Sequential Intercept Model

Introduction

The Sequential Intercept Model was developed by Mark Munetz and Patricia Griffin (2006) to help communities understand the way people with mental health issues interact with the criminal justice system and to target interventions to prevent people from getting deeper involved in the system.

The Sequential Intercept Model is usually focused around 5 broad target points, or areas where people with mental health issues may find themselves in contact with police or legal officials.

The five Intercepts are:

  1. Law Enforcement
  2. Initial Detention / Court Hearings
  3. Jail / Court
  4. Re-Entry
  5. Community Corrections

The model was based on ensuring that people with mental health issues are not forced into the criminal justice system at greater rates than people without mental health issues.

Law Enforcement and Emergency Services

Noting that up to 10% of police calls by patrol officers involve mental health issues (Cordner, 2006), the first interception point is front-line police and emergency services workers. Munetz & Griffin (2006) describe several strategies to help intervene at this point:

  • Mobile Crisis Teams of mental health workers
  • Employing mental health workers as civilians in the Police Service
  • Pairing police officers with mental health workers to go on patrol calls
  • Specially trained mental health police officers

All of these approaches involve combining front-line policing with mental health support to ensure that sensitivity is respected. Emergency services may also respond to mental health issues where individuals are psychotic or otherwise struggling with a connection to reality, which can put these staff in danger.

Initial Detention / Court Hearings

After an individual has been arrested, the next interception point of the sequential intercept model is initial detention and hearings post-arrest. Individuals may be diverted at this point to programs for non-violent, low level crime (such as petty theft or trespassing) based on the symptoms of their mental illness.

Diverting this individual to mental health treatment can avoid exacerbating their mental health issues. Additionally the court may “employ mental health workers to assess individuals after arrest in the jail or the courthouse and advise the court about the possible presence of mental illness and options for assessment and treatment, which could include diversion alternatives or treatment as a condition of probation.”

Jail / Court

Individuals who have mental illnesses and get involved in the criminal justice system are likely to spend a significantly longer jail term than individuals with the same charges who do not have mental illnesses. (Hoke, 2015) For this reason, the third intercept point is the jail or court system, where many individuals with mental illness are managed.

One important opportunity is the establishment of Mental Health Courts set up specifically for people with diagnosed mental illnesses relevant to their crimes.

Re-Entry

After an individual has exited the court system (if on probation) or jail (if sentenced to serve time), it is time for them to re-enter society. Transition points like this are times where an individual may be feeling the least supported and at greatest risk of suicide (Pease, Billera & Gerard, 2016) or of reoffending. (Caudill & Trulson, 2016) Discharge planning is common in hospitals but not in jail, which can make continuing care difficult for clients who are released from jail.

One potential model for solving this noted by Munetz & Griffin is the APIC (Assess, Plan, Identify, and Coordinate) Model by Osher, Steadman & Barr (2003). This plan “highlights the importance of collaboration among multi-sectoral community partners to ensure that the community is committed to the transition process.” (Evidence Exchange Network, 2014)

Community Corrections

The final intercept in the Sequential Intercept Model is community corrections, which is probation or parole. Since mental health treatment is often a condition of staying out of jail, these individuals represent an excellent opportunity to help those in the criminal justice system continue to access care, despite the adversarial nature of the parole/probation relationship.

References

Evidence Exchange Network for Mental Health and Addictions. (2014). “The Assess, Plan, Identify, and Coordinate (APIC) Model.” Retrieved on March 15, 2017 from http://eenet.ca/wp-content/uploads/2014/04/APIC-summary-addendum_March2014.pdf

Caudill, J. W., & Trulson, C. R. (2016). The hazards of premature release: Recidivism outcomes of blended-sentenced juvenile homicide offenders. Journal Of Criminal Justice, 46219-227. doi:10.1016/j.jcrimjus.2016.05.009

Cordner, G. (2006) “People with Mental Illness”. Center for Problem-Oriented Policing. No 4. Retrieved on March 17, 2017 from http://www.popcenter.org/problems/mental_illness/print/

Pease, J. L., Billera, M., & Gerard, G. (2016). Military Culture and the Transition to Civilian Life: Suicide Risk and Other Considerations. Social Work, 61(1), 83-86. doi:10.1093/sw/swv050

Hoke, S. (2015). Mental Illness and Prisoners: Concerns for Communities and Healthcare Providers. Online Journal Of Issues In Nursing, 20(1), 1. doi:10.3912/OJIN.Vol20No01Man03

Osher, F., Steadman, H. J., & Barr, H. (2003). A Best Practice Approach to Community Reentry From Jails for Inmates With Co-Occuring Disorders: The APIC Model. Crime & Delinquency, 49(1), 79.

