Trial Outcomes & Findings for Justice-Involved Veterans and Moral Reconation Therapy (NCT NCT02524171)

NCT ID: NCT02524171

Last Updated: 2023-07-27

Results Overview

The Psychological Inventory of Criminal Thinking Styles (56 items) was administered to assess criminal thinking. The measure includes scales of Mollification, Cutoff, Entitlement, Power Orientation, Super-optimism, Cognitive Indolence, and Discontinuity . Scores on these scales were summed to create a General Criminal Thinking score, which has been validated as an overall index of recidivism risk. Higher scores equate to more criminal thinking. Scores were converted to a T-score metric (M=50, SD=10), calculated in reference to norms from samples of incarcerated offenders.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

344 participants

Primary outcome timeframe

6 months (post-baseline)

Results posted on

2023-07-27

Participant Flow

Recruitment began on April 4, 2016 from 3 VA Mental Health Residential Rehabilitation Treatment Program (MH RRTP) at Bedford, MA, Little Rock, AR, and Palo Alto, CA. Recruitment officially closed on July 31, 2018.

A total of 344 participants were enrolled across the 3 sites but only 341 were randomized to either the intervention group or control group. Three participants decided to withdraw from the study for various reasons such as declining to finish the baseline interview or deciding that he/she did not want to participate.

Participant milestones

Participant milestones
Measure
Moral Reconation Therapy (MRT)
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
6-month Follow-up
STARTED
172
169
6-month Follow-up
COMPLETED
119
124
6-month Follow-up
NOT COMPLETED
53
45
12-month Follow-up Interview
STARTED
172
169
12-month Follow-up Interview
COMPLETED
127
128
12-month Follow-up Interview
NOT COMPLETED
45
41

Reasons for withdrawal

Reasons for withdrawal
Measure
Moral Reconation Therapy (MRT)
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
6-month Follow-up
Lost to Follow-up
53
45
12-month Follow-up Interview
Lost to Follow-up
45
41

Baseline Characteristics

Justice-Involved Veterans and Moral Reconation Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Total
n=341 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
166 Participants
n=5 Participants
163 Participants
n=7 Participants
329 Participants
n=5 Participants
Age, Categorical
>=65 years
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Age, Continuous
45.83 years
STANDARD_DEVIATION 12.191 • n=5 Participants
46.60 years
STANDARD_DEVIATION 12.169 • n=7 Participants
46.21 years
STANDARD_DEVIATION 12.168 • n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
8 Participants
n=7 Participants
16 Participants
n=5 Participants
Sex: Female, Male
Male
164 Participants
n=5 Participants
161 Participants
n=7 Participants
325 Participants
n=5 Participants
Race/Ethnicity, Customized
White
97 Participants
n=5 Participants
100 Participants
n=7 Participants
197 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
45 Participants
n=5 Participants
52 Participants
n=7 Participants
97 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian/Alaska Native
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian/Pacific Islander
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic or Latino/a, White
10 Participants
n=5 Participants
6 Participants
n=7 Participants
16 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
12 Participants
n=5 Participants
7 Participants
n=7 Participants
19 Participants
n=5 Participants
Controlled environment
No
14 Participants
n=5 Participants
10 Participants
n=7 Participants
24 Participants
n=5 Participants
Controlled environment
Jail
17 Participants
n=5 Participants
10 Participants
n=7 Participants
27 Participants
n=5 Participants
Controlled environment
Alcohol or drug treatment
130 Participants
n=5 Participants
135 Participants
n=7 Participants
265 Participants
n=5 Participants
Controlled environment
Medical treatment
2 Participants
n=5 Participants
6 Participants
n=7 Participants
8 Participants
n=5 Participants
Controlled environment
Psychiatric treatment
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Controlled environment
Other
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
Sites (U.S.)
Pacific
56 Participants
n=5 Participants
55 Participants
n=7 Participants
111 Participants
n=5 Participants
Sites (U.S.)
Continental
55 Participants
n=5 Participants
55 Participants
n=7 Participants
110 Participants
n=5 Participants
Sites (U.S.)
Northeast
61 Participants
n=5 Participants
59 Participants
n=7 Participants
120 Participants
n=5 Participants
Days in the residential program
91.20 Days
STANDARD_DEVIATION 96.035 • n=5 Participants
92.55 Days
STANDARD_DEVIATION 100.326 • n=7 Participants
91.868 Days
STANDARD_DEVIATION 98.183 • n=5 Participants

PRIMARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Psychological Inventory of Criminal Thinking Styles (56 items) was administered to assess criminal thinking. The measure includes scales of Mollification, Cutoff, Entitlement, Power Orientation, Super-optimism, Cognitive Indolence, and Discontinuity . Scores on these scales were summed to create a General Criminal Thinking score, which has been validated as an overall index of recidivism risk. Higher scores equate to more criminal thinking. Scores were converted to a T-score metric (M=50, SD=10), calculated in reference to norms from samples of incarcerated offenders.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Risk for Criminal Recidivism (Criminal Thinking)
53.66 score on a scale
Interval 49.2 to 58.1
53.30 score on a scale
Interval 48.7 to 58.0

PRIMARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Psychological Inventory of Criminal Thinking Styles (56 items) was administered to assess criminal thinking. The measure includes scales of Mollification, Cutoff, Entitlement, Power Orientation, Super-optimism, Cognitive Indolence, and Discontinuity . Scores on these scales were summed to create a General Criminal Thinking score, which has been validated as an overall index of recidivism risk. Higher scores equate to more criminal thinking. Scores were converted to a T-score metric (M=50, SD=10), calculated in reference to norms from samples of incarcerated offenders.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Risk for Criminal Recidivism (Criminal Thinking)
50.96 score on a scale
Interval 46.5 to 55.4
49.80 score on a scale
Interval 45.2 to 54.4

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The quantity and frequency of patients' self-reported alcohol use in the past 6 months, measured with the Timeline Follow-Back interview that was administered at the 6-month follow-up interview.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Alcohol Use
94 percentage of days abstinent (past 6 mo)
Interval 90.0 to 100.0
95 percentage of days abstinent (past 6 mo)
Interval 90.0 to 100.0

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The quantity and frequency of patients' self-reported drug use in the past 6 months, measured with the Timeline Follow-Back interview. It was administered at each time point to calculate for the past 6 months total number of days using any drugs (marijuana, cocaine, amphetamines, heroin, other opiates, benzodiazepines, barbiturates, inhalants, or hallucinogens).

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Drug Use
23.07 Days (in past 6 months)
Interval 5.0 to 41.1
15.01 Days (in past 6 months)
Interval -3.7 to 33.7

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

Scale A of the Measures of Criminal Attitudes and Associates (MCAA; Mills, Kroner, \& Forth, 2002) was administered at each interview to quantify participants' associations with criminal peers, a strong predictor of criminal recidivism (Mills, Kroner, \& Hemmati, 2004). Participants were asked to consider the four adults (excluding family, co-workers, or other residents in treatment) with whom they spend the most free-time. A count variable was created by summing the number of friends for which the participant answered yes to any of the questions of criminal involvement (possible range=0-4, where a higher score indicates a worse outcome)

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Criminal Associates
0.43 friends with criminal involvement
Interval 0.2 to 0.8
0.28 friends with criminal involvement
Interval 0.1 to 0.6

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Employment module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Employment Problem Severity
0.58 score on a scale
Interval 0.5 to 0.7
0.61 score on a scale
Interval 0.5 to 0.7

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Alcohol module of the ASI was administered at each time point to assess problem severity in this domain, using composite score indices (ranging from 0 to 1); higher scores indicate greater problem severity. ASI composite scores such as this have long been used to provide internally-consistent evaluations of a patient in a particular problem area (Grahn \& Padyab, 2020).

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Alcohol Use Problem Severity.
0.09 score on a scale
Interval 0.0 to 0.2
0.06 score on a scale
Interval 0.0 to 0.1

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Legal Status module of the Addiction Severity Index (ASI; McLellan et al., 2006) was administered at each interview to assess legal problem severity. The latter is based on a composite index derived from five items: Are you presently awaiting charges, trial, or sentence? How many days in the past 30 have you engaged in illegal activities for profit? How serious do you feel your present legal problems are? (0=Not at all, 4=Extremely) How important to you now is counseling or referral for these legal problems? (0=Not at all, 4=Extremely) How much money did you receive from illegal sources in the past 30 days? These items were standardized and aggregated and yield scores ranging from 0 to 1; higher scores indicate greater problem severity of legal problems.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Legal Problem Severity
0.14 score on a scale
Interval 0.1 to 0.2
0.13 score on a scale
Interval 0.1 to 0.2

SECONDARY outcome

Timeframe: 6 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Family/Social module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Family/Social Problems
0.1 score on a scale
Interval 0.1 to 0.2
0.1 score on a scale
Interval 0.0 to 0.2

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The quantity and frequency of patients' self-reported alcohol use in the past 6 months, measured with the Timeline Follow-Back interview that was administered at the 12-month follow-up interview.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Alcohol Use
94 percentage of days abstinent (past 6 mo)
Interval 90.0 to 100.0
94 percentage of days abstinent (past 6 mo)
Interval 90.0 to 100.0

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The quantity and frequency of patients' self-reported drug use in the past 6 months, measured with the Timeline Follow-Back interview. It was administered at each time point to calculate for the past 6 months total number of days using any drugs (marijuana, cocaine, amphetamines, heroin, other opiates, benzodiazepines, barbiturates, inhalants, or hallucinogens).

