Acceptability and effectiveness of a web-based psychosocial intervention among criminal justice involved adults

Abstract

BackgroundThe acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied. This study is a secondary analysis of baseline characteristics associated with criminal justice system (CJS) status as treatment outcome moderators among participants enrolling in a large randomized trial of a web-based psychosocial intervention (Therapeutic Education System [TES]) as part of outpatient addiction treatment.MethodsWe compared demographic and clinical characteristics, TES participation rates, and the trial’s two co-primary outcomes, end of treatment abstinence and treatment retention, by self-reported CJS status at baseline: 1) CJS-mandated to community treatment (CJS-mandated), 2) CJS-recommended to treatment (CJS-recommended), 3) no CJS treatment mandate (CJS-none).ResultsCJS-mandated (n = 107) and CJS-recommended (n = 69) participants differed from CJS-none (n = 331) at baseline: CJS-mandated were significantly more likely to be male, uninsured, report cannabis as the primary drug problem, report fewer days of drug use at baseline, screen negative for depression, and score lower for psychological distress and higher on physical health status; CJS-recommended were younger, more likely single, less likely to report no regular Internet use, and to report cannabis as the primary drug problem. Both CJS-involved (CJS -recommended and -mandated) groups were more likely to have been recently incarcerated. Among participants randomized to the TES arm, module completion was similar across the CJS subgroups. A three-way interaction of treatment, baseline abstinence and CJS status showed no associations with the study’s primary abstinence outcome.ConclusionsOverall, CJS-involved participants in this study tended to be young, male, and in treatment for a primary cannabis problem. The feasibility and effectiveness of the web-based psychosocial intervention, TES, did not vary by CJS-mandated or CJS-recommended participants compared to CJS-none. Web-based counseling interventions may be effective interventions as US public safety policies begin to emphasize supervised community drug treatment over incarceration.

The application of digital health to the assessment and treatment of substance use disorders: The past, current, and future role of the National Drug Abuse Treatment Clinical Trials Network

“…This study found that participants who received TES as part of their care model had a markedly lower rate of treatment dropout (hazard ratio = 0.72, 95% CI = 0.57, 0.92) and a higher rate of drug abstinence (odds ratio = 1.62, 95% CI = 1.12, 2.35), an effect that was most evident among patients who had a drug-positive urine and/or alcohol-positive breath screen at the time of entering the study (odds ratio = 2.18, 95% CI = 1.30, 3.68). This pattern highlighting the effectiveness of TES was across diverse groups of patients, including those with stimulant, cannabis and alcohol use disorders (Cochran et al, 2015), those with and without criminal justice involvement (Lee et al, 2017) those with and without Internet access (Tofighi et al, 2016), and across both males and females and diverse racial and ethnic groups (Campbell et al, 2017). TES was also found to have promising cost-effectiveness (Murphy et al, 2016).…”

A Perspective on the Integration of eHealth in Treatment of Offenders: Combining Technology and the Risk-Need-Responsivity Model

“…The same trend seems to be recognizable in research on web-based intervention in forensic psychiatry: a review identified nine studies that focused on evaluation of different types of text-based digital interventions ( 14 ). Seven of those showed outcomes at least as effective as comparison groups and more effective than no intervention groups ( 16 , 35 – 40 ), while only two studies found no improvements ( 41 , 42 ). Consequently, psycho-education or standardized assignments in face-to-face treatment might be replaced by eHealth interventions, which could take valuable time of therapists' hands and provide them with more room for in-depth treatment.…”

Community-based substance use treatment programs for reentering justice-involved adults: A scoping review

“…The most prominent intervention type was medications for opioid use disorder (MOUD), comprising nearly 35% ( n = 20) of the total sample. Thirteen articles (22.4%) examined interventions that emphasized peer support or social support systems, nine articles (15.5%) examined case management approaches, and seven articles (12%) examined behavioral therapies like cognitive behavioral therapy ( Lee et al, 2017 ), dialectical behavioral therapy ( Nyamathi et al, 2017b , Nyamathi et al, 2017a ), motivational interviewing ( Polcin et al, 2018 ), contingency management ( Lee et al, 2017 ), and individual, family, or group therapy ( Miller et al, 2017 , McHugo et al, 2021 ).…”

“… Kelly et al, 2020 . Friese and Wilson, 2021 ; Lee et al, 2017 ; Maruca et al, 2021 ; Morse et al, 2021 ; Reingle Gonzalez et al, 2019 . Note.…”