A Program Evaluation: Synchronous Online Cognitive Behavioral Intervention

Background and Purpose: Far less prevalent in intervention research for justice involved or other mandated clients (JIOMC) is the advent of synchronous online cognitive-behavioral group intervention (SOC-BGI). Research evaluating SOGI substance use and recidivism outcomes in JIOMC is of great importance for the social work profession. Clinical social workers are the largest group of mental health professionals in America and the frequency of social workers providing substance use and other services in the legal system continues to grow. In addition to using research to inform practice, social work ethics require the evaluation of practice to also inform research. Study Objectives: The purpose of the study was to provide an effectiveness-oriented evaluation regarding the feasibility of SOC-BGI facilitated by licensed clinical social workers. The aims of the study included the evaluation of longitudinal changes in 1) Motivation, 2) Recidivism, and 3) DSM-5 symptoms. Method: The study used a one-group pretest-posttest design with four observations (pretest, posttest, 3-month and 12-month follow-up). A convenience sample was used. To meet inclusion research participants were required to meet the following criteria: 1) Be 18 years of age or older, 2) Experienced some previous legal, academic, occupational or other disciplinary problem stemming from a prior substance use issue that resulted in a mandate for intervention. Exclusion criteria for the study included clients being actively suicidal or being intoxicated at the time of the baseline assessment. Measures included the University of Rhode Island Change Assessment (URICA) Scale, self-reported DSM substance use disorder symptoms, and self-reported and externally validated recidivism. The longitudinal data in the present study was analyzed using a linear mixed model (LMM). Main effects were compared using a Bonferroni adjustment. An additional Bonferroni correction was also made to adjust for type I error associated with multiple dependent variables. Effect sizes were estimated using Hedge’s g. Results: On the URICA Contemplation subscale, from Baseline to posttest, the participants had a statistically significant improvement (p = .004) and a moderate Hedge’s g effect size of -.54. All other pairwise comparisons on the URICA subscales were statistically insignificant. From baseline to 12-month follow-up, there was a significant reduction in self-reported Diagnostic Statistical Manual 5 substance use symptoms (t = 4.68, df = 29, p < .001) and a large effect (Hedges’ g = .84). Of the 30 participants who could be reached via phone, all denied having been arrested following the SOC-BGI. External validation, via searching state-wide court records, showed no arrest for the 30 participants. Conclusions and implications: The findings fill a gap in the forensic social work literature and support the need for more rigorous empirical evaluation. The study findings must be viewed in the context of their limitations. However social workers now have some limited empirical basis for the associations among early OSC-BGI, motivation, and improved 12-month outcomes in reported substance use symptoms and recidivism. Experimental research is needed, as the present study does not allow for causal conclusions to be drawn.