Alexander KarshCase study
Of Sound Mind · Summer 2026
Delivered · Participant evaluations · Summer 2026

Same words. Different room.

Judges and faculty own the law and the clinical substance. I own the learning architecture, the practice mechanics and the tools that make it usable.

I inherited the 2023 version of this course: a 256-slide deck, a binder, two stand-alone scenarios and a set of evaluations. Over two seasons I rebuilt it with the coordinator and six faculty. Their words stayed theirs, checked against every source file.

Program manager · Spring to summer 2026 · Names barred throughout

The morning the printer broke ↓
Delivered

Summer 2026, one day, 9:00 to 3:30

Audience

Judicial officers, appellate through Orphans’ Court

Faculty

Five judges and one clinician

My role

Program manager, spring to summer

Evidence

Fifteen participant evaluations, self-reports

“I feel very comfortable with you at the helm.”

The course coordinator, a planning call, July 2026

“It’s because you do so much, and you really… you are so good-natured, and you’re doing a great job.”

The same coordinator, a working session later that month
00 · The course

One day, eight sessions, and a case that ran through all of them.

One fictional defendant came back after every block, with one new layer in his file. Faculty held the science and the law; I built the day around him. Thirteen of the fifteen judges who answered said they intend to use the concepts.

Morning · The science

9:00–9:15Welcome, Introductions & Overview
9:15–10:20Mental Illness and Hearing Voices
10:20–10:30Break
10:30–12:30Trauma, ACEs, and Motivational Interviewing
12:30–1:00Lunch

Afternoon · The bench

1:00–1:30Justice Reinvestment Act and Measuring Success
1:30–2:00Diversion in Practice
2:00–2:10Break
2:10–3:00HG §§ 8-505/8-507, AOT & Emergency Petitions
3:00–3:25Case Application, Questions, and Takeaways
3:25–3:30Closing and Final Reflections

My first rule

My first rule for myself was to lighten the faculty’s load. They’re busy volunteers, not teachers, and my job isn’t to hand them more work: a pre-course packet I think is full of wonderful research is, on their end, one more thing to get through, and so is every email. The question I kept asking was what would make this easier, and what would make them want to come back and volunteer to teach again.

What I did, workstream by workstream

01

Faculty and rosterI read the 2023 evaluations first. The consensus in them was that the clinician’s simulation of what it’s like to hear voices in a courtroom was one of the most memorable parts of the day. She probably would have been invited back anyway, and I think the court and the coordinating judge wanted her. What I did was go into the first planning meeting saying we needed her because of that 2023 feedback, and then make sure the budget and the procurement were there to fly her in and cover the hotel. I rebuilt the lineup when a 2023 judge declined. When a faculty judge retired mid-planning and lost courthouse access, I moved her materials to attachments she could open from home.

“I will never forget that the next time I deal with someone who may be hearing voices.”

A judge, 2023 evaluation

“The audio exercise most supported my understanding of what litigants with certain psychiatric issues are experiencing and encouraged me to explore various approaches to helping litigants with said issues.”

A judge, 2026 evaluation
02

Agenda and learning outcomesI turned the 2023 agenda into the first planning document and revised it after every faculty conversation, always as a proposal. Learning outcomes went from three, to four by spring, to six on the day. I caught a ten-minute change to the opening that existed only in the dry-run recording.

03

The recurring caseI replaced the two stand-alone scenarios with one fictional composite defendant, wrote the planning note and capture sheet with a fully worked example, and kept every fact proposed until the coordinator and the statutory judge approved it.

04

SlidesI built a template family for faculty to fill, recovered five slides whose text no tool could read, and held 256 slides to one visual system with nothing under 18 point. The rest of this page is that work.

05

Binder and roomI rebuilt the participant binder with a linked contents page, redesigned the ACEs questionnaire at the clinician’s request and filed the room setup. I also wrote the run of show, which listed each session with its slide range, its faculty and the slide where Jordan returns.

06

ChecksI ran an AI-assisted check of faculty wording and every figure before the first send. It caught a statute cited with the wrong section number, a court participation figure that didn’t match its source, and a percentage with no source behind it.

07

Faculty reviewI built an individual review packet for each faculty member, an all-faculty crosswalk and a checklist to approve, validate or change every item in each block. The cover note I wrote for the 2023 slides offered three choices and pressed none: reuse them as they were, rebuild from them, or set them aside and build new.

