Desai Alisha, Holliday Ryan, Stimmel Matthew, Borges Lauren M
Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado.
University of Colorado Anschutz Medical Campus, Aurora.
Fed Pract. 2023 Feb;40(2):40-46. doi: 10.12788/fp.0358. Epub 2023 Feb 16.
Justice-involved veterans demonstrate greater mental health and psychosocial needs relative to justice-involved nonveterans and veterans without a criminal history. Veterans treatment courts (VTCs) serve as an alternative to incarceration for veterans whose criminogenic risk is believed to be related to mental health symptoms. Despite observed improvements in functioning and recidivism risk following successful VTC completion, little is known about factors that impede engagement with VTCs. This paper describes a trauma-informed training program that included psychoeducation, skills training, and consultation and was developed for court professionals to facilitate veteran engagement in VTCs.
Needs assessments and court observations informed program development. Based on identified needs, the training incorporated skills from dialectical behavior therapy, acceptance and commitment therapy, and motivational interviewing. Two VTCs in the Rocky Mountain region participated in the pilot trauma-informed training, each lasting about 90 to 120 minutes. Feedback from attendees indicated that the focus on skills training-specifically, managing intense emotions, addressing ambivalence, and approaching sanctions and rewards-was uniquely helpful. The function of posttraumatic stress disorder symptoms and structure of evidence-based treatments were identified as useful educational components.
Veterans Health Administration mental health professionals can serve an important role in facilitating effective practices for professionals working within VTCs. This pilot program provided preliminary support for skills-based training to bolster communication, motivation, distress tolerance, and engagement among veterans court participants. Future directions of this program may include expanding the training into a full-day workshop, conducting comprehensive needs assessments, and examining program outcomes.
与司法系统有涉的退伍军人相比于与司法系统有涉的非退伍军人以及无犯罪记录的退伍军人，表现出更大的心理健康和社会心理需求。退伍军人治疗法庭（VTCs）为那些犯罪风险被认为与心理健康症状相关的退伍军人提供了一种替代监禁的方式。尽管成功完成退伍军人治疗法庭项目后，参与者的功能和再犯风险有所改善，但对于阻碍参与退伍军人治疗法庭的因素却知之甚少。本文描述了一个基于创伤知情的培训项目，该项目包括心理教育、技能培训和咨询，是为法庭专业人员开发的，以促进退伍军人参与退伍军人治疗法庭。
需求评估和法庭观察为项目开发提供了依据。根据确定的需求，培训纳入了辩证行为疗法、接纳与承诺疗法和动机访谈的技能。落基山地区的两个退伍军人治疗法庭参与了创伤知情培训试点，每次培训持续约90至120分钟。参与者的反馈表明，专注于技能培训——特别是管理强烈情绪、处理矛盾心理以及应对制裁和奖励——特别有帮助。创伤后应激障碍症状的作用和循证治疗的结构被确定为有用的教育内容。
退伍军人健康管理局的心理健康专业人员可以在促进退伍军人治疗法庭内专业人员的有效实践方面发挥重要作用。这个试点项目为基于技能的培训提供了初步支持，以加强退伍军人法庭参与者之间的沟通、动机、痛苦耐受性和参与度。该项目未来的方向可能包括将培训扩展为全天的工作坊、进行全面的需求评估以及检查项目成果。
