Implementation outcomes from a pilot study of training probation officers to deliver contingency management for emerging adults with substance use disorders.

INTRODUCTION: Emerging adults (EAs) in the criminal legal system are at high risk for substance use and related negative outcomes. EAs also have low levels of engagement in treatment services, a pattern exacerbated for those living in rural communities. This pilot study investigated implementation outcomes of task-shifting an evidence-based substance use intervention, via a developmentally targeted program, provided by probation officers (POs) to selected EA clients. METHODS: Ten POs recruited from two counties in Oregon who provide services to rural clients were trained and supported in delivering contingency management for EAs (CM-EA) to 17 EAs on their current caseloads. The pilot took place entirely during the COVID-19 pandemic. POs submitted session audiotapes and checklists from meetings with participating EA clients and participated in focus groups. EA clients completed baseline interviews and agreed to have their adult criminal records collected. Ten semi-structured interviews were completed with probation/parole administration and staff from four rural counties across three states highly impacted by the opioid epidemic about the barriers and facilitators for delivering a program like CM-EA in their offices. RESULTS: Based on self-reports and observational coding, POs demonstrated fidelity and adoption as they delivered all CM-EA components and engaged in CM-EA quality assurance protocols. Penetration was demonstrated by the selection of EAs reflecting the demographics of their local offices (i.e., White, non-Hispanic, balanced across sex), struggling with polysubstance use, and primarily holding felony convictions. Emerging themes from focus groups and interviews revealed feasibility, acceptability, and appropriateness of CM-EA, including use with clients not currently in the research program and reported intentions to continue CM-EA use. Barriers for future use include those found for the delivery of other programs in rural areas such as resource limitations. CONCLUSIONS: There is initial support for the implementation outcomes related to task-shifting a program like CM-EA to POs, particularly those serving rural clients, to increase access to evidence-based substance use services for EAs. Future research with larger samples and multiple follow-ups will allow for effectiveness testing and further program refinement for this high-priority population.

The impact of trauma-focused psychotherapies on anger: A systematic review and meta-analysis.

OBJECTIVE: Anger is one of the most prevalent concerns among individuals with posttraumatic stress disorder (PTSD) and is often a residual symptom following PTSD treatment. The purpose of this systematic review and meta-analysis was to determine how effective trauma-focused PTSD psychotherapies are in reducing anger. METHOD: The study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This study conducted a systematic review of studies that reported the effect of trauma-focused treatments on anger outcomes. Additionally, a meta-analysis was conducted with a subset of studies that used randomized controlled trials (RCTs) methodologies to compare trauma-focused PTSD treatments to nontrauma-focused and control conditions. RESULTS: The systematic review included 16 studies with a total of 1,846 participants. In 11 of the studies, there was a significant decrease in an anger dimension following treatment. Eight studies with 417 total participants met inclusion criteria for the meta-analysis. The meta-analysis yielded a pooled effect size of PTSD treatment on anger of Hedges's g = 0.33. CONCLUSION: Overall, trauma-focused treatments for PTSD significantly improve anger, but the magnitude of change is small-to-medium. Additional research is needed to determine how best to maximize anger outcomes following trauma-focused treatment or determine if and when targeted anger treatment is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Pilot Study of Yoga with Incarcerated Youth Using the Prison Yoga Project Approach.

In recent decades, there has been more significant implementation and research of yoga programs in prisons and correctional facilities. Existing literature suggests that adult and juvenile prison-based yoga programs may improve stress-management and self-regulation skills; reduce depression, anxiety, aggression, and addictive behaviors; and increase prosocial behaviors. However, yoga in juvenile correctional facilities is still understudied compared to adult populations. The Prison Yoga Project (PYP) and Yoga FLAME (Focus, Letting go, Anger management, Mindfulness, and Exhaling negativity) are two frameworks used to structure the implementation of prison-based yoga programs among incarcerated adolescents. The present study aimed to describe trauma-related stress and self-regulation levels in a sample of incarcerated youth and to explore yoga's effects on developing stress-reduction skills. The study collected measures on overall and in-session stress reduction and baseline self-regulation. Because of the COVID-19 pandemic and public-safety restrictions, the present study was prematurely terminated after 5 months. Only pre-assessment measures were collected. Across time, participants reported a 38% mean stress reduction from the beginning to the end of a yoga session. Incarcerated youth with higher initial self-regulation levels showed higher pre- to post-session improvements in stress. The present findings provide valuable evidence that yoga practice using the combined PYP and FLAME framework can deliver practical benefits to juvenile correctional facilities. Furthermore, yoga may be used to foster rehabilitation, enhance skill development, and facilitate greater success in youth transitioning back into the community.