Brief Motivational Intervention for Substance Use may Decrease Violence Among Heavy Alcohol Users in a Jail Diversion Program

• Author: Sean M. Mitchell,Kenneth R. Conner,Marc T. Swogger,Katie Dhingra,Imogen Catterall
• DOI: 10.1177/0093854820958747
• Published date: 01 March 2021
• Date: 01 March 2021
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2021, Vol. 48, No. 3, March 2021, 274 –292.

DOI: https://doi.org/10.1177/0093854820958747

Article reuse guidelines: sagepub.com/journals-permissions

© 2020 International Association for Correctional and Forensic Psychology

274

BRIEF MOTIVATIONAL INTERVENTION FOR

SUBSTANCE USE MAY DECREASE VIOLENCE

AMONG HEAVY ALCOHOL USERS IN A JAIL

DIVERSION PROGRAM

IMOGEN CATTERALL

Leeds Beckett University

SEAN M. MITCHELL

University of Rochester Medical Center

Texas Tech University

KATIE DHINGRA

Leeds Beckett University

KENNETH R. CONNER

MARC T. SWOGGER

University of Rochester Medical Center

Rates of harmful alcohol use are high among justice-involved individuals and may contribute to violent recidivism. Robust

treatments for alcohol-related violence in criminal justice systems are thus a public health priority. In this analysis of existing

randomized controlled trial data (N = 105), we examined the impact of a brief motivational intervention (BMI) for harmful

substance use on violent recidivism among individuals in a pretrial jail diversion program. Results indicated that, after con-

trolling for violence history, the intervention’s impact on violent recidivism was moderated by baseline harmful alcohol use.

Specifically, among people with severe alcohol problems at baseline, the BMI + standard care group had less violent

recidivism at a 1-year follow-up than participants randomized to standard care alone. This finding was unchanged when we

accounted for psychopathic traits. Our study provides preliminary evidence that a BMI may be useful for decreasing violent

recidivism among heavy drinkers in criminal justice systems.

Keywords: brief motivational intervention; violence; alcohol; substance use; aggression

ALCOHOL USE AND VIOLENCE

The complicated relation between alcohol consumption and violence has been acknowl-

edged since at least the 4th century BC (Bellis & Hughes, 2011), and this has now been

corroborated in numerous, disparate populations (Graham & Livingston, 2011). Alcohol’s

AUTHORS’ NOTE: We have no known conflict of interest to disclose. This work was supported by the

National Institute on Drug Abuse to Marc T. Swogger (R01 DA059940) and the National Institute of Mental

Health (T32 MH020061; L30 MH120575). We would like to thank Angela Fauth for her help with preparing

this manuscript. Correspondence concerning this article should be addressed to Marc T. Swogger, Department

of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Box Psych, Rochester, NY 14642;

e-mail: Marc_Swogger@URMC.Rochester.edu.

958747CJBXXX10.1177/0093854820958747Criminal Justice and BehaviorCatterall et al. / Short Title

research-article2020

Catterall et al. / BMI FOR SUBSTANCE USE MAY DECREASE VIOLENCE 275

causal and indirect relations to violence are now well established (Duke et al., 2018). Binge

drinking leads to disinhibition and narrowed attention, which may result in violence among

at-risk individuals (Giancola et al., 2012). Moreover, harmful alcohol use is related to

reduced serotonergic function, which also underlies tendencies toward negative emotionality

and violence (Comai et al., 2016; Driscoll et al., 2017; Heinz et al., 2011). Alcohol con-

sumption increases the occurrence of general and intimate partner violence and can lead to

escalating severity in already violent situations (Cafferky et al., 2018; Shorey et al., 2014;

Swogger et al., 2010), making harmful alcohol use a key, modifiable risk factor that can be

targeted in violence prevention efforts (Leonard & Quigley, 2017; Testa et al., 2014). In the

present study, we tested the hypothesis that, for people with harmful alcohol use, a brief

motivational intervention (BMI) will reduce violent recidivism.

ALCOHOL USE AND VIOLENT OFFENDING AND RECIDIVISM

Alcohol consumption may, in part, account for high violent recidivism rates among people

involved in criminal justice systems; nearly 70% of individuals released from incarceration

are rearrested within 3 years (Bronson et al., 2017). In the United States, approximately

20% of individuals released from prison are rearrested for violent crimes within 3 years

(Alper et al., 2018). Rates of harmful alcohol use are significantly higher within criminal

justice samples than in general population samples (United Nations Office on Drugs and

Crime, 2017). Between 55% and 75% of justice-involved people in the United States and

United Kingdom screen positive for an alcohol use disorder (Newbury-Birch et al., 2016;

Orr et al., 2015; Parkes et al., 2011) compared with 5% to 25% in general adult community

samples (Fazel et al., 2006; Newbury-Birch et al., 2009). Approximately 37% of individuals

who are incarcerated in jail who were arrested for violent crimes report that they used alco-

hol at the time of their offense (Snyder et al., 2010). It is clear that harmful alcohol use is a

relevant problem and treatment target for reducing violence among individuals involved in

criminal justice systems. Without treatment, justice-involved individuals with harmful alco-

hol use often repeat the same behaviors that resulted in their prior involvement with crimi-

nal justice systems (Felson & Staff, 2010). This highlights the importance of creating and

testing treatments for justice-involved people who engage in harmful alcohol use to break

the alcohol–violence–incarceration cycle.

BMI FOR ALCOHOL USE AMONG JUSTICE-INVOLVED PEOPLE

There are several evidence-based treatments for individuals with harmful alcohol use.

Twelve-step facilitation therapy, which aims to overcome barriers to participation in absti-

nence-based groups (e.g., Alcoholics Anonymous), has empirical support (Kaskutas et al.,

2009). Many behavioral therapies, including contingency management, cognitive behav-

ioral therapy, and third-wave behavioral therapies (e.g., acceptance and commitment ther-

apy), have amassed support for decreasing alcohol use (Byrne et al., 2019; Carroll &

Kiluk, 2017; Shelton et al., 2011; Tomlinson, 2018). However, such interventions often

require considerable time and training, hindering their application in forensic settings

(Berzins & Trestman, 2004). As Kazdin and Blase (2011) note, the real-world impact of

these more intensive behavioral interventions may well be moderated by their cost-effec-

tiveness. These more intensive behavioral treatments are sometimes mandated in criminal