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Goldman PN, Hull I, Wilson JD. "No Excuses Anymore": Substance Use Screening and Treatment for Justice-involved Youth. J Addict Med 2023; 17:454-462. [PMID: 37579109 PMCID: PMC10440419 DOI: 10.1097/adm.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE The aim of this study was to present best practices for substance use disorder (SUD) screening and treatment in the juvenile justice setting. METHODS Semistructured qualitative interviews, informed by the Capability-Opportunity-Motivation-Behavior Model, were conducted with medical and behavioral health providers with experience caring for justice-involved youth. Interviews were analyzed using thematic and content analysis to elucidate best practices and identify facilitators and barriers affecting implementation of evidence-based substance use screening and treatment. RESULTS We interviewed 14 participants from 12 unique institutions and 9 states. All participants described the populations in their facilities as predominately male and minoritized, with substance use being an exceedingly common problem. Eight main themes emerged from analysis of the barriers and facilitators discussed by participants. These included the importance of (1) ensuring substance use-specific training for all team members, (2) integrating medical and behavioral health care, (3) addressing staff reticence and stigma, (4) building an institutional culture that supports screening and treatment, (5) dedicating adequate resources with respect to time, staffing, and funding, (6) formalizing and standardizing screening and treatment protocols, (7) engaging youth using trauma-informed approaches that emphasize youth strengths and autonomy, and (8) collaborating with multidisciplinary teams and community partners to maximize linkage to follow-up care after release. CONCLUSIONS Our findings highlight an urgent need for improved implementation of evidence-based, developmentally appropriate substance use treatment for justice-involved youth. Although the majority of participants screen youth, they described variable implementation of behavioral health interventions and limited provision of on-site withdrawal management and treatment using medications for SUD.
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Affiliation(s)
- Paula N Goldman
- From the Division of Adolescent Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA (PNG, JDW); Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (IH, JDW)
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Laricchiuta D, Garofalo C, Mazzeschi C. Trauma-related disorders and the bodily self: current perspectives and future directions. Front Psychol 2023; 14:1166127. [PMID: 37275691 PMCID: PMC10235635 DOI: 10.3389/fpsyg.2023.1166127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Trauma-related disorders are debilitating psychiatric conditions that influence people who have directly or indirectly witnessed adversities. Dramatic brain/body transformations and altered person's relationship with self, others, and the world occur when experiencing multiple types of traumas. In turn, these unfortunate modifications may contribute to predisposition to trauma-related vulnerability conditions, such as externalizing (aggression, delinquency, and conduct disorders) problems. This mini-review analyzes the relations between traumatic experiences (encoded as implicit and embodied procedural memories) and bodily self, sense of safety for the own body, and relationship with others, also in the presence of externalizing conducts. Furthermore, an emerging research area is also considered, highlighting principles and techniques of body-oriented and sensorimotor therapies designed to remodel bodily self-aspects in the presence of trauma, discussing their potential application with individuals showing externalizing problems.
