Moral Reconation Therapy and Veterans. Joel Rosenthal, PhD National Training Director VA Veterans Justice Programs
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1 Moral Reconation Therapy and Veterans Joel Rosenthal, PhD National Training Director VA Veterans Justice Programs October 9, 2012
2 Veterans Potentially In Need of Tailored Treatment Veterans in the Justice System BJS generated statistics 181,000 in prison or jail 8% of the Adult Incarcerated Population Estimated 146,000 Veterans released each year Contacts by VA Veterans Justice Programs 215,000 (HCRV prison outreach beginning August, 2007; VJO jail outreach, court coverage, and law enforcement interface beginning October, 2009) 1
3 Center for Health Care Evaluation VA Palo Alto Health Care System A Structured Evidence Review to Identify Treatment Needs of Justice-Involved Veterans and Associated Psychological Interventions Investigators: Janet C. Blodgett, MSc Ingrid Fuh, BS Natalya C. Maisel, PhD Amanda M. Midboe, PhD
4 Response to Veterans Justice Programs Goal Goal (1 of 5 VJP goals) Matching of justice-involved Veterans with the medical, mental health/psychiatric, vocational, and social services that would improve health and optimize successful community integration and safety for these Veterans. Review Response Critical examination of the needs and treatments in particular psychological treatments which either are, or are thought to be, relevant to justice involved Veterans. 3
5 Structured Review - Five Key Questions What are the treatment needs of justice-involved Veterans? What are the main assessment tools to identify the mental health treatment needs and recidivism risk level in justice-involved Veterans? What are the evidence-based or promising psychosocial treatments for justice-involved Veterans? What are the evidence-based or promising psychosocial treatments for justice-involved Veterans at a high risk for recidivism? What are the factors that impact access to and engagement in treatment for justiceinvolved Veterans?
6 Review Findings Need as related to Justice Involved Veterans General mental health Addiction and antisocial personality disorder Trauma related issues Violence related issues Recidivism Risk RNR Principles for assessment and treatment matching Consider additional CBT interventions to alter criminogenic thinking and behavior Thinking for a Change, Reasoning & Rehabilitation, Moral Reconation Therapy Recommendations for Future Research Recidivism Risk Treatments and Veterans Effectiveness of established approaches with Veterans Treatment matching to subgroups of justice involved Veterans Integration into VA system and with community providers 5
7 MRT in the VA Early efforts Curriculum development Current Efforts Increasing sites VJO and MH staff training Venues Consultation and support VTCS, Justice System Providers Data collection
8 Formal VA Research Project Improving Treatment Engagement & Outcomes Among Justice-Involved Veterans VA Health Services Research and Development (IIR ) Co-PIs: Dan Blonigen, PhD, and David Smelson, PhD VAs Bedford, Little Rock, Palo Alto Veteran residents in Domiciliaries Planned N = 365, Length of Follow-Up = 6 and 12 months Hypotheses those in MRT (vs. Control Group) will have Lower overall risk for criminal recidivism Better health related outcomes (sa, mh, housing, employment) Recidivism effects will be mediated by MRT completion and sa/mh care Anticipated Implications Establish MRT as evidence-based in VA for justice involved Veterans, subgroups Identify strategies to override barriers to implementation Reduce Veteran recidivism risk Improve long-term health and well-being of justice-invovled Veterans
9 Winning the Invisible War Adaptation of How to Escape Your Prison Conceptual Perspective Content Adaptations Addition of Veteran-Related Stories Exercise Adaptations
10 To view the SER/for additional information structured-evidence-review-identify-treatment-needsjustice-involved-veterans-and-associated Joel Rosenthal, PhD National Training Director VA Veterans Justice Programs
11 Moral Reconation Therapy and Veterans Laura Sales, LCSW Veterans Justice Outreach Specialist VA Colorado Springs October 9, 2012
12 MRT with Veterans: Develop an understanding with the Court Referrals: Who will they come from; need to be ongoing; importance of replacing every graduate with at least one new referral Completion of MRT Is it in-sync with the VTC Rules, expectations, communications: lateness, absences, sleeping in Group, paying attention, Materials ready before group, must always be working on Steps, Cursing, Acting Out, Cell phones, confidentiality Confidentiality what does this look like 11
13 MRT with Veterans: Challenges for Veterans 1 more thing to do Memory issues especially with Step 1 and Step 2 Not a process group, but can be triggering 12
14 MRT with Veterans: Benefits of Veteran Specific MRT The Camaraderie Level of Pride Identified and shared among each other Level of Understanding and support for one another MRT at VHA facilitators work with their therapists 13
15 14
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