Elison-Davies Sarah, Newsome Jamie, Jones Andrew, Davies Glyn, Ward Jonathan
LifeWorks, Manchester Science Park, Manchester, UK.
REFORM Alliance, New York City, New York, USA.
Health Justice. 2022 Sep 7;10(1):28. doi: 10.1186/s40352-022-00190-w.
Methamphetamine use can be associated with involvement with correctional services and incarceration. Traditionally, treatments for methamphetamine use have been delivered in-person - however, lockdowns initiated during the COVID-19 pandemic significantly reduced access to such in-person support in prisons. Therefore, in May 2020 a digital cognitive-behavioral therapy (CBT) program for substance use disorders - 'Breaking Free from Substance Abuse' - was made available across prisons in Ohio in order to meet this treatment gap. This represents the first time this digital CBT intervention has been made widely available to incarcerated people residing in prisons or jails in the United States (US). This was a within-subjects study using data from 2187 Ohio prison residents who engaged with this digital CBT program to address their methamphetamine use.
Participants reported multiple psychosocial risk factors, including moderate to severe substance dependence, depression and anxiety; interpersonal conflict; aggressive behavior; paranoia; and difficulties with work, education and accommodation. Significant reductions in substance dependence, depression/anxiety and biopsychosocial impairment, and improvements in quality of life, were identified in the sample. Risk factors were associated with less positive outcomes, specifically interpersonal conflict and poor mental health. Completion of specific components of the program were associated with more positive outcomes - a dose response was also identified.
Digital CBT can be delivered in secure US correctional settings and may help to fill unmet needs for in-person treatment. Specifically, this digital CBT program may support incarcerated individuals to address methamphetamine use, with outcomes being associated with psychosocial risk factors and program engagement.
使用甲基苯丙胺可能与涉及惩教服务和监禁有关。传统上，针对甲基苯丙胺使用的治疗是面对面进行的——然而，在新冠疫情期间实施的封锁显著减少了监狱中获得此类面对面支持的机会。因此，2020年5月，俄亥俄州的监狱推出了一项针对物质使用障碍的数字认知行为疗法（CBT）项目——“摆脱药物滥用”，以填补这一治疗缺口。这是该数字CBT干预首次在美国广泛提供给居住在监狱或看守所的被监禁者。这是一项受试者内部研究，使用了2187名参与该数字CBT项目以解决其甲基苯丙胺使用问题的俄亥俄州监狱居民的数据。
参与者报告了多种心理社会风险因素，包括中度至重度物质依赖、抑郁和焦虑；人际冲突；攻击性行为；偏执；以及工作、教育和住宿方面的困难。样本中物质依赖、抑郁/焦虑和生物心理社会损害显著减少，生活质量得到改善。风险因素与不太积极的结果相关，特别是人际冲突和心理健康不佳。该项目特定组成部分的完成与更积极的结果相关——还发现了剂量反应。
数字CBT可以在美国安全的惩教环境中提供，可能有助于填补未满足的面对面治疗需求。具体而言，该数字CBT项目可能支持被监禁者解决甲基苯丙胺使用问题，结果与心理社会风险因素和项目参与度相关。
