Justice-Involved Veterans and Moral Reconation Therapy

Approximately 146,000 Veterans are released each year from correctional settings; however,
two thirds will likely reoffend and return to the justice system. Antisocial cognitions and
behaviors are the strongest predictors of reoffending and are highly prevalent among
justice-involved Veterans (JIVs). However, in the absence of treatments with demonstrated
effectiveness with JIVs, no systematic approach to address antisocial cognitions and
behaviors has been implemented in VA. Moral Reconation Therapy (MRT) is a
cognitive-behavioral intervention that aims to reduce antisocial cognitions and behaviors.
MRT has the best empirical support for reducing risk for criminal recidivism among civilian
offenders, and its associated mechanisms (improvements in interpersonal functioning and
impulse control) have been linked to improvements in health-related outcomes that are also
risk factors for recidivism (substance use, mental health, housing, and employment problems).
However, no trials have been conducted with JIVs. Differences between JIVs and
justice-involved civilians (e.g., prevalence of traumatic brain injuries; interpersonal
problems) suggests prior research on MRT with civilians may not be generalizable, and
prompted the VA's Veterans Justice Programs (VJP) and the developers of MRT to develop a
Veteran-specific curriculum of this intervention.

Using the new Veteran-specific manual, the overarching objective of the current proposal is
to implement and evaluate MRT as an intervention to reduce risk for criminal recidivism and
improve health-related outcomes among JIVs in VA Mental Health Residential Rehabilitation
Treatment Programs (MH RRTPs). Using a Hybrid Type 1 design, this project will test the
effectiveness of MRT in a multisite RCT (Palo Alto, Little Rock, and Bedford VAs) and conduct
a formative evaluation to facilitate future implementation of MRT in VA:

Inclusion Criteria:

- Veterans who

- (a) are entering a mental health residential rehabilitation treatment program (MH
RRTP) at one of three study sites (Palo Alto, Little Rock, or Bedford VA), and

- (b) had been arrested and charged and/or released from incarceration in the past
5 years prior to MH RRTP admission will be eligible for participation

Exclusion Criteria:

- The only exclusion criterion is being too cognitively impaired to understand the
informed consent process and other study procedures.