In this Phase II SBIR we propose to complete the production of a computer-based interactive multimedia (CBIM) training program for substance abusing offenders, """"""""SKILLS."""""""" It will consist of 1) multimedia adaptations of 15 skill trainings considered crucial in effective cognitive behavioral treatment programs, with practice opportunities; 2) patient-completed workbooks, and 3) a counselor manual. We will place particular emphasis on cognitive-behavioral skill scenarios useful in reducing HIV/AIDS risk behavior. In addition, we will conduct a randomized controlled pilot test (RCPT) of SKILLS efficacy. For the RCPT, all subjects (males and females at least age 18) will be substance abusing offenders (SAOs) sentenced to the """"""""Community Corrections Facility"""""""" (CCF) of the Diagnostic & Rehabilitation Center (DRC) in Philadelphia PA with an average stay of 5 months. 123 SAOS with histories of recent cocaine or other stimulants and/or opiate use will be randomly assigned to 3 conditions, the experimental condition consisting of counselor supported SKILLS training or of two control conditions (supportive 12- step counseling or a digitized video 12-Step training program). A full battery of baseline measures will be administered including the Drug Scales of the Addiction Severity Index, the TCU Intake Crime Chart, the TCU Pre-Treatment Survey of Correctional Populations and the TCU HIV Risk Assessment. Outcome measures will be obtained with the same or related instruments while in detention, and nine months after the baseline assessment at which time the offender would have been on parole for several months. Parameters will include risk-taking and social support scales, HIV/AIDS risk behavior, compliance with treatment protocol and facility rules, results of urinalyses, evidence of treatment-seeking efforts and criminal recidivism. Substance abuse, criminal behavior and HIV/AIDS risk behavior are intimately intertwined and the majority of individuals under criminal justice supervision are significantly involved with illicit drugs. The resources to adequately treat substance abusing offenders and reduce HIV/AIDS risk behavior are severely limited. SKILLS is intended to address the critical need for effective and affordable substance abuse treatment in the field of corrections. It takes advantage of modern technology and of the inherent efficiencies of utilizing well designed computer based interactive multimedia to accomplish training in those cognitive behavioral skills which have been shown to help in the reduction of drug relapse and criminal recidivism, and might reasonably be expected to help in reducing HIV/AIDS risk behavior. ? ? ?