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Emezue C, Karnik NS, Reeder B, Schoeny M, Layfield R, Zarling A, Julion W. A Technology-Enhanced Intervention for Violence and Substance Use Prevention Among Young Black Men: Protocol for Adaptation and Pilot Testing. JMIR Res Protoc 2023; 12:e43842. [PMID: 37126388 PMCID: PMC10186193 DOI: 10.2196/43842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Black boys and men from disinvested communities are disproportionately survivors and perpetrators of youth violence. Those presenting to emergency departments with firearm-related injuries also report recent substance use. However, young Black men face several critical individual and systemic barriers to accessing trauma-focused prevention programs. These barriers contribute to service avoidance, the exacerbation of violence recidivism, substance use relapse, and a revolving-door approach to prevention. In addition, young Black men are known to be digital natives. Therefore, technology-enhanced interventions offer a pragmatic and promising opportunity to mitigate these barriers, provide vital life skills for self-led behavior change, and boost service engagement with vital community resources. OBJECTIVE The study aims to systematically adapt and pilot-test Boosting Violence-Related Outcomes Using Technology for Empowerment, Risk Reduction, and Life Skills Preparation in Youth Based on Acceptance and Commitment Therapy (BrotherlyACT), a culturally congruent, trauma-focused digital psychoeducational and service-engagement tool tailored to young Black men aged 15-24 years. BrotherlyACT will incorporate microlearning modules, interactive safety planning tools for risk assessment, goal-setting, mindfulness practice, and a service-engagement conversational agent or chatbot to connect young Black men to relevant services. METHODS The development of BrotherlyACT will occur in 3 phases. In phase 1, we will qualitatively investigate barriers and facilitators influencing young Black men's willingness to use violence and substance use prevention services with 15-30 young Black men (aged 15-24 years) who report perpetrating violence and substance use in the past year and 10 service providers (aged >18 years; any gender; including health care providers, street outreach workers, social workers, violence interrupters, community advocates, and school staff). Both groups will be recruited from community and pediatric emergency settings. In phase 2, a steering group of topic experts (n=3-5) and a youth and community advisory board comprising young Black men (n=8-12) and service providers (n=5-10) will be involved in participatory design, alpha testing, and beta testing sessions to develop, refine, and adapt BrotherlyACT based on an existing skills-based program (Achieving Change Through Values-Based Behavior). We will use user-centered design principles and the Assessment, Decision, Administration, Production, Topical, Experts, Integration, Training, and Testing framework to guide this adaptation process (phase 2). In phase 3, a total of 60 young Black men will pilot-test the adapted BrotherlyACT over 10 weeks in a single-group, pretest-posttest design to determine its feasibility and implementation outcomes. RESULTS Phase 1 data collection began in September 2021. Phases 2 and 3 are scheduled to start in June 2023 and end in September 2024. CONCLUSIONS The development and testing of BrotherlyACT is a crucial first step in expanding an evidence-based psychoeducational and service-mediating intervention for young Black men involved in violence. This colocation of services shifts the current prevention strategy from telling them why to change to teaching them how. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43842.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, IL, United States
| | - Niranjan S Karnik
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, IL, United States
| | - Blaine Reeder
- Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, United States
| | - Michael Schoeny
- Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, United States
| | - Rickey Layfield
- Urban Male Network, Vice President of Programming, Chicago, IL, United States
| | - Amie Zarling
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | - Wrenetha Julion
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, IL, United States
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Moyes E, Nutman G, Mirman JH. The Efficacy of Targeted Mindfulness-Based Interventions for Improving Mental Health and Cognition Among Youth and Adults with ACE Histories: A Systematic Mixed Studies Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1165-1177. [PMID: 36439656 PMCID: PMC9684378 DOI: 10.1007/s40653-022-00454-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Mindfulness-based interventions (MBIs) are associated with increased psychological wellbeing. The literature suggests that individuals exposed to adverse childhood experiences (ACEs) may benefit greatly from MBIs. However, research has tended to focus on universal MBIs for this population with less attention on the effectiveness of targeted approaches. Moreover, there is growing concern regarding the methodological rigor of MBI research. This systematic mixed studies review (SMRS) reports the effectiveness of MBIs for improving mental health and cognition among individuals with ACE histories. Additionally, the review reports the quality and rigor of the included research. Systematic searches of PsycInfo, EMBASE, MEDLINE, ProQuest Dissertations and Theses, ProQuest Social Science database and the Child Development and Adolescent Studies database were conducted. Results were screened and data were extracted then synthesized using a data-based convergent synthesis design. Thirteen studies were included in the final review. Six prominent themes emerged. Themes indicated that MBIs were effective for improving mental health and cognition for individuals with ACEs. For example, improvements in mood and anxieties, as well as a better ability to manage emotions. Shortcomings in the quality of MBI research included lack of reporting of methodological details (e.g., randomization procedures) and not systematically reporting adverse event evaluations. Recommendations are made for future research to strengthen the evidence base for MBIs for individuals with ACEs. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40653-022-00454-5.