Munetz, M.R. & Griffin, P.A. (2006) Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness. Psychiatric Services. 57(4) Accessed electronically on March 25, 2016 from http://ps.psychiatryonline.org/doi/pdf/10.1176/ps.2006.57.4.544

Cite this article as: MacDonald, D.K., (2017), "Sequential Intercept Model," retrieved on March 26, 2017 from http://dustinkmacdonald.com/sequential-intercept-model/.
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Financial Social Work

Introduction

Financial social work is an under-valued component of a counsellor or social worker’s activities, however with the average debt level in the US (including mortgages) above $130,000 and credit card debt above $16,000 (El Issa, 2016), financial issues are a significant component of many individual’s negative emotional health.

Money problems are a leading cause of divorce (Dew, Britt, & Huston, 2012), anxiety (Archuleta, Dale & Spann, 2013) and suicide (Coope, et. al., 2015; Hempstead, et. al., 2015). Poor financial skills can cause even an individual with a high income to experience stress, much less low-income individuals who may find themselves accessing counselling or community social work services.

What is Financial Social Work?

Financial social work or financial counselling is the process of working with clients to “provide practical, sustainable skills for controlling and managing finances…and create real behavioral change in your clients.” (Center for Financial Social Work, n.d.) This is a comprehensive process of assessing an individual’s financial situation and building lifeskills of budgeting, responsible use of credit and debt management.

Financial social work is often performed by non-profit credit counsellors, Marriage and Family Therapists (MFT) and may be performed by social workers in other capacities, such as those who work as case managers with individuals on a low-income or struggling with substance abuse issues.

Assessing Financial Anxiety

Archuleta, Dale & Spann (2013) discuss the Financial Anxiety Scale (FAS), a tool that can be used to assess the impact of financial counselling or financial social work’s on an individual well-being. As they proceed through their treatment, their anxiety reduces.

Financial Anxiety Scale (FAS)

Each item on the FAS can be rated either yes/no (with a cut-off score of 4 or higher) or on a Likert scale for clinical purposes.

  1. I feel anxious about my financial situation.
  2. I have difficulty sleeping because of my financial situation.
  3. I have difficulty concentrating on my school/or work because of my financial situation.
  4. I am irritable because of my financial situation.
  5. I have difficulty controlling worrying about my financial situation.
  6. My muscles feel tense because of worries about my financial situation.
  7. I feel fatigued because I worry about my financial situation.

Money Personalities

Money personalities (Mellan, 1995) describe an individual’s approach to working with money, and what makes an individual happiest or unhappiest as they work with money. Brief descriptions of the money personalities are below:

  • Amasser – an individual who prefers to have large amounts of money but may also struggle with significant anxiety as they try to do this
  • Avoider – an individual who avoids working with money because of the negative emotions involved, because of feelings of inadequacy or overwhelm
  • Hoarder – an individual who likes to save money. In extreme cases a hoarder may literally hoard money in their house or other areas instead of investing them
  • Money Monk – an individual who is afraid of money, considers it unclean or dirty, and tries to avoid having a relationship with it at all
  • Spender – an individual who likes to spend money and gets immediate satisfaction from spending

Financial Social Work Qualifications

In order to practice financial social work or credit counseling it is important to receive training in this area. Rappleyea, et. al. (2014) discuss a curriculum for financial social work training that was designed for Marriage and Family Therapist (MFT) students. Some of the many topics suggested in this paper that are valuable to learn include:

  • Money personalities (described above)
  • How to track expenses
  • How to live within your means
  • How to spend money in a way that leads to happiness rather than guilt or unhappiness
  • How to understand emotions created by money

Financial Social Work Certification

The Center for Financial Social Work provides the Certification in Financial Social Work. It provides 20 CE credits, workbooks and curriculum on financial planning, credit, debt, savings and spending plans and investing. The whole package costs $595. There is also information available from the Center on how to develop financial support groups to help individuals make better choices.

