Search

The therapeutic working alliance is an important factor in producing treatment change and positive therapeutic outcomes for people with mental illness, yet little is known about the working alliance's role in treatment change in people with mental illness that is justice involved. In addition to treating the mental illness symptoms of justice-involved people with mental illness, addressing factors known to predict criminal behavior (including criminal thinking) could optimize posttreatment outcomes and reduce future justice involvement. This study examines the role of the working alliance in treatment change in a clinical treatment sample of 265 adult male and female justice-involved people with mental illness and substance use disorders completing probation sentences in a residential treatment facility.Repeated measures moderation analyses were used to test participants' reported working alliance as a moderator of change from pre- to posttreatment scores of self-reported mental illness symptoms and criminal thinking.The working alliance significantly moderated reductions in depression, anxiety, anger, and manic symptoms (R 2 ranging from .03 to .09), and general, reactive, and current criminal thinking (R 2 ranging from .04 to .11).These findings expand the literature on the relation between working alliance and changes in mental illness symptoms by testing this association in the understudied population of justice-involved people with mental illness; these results also suggest the working alliance is associated with changes in criminal thinking. Treatment providers working with justice-involved people with mental illness should assess and emphasize the development of a working alliance to maximize treatment change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research on the effects of restricted housing on inmate well-being indicates mild to moderate psychological effects and barriers opportunities for treatment and positive growth. Yet, there are few interventions tailored both to the needs of this high-risk population and to the institutional constraints of their environment. Given the financial and safety burdens associated with housing someone in segregation compared to the general population, correctional psychology should focus on developing programs that work. Using a prepost design, this study presents findings from a pilot investigation (N = 39) on the effects of a new, largely self-directed program (Stepping Up, Stepping Out [SUSO]) for inmates with mental and behavioral health concerns who are placed in restrictive settings. Results suggest that SUSO is associated with meaningful reductions in overall emotional distress and criminal attitudes; however, improvements in more stable criminal thinking patterns (i.e., distorted cognitions that are used to justify and support antisocial behavior; see Walters, 2012) were not observed. Overall, posttreatment working alliance was rated favorably by program participants. Demographic and preintervention comparisons between program completers and dropouts are also reported. Though preliminary findings suggest SUSO is a promising intervention for alleviating distress and aspects of criminal risk for inmates placed in restricted housing, future research should assess fidelity and engagement leading to a randomized controlled trial to determine the effectiveness of this program. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

[Correction Notice: An Erratum for this article was reported online in Psychological Services on Oct 8 2020 (see record 2020-75253-001). In the article, the authors listed the wrong version of a measure in the Method section of Study 2. The article should have listed PICTS-Layperson-Short Form (PICTS-L-SF) instead of the PICTS-Short Form (PICTS-SF) as the measure used. The correct citation for the measure appears in the erratum.] Corrections research literature is replete with treatment and intervention outcome studies but lacking empirical examinations of the process of change in justice-involved populations. The current studies expand upon previous outcome evaluations of Changing Lives and Changing Outcomes (CLCO), a treatment program for justice-involved persons with mental illness, by using process research designs to examine therapeutic mechanisms of change. Study 1 used CLCO participants' (n = 264) pre and post module quizzes to examine differences in content retention between Mental Illness, Criminalness, and Both mental illness and criminalness domains to determine if participants differentially learn treatment content. In Study 2, 1 CLCO module was administered to 9 groups of adult men on probation in a residential treatment facility (n = 4 to 8 per group) in 3 iterations: (a) Mental Illness-only content (n = 16), (b) Criminalness-only content (n = 20), (c) Full module (mental illness and criminalness content; n = 22). Results for both studies indicated significant treatment gains across outcome measures of interest (namely content retention and symptomology). Contrary to expectations in Study 1, effect sizes of Mental Illness and Criminalness content retention were similar, suggesting there are not differential effects in the magnitude of content retained between the 2 domains. In Study 2, the integration of mental illness and criminalness content produced greater global improvement than focusing on mental illness or criminalness alone. These results underscore the necessity and effectiveness of integrating mental illness and criminalness in the treatment of justice-involved persons with mental illness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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