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Affiliation(s)
- Ellie Moyes
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - George Nutman
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - Jessica Hafetz Mirman
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
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Guo Q, Ma B, Leng J, Wang Z, Lu J. The association of mindfulness and prosocial behavior is not stronger among highly ethical individuals. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01261-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Zhang J, Zheng Z, Wang L, Luberto CM, Sophie Zhang M, Wen Y, Su Q, Jiao C. Effectiveness of a 4-Day Mindfulness-Based Intervention in a 2-Month Follow-Up for Chinese Incarcerated People. Behav Ther 2022; 53:981-994. [PMID: 35987553 DOI: 10.1016/j.beth.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/26/2022] [Accepted: 04/05/2022] [Indexed: 11/02/2022]
Abstract
Mindfulness-based interventions, an evidence-based stress reduction approach, may help incarcerated people cope with stress-related problems in the challenging environment of prison. However, due to their unique living environment, the duration and instructor guidance required by standard mindfulness-based interventions would be infeasible in most prisons. Therefore, the aims of the current study were to test the effects of two different 4-day interventions (i.e., instructor-guided and audio-based) with content similar to Mindfulness-Based Cognitive Therapy for newly incarcerated males, and to compare the effectiveness of the two interventions relative to a no-intervention control group. Using daily assessments, we explored changes in perceived stress, insomnia, and negative affect in the 56 days following the instructor-guided (N = 25), audio-based (N = 21), and control (N = 44) intervention; length of mindfulness practice during the follow-up was also compared between the two intervention groups. Hierarchical linear model results showed significantly greater linear decreases in perceived stress after both mindfulness interventions during the 56-day follow-up (γ11 = -0.011, p < .001, 95% CI [-0.017, -0.004] for instructor-guided intervention; γ12 = -0.013, p < .001, 95% CI [-0.018, -0.006] for audio-based intervention), as compared to the control group. Compared to the control group, the instructor-guided group reported a significantly greater decrease in insomnia (γ11 = -0.007, p < .001, 95% CI [-0.014, -0.002]), but the audio-based group did not (γ12 = -0.002, p = .160, 95% CI [-.007, .004]). Neither mindfulness-based intervention group reported a significantly greater decrease in negative affect compared to the control group (γ11 = -0.002, p = .170, 95% CI [-0.005, 0.001] for instructor-guided intervention; γ12 = -0.002, p = .150, 95% CI [-0.006, 0.002] for audio-based intervention). No significant difference between the two intervention groups was found in the change of outcomes (γ11 = 0.002, -0.005 and 0.000, p = .350, .130 and .390, 95% CI [-0.008, 0.011], 95% CI [-0.014, 0.004] and 95% CI [-0.004, 0.006] subsequently for perceived stress, insomnia and negative affect). Daily mindfulness practice was significantly longer for the audio-based group on the first day of follow-up (γ02 = -0.758, p < .05, 95% CI [-1.333, -0.129]), but it gradually decreased to the same amount as the instructor-guided group (t (32) = 0.051, p = .959). Short-term mindfulness interventions, either instructor-guided or audio-based, appear to be beneficial for Chinese prisoners in reducing stress. Live instruction may have potential benefit in reducing insomnia and sustaining daily practice.