On file

Kickoff meeting prep
Kickoff meeting prepSpring 2026
First planning document
First planning documentSpring 2026
Agenda at a glance
Agenda at a glanceSpring 2026
Planning document, revised
Planning document, revisedSpring 2026Roster, agenda with content notes, learning outcomes and the course description.
Recurring case: planning note
Recurring case: planning noteSummer 2026With the capture sheet and one worked example.
Faculty meeting recap
Faculty meeting recapSummer 2026
The case file, for the tables
The case file, for the tablesSummer 2026
ACE questionnaire, redesigned
ACE questionnaire, redesignedBinder, p. 70
A judge’s tip sheet, set
A judge’s tip sheet, setBinder
Evaluation summary
Evaluation summarySummer 2026
The slide rules

Same words

Checked against the source, word for word. A full slide becomes two.

18 point floor

A third of the room read from the back. Split, never shrink.

One master

Same title, same rule, same footer, every slide.

Faculty first

Preserve when preserving is right.

01 · The opening

Four good reasons, beside a question mark.

The slide that tells judges why they are in the room. The reasons are the coordinator’s and they hold up. In 2023 they shared the slide with a grey box of clip art.

The 2023 introduction slide
2023
Introduction

Behavioral Science

WHY take the time, as judges, to understand these concepts?

Helps us to create better sentences and reduce recidivism (as evidenced by the successful use of such concepts in problem solving courts)

Such concepts are rooted in the Justice Reinvestment Act (JRA) that we are bound to apply and follow

Such concepts are rooted in the proper and often underutilized 8-505/8-507 commitments for inpatient substance abuse treatment

Tools used in both DV and in Family Law cases rely upon behavioral science for better outcomes

Of Sound MindSummer 2026
As delivered
01

WHY carries the questionHer words in her order. The clip art is gone and the word itself does the work, in sage, at the head of the slide.

02

The bullets took the room the box hadBody type sits well above the 18 point floor, and each reason gets a line and a half instead of four.

02 · A relationship

The sentence was a diagram all along.

“Judicial Branch Commits to Executive Branch Pursuant to a Comprehensive Statutory Scheme” was the first item in a numbered list beside a clip-art book. It describes two parties and a direction, so the slide draws them.

HG 8-507 Commitments
  1. Judicial Branch Commits to Executive Branch Pursuant to a Comprehensive Statutory Scheme
  2. It is a State Responsibility: MDH “shall”:
    ○ “provide the services required”
    ○ “facilitate the immediate treatment “
But Broad Delegation: 8-507 (d) and 8-505 (e),
(1) The Department shall provide the services required by this section.
(2) A designee of the Department may carry out any of the Department’s duties under this section.”
Faculty draft, rebuilt from the source file
8-505 / 8-507 and community based treatment

HG 8-507 Commitments

Judicial Branch
Commits to
Executive Branch
Pursuant to a Comprehensive Statutory Scheme

It is a State Responsibility: MDH “shall”:

“provide the services required”
“facilitate the immediate treatment “
But

Broad Delegation: 8-507 (d) and 8-505 (e),

(1)The Department shall provide the services required by this section.
(2)A designee of the Department may carry out any of the Department’s duties under this section.”
Of Sound MindSummer 2026
As delivered
01

One branch commits to the otherThe two branches are blocks; the commitment is a tiled bridge between them, and the statutory scheme runs underneath as a caption.

02

“But” is the hingeThe State’s duty sits on one side, the delegation that qualifies it on the other, and the slide’s one conjunction stands between them at title size.

03 · A statute

One crowded slide, given room to breathe.

Health-General 8-505(a), all three clauses crammed onto one slide in orange SmartArt. Every text extractor I ran reported it as empty, because the words sat inside a diagram object. I recovered the text and gave the statute two slides.

The statute slide as supplied, three clauses in orange SmartArt on one slide
As supplied · one slide

As delivered · two slides

8-505 / 8-507 and community based treatment1 of 2

Prerequisites: 8-505(a)

(1)

“Before or during a criminal trial, before or after sentencing, or before or during a term of probation, the court may order the Department to evaluate a defendant to determine whether, by reason of drug or alcohol abuse, the defendant is in need of and may benefit from treatment if:

(i)

It appears to the court that the defendant has an alcohol or drug abuse problem;

or
(ii)

The defendant alleges an alcohol or drug dependency.

