The Andrews' Principles of Risk, Need, and Responsivity as Applied in Drug Abuse Treatment Programs: Meta-Analysis of Crime and Drug Use Outcomes

For whom are treatments for criminal recidivism effective? Moderator effects from a randomized controlled trial of justice-involved veterans

OBJECTIVE

In a recent trial, moral reconation therapy (MRT)-a cognitive-behavioral intervention for criminal recidivism-was not more effective than usual care (UC) for veterans in behavioral health treatment. To determine for whom treatments of recidivism are most effective, we tested if recency of criminal history or psychopathic traits moderated MRT's effects on outcomes.

METHOD

In a multisite trial, 341 veterans (95.3% male; 57.8% White/Non-Hispanic) with a criminal history who were admitted to behavioral health treatment programs were randomly assigned to UC or UC + MRT and followed at 6- and 12-months. Incarceration (yes/no) or criminal conviction (yes/no) in the year prior to enrollment and psychopathic traits at baseline (median split) were prespecified as moderators of treatment effects on primary (criminal thinking, criminal associations) and secondary outcomes (legal, employment, and family/social problems; substance use problems and days of use).

RESULTS

Among veterans incarcerated in the year prior to enrollment, MRT (vs. UC) was associated with greater reductions in criminal associations (6 months) and days drinking or using drugs (12 months). Among those convicted in the year prior to enrollment, MRT (vs. UC) was associated with greater reductions in employment problems (12 months) and days drinking or using drugs at each follow-up. For those high in psychopathic traits, MRT (vs. UC) was associated with greater reductions in days drinking or using drugs at each follow-up.

CONCLUSIONS

For veterans in behavioral health treatment with recent criminal histories and high in psychopathic traits, MRT may be effective for reducing risk for criminal recidivism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disentangling the relationship between posttraumatic stress disorder, criminogenic risk, and criminal history among veterans

OBJECTIVE

Posttraumatic stress disorder (PTSD) is positively associated with involvement in the criminal justice system among veterans. Research that examines whether this association is confounded by risk factors ("criminogenic needs") from the risk-need-responsivity model of correctional rehabilitation can inform risk management with this population.

HYPOTHESES

We hypothesized that (a) veterans with probable PTSD would score higher on all criminogenic needs than veterans without PTSD and (b) probable PTSD would be associated with criminal history but not after accounting for criminogenic needs.

METHOD

We conducted secondary analyses of data from 341 veterans (95.3% male; 57.8% White/non-Hispanic/Latinx; Mage = 46.2 years) with a history of criminal justice system involvement who were admitted to mental health residential treatment. At treatment entry, participants completed interviews to assess criminal history, risk-need-responsivity-based criminogenic needs, and PTSD symptom severity. Cross-sectional analyses tested for differences between participants with and without probable PTSD on criminogenic needs and criminal history, and a multiple regression model examined the unique contributions of probable PTSD and criminogenic needs on criminal history.

RESULTS

The majority of the sample (74%, n = 251) met probable criteria for PTSD. Compared with veterans without PTSD, those with probable PTSD scored significantly higher on criminogenic needs of antisocial personality patterns, antisocial cognitions, antisocial associates, substance use, and family/marital dysfunction but did not differ on multiple indices of criminal history (Cohen's ds = 0.60-0.86). In the regression model, higher age (β = 0.52, p < .001) and higher scores on measures of antisocial personality patterns (β = 0.19, p = .04) and antisocial cognitions (β = 0.22, p = .02) were significantly associated with higher scores on a criminal history index.

