Dialectical Behavior Therapy for Justice-Involved Veterans: A Randomized Clinical Trial
VA Office of Research and Development
Summary
Dialectical Behavior Therapy for Justice-Involved Veterans (DBT-J) is a comprehensive, integrative program distinctively designed to address the range of mental health, substance use, case management, and legal needs of Veterans with current or ongoing criminal justice involvement. Data from two prior clinical trials attest to the program's feasibility and acceptability and preliminarily suggest participation in the program may yield meaningful improvements in risk for criminal behavior and resolution of high-priority case management needs. However, continued research is needed to further investigate the program's efficacy. This Phase III clinical trial aims to investigate the superiority of DBT-J over a supportive group therapy treatment in decreasing risk of future criminal behavior and increasing psychosocial functioning. Secondary and exploratory aims will also investigate superiority of DBT-J in improving secondary treatment targets, potential differential efficacy across special-interest Veteran subgroups, and long-term consequences of program participation.
Description
Despite substantial efforts to curb Veteran suicide, Veterans continue to die by suicide at rates that far exceed their civilian peers. To date, substantial resources have been invested into understanding and treating underlying risk factors and precipitants of Veteran suicide. However, criminal justice involvement remains an under-examined and under-assessed risk factor for Veteran suicide. Accumulating research suggests justice-involved Veterans are a high-risk, high need population, particularly within the Veterans Health Administration. For example, 11% of Veteran suicides are precipitated…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Veteran aged 18+ * Able to provide consent * Current or recent history of criminal justice involvement, defined as * (a) criminal arrest, order of protection, or incarceration within two years prior to participation and/or * (b) supervision by probation or parole at the time of participation Exclusion Criteria: * Limited English proficiency * Inability to tolerate group therapy format * Enrollment in a concurrent clinical trial * Current or scheduled enrollment in a DBT- or RNR-based program * Prior participation in DBT-J program
Interventions
- BehavioralDialectical Behavior Therapy for Justice-Involved Veterans
16 weeks of Dialectical Behavior Therapy for Justice-Involved Veterans, including weekly 60-minute group therapy and biweekly 30-minute individual case management
- BehavioralSupportive Group Psychotherapy for Justice-Involved Veterans
16 weeks of clinician-facilitated supportive group psychotherapy for justice-involved Veterans, including weekly 75-minute group psychotherapy (20 hours total intervention). All interventions delivered via telehealth.
Locations (2)
- Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado
- James J. Peters VA Medical Center, Bronx, NYThe Bronx, New York