Of Sound MindSummer 2026
1 of 2 · The power, and the choice between two tests
8-505 / 8-507 and community based treatment2 of 2

Prerequisites: 8-505(a)

(2)

A court shall set and may change the conditions under which an examination is to be conducted under this section.

(3)

The Department shall ensure that each evaluation under this section is conducted in accordance with regulations adopted by the Department.”

Of Sound MindSummer 2026
2 of 2 · The two conditions
01

One slide became twoFaculty had all three clauses on one slide. Clause (1) and its two tests now have a slide of their own; the two procedural clauses have the other, at a size the back row can read.

02

The choice is drawn as a choiceThe statute offers two alternative tests, so they sit side by side as equal fields with a single “or” between them.

03

Recovered, then set as live typeWording unchanged and editable, so faculty could still revise it the week of the course.

04 · Questions

A stock photo of Scrabble tiles.

Three questions the faculty member wanted the room to sit with, beside a stock photo of Scrabble tiles spelling FAQ. The photo was doing nothing, and three equal boxes gave the lead question the same weight as its follow-ups.

The FAQ slide as supplied, beside a stock photo of Scrabble tiles
As supplied
8-505 / 8-507 and community based treatment

FAQ #1

F4
A1
Q10

What precludes an otherwise ideal candidate from participating in drug treatment programs?

What do you do when someone has outstanding cases in other jurisdictions?

What about interjurisdictional & intra-jurisdictional detainers?

Of Sound MindSummer 2026
As delivered
01

The Scrabble tiles became azulejo tilesStill Scrabble, point values and all, but glazed in the course motif and stacked down the full left edge, with the faculty member’s blessing.

02

The lead question got the wide panelThe two follow-ups sit below it, subordinate to it and equal to each other. The tile column carries all five FAQ slides.

05 · A wall of text

One slide became three reading beats.

The faculty exercise, as drafted: facts, the court’s order and the defendant’s signed statement on a single slide, in 10-point type. Nothing could be cut, so it was split.

Exercise #1

Defendant Willing’s DOC incarceration for robbery convictions ended in 2009. Since his release in 2009, he had not been arrested until 6 months ago when he was apprehended on these theft charges. He pled guilty. Mr. Willing admitted that he stole many Amazon packages from many porches during the last year. Candidly, he noted a significant history of opioid addiction and recent relapses.

An 8-505 evaluation was requested by Mr. Willing and ordered by Judge Warmhart. The thourough 8-505 evaluation recommended a residential treatment placement at the Excellent Program.

4 months ago, Judge Warmhart sentenced Mr. Willing on the record and in a contemporaneous written order restated what he had ordered on the record:

“Sentence: Defendant Willing is committed under Health General 8-507 for the length of time needed to complete residential treatment and aftercare, but not to exceed two years from this date. The Defendant shall complete residential treatment at the Excellent Program or at another residential program designated by the Maryland Department of Health (MDH). Further, upon the completion of residential treatment, Defendant Willing shall comply with all reasonable conditions of any clinically appropriate continuity of care plan approved by MDH, which may set forth reasonable medication, therapy, residence, employment , daily activities or other reasonable terms supportive of Mr. Willling’s recovery. This continuity of care plan shall be binding on Mr. Willing only for a necessary length of time not to exceed two years. This is a final judgement.”

On the record, on the day of sentencing , Mr. Willing signed a statement typed onto the executed CC/DC form 8-507 Commitment order which stated: “ I knowingly, voluntarily and intelligently agree to be bound by any clinically appropriate and reasonable treatment terms required by the Excellent Program, the Maryland Department of Health or an appropriate treatment provider designated by MDH.” Mr. Willing also signed the CC/DC consent to treatment and records release forms. Immediately he was admitted to the Excellent Program.

Faculty draft, rebuilt from the source file

As delivered, three slides

8-505 / 8-507 · Exercise1 of 3

Exercise #1

Defendant Willing’s DOC incarceration for robbery convictions ended in 2009. Since his release in 2009, he had not been arrested until 6 months ago when he was apprehended on these theft charges. He pled guilty. Mr. Willing admitted that he stole many Amazon packages from many porches during the last year. Candidly, he noted a significant history of opioid addiction and recent relapses.