CONCLUSIONS

The findings suggest that veterans with probable PTSD may score higher on a number of criminogenic needs that are known to be drivers of recidivism. An approach that integrates trauma-informed and risk-need-responsivity principles to address veterans' dynamic criminogenic and clinical needs may be critical to risk management in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

What Matters More in Explaining Drug Court Graduation and Rearrest: Program Features, Individual Characteristics, or Some Combination

This study examines the program- and individual-level factors that impact the success of drug court clients in terms of: (1) graduation; and (2) not being arrested while participating in the court program. The data consist of 848 individuals in nine drug courts. This paper discusses how different individual- and program-level factors impact the success of drug court participants. The findings suggest that individual- and program-level factors are both important in predicting program graduation and arrest during drug court participation, while controlling for participant demographics. Clients' education, drug/alcohol usage, program staffing, and clinical standards impact program graduation while criminal history, drug/alcohol usage, number of program hours offered, program staffing, and use of rewards and sanctions predict in-program arrest. Models combining both program- and individual-level factors performed better than either alone, leading to recommendations that agencies should emphasize improving program quality while targeting clients' needs to achieve greater success.

Recidivism of Individuals Who Completed Schedule I Drugs Deferred Prosecution Treatment: A Population-Based Follow-Up Study from 2008 to 2020 in Taiwan

Deferred Prosecution with Condition to Complete the Addiction Treatment (DPCCAT) is a judicial diversion program in Taiwan that shifts people who use drugs away from the label drug offender and toward the label patient. However, little is known about the effectiveness of completing a DPCCAT program on people who use drugs. Using a nationwide population-based retrospective panel data from 2008 to 2020, recidivism is defined as a person was caught urine positive and charged by a prosecutor after their completion of DPCCAT. After controlled gender, age, and region, comparisons of recidivism rates and time to relapse between Schedule I drug use only, Schedule I & II drug use, and heterogeneous group were examined. Of 24,248 participants with DPCCAT, 11,141 (46%) completed the one-year treatment program. Of completers, the five-year recidivism rates are significantly lower for the Schedule I drug use only (26%) than Schedule I & II drugs use (52%) and heterogeneous group (47%). Results from Cox regression indicated that the duration of recidivate to drug use is significantly longer for the Schedule I drug only than the other two groups after controlling for demographics. The main findings support that completion of a DPCCAT program only reduces the risk of recidivism for people who use Schedule I drug only and is less effective for polydrug users and heterogeneous group. We suggest that characteristics of people who use drugs and other criminal offenses should be taken into consideration for triage when DPCCAT is offered.

Guiding officers to deflect citizens to treatment: an examination of police department policies in Illinois

BACKGROUND

The U.S. overdose crisis has motivated police departments to enact policies allowing officers to directly deflect individuals to substance use disorder treatment and other services shown to reduce recidivism and subsequent overdose risk, as well as refer people who voluntarily present at police facilities with a desire for treatment. As a new way of operating, and one that relies on an officer's use of discretion for successful implementation, the practice benefits from guidance through written directives, training, and supervisory support. However, there is little information on the establishment, content, and execution of police department deflection policies, which hampers the implementation and dissemination of this promising practice. We analyzed 16 policies of Illinois police department deflection programs. Using content analysis methodology, we coded the policies for language and terminology, as well as program components and procedures. We aimed to examine how the policies were written, as well as the content intending to guide officers in their work.

RESULTS

We found the policies and programs had notable differences in length, detail, terminology, and reading level. Only one policy mentioned the use of any type of addiction treatment medication, many used stigmatizing language (e.g., "abuse" and "addict"), and few mentioned "harm reduction" or training in the practice of deflection. Many policies restricted participation in deflection (i.e., no minors, outstanding warrants, current withdrawal symptoms), and critically, a majority of policies allowed police officers to exclude people from participation based on their own judgment.

CONCLUSIONS

We recommend police departments consider the readability of their policies and reduce barriers to deflection program participation to engage a larger pool of citizens in need of substance use disorder treatment. Since there is limited research on police policies generally, and the field of deflection is relatively new, this study offers insight into the content of different department policies and more specifically, how officers are directed to operate deflection programs.

Self-compassion in Treatment and with Ourselves

PURPOSEOF REVIEW

This article explores the emerging role of compassion in the treatment of individuals who have caused sexual harm. It also brings focus to the importance of self-care and self-compassion for the practitioners who do this work.

