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

项目概要/摘要。 涉及司法的个人之间的物质使用构成了一个公共卫生问题， 对罪犯、他们的家庭和他们的社区造成的后果。随着刑事司法改革成为现实 在美国，更多涉及司法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，测量精神病人格的异质性， 特质可以指导使用简短的物质使用干预的人谁将受益。我们的创新 评估和匹配治疗的方法有希望a）揭示简短的真实疗效 动机干预（BMI）的司法参与物质使用者在不同水平的精神病特征， 和B）解释BMI文献中的矛盾。此外，目前的提案是第三阶段 一项随机临床试验，我们将使用严格的多方法评估来测试两种假定的 变革机制：致力于变革和自我调节。通过阐明这些机制， 其中正义涉及物质使用者的治疗变化，我们将作出调整，进一步加强 我们的干预和扩大受益人群的范围。将检验的假设包括：1） BMI适用于刑事司法监督环境，将减少物质使用， 标准治疗的个人与低/中度情感特征的精神病，2），减少 药物使用将通过致力于改变和加强自我调节来调节， 适应，针对这些过程，并导致更好的干预，和3），适度减少 在物质使用将介导减少暴力累犯在后续行动。

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.