An 8-505 evaluation was requested by Mr. Willing and ordered by Judge Warmhart. The thourough 8-505 evaluation recommended a residential treatment placement at the Excellent Program.

Of Sound MindSummer 2026
1 of 3 · The facts
8-505 / 8-507 · Exercise2 of 3

Exercise #1

4 months ago, Judge Warmhart sentenced Mr. Willing on the record and in a contemporaneous written order restated what he had ordered on the record:

“Sentence: Defendant Willing is committed under Health General 8-507 for the length of time needed to complete residential treatment and aftercare, but not to exceed two years from this date. The Defendant shall complete residential treatment at the Excellent Program or at another residential program designated by the Maryland Department of Health (MDH). Further, upon the completion of residential treatment, Defendant Willing shall comply with all reasonable conditions of any clinically appropriate continuity of care plan approved by MDH, which may set forth reasonable medication, therapy, residence, employment , daily activities or other reasonable terms supportive of Mr. Willling’s recovery. This continuity of care plan shall be binding on Mr. Willing only for a necessary length of time not to exceed two years. This is a final judgement.”

Of Sound MindSummer 2026
2 of 3 · The order, set as a document
8-505 / 8-507 · Exercise3 of 3

Exercise #1

On the record, on the day of sentencing , Mr. Willing signed a statement typed onto the executed CC/DC form 8-507 Commitment order which stated:

“

I knowingly, voluntarily and intelligently agree to be bound by any clinically appropriate and reasonable treatment terms required by the Excellent Program, the Maryland Department of Health or an appropriate treatment provider designated by MDH.”

Mr. Willing also signed the CC/DC consent to treatment and records release forms. Immediately he was admitted to the Excellent Program.

Of Sound MindSummer 2026
3 of 3 · The statement, set as a quotation

From the faculty draft. This exercise was later replaced by the recurring case, below.

06 · The punchline

The rule the exercise was built to land.

After the exercise, the point the faculty wanted the room to leave with. In the draft it was a single bullet beside a stock photograph of an asteroid.

The Big Point…Houston, We Do Have a Problem!
  • 8-507 is not a freestanding sentence. It is a commitment that always runs parallel to a recognized criminal status of the defendant (pretrial release, detained pending trial or sentence, on probation).
Faculty draft, rebuilt from the source file
Azulejo-tiled porthole: a comet over the Lisbon skyline at night
The Big Point…

Houston, We Do Have a Problem!

8-507 is not a freestanding sentence.

It is a commitment that always runs parallel to a recognized criminal status of the defendant (pretrial release, detained pending trial or sentence, on probation).

Of Sound MindSummer 2026
As delivered
01

The only dark slide in the sectionSo the turn reads as a turn. The asteroid became a tiled porthole in the course’s own hand.

02

The rule is set first, in the serif“8-507 is not a freestanding sentence.” The explanation follows in the body type.

07 · The recurring case

Two scenarios at the back, and the person who replaced them.

The spring draft still ran two stand-alone scenarios back to back. I proposed one fictional composite defendant who returns after each teaching block, so judges make another decision with the tools they have just been given.

At the first faculty meeting I brought the idea up, and the clinician jumped in right away: she does the same thing in her continuing medical education courses, where the group meets the same victim all day. One of the judges said she thought it was a great idea.

Before

A 2023 standalone scenario slide
2023One of the two scenarios near the end of the 2023 deck. Faculty’s slide, as supplied.
The May 2026 draft with two scenarios
Spring 2026 draftThe plan after the first faculty meeting still ran two cases back to back, 2:40 to 3:20.

As delivered, first and second appearances

◆ Jordan Ellis · First appearance · This morning

Meet Jordan Ellis.

Jordan is 24 and lives in Anne Arundel County. He has pleaded guilty to package theft committed during active opioid use and awaits sentencing.

What Jordan reports

At intake, Jordan reported four days without sleep and a voice telling him not to talk. He reports opioid use that began shortly after his mother’s death and was active at arrest.

Case before the court

An 8-505 evaluation has been requested by Mr. Ellis and is pending ahead of disposition.