RECENT FINDINGS

Early studies into interventions designed to prevent offending behavior focused more on risk reduction than client resilience and well-being. The good lives model shifted focus to rehabilitation centered on clients' strengths. Recent critiques highlight the importance of compassion in treatment and self-compassion for practitioners working in this field. Compassion plays a fundamental role in therapy with clients who have caused sexual harm.

Risk-need-responsivity: Evaluating need-to-service matching with reach, effectiveness, adoption, implementation, maintenance

With a sample of 125 adults under community supervision (71.20% male, 76.00% White, mean age = 33.17 years), this study evaluated need-to-service matching using an evaluation framework from implementation science. Need-to-service matching is a case management strategy intended to align service referrals in case plans with justice-involved persons' criminogenic needs. The results indicated that need-to-service matching reached a high percentage of its target population at 81.70%. Within criminogenic need areas, good match frequencies ranged from 80.00% in family/marital problems to 98.29% in alcohol/drug problems. Clinical staff also met the adherence benchmark applied by the current study, which required a 75.00% match between individuals' criminogenic needs and the services they received. Justice-involved persons had, on average, 90.46% of their criminogenic needs matched with at least one service referral. Over-prescription of services (i.e., recommendation of services that were not needed) was high, with frequencies in need areas ranging from 60.98% in education/employment to 82.21% in antisocial patterns. Methods from implementation science are useful for structuring evaluations of need-to-service matching, understanding implementation success and failure, and generating recommendations for improving implementation practice. The field would benefit greatly from benchmarks for need-to-service matching evaluation elements.

A Latent Profile Analysis of Rural Women who Use Drugs and Commit Crimes

The majority of rural Appalachian women in jail meet criteria for a drug use disorder and need treatment. Using a latent profile analysis of a random sample of rural women in Appalachian jails (N=400), the current study established groups of women based on criminal history, drug use in the commission of crimes, and role of the partner's drug use in the commission of crimes. Analysis found five distinct profiles of rural women based on involvement of criminal activities as a function of drug use severity. Results suggest that among criminally involved rural women, severity of drug use is a critical factor in the criminal career. Findings can be used to better inform treatment approaches and tailor treatment to meet the needs of this vulnerable population.

Estimating a treatment effect on recidivism for correctional multiple component treatment for people in prison with an alcohol use disorder in England

Background

There is an emerging literature on the impact of correctional substance abuse treatment (SAT) on reoffending for people in prison with substance misuse issues. This study estimates a pathway effect for people in prison receiving multiple component treatments for an alcohol use disorder (AUD) to reduce reoffending by applying treatment effect estimation techniques for observational studies. Treatment groups comprised pharmacological treatments, psychosocial interventions (PSIs) and interventions that incorporate Risk Need Responsivity (RNR) programming. RNR compliant treatment matches treatment dose to the risk of reoffending, targets criminogenic need and is tailored to a person’s learning style.

Methods

Multiple treatment effect estimators are provided for people in prison diagnosed with an AUD in England when compared to a derived control group for: Pharmacological treatment only; RNR compliant treatment and PSIs.

Results

The outcomes for RNR compliant treatment suggest a lower recidivism rate compared to the control group. Pharmacological only treatment results in a statistically significant higher level of reoffending relative to the control group.

Conclusions

The creation of a universal system of ‘equivalence of care’ framed within a public health context in English correctional SAT may have had an unintended consequence of diluting approaches that reduce recidivism. There is an opportunity to develop an integrated, cross-disciplinary model for correctional SAT that unites public health and RNR compliant approaches.

