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THE HISTORY OF THE SPECIALIZED TREATMENT PROGRAM AT A.G. DOZIER SCHOOL JACKSON JUVENILE OFFENDER CORRECTION CENTER
Chief of Staff, Resident Scholar November 16, 2001 In the Fall of 1984, the ACLU filed a class action suit, Bobby M. v. State of Florida, alleging that the A.G. Dozier School (AGDS) was not a treatment facility and that sending boys to AGDS was, therefore, unconstitutional. The facility had long had a reputation for punishment and confinement as a reform school, and little in the way of treatment. The then District Director of HRS requested that I, as a representative of the Department of Psychology at F.S.U., perform an on-site assessment of AGDS and make recommendations to bring it into compliance prior to the beginning of the lawsuit defense. This was part of the then Governor's plan to have the universities become more responsive to the needs to the State. It was readily apparent that there were systemic changes that would be required. (1) Far too many (40%) of the boys were on psychotropic medication to control behavior. (2) The psychology staff was small and had dubious credentials. (3) There was no organized, coherent treatment program. (4) There was a heavy emphasis on punishment and physical restraint. (5) Treatment plans were weak and non-individualized, and emphasized flat time rather than program goals completion. (6) There was a weak, almost nonexistent, aftercare follow up. (7) There was poor coordination between the counseling, education, and work crew programs, and direct care staff. The treatment recommendations by me were to: (1) Replace existing psychiatric services and have a contract psychiatrist remove all boys from psychotropic medication unless they had a specific diagnosis beyond the conduct disordered realm. (2) Put in place a behavior program with a token economy system for rewarding positive behavior and reducing punishment and physical restraint. (3) Make individual treatment plans and a targeted transfer date, instead of flat time. (4) Build a strong psychological presence with a pyramid of two or three Ph.D. level psychologists and ten or so Masters level psychology specialists. (5) Offer each boy both individual and specialized group therapy in areas such as substance abuse, anger control, health and parenting skills. (6) Start a 15 month program for sex offenders. (7) Start a six month substance abuse treatment program. (9) Start a three month anger management program. (10) Set up a systematic aftercare tracking system to determine program effectiveness. Initially, the Governor's office strongly considered closing AGDS, which was the real desire of the ACLU, but the immediate relocation of several hundred severe juvenile delinquents was too formidable a problem and, instead, endorsed the plan of the District to fix the program. With pressure from the law suit, later settled in a Consent Decree, the HRS District Director believed that only a major department such as the Psychology Department at F.S.U. could get these recommendations under way in a reasonable time, and the Department was encouraged to submit a proposal, which we did. Ms. Lou Goldhagen, then the Director of the Psychology Clinic, took the major role in writing the proposal and became the Executive Director of the Specialized Treatment Program (STP), while I became the Chief of Staff and recruited and trained the staff and wrote the treatment program. Of particular interest, a special 15 month program for treatment of adolescent sex offenders was developed which has been highly successful. Initially there was some unhappiness on the part of AGDS administrators because after long periods of very lean budgets, money became available for a rebuilding of physical facilities as well as program monies which AGDS had needed for years. STP and AGDS learned to appreciate each other and to work together. The Consent Decree signed between HRS and the ACLU that adopted the program modifications appointed court monitors to make on-site inspections to see that the Consent Decree was followed. This monitoring process went on for five years and, ultimately, AGDS staff came to appreciate the good the law suit did toward bringing AGDS up from the lowest rating in the state to being the flag ship. Masters level clinical students from the Department filled in for Psychology Specialists while recruiting was underway, and as it worked out, having six or eight students participate made a nice balance which continues today. A mix of experienced psychology specialists and bright enthusiastic advanced psychology students was good for both groups. A critical aspect of the program and the program evaluation was a large database that was built up on the juveniles using demographic, psychometric, treatment response, and recidivism to evaluate the program's efficacy. As a result of establishing this large database, it was possible to perform a number of dissertations assessing various aspects of the program, and most of these dissertations were published in the scientific literature advancing knowledge of what works with severe juvenile delinquency, particularly sex offending. It also provided impressive demonstration of the efficacy of the program, particularly the sex offender treatment program, which led to a larger and larger percentage of dedicated sex offender beds. A contract psychiatrist with a strong behavioral background and a conviction that with conduct disordered boys less medication is better was hired and took all boys off medication on entry, and returned less than five percent of them who had dual diagnoses to low level of medication. These were primarily for attentional deficit hyperactive disorder or non situational depression. Currently there are two adjoined institutions, Jackson Juvenile Offender Correction Center, with 96 beds, and AGDS, with 192 beds, served by STP. Of these 288 beds, 112 of them are dedicated for adjudicated sex offenders. The contract currently is for three years and pays $4,356,657 for the service to both institutions, and continues to support six or eight clinical students as it has for 17 years. This means that about 90 clinical students have been supported for a year or more. We have an eight year follow up study on the sex offender graduates of the program and less than five percent of them have reoffended with a sexual crime. A weakness of the program is vocational habilitation in that it is very difficult for sex offenders to obtain employment in fast food and domestic services. This seems to be the reason why more than 30% of the graduates commit some crime such as burglary, drug sales or robbery… they need money.
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