Brief motivational feedback improves post-incarceration treatment contact among veterans with substance use disorders

Abstract

Objectives: To test the efficacy of providing brief motivational feedback to increase post-incarceration substance use disorders (SUD) treatment contact.

Design: Randomized clinical trial (feedback vs. control) with a 2-month post-incarceration follow-up.

Participants: Veterans (N = 73) incarcerated in a county jail system who met SUD diagnostic criteria.

Measures: Baseline assessment included the Addiction Severity Index, the Form-90 assessment of recent alcohol use, and a DSM-IV SUD criteria checklist. The primary outcome was Veterans Administration (VA) appointments. Secondary outcomes were the Addiction Severity Index-Followup and the Treatment Services Review.

Intervention: All participants received baseline assessment. The feedback condition received personalized feedback and encouragement to explore ambivalence about change and treatment in a single interview.

Results: Participants receiving feedback were more likely to schedule appointments at a VA addictions clinic within 60 days of their jail release dates (67 vs. 41%; P < 0.03). Though differences were not statistically significant, more feedback participants attended addictions clinic appointments (47 vs. 32%; ns) and were retained in addictions treatment at 90 days (31 vs. 14%; P < 0.08). Treatment appointments were more likely when intervention occurred close to release. Loss of participants to post-release follow-up interviews was >50%, limiting power to detect significant differences by self-report.

Conclusion: Brief motivational feedback shows promise as a way to link incarcerated individuals to SUD treatment services.