Risk Assessment in Juvenile and Young Adult Offenders: Predictive Validity of the SAVRY and SAPROF-YV

Most juvenile risk assessment tools heavily rely on a risk-focused approach. Less attention has been devoted to protective factors. This study examines the predictive validity of protective factors in addition to risk factors, and developmental differences in psychometric properties of juvenile risk assessment. For a national Dutch sample of 354 juvenile and young adult offenders (16-26 years) risk and protective factors were retrospectively assessed at discharge from seven juvenile justice institutions, using the Structured Assessment of Violence Risk in Youth (SAVRY) and Structured Assessment of Protective Factors for violence risk – Youth Version (SAPROF-YV). Results show moderate validity for both tools predicting general, violent, and nonviolent offending at different follow-up times. The SAPROF-YV provided incremental predictive validity over the SAVRY, and predictive validity was stronger for younger offenders. Evidently both the SAVRY and SAPROF-YV seem valid tools for the assessment of recidivism risk in juvenile and young adult offenders. Results highlight the importance of protective factors, especially in juvenile offenders, emphasizing the need for a balanced risk assessment.

Polysubstance use among frequent marijuana users: an examination of John Henryism Active Coping, psychiatric symptoms, and family social support among African American incarcerated men

Incarcerated African American men who use marijuana are vulnerable to polysubstance use, which is associated with greater risk for negative health and psychosocial outcomes than marijuana use alone. It is imperative to understand risk and protective factors for polysubstance use among this vulnerable population to inform the development of culturally tailored substance use interventions. The current study examined the association between John Henryism Active Coping (JHAC), family social support, psychiatric symptoms, and polysubstance use among African American incarcerated men who frequently use marijuana. Results indicated that higher John Henryism Active Coping (JHAC) is associated with decreased likelihood of engaging in polysubstance use, while psychiatric symptoms are associated with increased likelihood of polysubstance use. Incorporating elements of JHAC into concurrent mental health and substance use treatment may reduce risk for overdose and reincarceration among African American incarcerated men upon release into the community.

The Role of Motivation in Predicting Addiction Treatment Entry Among Offenders With Substance Use Disorders Under Probation Supervision

Many offenders with a substance use disorder (SUD) do not enter addiction treatment. The aim of this study was to examine predictors of addiction treatment entry and to get more insight in the predictive value of treatment motivation. A total of 83 male offenders with a SUD under probation supervision in the Netherlands were assessed at the start of probation supervision and at 12-month follow-up. A total of 38 offenders (45.5%) entered addiction treatment in the follow-up period. Offenders with any mandated treatment (p = .028) and higher treatment motivation (p = .005) were more likely to enter treatment. Multiple logistic regression analysis showed that treatment motivation predicts addiction treatment entry in the first year of probation (OR = 2.215, p < .01). This emphasizes the relevance of treatment motivation for addiction treatment entry among offenders with a SUD. Pretreatment motivational interventions are therefore recommended for offenders with low motivation for treatment in probation settings.

Risk assessment and juvenile resentencing: A critical analysis

Recent United States Supreme Court decisions in Miller v. Alabama (2012) and Montgomery v. Louisiana (2016) have created the need to resentence individuals who received a sentence of mandatory life without parole (LWOP) for offenses committed when they were younger than 18 years old. Neither of these decisions explicitly cite reoffense risk as a sentencing criterion, but a careful reading of the reasoning in these cases suggests that such a risk should be among the considerations addressed by resentencing courts. If so, important theoretical and scientific questions are raised about the nature of risk assessment tools, in particular the distinction between static and dynamic risk factors. Additionally, the novelty of LWOP resentencing raises further questions about the applicability of these tools to individuals who have been incarcerated for long periods of time. We address these questions, call for additional research on dynamic risk factors, and offer recommendations for professionals involved in these types of assessments.

