Advanced cognitive treatment services (ACTS) associated with significant reduction in substance abuse in ex-offenders

Background: The Montgomery County Office of Ex-Offender Reentry collaborated with the Substance Abuse Resources and Disability Issues Program in the Boonshoft School of Medicine at Wright State University and 12 community organizations that serve ex-offenders to deliver an intensive 10-week program called Advanced Cognitive Treatment Services (ACTS). Based on the evidence-based Thinking for a Change intervention, ACTS is a 300-hr cognitive-behavioral therapy program focused on cognitive restructuring, social-skills development, and development of problem-solving skills. In addition, community organizations offered peer support, case management, SUD treatment, housing, child support, education and employment services. Methods: Ninety-one ex-offenders (79 male; 46 high-risk and 45 moderate-risk for re-offending) were randomly assigned to the ACTS treatment group or a control group within a week of reentry. Before and immediately after the 10-week treatment period, the voluntary participants completed the Drug Abuse Screening Test (DAST), Satisfaction with Life Scale (SWLS), Symptom Distress Scale (SDS), and the AUDIT. ANOVAs were conducted to compare test scores for high- and moderate-risk ex-offenders in the treatment and control groups. Results: DAST and SDS scores were significantly reduced for ex-offenders following the ACTS treatment, compared to controls. Significant interactions indicated that high-risk ex-offenders in the ACTS group were positively affected by the intervention, compared to high-risk ex-offenders in the control group whose scores significantly worsened over time. Conclusions: ACTS appeared to play a positive role in reducing drug abuse problems, especially for high-risk ex-offenders. Reductions in DAST scores were associated with improvements in SWLS and SDS scores and reduced recidivism rates.