Interventions that focus on the psychiatric and criminogenic needs of justice-involved persons with mental illness are rare. A Treatment Manual for Justice Involved Persons with Mental Illness: Changing Lives and Changing Outcomes (CLCO) was developed specifically for meeting these co-occurring needs. Although results from an initial evaluation indicated that CLCO successfully resulted in reduced symptomatology and some aspects of criminal risk, much additional work examining the effectiveness of CLCO remains to be done. The present evaluation examined the extent to which offenders gained knowledge (i.e., content retention) throughout the program, the extent to which content retention was predictive of program completion, and the extent to which treatment engagement (i.e., session attendance and homework completion) was predictive of program completion. Participants consisted of male and female felony offenders in a residential treatment facility (n = 130), and dually diagnosed male offenders in a residential treatment facility (n = 39). Results indicated that participants in this intervention retained treatment content, and this content retention was predictive of treatment completion. Implications of these findings suggest that CLCO is a promising new intervention for justice-involved persons with mental illness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Individuals forensically committed to a state hospital are at an increased risk of suicide; however, there is extremely limited research examining suicide risk estimates and risk factors among inpatients deemed not guilty by reason of insanity (NGRI). This study aimed to determine (a) rates of suicidal ideation history, suicide attempt history, and current distress due to suicidal ideation, and (b) the associations between psychiatric symptom severity, criminal risk factors, and suicide risk. NGRI inpatients (n = 207) from 2 state hospitals were administered assessments of psychiatric symptom severity and criminal risk factors (i.e., criminal tendencies and antisocial personality traits). Results indicated 46.4% of participants reported at least 1 previous suicide attempt, 58% reported previous suicidal ideation, and 10.1% reported some level of current distress due to suicidal ideation. Binary logistic regression results indicated psychiatric symptom severity, not criminal tendencies or antisocial personality traits, was associated with a greater likelihood of current distress due to suicidal ideation. There was a significant interaction between criminal tendencies and antisocial personality, which indicated that individuals higher in criminal tendencies and lower in antisocial personality traits are predicted to have the greatest probability of reporting current distress due to suicidal ideation. Additionally, psychiatric symptom severity and antisocial personality traits were associated with a greater likelihood of a suicide attempt history, whereas criminal tendencies were associated with a decreased likelihood. Clinical implications are discussed, particularly the need for suicide risk assessments and management to consider both psychiatric symptoms and criminal risk factors. (PsycINFO Database Record

There is a widely held belief that the use of administrative segregation (AS) produces debilitating psychological effects; however, there are also those who assert that AS is an effective strategy for reducing prison antisocial behavior and prison violence. Given these conflicting opinions it is not surprising that the use of segregation in corrections has become a hotly debated and litigated issue. To clarify the competing perspectives, two independent meta-analytic reviews, in an unplanned systematic replication, were undertaken to determine what effect AS has on inmate's physical and mental health functioning, as well as behavioral outcomes (e.g., recidivism). Collectively, the findings from these two meta-analytic reviews indicated that the adverse effects resulting from AS on overlapping outcomes ranged from d = 0.06 - 0.55 (i.e., small to moderate) for the time periods observed by the included studies. Moderator analyses from both investigations further reveal considerably smaller effect sizes among studies with stronger research designs compared to those with weaker designs. These results do not support the popular contention that AS is responsible for producing lasting emotional damage, nor do they indicate that AS is an effective suppressor of unwanted antisocial or criminal behavior. Rather, these findings tentatively suggest that AS may not produce any more of an iatrogenic effect than routine incarceration. Coding for these meta-analyses also revealed serious methodological gaps in the current literature. Recommendations for future research that will provide a much better understanding of the effects of AS are offered.

Few empirical studies have examined how doctoral psychology training programs introduce corrections as an area of study or a venue for practice, making it difficult to understand the link between academic programs and a psychology services workforce in corrections. A representative group of directors of American Psychological Association accredited doctoral programs in clinical and counseling psychology (N 170) were surveyed for information on corrections coursework, faculty interest, and practicum opportunities. More than half the programs offered exposure to clinical practice in corrections; largely practicum and rarely specific coursework. Faculty considerations were the most frequently nominated factors that limited correctional training in doctoral programs. The discussion focuses on implications for policy and practice in the training of the corrections workforce and in developing corrections-competent faculty.

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.

Andrews and colleagues showed that the principles of Risk-Need-Responsivity (RNR) effectively reduced recidivism. The purpose of this study was to advance Andrews and colleagues’ work by examining whether correctional services that adhered to RNR were more expensive than services that did not adhere to RNR. Articles included in the Andrews et al. (1990) meta-analysis of correctional services were gathered and reevaluated based upon a coding process which emphasized the maximum cost of service provision. Results indicated that appropriate correctional services (services that adhered to RNR) were not significantly more expensive than inappropriate correctional services (services that did not adhere to RNR) or traditional criminal sanctions. Also indicated was a practical cost difference between appropriate and inappropriate correctional services, where inappropriate correctional services had increased costs, possibly because of increased time of service provision. The implications of these findings for policy and correctional administrative decision making with regard to offender treatment are discussed.