[Conditions of effective correctional treatment for reducing recidivism: Focusing on risk principle]

Research on correctional treatment based on the risk principle (Andrews & Bonta, 2010) has found that the intensity of intervention matched with the risk level of offenders’ recidivism is successful to reduce recidivism. However, there is no research dealing with this issue in a non-Western context. The purpose of this study was to examine the validity of the risk principle in rehabilitation for Japanese juvenile delinquents. The sample was 321 Japanese male inmates of the juvenile detention and assessment centers. They were followed for an average of 573 days after discharge to assess recidivism. Among high-risk juvenile delinquents, those who were treated in the juvenile training school showed significantly lower rates of recidivism than those who were placed under community supervision, while among low risk juveniles, there was no significant difference in recidivism between the two treatment conditions. The results indicate that the risk principle is valid for the correctional treatment of Japanese juvenile delinquents, suggesting its cross-cultural universality. Implications for juvenile justice policies and directions for future research are discussed.

What Doesn’t Work to Reduce Reoffending?

Abstract. This paper describes a review of meta-analyses and systematic reviews, to explore what appears to be ineffective in reducing reoffending among people convicted of crime. The focus of this review is on secondary or tertiary crime prevention initiatives, concentrating on interventions aiming to reduce offending among adults serving sentences in custody or the community. Twenty-one reviews met the inclusion criteria, covering interventions aiming to reduce violence, domestic violence, sexual offending, drug misuse, driving under the influence, and general reoffending. Fourteen of these reviews identified interventions that have no impact on criminal recidivism, and three identified interventions that in at least one study were actively harmful by increasing the risk of recidivism of participants. Findings suggest that ineffective interventions may comprise drug testing as a stand-alone strategy, insight-oriented and behavioral interventions for sexual offending, brief interventions for alcohol misuse, and in prison in the longer-term, agonist pharmacological treatment alone for drug misuse. Those interventions that had demonstrated, in at least one of the evaluations reviewed, that they were associated with negative behaviors were court-mandated treatment for domestic violence, boot camps, incarceration-based agonist drug treatment and custodial (when compared to noncustodial) sanctions. Taken together with the findings of previous reviews in this area, the authors identify features of interventions which are likely to be ineffective in reducing reoffending. Explanations for these interventions’ likely failure to reduce reoffending draw on criminological and social psychological research and behavioral science. The authors also note that this review may not include all relevant evidence and findings should therefore be considered indicative.

Organizational Factors and Probation Officer Use of Evidence-Based Practices: A Multilevel Examination

Growing evidence pointing to the ineffectiveness of control-oriented supervision practices has led to an emphasis on evidence-based practices (EBPs), or practices that are empirically tied to recidivism reduction. Research on EBPs in probation highlights the importance of case management-oriented supervision and provision of proactive, appropriate program referrals. Despite research support, challenges exist regarding implementing EBPs in real-world practice. Utilizing survey data from 813 adult probation officers across 43 agencies, the current study examined variation in use of case management and proactive referral practices. Findings highlight the important role organizational commitment plays in supporting implementation efforts. Implications suggest a need for probation agencies to promote and sustain staff commitment to their agency before embarking on significant reform efforts.

Serious juvenile offenders: classification into subgroups based on static and dynamic charateristics

BACKGROUND

The population in juvenile justice institutions is heterogeneous, as juveniles display a large variety of individual, psychological and social problems. This variety of risk factors and personal characteristics complicates treatment planning. Insight into subgroups and specific profiles of problems in serious juvenile offenders is helpful in identifying important treatment indicators for each subgroup of serious juvenile offenders.

METHODS

To identify subgroups with combined offender characteristics, cluster-analyses were performed on data of 2010 adolescents from all juvenile justice institutions in the Netherlands. The study included a wide spectrum of static and dynamic offender characteristics and was a replication of a previous study, in order to replicate and validate the identified subgroups. To identify the subgroups that are most useful in clinical practice, different numbers of subgroup-solutions were presented to clinicians.

RESULTS

Combining both good statistical fit and clinical relevance resulted in seven subgroups. Most subgroups resemble the subgroups found in the previous study and one extra subgroups was identified. Subgroups were named after their own identifying characteristics: (1) sexual problems, (2) antisocial identity and mental health problems, (3) lack of empathy and conscience, (4) flat profile, (5) family problems, (6) substance use problems, and (7) sexual, cognitive and social problems.