Financial Social Work Jobs

Financial social work job titles include Case Manager, Credit Counsellor, Financial Counselor, and Marriage and Family Therapist (MFT). All of these job roles may involve elements of financial counselling or financial social work either as a primary or secondary function of the role.

Financial Self-Care

It’s important that social workers recognize that financial health is a part of their own development and self-care. If you are worried about money, it’s difficult to be fully present for your clients. Developing a budget, reducing and eliminating debt, and investing are valuable skills for both your clients and yourself.

Taking care of these things will help reduce your burnout and make you a more effective social worker.

References

Archuleta, K. L., Dale, A., & Spann, S. M. (2013). College Students and Financial Distress: Exploring Debt, Financial Satisfaction, and Financial Anxiety. Journal Of Financial Counseling And Planning, 24(2), 50-62.

Center for Financial Social Work. (n.d.) “Become Certified in Financial Social Work”. Retrieved on March 8, 2017 from https://www.financialsocialwork.com/financial-social-work-certification

Coope, C., Donovan, J., Wilson, C., Barnes, M., Metcalfe, C., Hollingworth, W., & Gunnell, D. (2015). Research report: Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): A review of coroners׳ records. Journal Of Affective Disorders, 18398-105. doi:10.1016/j.jad.2015.04.045

Dew, J., Britt, S., & Huston, S. (2012). Examining the Relationship Between Financial Issues and Divorce. Family Relations, 61(4), 615-628. doi:10.1111/j.1741-3729.2012.00715.x

El Issa, E. (2016) 2016 American Household Credit Card Debt Study. NerdWallet. Retrieved on March 8, 2017 from https://www.nerdwallet.com/blog/average-credit-card-debt-household/

Mellan, O. (1995). Money Harmony: Resolving money conflicts in your life and relationships. New York, NY: Walker & Company.

Rappleyea, D. L., Jorgensen, B. L., Taylor, A. C., & Butler, J. L. (2014). Training Considerations for MFTs in Couple and Financial Counseling. American Journal Of Family Therapy, 42(4), 282-292. doi:10.1080/01926187.2013.847701

Hempstead, K. A., & Phillips, J. A. (2015). Research Article: Rising Suicide Among Adults Aged 40–64 Years. The Role of Job and Financial Circumstances. American Journal Of Preventive Medicine, 48491-500. doi:10.1016/j.amepre.2014.11.006

Cite this article as: MacDonald, D.K., (2017), "Financial Social Work," retrieved on March 26, 2017 from http://dustinkmacdonald.com/financial-social-work/.

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Suicide and Religion

Introduction

Studies on the connection between religion and suicide have led to mixed results. Some studies indicated higher levels of suicidality, no relation or reduced risk. Many of the studies that indicated a relationship (either positive or negative), had mediators attached – such as that individuals who were more religious were less likely to attempt suicide as long as they lacked other social supports.

Religiosity and Suicide

Meta-reviews, large scale analyses of suicide risk have helped shed some evidence on the connection between religion and suicide.

Lawrence, Oquendo & Stanley (2016) noted that suicide and religion are both complex dimensions (e.g. suicide ideation versus attempts versus death, religious affiliation versus attendance.) Being part of a majority religious community was found to be a greater protective factor against suicide than a minority community, but that attending religious services was not as important as having social supports (whether religious or not.)

Norko et. al. (2017) noted that all major faith communities (including Islam, Hinduism, Judaism, Buddhism, and Christianity) have strong objections to suicide.

In Lawrence et. al. (2016) a sample of clinically depressed patients in a hospital setting were found to have a higher rate of suicidality if they identified a religious affiliation, the more they attended religious services, and the more they indicated religion was important.

Finally, Wu, Wang & Jia (2015), analyzing over 5000 participants across several large studies identified the three elements that are responsible for the protective factor of suicide: being of a western culture, being older, and living in a area with religious homogeneity.

