Changing criminal thinking: An examination of heterogeneity in treatment effects in a sample of justice-involved persons with dual diagnoses.

Abstract

Recent studies have indicated variable reductions in criminal thinking for justice-involved persons with mental illness exposed to cognitive–behavioral treatments. To date, however, no studies have identified risk factors for limited response or modeled observed disparities in responsivity to interventions aimed at reducing criminal thinking. Using an archival data set of 162 probationers with a dual diagnosis who were exposed to changing lives and changing outcomes, a latent profile analysis modeled unobserved heterogeneity in treatment response per observed changes in criminal thinking. Most participants endorsed significant changes in self-reported reactive criminal thinking with minimal changes in proactive criminal thinking. Neither self-reported pretreatment severity of psychopathology nor self-reported compliance with psychotropic medication predicted response to treatment. Although diagnosis also did not predict responsiveness, more favorable views of treatment predicted greater decreases in criminal thinking. Moreover, those expressing fewer levels of criminal thinking after treatment were also found to express a decrease in attitudes supportive of violence. Limitations and treatment recommendations are discussed, including the need for correctional treatments to improve responsiveness to individual treatment needs.

A longitudinal examination of stepping up, stepping out with incarcerated men in restrictive housing: An expansion of the 2021 pilot.

“…Future program evaluations should expand SUSO data collection across multiple delivery methods (e.g., group, more intensive individual, as an add-on within step-down programs), providers, and institutions. It would also be important to examine additional predictors of program completion and compliance (e.g., initial attitudes toward treatment, number of prior disciplinary infractions, history of psychosis or other indicators of psychopathology) and potential moderators (e.g., mental health symptom severity, number of prior placements in restrictive housing) that may help explain heterogeneity in treatment responsiveness such as why some individuals show reductions in PCT while others do not (Lester et al, 2022). Although self-reported measures of criminal thinking and attitudes like those used in this program evaluation are predictive of behavioral outcomes inside and outside prison walls, directly assessing these outcomes over time is also important for ensuring observed changes are not just a product of teaching people how to think differently.…”

“…In one study of over 4,000 incarcerated people, behavioral and mental health variables significantly correlated with procriminal sentiments, aggression, and lowered self-control; these authors concluded that attitudinal and emotional risk factors related to reoffense are essential treatment components for those with and without serious psychological symptoms (Wolff et al, 2013). Thus, interventions for people who engage in criminal behavior and experience mental health problems, regardless of symptom severity, will be most effective when they address both concerns together (Lester et al, 2022; Morgan et al, 2012; Scanlon & Morgan, 2021)…”

“…Given the more robust sample size, we anticipated decreases in reported criminal thinking styles, particularly reactive styles (i.e., those that are more spur-of-the-moment). Research with similar programs for justice-involved persons tends to show greater improvement for these styles compared to proactive styles (i.e., those that are more planful; see Lester et al, 2022; Walters, 2009). Importantly, this study reflects the programmatic outcomes expected when ideal scientific controls and standardized implementation are not possible.…”

“…In one study of over 4,000 incarcerated people, behavioral and mental health variables significantly correlated with procriminal sentiments, aggression, and lowered selfcontrol; these authors concluded that attitudinal and emotional risk factors related to reoffense are essential treatment components for those with and without serious psychological symptoms (Wolff et al, 2013). Thus, interventions for people who engage in criminal behavior and experience mental health problems, regardless of symptom severity, will be most effective when they address both concerns together (Lester et al, 2022;Morgan et al, 2012;Scanlon & Morgan, 2021) Increasing attention has been paid to reforming the use of restrictive housing especially for certain subgroups like those with serious psychological impairment (e.g., NY Senate Bill, S.2836, 2021. Several states have created alternative therapeutic housing or stepdown programs to improve people's chances of remaining in the general population once released from restricted settings (Glowa-Kollisch et al, 2016;Labrecque et al, 2021).…”

Purpose in Life

“…At times, strategies developed to change criminal and extremist attitudes might be useful (Schumann et al, 2022). Several novel approaches incorporating cognitive behavioral and positive psychology techniques include "Taking a Chance on Change" (Folk et al, 2016), "Changing Lives and Changing Outcomes" (Lester et al, 2022), and Acceptance and Commitment Therapy-oriented interventions (Zarling and Russell, 2022). Finally, 20-30-year-old Rwandan participants in a demonstration sociotherapy project for highly traumatized youth (born to genocide perpetrators and survivors) marked by stigma, thoughts of revenge, shame, depression, and antisocial behaviors reported improved purpose in life, good relationships with others, and self-esteem, in addition to improvements in other aspects of psychological well-being (Biracyaza and Habimana, 2020).…”