The purpose of this study was to examine the national practices of psychotherapy services for male offenders with mental illness (OMI) in state correctional facilities. Participants consisted of 230 correctional mental health service providers from 165 state correctional facilities. Results indicated that mental health professionals provided a variety of services to OMI that can be conceptualized by six goals considered important in their work: mental illness recovery, emotions management, institutional functioning, re-entry, risk-need, and personal growth. Mental health professionals in this study generally viewed mental illness recovery, institutional functioning, and personal growth as significantly more important and spent more time focused on these goals than emotions management, re-entry, and risk-need. Mental health professionals tended to believe the services they provided were effective across four key treatment foci including mental illness, skill development, behavioral functioning, and criminogenic needs with more progress perceived in areas related to mental illness and skill development than their ability to effectively change behavioral functioning. Implications of these findings and directions for future research are discussed.

This study examined inmate attitudes toward treatment, mental health treatment utilization, and treatment effects that maximize treatment effectiveness. Participants consisted of 278 incarcerated male adult offenders from the Kansas Department of Corrections. Multiple linear regression analysis indicated that inmate attitudes toward treatment were predictive of the number of mental health treatment sessions (dosage) inmates received. Hierarchical linear regression analyses indicated positive help-seeking attitudes were associated with institutional behavior (decreased number and severity of disciplinary infractions) and scores on a measure assessing risk for future criminal behavior; however, the amount of mental health treatment an inmate received (treatment dosage) was associated with problematic institutional behavior (i.e., increased severity and number of disciplinary infractions). These results indicated that treatment dosage and behavioral outcomes were impacted by inmate attitudes toward treatment. As a result, correctional psychologists may be better able to predict which inmates will receive the most benefit from services. Implications of these findings for practitioners and policy makers are discussed.

This article presents the presidential address delivered by Robert D. Morgan during the 118th annual meeting of the American Psychological Association (APA). This address challenges us, as public service psychologists, to improve services currently offered and to be leaders among those providing mental health services in the public sector. To accomplish this task we must (a) return to our roots as social scientists, (b) rely on basic research to prove our worth as service providers, (c) integrate program evaluation as an essential component in our services, and (d) integrate public service psychology training opportunities at the academic level while developing research networks with academic training programs. Those of us in the public sector are essential health care providers for veterans, individuals that are criminal justice involved, hospitalized in community and state hospitals, and those living in Indian country. We also serve those in law enforcement who protect us. We are grass- roots service providers in agencies that are over- burdened and underfunded, and we work in systems that, quite frankly, often times make little sense. Our clients are underserved, they are marginalized, and they are desperately in need of services. Although we are able to help the individuals we serve, we can do better. What I want to discuss with you today are my thoughts on how we can and must do better. I will discuss our need to return to our roots as social scientists. I will then outline our role as health care providers in the public sector with a focus on using basic research to prove our worth in this health care market. I will share with you my thoughts on how we can improve the ser- vices we provide to our clients by integrating program evaluation into our work. Finally, I will discuss the role we, as trainers and super- visors, play in the future generation of public sector psychologists. We in Public Service psychology have cho- sen to work within the often burdensome bu- reaucracy of government to provide services to those who could not otherwise afford or have access to the mental health services they need. We serve those in law enforcement where it has long been recognized that the occupational stress of policing contributes to rates of suicide among this group that is twice that of the gen- eral population (Forastiere et al., 1994). If we do not provide services for the individuals that protect us on a daily basis, who will? For my home section, criminal justice, did you know there are currently three times more persons with mental illness in state and federal correc- tional facilities than psychiatric hospitals (Abramsky & Fellner, 2003)? Similar crises are prevalent in all sectors of public service and psychologists must be at the forefront in serving individuals and developing interventions tai- lored to the unique needs of these individuals. If we do not, who will? If we do not develop services tailored to the specific needs of these individuals, then who?

To examine the prevalence of criminal thinking in mentally disordered offenders, incarcerated male (n = 265) and female (n = 149) offenders completed measures of psychiatric functioning and criminal thinking. Results indicated 92% of the participants were diagnosed with a serious mental illness, and mentally disordered offenders produced criminal thinking scores on the Psychological Inventory of Criminal Thinking Styles (PICTS) and Criminal Sentiments Scale-Modified (CSS-M) similar to that of non-mentally ill offenders. Collectively, results indicated the clinical presentation of mentally disordered offenders is similar to that of psychiatric patients and criminals. Implications are discussed with specific focus on the need for mental health professionals to treat co-occurring issues of mental illness and criminality in correctional mental health treatment programs.

