A randomized controlled trial of a Group psychological intervention to increase locus of control for alcohol consumption among Alcohol‐Misusing Short‐term (male) Prisoners (GASP)

Abstract

Background and aim Reducing alcohol misuse by male prisoners is an important global issue. Control of drinking behaviour could be a useful target for intervention in this population, and locus of control could be a causal factor in this. We aimed to assess the effect of a clinical psychologist‐facilitated group intervention on male prisoners’ locus of control of drinking behaviour. Design A two‐arm, single‐site, open, randomized controlled trial. Setting A category B local training prison in South Wales, housing about 770 mainly sentenced men. Participants Prisoners serving less than 2 years who met inclusion criteria for pre‐imprisonment alcohol misuse, alone or with drug misuse. A total of 119 were allocated to the intervention arm and 119 to the control arm; 104 and 87, respectively, completed the post‐randomization baseline interview and 68 and 60 completed a second interview approximately 4 weeks later, respectively, after intervention or treatment as usual (TAU) alone. Intervention Nine clinical psychologist‐facilitated groups in the prison over 3 weeks. Range of participants per session was one to seven, with three to five most usual. Measures The primary outcome was locus of control of behaviour (LCB); secondary outcomes included mental state generally (comprehensive psychiatric rating scale/CPRS) and specifically (Beck Depression Inventory/BDI). An integral process evaluation was conducted. Findings LCB scores decreased during the study, but without significant intervention effect [−1.7, 95% confidence interval (CI) = –5.1 to 1.6, P = 0.329]. Change among completers in the control group was from a mean score of 37.4 [standard deviation (SD) = 10.0] to 33.7[SD = 11.7] and in the intervention group from 37.4 (SD = 11.6) to 31.9 (SD = 11.8). Secondary outcomes, including change in mental state, did not differ between arms, but 686 (64%) sessions were lost, most because of ‘prison issues’. Conclusions A clinical psychologist‐facilitated group intervention did not have a statistically significant effect on sense of control of drinking behaviour among men with pre‐imprisonment alcohol misuse serving less than 2 years in a South Wales prison. The study proved coterminous, however, with 40% prison staff cuts which seem likely to have contributed to the high loss of group sessions and possibly overwhelmed any treatment effect. Intervention completion failures, previously cited as harmful, had no effect here, so the trial should be repeated when the prison climate improves.

Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review

“…The sample size of the participants in the included studies ranged from 34 to 759. Twenty studies were conducted in high-income countries (USA 10, 18 , 19 , 21 – 28 UK 3, 29 – 31 Netherlands 1, 32 Norway 1, 33 Spain 2, 34 , 35 China 2, 36 , 37 and Sweden 1 38 ; one study was conducted in an upper-middle-income country Malaysia). 39 There were no studies that were conducted in middle-income or lower- income countries.…”

“…The intervention group underwent different therapies such as motivation enhancement therapy (MET), 17 , 18 , 21 , 28 , 40 seeking safety program, 41 cognitive behavior therapy (CBT), 42 interpersonal therapy (IPT), 25 acceptance and commitment therapy (ACT), 34 , 35 cognitive behavioral suicidal prevention therapy (CBSP), 43 group interpersonal psychotherapy, 24 , 44 music therapy, 33 , 37 art therapy, 36 group psychological intervention, 31 and mindfulness-based relapse prevention intervention. 27 The average duration of intervention in the studies ranged from 10 min to 120 min, with the frequency of sessions being one per week to six per week across one month to six months.…”

Resilience-Related Resources Predict Physicians’ Fatigue, Job Search Behavior, and Productivity Outcomes

“…36 Although CSEs have received less attention in the occupational health literature, meta-analytic reviews also have established the components of CSE as predictors of burnout, 26 and other research has shown that each of the components of CSE may be influenced by interventions. [37][38][39][40] The Present Study Because CSE, optimism, and mindfulness are conceptually related indicators of dispositional resilience, we sought to assess the relative contribution of each of these characteristics to predicting occupational health outcomes. We investigated five outcomes that reflect three important components of EM physicians' work experiences: fatigue, turnover intentions, and productivity.…”

“…Not surprisingly then, high CSE individuals also tend to perform better and have more positive perceptions of their work environment 36 . Although CSEs have received less attention in the occupational health literature, meta-analytic reviews also have established the components of CSE as predictors of burnout, 26 and other research has shown that each of the components of CSE may be influenced by interventions 37–40 …”