Motivational Assessment Program to Initiate Treatment

Summary

Substance abuse treatment in the criminal justice system can reduce drug use and related criminal behavior. Although drug and alcohol treatment are common mandates in criminal justice programs, only a minority of clients actually initiate treatment. This proposal will compare two intervention formats that target motivation to initiate and engage in treatment among a group of probationers who have drug or alcohol treatment conditions. Six hundred drug and alcohol offenders in two probation sites (Baltimore, MD and Dallas, TX) will be randomized to receive: 1) an in-person motivational interviewing session (MI), 2) a motivational computer program (MC), or 3) supervision intake and monitoring as usual (SAU). The MI condition will be structured along the lines of the "Check-Up" format which consists of an assessment and personalized feedback delivered in an MI style; the content of the MC condition will be drawn from previous literature on effective motivational computer programs. Both interventions will be delivered at the start of the probation process, with follow-up assessments at 2 and 6 months. Primary outcomes include engagement and participation in substance abuse treatment; secondary outcomes include drug and alcohol use, probation progress, criminal behavior, and HIV testing and care. This project will be the first to develop and test two interventions for encouraging criminal justice clients to follow through with treatment recommendations, with the goal of increasing treatment initiation, and reducing subsequent drug use and criminal behavior. It also contributes to ongoing partnerships with two large probation agencies-the Dallas County Supervision and Corrections Department and the Maryland Division of Parole and Probation.

Conditions

• Substance-Related Disorders

Interventions

BEHAVIORAL

Motivational Interviewing

MI is a "client centered, directive style of interacting with a person to help explore and resolve ambivalence about change" (Miller \& Rollnick, 2002). MI borrows from Client-Centered Counseling in its emphasis on empathy, optimism, and respect for client choice (Rogers, 1961). MI also draws from Self-Perception Theory, which says that a person becomes more or less committed to an action based on the verbal stance he or she takes (Bem, 1972). The effects of MI tend to be in the small-to-medium range when compared to no treatment, and nonsignificant when compared to more extensive treatment.

BEHAVIORAL

Motivational Computer

The growing use of technology has led to the development of automated interventions for behavior change, including some that target drug and alcohol use (Elliott, et al, 2008; Lustria, et al, 2009; Revere \& Dunbar, 2001; Walters, et al, 2006) and treatment interest (Lieberman \& Massey, 2008). As discussed by Hester \& Miller (2006), automated interventions have several potential advantages over face-to-face interventions: (I) They require little or no staff contact, which may increase cost-effectiveness; (2) they can allow for automatic data collection and follow-up; and (3) they can be disseminated with little loss of fidelity.

Sponsors & Collaborators

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• University of North Texas Health Science Center

  lead OTHER

Principal Investigators

• Scott T Walters, PhD · UNT Health Science Center

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2012-06-30

Primary Completion

2015-06-30

Completion

2016-02-29

Countries

• United States

Study Locations