This paper addresses the question of whether individual violence can be reduced in frequency or severity, if so to what extent and by which methods. It opens with a brief overview of the nature of personal violence and discussion of some key definitional and methodological problems. However, its principal focus is on the findings obtained from a series of meta-analytic reviews of structured programmes for adolescents and adults who have shown repeated aggression or been convicted of personal violence, drawing together the results of studies conducted in prison, probation, youth justice and allied services. Additional results are considered from a systematic review of studies of violence prevention among offenders with mental disorders. This incorporates the preliminary findings of a meta-analysis of controlled trials of psychosocial interventions with that population. Overall, it is concluded that there is sufficient evidence currently available to substantiate the claim that personal violence can be reduced by psychosocial interventions, but that much more research is required to delineate the parameters of effectiveness in this context. Proposals are made for future investigations with reference to the theoretical understanding of causal relationships and the design of experimental trials.
Previous research has suggested that alcohol dependency may be associated with particular cognitive schemas. The objective of this study was to examine the severity of reported maladaptive schemas, and of anxiety and depression levels of an alcohol dependent group prior to and following a period of abstinence, and in comparison with a non-clinical sample. A total of 100 participants, comprising an alcohol dependent clinical (ADC) group (n = 50) and a non-clinical group (n = 50), were recruited. Data were collected on demographic characteristics, drinking patterns, severity of alcohol dependence, depression, anxiety, and maladaptive schemas. ADC participants reported higher levels of depression and anxiety than did the non-clinical group immediately before a period of abstinence. The groups differed significantly on 6 of 15 schema beliefs. Following a brief (3-week) period of abstinence and participation in a psycho-educational program, the ADC group demonstrated significant improvements in relation to depression, anxiety, and 13 out of 15 maladaptive schema beliefs. Further research is required to understand the association and potential relevance of particular schemas to alcohol dependency.
To examine the hypothesis that a demonstration clinic integrating homeless, primary care, and mental health services for homeless veterans with serious mental illness or substance abuse would improve medical health care access and physical health status. A quasi-experimental design comparing a 'usual VA care' group before the demonstration clinic opened (N = 130) and the 'integrated care' group (N = 130). Regression models indicated that the integrated care group was more rapidly enrolled in primary care, received more prevention services and primary care visits, and fewer emergency department visits, and was not different in inpatient utilization or in physical health status over 18 months. The demonstration clinic improved access to primary care services and reduced emergency services but did not improve perceived physical health status over 18 months. Further research is needed to determine generalizability and longer term effects.
Veterans are a significant subpopulation in criminal justice populations, comprising between 9% and 10% of arrestee, jail, prison, and community-supervision populations. In order to address the needs of justice-involved veterans, the U.S. Department of Veterans Affairs (VA) Veterans Justice Programs (VJP) offer services to veterans at multiple points in their involvement in the criminal justice system. Within the context of the VA's national mandate to develop VJP, this article presents best practice case examples using the Sequential Intercept Model as the intervention frame, and discusses each in context of a community psychology framework for innovation dissemination. The case examples demonstrate how central program guidance is adapted locally to meet the national mandate using strategies that fit the local environment, illustrating the innovations in action orientation, boundary spanning, and flexibility of organizations. This review provides examples of creative reinvention that expand on the mandate and work to meet local needs. To optimize services to veterans released from custody or supervised in the community, future study of the implementation of this national mandate should examine all VJP sites to identify the full range of best practices in local program implementation.
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