CONCLUSIONS

Subgroups of offenders as identified seem rather stable. Therefore risk factor scores can help to identify characteristics of serious juvenile offenders, which can be used in clinical practice to adjust treatment to the specific risk and needs of each subgroup.

Criminogenic Needs, Substance Use, and Offending among Rural Stimulant Users

There is a need to understand the determinants of both substance use and criminal activity in rural areas in order to design appropriate treatment interventions for these linked problems. The present study drew on a predominant model used to assess and treat offenders -- the Risk-Need-Responsivity (RNR) model -- to examine risk factors for substance use and criminal activity in a rural drug using sample. This study extends the RNR model's focus on offenders to assessing rural-dwelling individuals using stimulants (N=462). We examined substance use and criminal justice outcomes at 6-month (91%) and 3-year (79%) follow-ups, and used Generalized Estimating Equations to examine the extent to which RNR criminogenic need factors at baseline predicted outcomes at follow-ups. Substance use and criminal justice outcomes improved at six months, and even more at three years, post-baseline. As expected, higher risk was associated with poorer outcomes. Antisocial personality patterns and procriminal attitudes at baseline predicted poorer legal and drug outcomes measured at subsequent follow-ups. In contrast, less connection to antisocial others and fewer work difficulties predicted lower alcohol problem severity, but more frequent alcohol use. Engagement in social-recreational activities was associated with fewer subsequent arrests and less severe alcohol and drug problems. The RNR model's criminogenic need factors predicted drug use and crime-related outcomes among rural residents. Services adapted to rural settings that target these factors, such as telehealth and other technology-based resources, may hasten improvement on both types of outcomes among drug users.

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system

BACKGROUND

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system.

OBJECTIVES

To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system.

METHODS

We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings.

RESULTS

Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs).

CONCLUSION

Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

A Multisite Randomized Block Experiment on the Seamless System of Care Model for Drug-Involved Probationers

This multisite randomized block experiment examines the efficacy of the seamless system of care for probationers (an integrated probation model combined with substance abuse treatment intervention onsite at a probation office). The sample consists of 251 drug-involved probationers randomized into probation with referral to community treatment or the seamless system of care. Key outcomes are examined over a 1-year period by recidivism risk level. When compared with probationers in the control group, the findings are that those in the seamless system of care group had fewer drug use days overall, less alcohol consumption, improved treatment initiation and adherence, but a higher number of days incarcerated. Low-risk seamless system participants had the most favorable outcomes compared with other study conditions. This study demonstrates the importance of tailoring interventions to the risk level of the probationer, and that the seamless system works better for lower risk offenders with substance use disorders.

Sexual Offenders' Perceptions of the Client-Therapist Relationship: The Role of Risk

The therapeutic alliance has been shown to be integral to treatment outcomes even in forensic settings. There is still a relative dearth of research examining factors related to the formation of the therapeutic alliance in sex offender treatment specifically. Using a sample of 202 incarcerated male sexual offenders participating in sex offender treatment, this study examined whether perceptions of the client-therapist relationship from the perspective of male sexual offenders varied by risk for sexual and general recidivism. Overall, we found a significant negative relationship between risk for sexual recidivism and bond formation. However, when therapist subscale scores on the Working Alliance Inventory were considered by therapist gender, higher risk sexual offenders perceived poorer bonds with their female therapists, relative to their male therapists. Findings are discussed as they pertain to therapeutic relationships and responsivity issues in sex offender treatment.

