issues of sex offender relapse. Designed to be used after sex offender treatment. Length of Program—10 sessions over 10-20 weeks. Training required? No. (Facilitators Guide Available) Training Cost: na Workbook Cost: $18. Bulk discounts available. Codependency CBT Workbook Option: Untangling Relationships Description: 12 session workbook focused on key issues of codependency. Training required? No. Training Cost: na Workbook Cost: $10. Bulk discounts available. Domestic Violence Perpetrators CBT Workbook Option: Bringing Peace to Relationships Description: MRT applied to domestic violence perpetrators with specialized workbook directly confronting issues in such relationships. Length of Program—Client attends group sessions until program completed, generally 20-30 sessions. Training required? Yes. Training Cost: $500 Workbook Cost: $25. Bulk discounts available. Character Development for At-Risk Students CBT Workbook Option: Character Development Description: 16 group sessions, 8 on will power, 8 on self-discipline. Training required? No. Facilitator's Guide Available. Training Cost: na Workbook Cost: $20. Bulk discounts available. MRT for Students in High School & College & Welfare to Work Programs CBT Workbook Option: Discovering Life & Liberty in the Pursuit of Happiness. Description: Step-by-step program that has clients complete homework and present homework in group. Objective criteria employed to assess client completion of each homework assignment. Used in all levels of school facilitated by teachers. Groups typically meet 1-2 times a week. Length of Program—Varies depending on location. Training required? Yes. Training Cost: $500 Workbook Cost: $25. Bulk discounts available. First Time DUI/DWI Offenders CBT Workbook Option: Driving the Right Way Description: 4 module workbook designed for 8 hours. Training required? No, but is available as is Facilitator's Guide. Training Cost: na Workbook Cost: $10. Bulk discounts available. Career Counseling CBT Workbook Option: Your LifeWork Description: see webpage.
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