Strengthening a Brief Intervention for Justice-Involved Substance Users by Harnessing Mechanisms of Change

项目摘要/摘要。 在涉及司法的个人中使用药物构成了一个公共卫生问题，与消极的 对罪犯、他们的家人和他们的社区的后果。随着刑事司法改革成为现实 在美国，更多涉及正义的物质使用者加入普通人群，有理由 治疗乐观主义。我们的初步工作表明，测量精神变态人格的异质性 特征可以指导使用一种简短的物质使用干预措施，使人们受益。我们的创新 评估和配对治疗的方法有希望)揭示一种简单的 对具有不同程度精神病特征的正义相关物质使用者进行动机干预(BMI) 以及b)解释BMI文献中的矛盾。此外，目前的提案是第三阶段 在随机临床试验中，我们将使用严格的多方法评估来测试两个假定的 变革机制：对变革的承诺和自律。通过以下方式阐明这些机制 哪些涉及司法公正的物质使用者的待遇发生了变化，我们将做出适应，进一步加强 我们的干预并增加受益人群的范围。将研究的假设包括：1) BMI，适用于刑事司法监督环境，将减少物质使用，相对于 为精神变态的低/中度情感特征的个人提供标准护理，2)减少 物质使用将通过承诺改变和增加自律来调节，从而使 针对这些过程的适应，并导致更好的干预，以及3)缓和的减排 在物质使用方面，将在后续行动中调解暴力累犯率的减少。

Project Summary/Abstract. Substance use among justice-involved individuals constitutes a public health problem that is linked to negative consequences for offenders, their families, and their communities. As criminal justice reform becomes a reality in the United States and more justice-involved substance users join the general population, there is reason for therapeutic optimism. Our preliminary work shows that measuring heterogeneity in psychopathic personality traits can guide the use of a brief substance use intervention to people who will benefit. Our innovative assessment and matching-to-treatment approach has promise for a) revealing the true efficacy of a brief motivational intervention (BMI) for justice-involved substance users at varying levels of psychopathic traits, and b) explaining contradictions in the BMI literature. Additionally, the current proposal is a Phase III randomized clinical trial in which we will use rigorous multi-method assessment to test two putative mechanisms of change: commitment to change and self-regulation. By elucidating the mechanisms through which justice-involved substance users' change in treatment, we will make adaptations that further strengthen our intervention and increase the range of people who benefit. Hypotheses that will be examined include: 1) that a BMI, adapted for use in criminal justice supervisory settings, will reduce substance use relative to Standard Care for individuals with low/moderate affective traits of psychopathy, 2) that the reduction in substance use will be mediated by commitment to change and an increase in self-regulation, enabling adaptations that target these processes and lead to a better intervention, and 3) that the moderated reduction in substance use will mediate a reduction in violent recidivism at follow-up.