General Responsivity Adherence in Juvenile Drug Treatment Court

Although the number of juvenile drug treatment courts (JDTC) in operation has increased since the first JDTCs were implemented in the 1990s, research continues to lag regarding the effectiveness of the treatment interventions that are provided. The purpose of the present study was to explore how the risk-need-responsivity models’ general responsivity principle could be used to inform the effectiveness of the interventions provided to 1,176 participants in nine JDTCs in the United States. Responsivity adherence was measured using the number of general responsivity-adherent techniques included in each intervention. The results indicated that an increase in general responsivity adherence was associated with an increase in substance-use severity score, which suggests that the effect of the JDTC model on treatment outcomes could vary by the type of interventions provided to participants. In addition, the findings suggest the need to further specify adherence to the general responsivity principle, particularly among substance-involved juvenile offenders.

Motivational tools to improve probationer treatment outcomes

BACKGROUND

Motivational interviewing (MI) is a promising practice to increase motivation, treatment retention, and reducing recidivism among offender populations. Computer-delivered interventions have grown in popularity as a way to change behaviors associated with drug and alcohol use.

METHODS/DESIGN

Motivational Assistance Program to Initiate Treatment (MAPIT) is a three arm, multisite, randomized controlled trial, which examines the impact of Motivational interviewing (MI), a motivational computer program (MC), and supervision as usual (SAU) on addiction treatment initiation, engagement, and retention. Secondary outcomes include drug/alcohol use, probation progress, recidivism (i.e., criminal behavior) and HIV/AIDS testing and treatment among probationers. Participant characteristics are measured at baseline, 2, and 6 months after assignment. The entire study will include 600 offenders, with each site recruiting 300 offenders (Baltimore City, Maryland and Dallas, Texas). All participants will go through standard intake procedures for probation and participate in probation requirements as usual. After standard intake, participants will be recruited and screened for eligibility.

DISCUSSION

The results of this clinical trial will fill a gap in knowledge about ways to motivate probationers to participate in addiction treatment and HIV care. This randomized clinical trial is innovative in the way it examines the use of in-person vs. technological approaches to improve probationer success.

TRIAL REGISTRATION

NCT01891656.

Intervening to prevent repeat offending among moderate- to high-risk domestic violence offenders: a second-responder program for men

Clear directions about best strategies to reduce recidivism among domestic violence offenders have remained elusive. The current study offers an initial evaluation of an RNR (Risk, Needs, and Responsivity)-focused second-responder program for men accused of assaulting their intimate partners and who were judged as being at moderate to high risk for re-offending. A quasi-experimental design was used to compare police outcomes for 40 men attending a second-responder intervention program to 40 men with equivalent levels of risk for re-offense who did not attend intervention (comparison group). Results showed that there were significant, substantial, and lasting differences across groups in all outcome domains. In terms of recidivism, rates of subsequent domestic-violence-related changes were more than double for men in the comparison group as compared with the intervention group in both 1-year (65.9% vs. 29.3%) and 2-year (41.5% vs. 12.2%) follow-up. Changes in the rates of arrest were consistent with reductions in men's general involvement with police, with men in the intervention group receiving fewer charges for violent offenses, administrative offenses, and property offenses over the 2 years following intervention than men in the comparison group. Not surprisingly, these differences result in a much lower estimated amount of police time with intervention men than for comparison men. Results are discussed with reference to the possible impact of sharing information with men about their assessed risk for re-offending within a therapeutic justice context.

Building effective service delivery mechanisms for justice-involved individuals: an under-researched area

Background

The Heath & Justice journal is devoted to addressing the unmet needs of those involved in or working in the justice system. With attention to both health and justice processes and outcomes, this journal is designed to provide a forum for scholarship and research that is usually dispersed across many different disciplines.

Findings

In this article, we focus on the need for more service related research to broaden our understanding of how to improve system, program, and client level outcomes. A review of pertinent research in each area is provided to illustrate contemporary findings.

Conclusions

Current research also makes the case for a focused discussion about processes, policies, and procedures that need further exploration. To better understand how to improve health and justice outcomes, research is needed in program fidelity, services, geographical and activity spaces, and other arenas that affect individual, program, and system level outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/2194-7899-2-2) contains supplementary material, which is available to authorized users.