Dialectical behavior therapy for justice-involved veterans: Changes in treatment targets in a small, pre–post design clinical trial.

Abstract

Dialectical Behavior Therapy for Justice-Involved Veterans (DBT-J; Edwards, Dichiara, Epshteyn, et al., 2022) was recently developed as an integrative psychotherapy + case management intervention to address the range of complex criminogenic, mental health, substance use, and case management needs commonly faced by justice-involved veterans. Research to date suggests delivery of DBT-J to be both acceptable and feasible (Edwards, Dichiara, Epshteyn, et al., 2022). However, data on therapeutic change experienced by DBT-J participants has been limited. The present study represents an initial investigation into longitudinal changes in criminogenic risk, psychological distress, substance use, case management needs, and quality of life experienced by 20 justice-involved veterans across their course of DBT-J participation. Results reflected notable improvements across treatment targets from pre-to posttreatment; these gains were largely maintained at 1-month follow-up. Such findings attest to the potential utility of DBT-J and to the need for continued research into the efficacy of this intervention. Impact StatementDialectical Behavior Therapy for Justice-Involved Veterans (DBT-J) was developed to address the range of criminogenic, mental health, substance use, and case management needs commonly faced by justiceinvolved veterans. Results of a small-scale, pre-postclinical trial suggested veterans participating in DBT-J experienced notable improvements across treatment targets during the assessment period. Findings highlight potential utility of DBT-J as a treatment for justice-involved veterans.

Prison or treatment? Gender, racial, and ethnic inequities in mental health care utilization and criminal justice history among incarcerated persons with borderline and antisocial personality disorders.

“…Of the 16 randomized clinical trials completed for dialectical behavior therapy, for example, only one assessed history of legal involvement (Rosenfeld et al, 2019). Furthermore, although some adaptations of dialectical behavior therapy have been developed for justice-involved persons (e.g., Edwards, Dichiara, et al, 2023; Edwards, Epshteyn, et al, 2023; Shelton et al, 2011), these adaptations have often not received the same level of rigorous scientific investigation as traditional programs for dialectical behavior therapy. The elevated prevalence of legal involvement among persons with BPD and/or ASPD (Sansone et al, 2014; Sijtsema et al, 2014), particularly among men, necessitates more routine assessment of patient legal histories and integration of legal considerations into treatment planning of standard programming for persons affected by these personality disorders.…”