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Drug Use
18.63 Days (in past 6 months)
Interval 0.4 to 36.8
15.03 Days (in past 6 months)
Interval -3.6 to 33.6

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

Scale A of the Measures of Criminal Attitudes and Associates (MCAA; Mills, Kroner, \& Forth, 2002) was administered at each interview to quantify participants' associations with criminal peers, a strong predictor of criminal recidivism (Mills, Kroner, \& Hemmati, 2004). Participants were asked to consider the four adults (excluding family, co-workers, or other residents in treatment) with whom they spend the most free-time. A count variable was created by summing the number of friends for which the participant answered yes to any of the questions of criminal involvement (possible range=0-4, where a higher score indicates a worse outcome)

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Criminal Associates
0.37 friends with criminal involvement
Interval 0.2 to 0.7
0.43 friends with criminal involvement
Interval 0.2 to 0.8

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Employment module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Employment Problem Severity
0.48 score on a scale
Interval 0.4 to 0.6
0.53 score on a scale
Interval 0.4 to 0.6

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Alcohol module of the ASI was administered at each time point to assess problem severity in this domain, using composite score indices (ranging from 0 to 1); higher scores indicate greater problem severity. ASI composite scores such as this have long been used to provide internally-consistent evaluations of a patient in a particular problem area (Grahn \& Padyab, 2020).

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Alcohol Use Problem Severity.
0.04 score on a scale
Interval 0.0 to 0.1
0.06 score on a scale
Interval 0.0 to 0.1

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Legal Status module of the Addiction Severity Index (ASI; McLellan et al., 2006) was administered at each interview to assess legal problem severity. The latter is based on a composite index derived from five items: Are you presently awaiting charges, trial, or sentence? How many days in the past 30 have you engaged in illegal activities for profit? How serious do you feel your present legal problems are? (0=Not at all, 4=Extremely) How important to you now is counseling or referral for these legal problems? (0=Not at all, 4=Extremely) How much money did you receive from illegal sources in the past 30 days? These items were standardized and aggregated and yield scores ranging from 0 to 1; higher scores indicate greater problem severity of legal problems.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Legal Problem Severity
0.09 score on a scale
Interval 0.03 to 0.15
0.09 score on a scale
Interval 0.02 to 0.15

SECONDARY outcome

Timeframe: 12 months (post-baseline)

Population: Intent to treat population (all participants assigned to MRT or UC) analyzed using mixed-effects models. Effectiveness was measured by the time x condition interaction term (UC as the reference group).

The Family/Social module of the ASI was administered at each timepoint to assess problem severity in this domain, using composite score indices (range 0 to 1); higher scores indicate greater problem severity.

Outcome measures

Outcome measures
Measure
Moral Reconation Therapy (MRT)
n=172 Participants
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 Participants
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Family/Social Problems
0.19 score on a scale
Interval 0.1 to 0.2
0.11 score on a scale
Interval 0.1 to 0.2

Adverse Events

Moral Reconation Therapy (MRT)

Serious events: 2 serious events
Other events: 0 other events
Deaths: 7 deaths

Usual Care (UC)

Serious events: 4 serious events
Other events: 0 other events
Deaths: 12 deaths

Serious adverse events

Serious adverse events
Measure
Moral Reconation Therapy (MRT)
n=172 participants at risk
MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program. Moral Reconation Therapy (MRT): MRT is a group-based cognitive-behavioral intervention to restructure antisocial thinking. Patients will receive two groups per week of this intervention for approximately 12 weeks, in addition to the usual care they receive in the mental health residential rehabilitation treatment program.
Usual Care (UC)
n=169 participants at risk
Usual care provided by the mental health residential rehabilitation treatment programs, which patients in both groups are in.
Social circumstances
Death
1.2%
2/172 • Number of events 2 • Adverse event data was collected in the 12 months post-baseline for each participant.
2.4%
4/169 • Number of events 4 • Adverse event data was collected in the 12 months post-baseline for each participant.

Other adverse events

Adverse event data not reported

Additional Information

Daniel M. Blonigen, PhD

Center for Innovation to Implementation, VA Palo Alto

Phone: 650-493-5000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place