Spirituality and Suicide

Spirituality can be examined through a lens different from organized religion. While religion may entail specific doctrine, spirituality instead examines one’s relationship with “self, others and ‘God’” (Mandhoui, et. al., 2016), in whatever form that takes.

Mandhoui et. al. (2016) surveyed individuals who were in hospital for suicide attempts. Those individuals lower in spirituality were more likely to attempt suicide at 18 months, with “value of life” tending to reduce the chance that someone re-attempts.

Amato, et. al. (2016) noted that spirituality can be integrated into suicide prevention programs such as case management, therapy and suicide assessment to determine the impact for that individual. They summarize the impact of spirituality by noting that “some individuals at high risk of suicide may find fellowship in an affirming community of faith; others may be helped by rituals that confer atonement or a state of exaltation; still others may learn, through mindfulness meditation, to suspend their inclination to judge themselves harshly.”

Specific Religions / Denominations and Suicide

Buddhism and Suicide

Buddhism has received some exploration in the scientific literature, especially in light of Buddhist monks who have self-immolated for political reasons, the most famous of whom was Thích Quảng Đức in 1963, but research on the exact suicide rate, especially when considered with other religions is lacking.

Lizardi & Gearing (2010) noted several elements that may decrease suicide in Buddhist individuals, including that the largest communities of Buddhists (Asian Americans and Pacific Islanders) have lower suicide rates than whites (who tend to belong to different religious communities) and a strong aversion to killing. In contrast, a belief in reincarnation and life-after-death may contribute to an increase in the suicide rate among specific individuals who adhere strongly to Buddhist traditions.

Catholicism / Protestantism and Suicide

Emile Durkheim in his 1897 work Suicide examined the suicide rates among Catholics and Protestants. He found that Catholics had much lower rates of suicide than Protestants and theorized that it was the result of social support provided in the Catholic community. Additional support was confirmed by Torgler & Schaltegger (2014) and Siegrist (1996) in a modern sample, who also found that church attendance reduced suicide.

Hinduism / Islam and Suicide

Ineichen (1998) examined a number of studies on Hinduism and Islam and consistently found that Muslims had much lower suicide rates than Hindus, focused on a variety of South Asian diaspora (such as individuals in the United Kingdom from other countries.)

Following up on this research, Thimmaiah et. al. (2016) explored a population of Muslims and Hindus in India and found that , while Muslims indicated more negative attitudes towards suicide which may help explain why they are less likely to attempt suicide.

Judaism and Suicide

Examining Jewish Israelis, Eliezer & Daniel (2012) found a rate of suicide lower in Jewish individuals than those who are Catholic or Protestant. Significantly, those with other risk factors for suicide (like veterans, immigrants or those who have experienced trauma) are at elevated at risk of suicide despite their religiosity.

Conclusion

After a review of the literature, it emerges that religious denominations and other factors can have an influence on suicide. Some religions have higher rates of suicide, and some have lower rates, which may be explained by the value system of those religions or the social support of those religions.

The suicide risk by religion, from highest to lowest is below:

  1. Protestant Christian
  2. Catholic Christian
  3. Jewish

Other religions with less well established data sets can be compared to each other, but not necessarily to other religions: Islam has a lower level of suicide than Hinduism, while Buddhism has a lower level of suicide than Native American spirituality.

References

Amato, J. J., Kayman, D. J., Lombardo, M., & Goldstein, M. F. (2016). Spirituality and religion: Neglected factors in preventing veteran suicide?. Pastoral Psychology, doi:10.1007/s11089-016-0747-8

Dyson, J., Cobb, M., Forman, D. (1997) The meaning of spirituality: a literature review. Journal of Advanced Nursing. 26(6). Retrieved on March 3, 2017 from http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2648.1997.00446.x/abstract doi: 10.1046/j.1365-2648.1997.00446.x

Durkheim, E. (1897). Le suicide: étude de sociologie. F. Alcan: Chicago, IL.

Eliezer, W., & Daniel, S. (2012). Suicide in Judaism with a Special Emphasis on Modern Israel. Religions, Vol 3, Iss 3, Pp 725-738 (2012), (3), 725. doi:10.3390/rel3030725

Ineichen, B. (1998). The influence of religion on the suicide rate: Islam and Hinduism compared. Mental Health, Religion & Culture, 1(1), 31.

