Although mandated substance abuse treatment within criminal justice systems has been shown to be successful in reducing relapse and recidivism, there remains a substantial need for improvement in effectiveness and efficiency. The 5-year NIDA-funded project, Cognitive Enhancements for Treatment of Probationers (CETOP) is helping to address this need by examining the effects of incorporating cognitive enhancements into the 140-bed (90 male and 50 female) Tarrant County Substance Abuse Treatment Facility (SATF). This facility provides 4 months of residential treatment and 3 months of aftercare to 420 probationers per year using a modified therapeutic community approach. Because treatment readiness is critical to treatment success, and because mandated participants are often at a low level of readiness, one part of CETOP has been the development and evaluation of an 8-hour group-oriented treatment induction unit. Although our research indicates that it was a qualified success, feedback from counselors, probationers, and observers has given us the basis for extending and improving our inquiry into readiness enhancement. In the proposed continuation, we will develop a readiness for treatment curriculum in which our most successful induction elements (supplemented by other proven techniques) will be organized into two independent modules: Treatment Motivation and Cognitive Skills. This revision will lead to greater administration flexibility: The modules can be used separately or jointly, and can be employed multiple times to maintain client readiness over the duration of treatment. The objectives of the proposed continuation are to determine the benefits from administering each module individually, both modules in combination, and from a repetition of either module later in treatment. Benefits during treatment will be measured in terms of individual and therapeutic community engagement and progress. Benefits during treatment will be measured by progress in aftercare and by urinalysis results. Three major study phases involving approximately 1400 probationers will be conducted over a 5-year period. Across all phases, individual characteristics at intake will be used to identify subgroups that exhibit different readiness patterns across treatment and subgroups that benefits differentially from the various module administration approaches. Training manuals and protocols will be prepared for transfer to other settings.
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