The authors examined the relationship between criminal thinking factors of control, cognitive immaturity, and egocentrism, and offender characteristics (i.e., age, education, sentence length, time served, reception of mental health services) in 435 adult male offenders. Results of a canonical correlation analysis identified 1 significant and meaningful relationship between a criminal thinking set containing all 3 factors and an offender characteristic set containing all characteristics except for age. Higher levels of criminal thinking on all 3 factors were associated with more education, longer sentence length, more time served, and lack of reception of mental health services. Implications for providing treatment with offenders that targets reducing criminal recidivism and future directions for investigation into the relationship between dynamic recidivism risk factors and offender characteristics are discussed.

In corrections, where staffing limitations tax an overburdened mental health system, telemental health is an increasingly common mode of mental health service delivery. Although telemental health presents an efficient treatment modality for a spectrum of mental health services, it is imperative to study how this modality influences key elements of the treatment experience. In this study, the authors compared inmates' perceptions of the working alliance, postsession mood, and satisfaction with psychiatric and psychological mental health services delivered through 2 different modalities: telemental health and face-to-face. Participants consisted of 186 inmates who received mental health services (36 via telepsychology, 50 via face-to-face psychology, 50 via telepsychiatry, and 50 via face-to-face psychiatry). Results indicate no significant differences in inmates' perceptions of the work alliance with the mental health professional, postsession mood, or overall satisfaction with services when telemental health and face-to-face modalities were compared within each type of mental health service. Implications of these findings are presented.

This study examined the role of romantic and/or intimate relationships on female offenders’ well-being and institutional behavior while incarcerated. Relationship satisfaction and social support were additional variables examined for association with well-being. Participants were 211 adult female inmates from a midwestern department of corrections. Results indicated increased anger, hostility, and number of disciplinary infractions for female inmates involved in romantic relationships as compared to those not involved in relationships. Findings also indicated increased anger and punishments for inmates in romantic relationships with females within the prison as compared to those in romantic relationships with males outside of the prison. Relationship satisfaction and social support did not significantly predict well-being or institutional behavior. Implications of the current findings are discussed.

What obstacles are faced by academic psychologists seeking professional licensure? Data presented here from all U.S. jurisdictions suggests that licensure requirements vary greatly across states and in some areas may be quite diffi cult to fulfi ll within the context of an academic position. Results of a survey of training directors of clinical and counseling doctoral programs accredited by the American Psychological Association indicated that, although licensure is expected of most faculty, a number of challenges may impede this goal. Programmatic efforts to facilitate licensure of new faculty, as well as implications of our fi ndings, possible remedies, and recommendations to new faculty, are presented.

With the increasing rise in the U.S. prison population, meeting the mental health needs of inmates before, during, and after incarceration remains an obstacle. What are the mental health experiences of inmates? For what types of problems are inmates willing to seek help, and what are the barriers to their service utilization? This study investigated inmates' attitudes and perceptions toward mental health services and examined whether these attitudes and perceptions vary with respect to ethnic group membership or among inmates of differing security levels. Implications of these findings for psychologists, including psychologists not employed in correctional settings, are highlighted.

The purpose of this study was to evaluate the efficacy of group psychotherapy with incarcerated offenders. Meta-analytic techniques were applied to 26 empirical studies that used a treatment group versus a control group. The outcome measures assessed in this study included institutional adjustment, anger, anxiety, depression, interpersonal relations, locus of control, and self-esteem. The results indicate that positive treatment effects were found for the use of group psychotherapy with incarcerated offenders across all outcomes. Supplemental analyses were also included to identify factors that contribute to the efficacy of group psychotherapy and indicate that the use of homework exercises resulted in significantly improved outcomes. Furthermore, participants mandated to treatment did not negatively influence the efficacy of group psychotherapy. Quantitative research synthesis, or meta-analysis, is a set of statistical procedures that allow empirical research from many sources (e.g., research articles) to be integrated for the purpose of creating generalizations (Glass, 1976). Metaanalytic reviews have been frequently utilized to evaluate the effectiveness of correctional programs and to identify what types of treatment programs work with offenders (e.g., Andrews et al., 1990; Lipsey, 1990; Losel, 1995); however, none of these reviews have focused specifically on the use of group psychotherapy with offenders. Group psychotherapy became increasingly popular as a treatment approach with incarcerated offenders in the 1950s because “group therapy has shown itself to be of real institutional value” (Abrahams & McCorkle, 1946, p. 464), and, currently, approximately 20% of male inmates in state correctional facilities receive group psychotherapy services (Morgan, Winterowd, & Ferrell, 1999). Unfortunately, the increased use of group psychotherapy in the past 50 years has not resulted in a parallel increase in research regarding the efficacy of its use. In fact, only 16% of mental health departments in state correctional facilities conduct group psychotherapy research (Morgan, Winterowd, & Ferrell, 1999). Thus, questions regarding the effectiveness of group psychotherapy with incarcerated offenders remain unanswered.