Lawrence, R. E., Brent, D., Mann, J. J., Burke, A. K., Grunebaum, M. F., Galfalvy, H. C., & Oquendo, M. A. (2016). Religion as a risk factor for suicide attempt and suicide ideation among depressed patients. Journal Of Nervous And Mental Disease, 204(11), 845-850. doi:10.1097/NMD.0000000000000484

Lawrence, R. E., Oquendo, M. A., & Stanley, B. (2016). Religion and suicide risk: A systematic review. Archives Of Suicide Research, 20(1), 1-21. doi:10.1080/13811118.2015.1004494

Mandhouj, O., Perroud, N., Hasler, R., Younes, N., & Huguelet, P. (2016). Characteristics of spirituality and religion among suicide attempters. Journal Of Nervous And Mental Disease, 204(11), 861-867. doi:10.1097/NMD.0000000000000497

Norko, M. A., Freeman, D., Phillips, J., Hunter, W., Lewis, R., & Viswanathan, R. (2017). Can Religion Protect Against Suicide?. Journal Of Nervous & Mental Disease, 205(1), 9-14. doi:10.1097/NMD.0000000000000615

Siegrist, M. (1996). Church Attendance, Denomination, and Suicide Ideology. Journal Of Social Psychology, 136(5), 559-566.

Thimmaiah, R., Poreddi, V., Ramu, R., Selvi, S., & Math, S. (2016). Influence of Religion on Attitude Towards Suicide: An Indian Perspective. Journal Of Religion & Health, 55(6), 2039-2052. doi:10.1007/s10943-016-0213-z

Torgler, B., & Schaltegger, C. (2014). Suicide and Religion: New Evidence on the Differences Between Protestantism and Catholicism. Journal For The Scientific Study Of Religion, 53(2), 316-340. doi:10.1111/jssr.12117

Wu, A., Wang, J., & Jia, C. (2015). Religion and Completed Suicide: a Meta-Analysis. Plos ONE, 10(6), 1-14. doi:10.1371/journal.pone.0131715

Cite this article as: MacDonald, D.K., (2017), "Suicide and Religion," retrieved on March 26, 2017 from http://dustinkmacdonald.com/suicide-and-religion/.

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Setting Limits and Boundaries with Callers

Introduction

Setting limits with Helpline callers is one of the most difficult tasks for a new helpline worker to master. It may go against a volunteer’s nature for them to be required to end calls with callers who still feel they need support or to set limits with callers who may be struggling with mental or cognitive disorders that make it more difficult for them to understand these limits.

The opposite side of that coin is that if volunteers do not set adequate limits with their callers, they will experience increased levels of burnout as they handle calls that are upsetting or even abusive; additionally, if limits are not placed on regular callers, they will “crowd out” crisis callers who may have less of an opportunity to receive support while at imminent risk because a repeat caller is using a disproportionate amount of service delivery.

5 Step Limit Setting Process

There is a 5-step process to setting limits with callers that is commonly used at the Distress Centre and I imagine other helplines or organizations where limit-setting is required. The five steps are as follows:

  1. Identify the inappropriate behaviour
  2. Identify what correct behaviour is
  3. Indicate the consequences for failing to change behaviour
  4. Give the caller an opportunity to change their behaviour
  5. Follow through on consequences (e.g. hanging up) if behaviour does not change

Let’s examine each of these steps in sequence:

Identify the inappropriate behaviour

The first step is to identify what inappropriate behaviour is. This can be an agency limit such as a prohibition on the discussion of sexual explicit content or of a caller masturbating on the phone, or this can be a personal limit like a volunteer being uncomfortable with a caller swearing.

The volunteer will identify the inappropriate behaviour, e.g. “I recognize you’re very angry but I need you to refrain from swearing during our conversation”

Identify what correct behaviour is

In a situation where there is a correct behaviour, the volunteer should indicate that. For example, “We can discuss this sexual experience but I need to stay focused on the emotions and not the physical elements of the act.”

Indicate the consequences for failing to change behaviour

This identifies what happens if a caller does not change their behaviour. “If we can’t stay focused on the emotions, I’m going to have to end the call.”

Give the caller an opportunity to change their behaviour

This is to allow the caller to show us they have recognized the issue, such as by refraining from swearing.

