Evidence Based Practice

Evidenced-Based Practices (EBP) is the progressive organizational use of direct, scientific, current evidence to guide efficient, cost-effective correctional services that positively impact subsequent recidivism / victimization and/or public satisfaction.

At Glory House there are several types of Evidence-Based Practices used. Dialectical Behavior Therapy (DBT), Moral Reconation Therapy (MRT®), and The Matrix Model are outlined below.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is a modified type of Cognitive Behavioral Therapy (CBT). Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.

DBT was developed by Marsha M. Linehan in the late 1970s. Her primary research interest is in the development and evaluation of evidence-based treatments for population withs high suicide risk and multiple, severe mental disorders.

DBT has 4 modules:

  • Mindfulness: the act of consciously focusing the mind in the present moment, without judgment, and without attachment to the moment.
  • Distress Tolerance: learning to accept, find meaning for and tolerating distress.
  • Interpersonal Effectiveness: focusing on the core interpersonal skills of obtaining objectives while maintaining relationships and one’s self-respect.
  • Emotional Regulation: to reduce emotional distress by learning to regulate one’s emotions.

Moral Reconation Therapy (MRT)

Moral Reconation Therapy (MRT®) was one of the first comprehensive, systematic attempts to treat substance-abusing offenders from a purely cognitive behavioral perspective. In 1985 formal MRT® was developed by Dr. Greg Little and Dr. Ken Robinson by combining Smothermon's concepts with theories of moral development (Kohlberg), ego and identity development (Erikson), behavioral conditioning, Maslow's needs hierarchy, and Carl Jung's concepts.

MRT® is an objective, systematic treatment system designed to enhance ego, social, moral, and positive behavioral growth in a progressive, step by step fashion. MRT® has 12 to 16 steps, depending on the treatment population. MRT® attempts to change how drug abusers and alcoholics make decisions and judgments by raising moral reasoning from Kohlberg's perspective.

Briefly, MRT® seeks to move clients from hedonistic (pleasure vs. pain) reasoning levels to levels where concern for social rules and others becomes important. Research on MRT® has shown that as clients pass steps, moral reasoning increases in adult drug and alcohol offenders and juvenile offenders.

MRT® focuses systematically on seven basic treatment issues: confrontation of beliefs, attitudes and behaviors, assessment of current relationships, reinforcement of positive behavior and habits, positive identity formation: enhancement of self-concept, decrease in hedonism and development of frustration tolerance, and development of higher stages of moral reasoning.

Matrix Model

The Matrix Model is a set of evidence-based practices delivered in a clinically coordinated manner as a “program.” The Matrix Model of outpatient treatment was developed at the height of the cocaine epidemic in Southern California in the 1980’s. The development of the Matrix Model was influenced by an ongoing interaction between clinicians working with clients and researchers collecting related information.

As clinical experience with stimulant dependent individuals was amassed, clinical impressions frequently generated questions that were answered by using relevant research findings. Treatment materials had to be developed that were sophisticated enough to capture the essence of the proven effective therapies, yet simple enough to be readily used and easily monitored in widely diverse clinical situations by patients and the clinical staff.

With funding from NIDA, the authors of the Matrix approach attempted to integrate existing knowledge and empirically supported techniques into a single, multi-element manual that could serve as an outpatient “protocol” for the treatment of cocaine and methamphetamine users (Rawson, Obert, McCann, Smith & Scheffey, 1989; Rawson, Obert & McCann, 1995).

Treatment is delivered in a 16-week intensive outpatient program primarily in structured group sessions targeting the skills needed in early recovery and for relapse prevention. A primary therapist conducts both the individual and group sessions for a particular patient and is responsible for coordinating the whole treatment experience. There is also a 12-week family and patient education group series and induction into an ongoing weekly social support group for continuing care. Weekly urine testing is another program component and participants are encouraged to attend 12-step meetings as an important supplement to intensive treatment and a continuing source of positive emotional and social support.

All information on the Matrix Model comes from Richard A. Rawson, Ph.D. & Michael McCann, M.A.