Housing and supports

Housing is unstable. His sister in Baltimore County is a willing contact but cannot house him.

What happened to you, not what’s wrong with you: what is one more thing you would need to know before sentencing Jordan?

Hold onto your answer. We will come back to it this afternoon.

Of Sound MindSummer 2026
First appearance · This morning
◆ Jordan Ellis · Second appearance · What came before

Jordan, before the charge.

Case file so far · Previously established

First appearance  Jordan Ellis, 24, lives in Anne Arundel County. Guilty plea to package theft during active opioid use; awaits sentencing. An 8-505 evaluation is pending.

What Jordan reports  Four days without sleep and a voice telling him not to talk. Housing is unstable.

Jordan is back. New to the file: what came before.

Jordan reports household substance use and parental separation. School stopped in spring 2020; he did not formally reengage. His mother died that year. He reports opioid use beginning shortly after.

What does this history help explain?

What does it not establish, and what would you order to learn more?

Of Sound MindSummer 2026
Second appearance · What came before
01

Every return carries the file so farA tinted band holds what is already established, so a judge who missed the morning can still decide in the afternoon.

02

No score anywhere on his fileAn ACE score is a population measure and predicts nothing about one person.

03

Why one case, four timesIn summer 2026 I commissioned a research brief on whether one defendant, met four times, would hold up better than a fresh hypothetical in every block. The brief is input for the design, not a literature review of mine. I used three of its arguments: a course can introduce a case and come back to it in more depth, adults learn around problems rather than subjects, and coming back to the same facts after a gap works better than one long stretch on them.

04

The printer failed on the morningSo the file moved onto the slides. That morning is the next section.

08 · The morning of

The printer broke. The day didn’t.

The plan was a one-page case file on every table, filled in at each of Jordan’s returns. On the morning of the course the printer failed, and the case file couldn’t be copied for every table.

Planned

A case file on every table

One printed page per table, filling in at each return.

What broke

The printer, that morning

No copies of the case file for the tables.

What we ran instead

The room itself

The file so far on every return slide, and table discussion.

The one-page Jordan Ellis case file, built for the tables
The case file, as planned for the tables
◆ Jordan Ellis · Second appearance · What came before

Jordan, before the charge.

Case file so far · Previously established

First appearance  Jordan Ellis, 24, lives in Anne Arundel County. Guilty plea to package theft during active opioid use; awaits sentencing. An 8-505 evaluation is pending.

What Jordan reports  Four days without sleep and a voice telling him not to talk. Housing is unstable.

Jordan is back. New to the file: what came before.

Jordan reports household substance use and parental separation. School stopped in spring 2020; he did not formally reengage. His mother died that year. He reports opioid use beginning shortly after.

What does this history help explain?

What does it not establish, and what would you order to learn more?

Of Sound MindSummer 2026
What carried it instead: the file so far, on every return
◆ Jordan Ellis · Fourth appearance · This afternoon

Jordan on the bench.

Jordan is in front of you this afternoon. At your table, decide:

1

What Jordan needs now

2

What the court still needs to know

3

What the court can do today

Show of hands

Who would order the 8-505 evaluation before sentencing?

Of Sound MindSummer 2026
The closing round: the table, then a show of hands
01

The file moved onto the slidesThat morning, the case file so far went onto each of Jordan’s return slides in place of the paper, so every table could still see what had already been established.

02

Slido came outLive polling was dropped for a show of hands. Faculty ran table discussion and casual polling from the front instead.

03

The closing round still ran at every tableWhat Jordan needs now, what the court still needs to know, and what the court can do today.

09 · A quote

A teaching point worth keeping.

A judge’s 2023 quote slide, black and white, the attribution boxed in a hard rectangle. She uses it to open her section on listening to defendants. It needed a frame that did not fight it.

The 2023 quote slide
2023
Justice Reinvestment Act

Every Defendant Ever

Illustration: headphones over an open book

“Most people do not listen with the intent to understand; they listen with the intent to reply.”

Stephen R. Covey

(1932 – 2012)
Of Sound MindSummer 2026
As delivered
01

The quote gets half the slideIn italic at display size, beside new art in the course palette.

02

The attribution leaves the boxCovey’s name at title weight with a sage rule and his dates. Her section title moves to the eyebrow, so the quote reads as hers.

