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Moral Reconation Therapy (MRT), an evidence-based intervention to reduce risk for criminal recidivism among justice-involved adults, was developed and primarily tested in correctional settings. Therefore, a better understanding of the implementation potential of MRT within non-correctional settings is needed. To address this gap in the literature, we evaluated the adoption and sustainment of MRT in the US Veterans Health Administration (VHA) following a national training initiative in fiscal years 2016 and 2017. In February 2019, surveys with 66 of the 78 VHA facilities that participated in the training were used to estimate the prevalence of MRT adoption and sustainment, and qualitative interviews with key informants from 20 facilities were used to identify factors associated with sustainment of MRT groups. Of the 66 facilities surveyed, the majority reported adopting (n = 52; 79%) and sustaining their MRT group until the time of the survey (n = 38; 58%). MRT sustainment was facilitated by strong intra-facility (e.g., between veterans justice and behavioral health services) and inter-agency collaborations (e.g., between VHA and criminal justice system stakeholders), which provided a reliable referral source to MRT groups, external incentives for patient engagement, and sufficient staffing to maintain groups. Additional facilitators of MRT sustainment were adaptations to the content and delivery of MRT for patients and screening of referrals to the groups. The findings provide guidance to clinics and healthcare systems that are seeking to implement MRT with justice-involved patient populations, and inform development of implementation strategies to be formally tested in future trials. [ABSTRACT FROM AUTHOR]

Veterans treatment courts (VTCs) have expanded dramatically despite their limited empirical base. This pilot study examined MISSION-Criminal Justice (CJ), a co-occurring disorders wraparound intervention, delivered alongside two VTCs. Baseline data from 26 male veterans enrolled in two VTCs and MISSION-CJ, and 6-month follow-up data for 18 of the 26 veterans, are presented. Veterans on average were 37.5 years old, 85% Caucasian, had significant histories of criminal justice involvement (14.3 lifetime arrests), had an average of 14.7 years of alcohol use and 9.3 years of illicit drug use, and roughly three-quarters reported mental health symptomatology. At 6-month follow-up, veterans demonstrated improvements in behavioral health, substance use, and criminal justice outcomes. This study demonstrated promising preliminary outcomes of MISSION-CJ in VTCs. A randomized controlled trial is a critical next step to examine whether these outcomes remain consistent with a more rigorous design. [ABSTRACT FROM AUTHOR]

The veterans' treatment court movement is just beyond the nascent period, and given the rapid proliferation of these courts in recent years it is imperative that the scientific community understand their operational procedures and assess whether they are meeting a unique need beyond those addressed by other problem-solving courts. This paper provides an in-depth examination of veteran culture and how it helps to distinguish veterans' treatment courts from other courts that focus on similar populations (e.g., drug, DWI, and mental health courts). Using in-depth semi-structured interviews and focus group data collected from veteran participants, veteran mentors, and court team members in Pennsylvania, we employ content analysis to explore the veteran culture as a motivator for participants to enroll in a veterans' treatment court and engage with others throughout participation in treatment. The results of this exploratory study suggest that a shared culture serves to motivate justice-involved veterans to seek out the veterans' treatment court over other treatment options and remain engaged in this problem-solving court, while inspiring a sense of obligation to do well in treatment for them and their fellow veterans. The shared experiences of military service and across-the-board support for fellow service members suggest that the veterans' treatment court creates a unique environment for pursuing treatment. [ABSTRACT FROM AUTHOR]