Therapeutic Outcomes of Changing Lives and Changing Outcomes for Male and Female Justice Involved Persons with Mental Illness

Abstract

Changing Lives and Changing Outcomes (CLCO) was developed to address the unique treatment needs of individuals with co-occurring mental illness and criminogenic risk. Previous evaluations of CLCO demonstrated effectiveness for male participants, but did not examine treatment effectiveness across participant sex. Therefore, the aim of this study was to examine differences in treatment outcomes among male and female probationers receiving CLCO. Participants were assessed pre- and posttreatment. Results indicated positive treatment effects across both psychiatric and criminogenic domains, including psychiatric symptomology and global mental health functioning, medication adherence, attitudes toward mental illness recovery, and antisocial cognitions. Female participants demonstrated enhanced treatment responsiveness relative to males across several domains. This study underscores the effectiveness of the program in addressing both mental health and criminogenic needs in correctional populations, while highlighting the differential impact of the program across participant sex. Implications, future directions, and limitations of the present study are discussed.

Treating women incarcerated in or at-risk of restrictive placements: A statement of the problem and considerations for practice.

“…While most follow-up scores remained below pretreatment scores, the magnitude of these differences was narrower than pre- to post-treatment differences, such that scores at follow-up tended to increase compared to immediate post-treatment. Consistent with other programs targeting criminal thinking (Gaspar et al, 2019; Walters, 2009), reactive styles (i.e., those that are impulsive or reckless) appeared more amenable to treatment than proactive styles (i.e., those that are planful or calculated) and decreases were maintained at follow-up. This finding is noteworthy, as reactive criminal thinking is more predictive of continued offending behavior than proactive (Walters, 2019) and is associated with higher criminal risk (Walters, 2020).…”

Changing criminal thinking: An examination of heterogeneity in treatment effects in a sample of justice-involved persons with dual diagnoses.

“…Results, however, were more varied for criminal thinking, with significant changes in reactive criminal thinking patterns (RCT; i.e., thinking patterns that are more impulsive in nature; d = .59) and nonsignificant results for proactive criminal thinking patterns (PCT; i.e., thinking patterns that are more intentional or planful; d = −.11; Morgan et al, 2014;Walters & Geyer, 2005). These findings were corroborated in a later analysis with a sample of men and women with dual diagnoses on probation who were mandated to treatment within a residential setting (Gaspar et al, 2019). Regardless of gender, results again indicated significant changes in reactive criminal thinking (d = .84) but marginal gains for proactive criminal thinking patterns (d = .001; Gaspar et al, 2019).…”

The relation between the working alliance on mental illness and criminal thinking among justice-involved people with co-occurring mental illness and substance use disorders.

“…We have self-reported mental illness diagnoses for 198 participants, of whom 190 included a diagnosis of at least one serious mental illness (i.e., depression, bipolar, or a psychotic disorder; see Table 1). All treatment recipients participated in a required treatment program, Changing Lives and Changing Outcomes ( CLCO ; Morgan et al, 2017), a psychotherapeutic program shown to significantly reduce criminal thinking and mental illness symptomology among CJ-PMI (see for example Gaspar et al, 2019).…”