10 · The system

Three templates, so faculty could build their own.

Six faculty, six working styles, one day. Rather than restyle everyone’s slides at the end, I built three slides for faculty to fill, each with its rules written into the placeholder text. One judge built her entire section in them.

Everything’s in the same color palette, everything goes together, and it’s not just to make things look pretty. It’s super organized. I glance, I see that shade of green, this is behavioral health.

Ledger · points, with a side column for the record

Template · Ledger

Slide Title

First point:

replace with your content. Keep to four points or fewer per slide.

Second point.

Body stays at this size; split the slide before shrinking the type.

Third point.

Bold a lead-in phrase if the point needs a headline.

Marginalia

Side notes, statute cites, or the aside you want on the record: the narrow column keeps it quiet.

Of Sound MindSummer 2026
The template
Diversion in Practice · Carroll County

The Before: What Was Missing

The gap

no formal mental-health programming via courts.

The understanding

approaching mental illness is different from approaching substance use.

The coordination

resources existed but were siloed.

Questions

What resources exist?

What language do the partners use?

How can we most efficiently unite the resources + end users?

Of Sound MindSummer 2026
In use · Diversion in Practice

Panels · points, with stat blocks and the swatch grid

Template · Panels

Slide Title

Lead point: replace with your content.

Second point. Delete the stat blocks or the swatch grid if the slide needs air.

00%
Stat label: replace
00%
Stat label: replace
The swatch grid
Of Sound MindSummer 2026
The template
Trauma, ACEs, and Motivational Interviewing

The ACE score

The ACE score is the count of categories answered yes, not a measure of a person.

A higher score means a greater likelihood of long-term consequences from unaddressed trauma. It predicts nothing about any one life.

10
Categories, before age 18
0
Scores collected or shared
Adapted from Kaiser Permanente, 1997
Of Sound MindSummer 2026
In use · Trauma and ACEs

Discussion · one question, three decisions, one show of hands

Template · Discussion

Slide Title

The question for the room, in the serif, in one sentence.

1

First thing each table decides.

2

Second thing each table decides.

3

Third thing each table decides.

Show of hands

Close on one yes-or-no the room can answer at once.

Of Sound MindSummer 2026
The template
◆ Jordan Ellis · Fourth appearance · This afternoon

Jordan on the bench.

Jordan is in front of you this afternoon. At your table, decide:

1

What Jordan needs now

2

What the court still needs to know

3

What the court can do today

Show of hands

Who would order the 8-505 evaluation before sentencing?

Of Sound MindSummer 2026
In use · The capstone

Preserved, not restyled

The clinician’s slide as it appeared in her own handout
Her handout
The same slide in the deck, with only the course footer added
As delivered · footer added, nothing else
01

The rules live in the placeholders“Split the slide before shrinking the type” is the template’s own second bullet, so a judge filling it in reads the rule at the moment it applies.

02

Knowing when not to restyle is part of the systemThe clinician’s 142 slides came in as pictures, exactly as she made them, with only the course footer added. Her design and her branding stayed hers.

What the room said

Fifteen judges answered afterward.

The answers were post-course self-reports, collected in late summer 2026.

12of 15

said they can confidently apply the concepts, or adapt them

13of 15

said they intend to use them as a high priority. The other two said their role doesn’t call for them.

0of 15

chose any negative statement about instruction

Ability to use the concepts after the course

Answer choices shortened from the survey. Bars run from 0 to 15.

Apply independently and adapt7
Confidently apply in my work5
Understand and can explain3
Familiar, would need guidance0
Still unclear0

“They presented lots of complicated material in an economical but understandable fashion.”

Judge, 2026 evaluation

“The slides and printed materials captured the essence of the presentations and made an excellent resource for future use.”

Judge, 2026 evaluation

“More Judges should take this course.”

Judge, 2026 evaluation
What they asked for

The evaluation drew four written critiques, quoted here in full.

“The first segment was probably too long.”

“Make the materials correlate to the presentation to allow notes on the handouts as we go along.”

“Maybe offer the course twice a year.”

“more classes to better explore subject material”

What I would change

One judge asked for handouts that follow the slides in order, with room for notes. The fix is to print each session’s slides in presentation order with a notes column beside them.