Follow through on consequences (e.g. hanging up) if behaviour does not change

In this step, the caller has not changed their behaviour so the volunteer ends the call. “I’m sorry, but I asked you to refrain from discussing the physical elements of this call. As you have continued to do so, I have to end the call now.” This should be followed by the volunteer hanging up!

This limit setting procedure can be used in a variety of settings, both in person and on the phone.

Call Restrictions

Call restrictions are different from in-call limits (described above), and instead describe things such as a caller being put on a 20 minute time limit per call, or being limited to one call a day. These limits are best deployed when a caller is using significantly more service than average.

One way that Distress Centre determines limits is by examining how often a caller uses our services and for how frequently. Our goal is to limit most callers (who have limits) to one call, once per day, and then to decide on how long. For instance, if a caller tends to call twice a day and speak for 30 minutes, we may set their restriction to one call a day, for 30 minutes.

This restriction is always suspended when a caller is in crisis so that we can de-escalate them or connect them to emergency support.

When placing a caller on restrictions it’s important to speak to them about the rationale for that. A caller who calls repeatedly is likely getting less out of each call than they would otherwise. One focused 30 minute call may deliver much more support to a caller than three 10 minute calls, for instance. One focused hour long call will provide more support to a caller than three hour long calls.

Speaking to the caller, you can explain that we want to make sure our service is available for that caller and help meet their needs but also meet the needs of our other callers and volunteers. If a caller is upset, we can help them find additional supports in their community in addition to the Distress Centre that can help meet their needs.

Working with Abusive Callers

Abusive callers can be very challenging. These are callers that frequently disregard the Five Step Limit Setting Procedure above and instead abuse volunteers by being insulting, sexually graphic or simply by disregarding their time limits consistently.

Abusive callers may need to be temporarily blocked until a staff member can speak with them, in order to reign in that behaviour. If a caller continues to be abusive, the best option may be to simply block that caller from using your service, referring them to alternates in your community.

Winding Up on Text and Chat

Text and chat is a different beast from the telephone. Conversations can stretch much longer if your responder is not careful. Fortunately there are a variety of winding up strategies that can be used on text and chat conversations.

When it comes time to wind up a conversation, you have a few options:

  • We’re just coming up on (45/60/75/90) minutes so we’ll need to wrap up soon. I’m wondering if there’s anything else on your mind?
  • We’ve been talking for (45/60/75/90) minutes, how are you feeling?
  • I’m going to have to open up our queue soon, is there anything you haven’t told me yet that you want to?
  • We’ve been talking for about an hour now so I’ll have to let you go for now

In situations where someone is using the service multiple times per day, you may wish to try things like:

  • I saw that you’ve spoken to one of our responders earlier today, how did that conversation go?
  • I’m wondering if we can focus on some coping strategies that can help you get through the rest of the night

In my experience most visitors respond positively to these gentle wind-ups and allow you to move towards wrapping up the conversation at the appropriate point.

Call Blocking

In a future post I will discuss the technological options available for call blocking; it’s a good idea to check with your telephone provider about the option of blocking abusive or harassing callers from your helpline.

Conclusion

Limit setting can be a challenging task for your volunteers to master but is essential for their continued success on your lines!

Cite this article as: MacDonald, D.K., (2017), "Setting Limits and Boundaries with Callers," retrieved on March 26, 2017 from http://dustinkmacdonald.com/setting-limits-and-boundaries-with-callers/.
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Childhood and Adolescent Taxon Scale (CATS)

Introduction

The Childhood and Adolescent Taxon Scale (CATS) worksheet was originally created to accompany the Violence Risk Appraisal Guide (VRAG) and the Sex Offender Risk Appraisal Guide (SORAG). Although the Psychopathy Checklist-Revised (PCL-R; Hare, 1991) can be used to assess psychopathy, there are many situations where a Psychologist or other individual trained in the administration of this tool is not available. In this situation, the CATS tool can be used to assess psychopathy instead.

Quinsey et. al. (2006) determined that the CATS tool is an appropriate replacement for the PCL-R assessment when determining psychopathy on the VRAG and SORAG assessments. Lister (2010) examined the CATS and found that there were no differences in rates of psychopathy as determined by the PCL-R and the CATS with Caucasian and African-American individuals.

