Study protocol: a hybrid effectiveness-implementation trial of Moral Reconation Therapy in the US Veterans Health Administration

Daniel M Blonigen, Michael A Cucciare, Christine Timko, Jennifer S Smith, Autumn Harnish, Lakiesha Kemp, Joel Rosenthal, David Smelson, Daniel M Blonigen, Michael A Cucciare, Christine Timko, Jennifer S Smith, Autumn Harnish, Lakiesha Kemp, Joel Rosenthal, David Smelson

Abstract

Background: Moral Reconation Therapy (MRT) is a cognitive-behavioral intervention aimed at reducing risk for criminal recidivism by restructuring antisocial attitudes and cognitions (i.e., "criminogenic thinking"). MRT has empirical support for reducing risk for criminal recidivism among civilian offenders. Recently, a version of MRT was developed for military veterans; however, no randomized controlled trials (RCT) have been conducted with the veteran-specific protocol, and the effectiveness and implementation potential of MRT outside of correctional settings has not been established.

Methods: Using a Hybrid Type 1 RCT design, this study will test the effectiveness of MRT to reduce risk for criminal recidivism and improve health-related outcomes among justice-involved veterans entering mental health residential treatment at three US Veterans Health Administration (VHA) Medical Centers. Upon admission to the treatment program, justice-involved veterans will complete a baseline assessment, be randomized to usual care (UC) or UC + MRT, and be followed 6 and 12 months post-baseline. A process evaluation will also be conducted to identify barriers and facilitators to implementation of MRT in residential treatment.

Discussion: The primary aim of this study is to evaluate the effectiveness of MRT with justice-involved veterans. If MRT proves effective in this trial, the findings can provide large healthcare systems that serve veterans with an evidence-based intervention for addressing criminogenic thinking among justice-involved adults, as well as guidance on how to facilitate future implementation of MRT in non-correctional settings.

Trial registration: This trial is funded by the VA Health Services Research & Development Program (IIR 14-081) and is registered with ClinicalTrials.gov (ID: NCT02524171 ).

Keywords: Effectiveness; Hybrid trial; Implementation; Justice-involved veterans; Moral Reconation therapy; Randomized controlled trial; Veterans health administration.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was granted by the VA Central IRB Review Committee (Study #15–04) on August 7, 2016. All patients recruited for the study will be required to sign a consent form.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. MRT is copyrighted and trademarked by CCI, whose members served as paid consultants on this project. CCI also receives compensation for MRT trainings and sales of MRT workbooks.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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