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Affiliation(s)
- Jieting Zhang
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
| | | | - Lina Wang
- School of Design and Art, Beijing Institute of Technology, Zhuhai
| | | | | | - Yuhua Wen
- Dongguan Prison of Guangdong Province
| | - Qi Su
- Dongguan Prison of Guangdong Province
| | - Can Jiao
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
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Nesset MB, Bjørngaard JH, Whittington R, Palmstierna T. Does cognitive behavioural therapy or mindfulness-based therapy improve mental health and emotion regulation among men who perpetrate intimate partner violence? A randomised controlled trial. Int J Nurs Stud 2020; 113:103795. [PMID: 33120137 DOI: 10.1016/j.ijnurstu.2020.103795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Intimate partner violence constitutes a serious health problem worldwide. To date the evidence is sparse on whether intimate partner violence group interventions could improve mental health outcomes among perpetrators and their partners. OBJECTIVES To compare the effectiveness of nurse-led cognitive-behavioural group therapy vs. mindfulness-based stress reduction group therapy in improving reported mental health outcomes and emotion regulation at 12 months' follow-up amongst perpetrators who voluntarily seek help for violence in intimate partnerships. DESIGN A randomised controlled trial. PARTICIPANTS A total of 125 persons at an outpatient service run by a University Hospital in Norway for men who perpetrate intimate partner violence were enroled in the study. METHODS The participants were randomly assigned to cognitive-behavioural group therapy (intervention group, N = 67) or mindfulness-based stress reduction group therapy (comparator group, N = 58). The pre-defined outcomes were symptoms of anxiety and depression as reported by the Hopkins Symptom Checklist 25 and general emotion regulation as reported by Difficulties in Emotion Regulation Scale at 12 months' follow-up. RESULTS A reduction of symptoms of anxiety and depression was reported, with no between-group differences (intervention group: coefficient: - 0.17, P = 0.009; comparator group: coefficient: - 0.13, P = 0.036). Both groups had a small but statistically significant reduction in the Difficulties in Emotion Regulation Scale scores at 12 months' follow-up (intervention group: coefficient: - 0.47, P = <0.001; comparator group: coefficient: - 0. 34, P = <0.001). CONCLUSION Even though there was reduction in symptoms in both groups at 12 months' follow-up with no between-group differences, the total symptom scores remained high in both groups. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01653860.
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Affiliation(s)
- Merete Berg Nesset
- Forensic Department and Research Centre Brøset, St. Olav's Hospital, Trondheim University Hospital, PO 1803 Lade, N-7440 Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Johan Håkon Bjørngaard
- Forensic Department and Research Centre Brøset, St. Olav's Hospital, Trondheim University Hospital, PO 1803 Lade, N-7440 Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Social Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Richard Whittington
- Forensic Department and Research Centre Brøset, St. Olav's Hospital, Trondheim University Hospital, PO 1803 Lade, N-7440 Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Tom Palmstierna
- Forensic Department and Research Centre Brøset, St. Olav's Hospital, Trondheim University Hospital, PO 1803 Lade, N-7440 Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Bouw N, Huijbregts SCJ, Scholte E, Swaab H. Mindfulness-Based Stress Reduction in Prison: Experiences of Inmates, Instructors, and Prison Staff. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:2550-2571. [PMID: 31189428 PMCID: PMC6745607 DOI: 10.1177/0306624x19856232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mindfulness intervention aims to reduce stress and to improve physical and mental health. The present study investigated feasibility and effectiveness of mindfulness intervention in a prison context, in both a qualitative and quantitative fashion. Specifically, the mindfulness-based stress reduction (MBSR) intervention was investigated, in a retrospective pre-post design, in five Dutch prisons. Twenty-two inmates (out of 25 approached, mean age: 40.1 years (SD = 11.1), convicted of murder, manslaughter, sexual offenses, drug offenses, robbery with violence, and/or illegal restraint/kidnap, and sentenced to incarceration between 15 and 209 months (M = 5.5 years; SD = 3.8) took part in a semistructured interview after completion of the MBSR intervention. The interviews addressed level of satisfaction and challenges regarding the MBSR intervention as well as potential effects on stress responsivity, coping style, impulse control, aggression, and self-esteem. Ten staff members and four MBSR instructors were interviewed about their own practical issues experienced while providing or facilitating the MBSR intervention, and about the effects or changes they observed in the inmates who underwent the intervention. Both participants and instructors/prison staff reported improvements in all of the addressed domains and expressed satisfaction with the intervention. Challenges were mainly identified in practical issues regarding the organization of the intervention sessions. Future studies should investigate mindfulness in longitudinal randomly controlled designs, should strive for a multi-method approach, and distinguish inmates according to personality characteristics.
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Affiliation(s)
- N. Bouw
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The
Netherlands
| | - S. C. J. Huijbregts
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The
Netherlands
| | | | - H. Swaab
- Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The
Netherlands
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