Conduct Disorder Symptoms

In order to answer question 4 below, it’s necessary to identify how many conduct disorder symptoms are present.

Count those present those that occurred before age 16 except for items 13 and 15 which are before aged 16:

  1. Often bullied, threatened or intimidated others
  2. Often initiated physical fights
  3. Used a weapon that could cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
  4. Was physically cruel to people
  5. Was physically cruel to animals
  6. Stolen while confronting a victim (e.g., mugging, purse snatching, extortion, robbery)
  7. Forced someone into sexual activity
  8. Deliberately engaged in fire setting with the intention of causing serious damage
  9. Deliberately destroyed others’ property (other than by fire setting)
  10. Broken into someone else’s house, car, or building
  11. Often lied to obtain goods or favors or to avoid obligations (i.e., “cons” others)
  12. Stolen items of nontrivial value without confronting a victim (like shoplifting, theft, or forgery)
  13. Before [age] 13, stayed out late at night, despite parental prohibitions
  14. Ran away from home overnight (or longer) at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
  15. Before [age] 13, was often truant from school

Childhood & Adolescent Taxon Scale (CATS) Items

The CATS scale has 8 items that are reviewed below, along with supplementary scoring guidelines.

Elementary School Maladjustment

This refers to the first 8 years of formal schooling after kindgarten. A couple of incidents of truancy, smoking on school property or other minor incidents like this would be classified as Mild or Moderate. Severe incidents include repeated truancy or violent actions like assault. Also included in Severe is actions that result in criminal convictions like selling drugs at school.

  • 0 – No Problems
  • 0 – Slight (Minor discipline or attendance) or Moderate Problems
  • 1 – Severe Problems (Frequent disruptive behavior and/or attendance or behavior resulting in expulsion or serious suspensions)

Teenage Alcohol Problem

The National Institute on Alcohol Abuse and Alcoholism produces a guide to screening and intervening with youth (NIAAA, 2015) who consume alcohol. Their screening and assessment rubric can be used to determine if there is a teenage alcohol problem.

Based on the empirically determined risk guidelines, someone who is 12-15 and drinks more than 6 days in the past year would indicate a 1 below, someone who is 16 and drinks more than 12 days in the last year, someone who is 17 would need to drink more than 24 days while an individual who is 18 or higher would need to drink more than 52 days a year.

  • 0 – No
  • 1 – Yes

Childhood Aggression Rating

  • 0 – No Evidence of Aggression
  • 0 – Occasional Moderate Aggression
  • 1 – Occasional or Frequent Extreme Aggression

More Than 3 DSM Conduct Disorder Symptoms

These are the conduct disorder symptoms filled out below.

  • 0 – No
  • 1 – Yes

Ever suspended or expelled from school

  • 0 – No
  • 1 – Yes

Arrested under the age of 16

  • 0 – No
  • 1 – Yes

Lived with both biological parents to age 16 (except for death of parents)

Separation for more than one month is required for coding a “no” on this item. This could be because of institutionalization, divorce, or other separations but does not include death of one or both parents.

  • 0 – Yes
  • 1 – No

Scoring the CATS

Each of these items will result in a 0 or 1 score. All items are summed and the value can then be used to complete Item 12.b on the VRAG or item 14b on the SORAG.

References

American Psychological Association. (2006) Quinsey, V.L., Harris, G.T., Rice, M.E. & Cormier, C.A. (2006) 2nd Ed. Violent Offenders: Appraising and Managing Risk. Washington D.C: American Psychological Association.

Hare, R.D. (1991) The Hare Psychopathy Checklist-Revised (Hare PCL-R). Toronto: Multi-Health Systems.

Lister, M.B. (2010) A Comparison of the Violence Risk Appraisal Guide, Psychopathy Checklist, and child and Adolescent Taxon Scale: Predictive Utility And Cross Cultural Generalizable. Dissertation.

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Cite this article as: MacDonald, D.K., (2017), "Childhood and Adolescent Taxon Scale (CATS)," retrieved on March 26, 2017 from http://dustinkmacdonald.com/childhood-adolescent-taxon-scale-cats/.
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