Group Behavioral Activation for Incarcerated Substance Users

 描述（由申请人提供）：物质使用障碍（SUD）是一个非常普遍的，往往未经治疗的问题，为监禁的个人在美国，他们与最终复发，累犯，和重复监禁。尽管SUD显然与释放后的负面结果有关，但绝大多数囚犯在监禁期间无法获得治疗。使临床情况变得复杂的是，被监禁的药物使用者还患有抑郁症和其他精神病理学并发症的比例更高。患有这些并发症的囚犯面临更高的多次监禁风险，需要更综合的治疗方法。行为激活（BA）可以很好地满足这一人群的独特需求。这是一种有效、直接且具有成本效益的治疗方法，已适用于各种环境和人群，包括为抑郁的低收入药物使用者设计的称为LETS ACT的团体版本。然而，这一方法还有待于在惩教环境中对药物使用者进行测试。 目前的研究将比较LETS ACT与药物使用，抑郁症和客观措施（如违反缓刑，逮捕和监禁药物使用者未来的监禁）的纵向结果。据推测，LETS ACT将与治疗结束时抑郁症的减少有关，并在释放后的一年内减少所有其他结果，特别注意物质使用复发和累犯。本申请中提出的工作将为这一高危人群提供急需的针对性干预测试。此外，这项研究将提供关于LETS ACT在矫正环境中的有效性的重要数据，如果成功，将为今后传播干预措施的工作奠定基础。该项目的主要培训目标是开展一系列研究，以更好地了解和处理与被监禁药物使用者反复参与刑事司法有关的因素，并最终通过限制药物使用和反复监禁来影响社会。

 DESCRIPTION (provided by applicant): Substance use disorders (SUDs) are a highly prevalent and often untreated problem for incarcerated individuals in the United States, and they are associated with eventual relapse, recidivism, and repeated incarceration. Although SUDs are clearly linked to negative outcomes post-release, the vast majority of inmates do not have access to treatment during their incarceration. Complicating the clinical picture, incarcerated substance users also suffer from higher rates of co-occurring depression and other psychopathology. Inmates with these co-occurring disorders are at even higher risk of multiple incarcerations, and require a more integrated treatment approach. Behavioral Activation (BA) may be well equipped to address the unique needs of this population. It is an efficient, straightforward, and cost-effective treatment that has been adapted for a variety of settings and populations, including a group version called LETS ACT designed for depressed low-income substance users. This approach, however, has yet to be tested with substance users in a correctional setting. The current study will compare LETS ACT to treatment as usual in longitudinal outcomes of substance use, depression, and objective measures such as probation violations, arrests, and future incarceration among incarcerated substance users. It is hypothesized that LETS ACT will be associated with a decrease in depression at the conclusion of treatment, and reductions in all other outcomes in the year following release with particular attention to substance use relapse and recidivism. The work proposed in this application will provide a much-needed test of a targeted intervention for this at risk population. Moreover, this research will provide important data on LETS ACT's efficacy in a correctional environment, and if successful, will set the stage for future work in disseminating the intervention. The main training goal for this project is to develop a line of research to better understand and treat factors related to repeated criminal justice involvement among incarcerated substance users and ultimately impact society through limiting substance use and repeated incarceration.