Clinical Trial: Justice-Involved Veterans and Moral Reconation Therapy

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Improving Treatment Engagement and Outcomes Among Justice-involved Veterans

Brief Summary: The purpose of this study is to determine whether Moral Reconation Therapy (MRT) is effective for reducing risk of criminal recidivism and improving other health-related outcomes (substance use, mental health, housing, and employment problems) among justice-involved Veterans entering residential mental health treatment programs in the Department of Veterans Affairs (VA).

Detailed Summary:

Approximately 146,000 Veterans are released each year from correctional settings; however, two thirds will likely reoffend and return to the justice system. Antisocial cognitions and behaviors are the strongest predictors of reoffending and are highly prevalent among justice-involved Veterans (JIVs). However, in the absence of treatments with demonstrated effectiveness with JIVs, no systematic approach to address antisocial cognitions and behaviors has been implemented in VA. Moral Reconation Therapy (MRT) is a cognitive-behavioral intervention that aims to reduce antisocial cognitions and behaviors. MRT has the best empirical support for reducing risk for criminal recidivism among civilian offenders, and its associated mechanisms (improvements in interpersonal functioning and impulse control) have been linked to improvements in health-related outcomes that are also risk factors for recidivism (substance use, mental health, housing, and employment problems). However, no trials have been conducted with JIVs. Differences between JIVs and justice-involved civilians (e.g., prevalence of traumatic brain injuries; interpersonal problems) suggests prior research on MRT with civilians may not be generalizable, and prompted the VA's Veterans Justice Programs (VJP) and the developers of MRT to develop a Veteran-specific curriculum of this intervention.

Using the new Veteran-specific manual, the overarching objective of the current proposal is to implement and evaluate MRT as an intervention to reduce risk for criminal recidivism and improve health-related outcomes among JIVs in VA Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs). Using a Hybrid Type 1 design, this project will test the effectiveness of MRT in a multisite RCT (Palo Alto, Little Rock, and Bedford VAs) and conduct a formative evaluation to facilitate future implementation of MRT in VA:


Sponsor: VA Office of Research and Development

Current Primary Outcome: Risk for criminal recidivism [ Time Frame: 12 months ]

Changes in patients' self-reported levels of antisocial attitudes and cognitions ("criminogenic thinking") since the baseline assessment.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • substance use [ Time Frame: 12 months ]
    The quantity and frequency of patients' self-reported alcohol and drug use since the baseline assessment.
  • mental health problems [ Time Frame: 12 months ]
    Changes in the severity of patients' s self-reported psychiatric distress since the baseline assessment.
  • Housing problems [ Time Frame: 12 months ]
    Changes in the severity of patients' s self-reported problems with securing stable housing since the baseline assessment.
  • Employment problems [ Time Frame: 12 months ]
    The severity of patients' s self-reported problems with securing stable employment.
  • substance use problems [ Time Frame: 12 months ]
    Changes in the severity of patients' self-reported problems with alcohol and drug use since the baseline assessment.


Original Secondary Outcome: Same as current

Information By: VA Office of Research and Development

Dates:
Date Received: August 5, 2015
Date Started: April 2016
Date Completion: December 2019
Last Updated: December 21, 2016
Last Verified: December 2016