A review of treatment programs for offenders with co-occurring addictive and mental disorders: support for booster interventions

Background: Treatment interventions are essential in supporting psychosocial skills, health promotion and successful reintegration to community living for incarcerated persons. Booster interventions are presumed to be important methods for maintaining the effects of treatment effects for persons with addiction and mental disorders, but there has been remarkably little empirical attention to this assumption. Objectives: This review aims are: (1) to describe existing literature on treatment programs for offenders with addiction and mental disorders in the reentry process, and, (2) to add to the literature on this topic by evaluating the impact of booster interventions upon maintenance of treatment effects and outcomes - specifically, a reduction in symptoms, reduced substance abuse, medication adherence, coping, independent functioning and decreased depressive symptoms. Methods: Electronic databases were searched for systematic reviews from January 2004 through January 2014 to include: CINAHL PubMed, and PsycINFO using selected keywords. Inclusion criteria were adult offenders, a treatment intervention in prison, jail, or forensic psychiatric hospital with a reentry focus for offenders with addiction and mental disorder. The AMSTAR was utilized to assess quality of the reviews. Results: Three systematic reviews were identified to examine treatment interventions for offenders with addiction and mental disorders. Little empirical evidence is available to demonstrate the contribution of booster interventions to overall treatment effects among justice-involved persons. Conclusion: Although evidence is not available, clinically it seems reasonable to expect booster interventions for offenders to reinforce treatment gains, strengthen self-care skills, and manage symptoms. Implications: Research designed specifically to study booster interventions are needed. Keywords: offender reentry, correctional institutions, offenders, treatment programs, mental illness, booster program

A Case Study using the Biopsychosocial Vulnerability-Stress Model as a framework to understand the incarceration experience

In the United States, the Center for Disease Control estimates that about 80% of incarcerated inmates have a substance abuse problem. More than one fourth of inmates are in prisons because of drug related arrests. Additionally, many inmates have cooccurring mental illness disorders as well as health related issues. A multiple (four) case study design was used to explore the association between co-occurring diagnoses, antisocial traits and challenging behaviors within the incarcerated population. The analysis revealed that the four co-occurring diagnoses studied did contribute to poor health outcomes. Study findings suggest that there is a great need to create services within the Department of Correction to assist inmates with co-occurring mental illness and substance abuse for improved health outcomes

A Booster Intervention in a Connecticut Correctional Institution: A Pilot Study

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A review of treatment programs for offenders with co-occurring addictive and mental disorders: support for booster interventions

Background: Treatment interventions are essential in supporting psychosocial skills, health promotion and successful reintegration to community living for incarcerated persons. Booster interventions are presumed to be important methods for maintaining the effects of treatment effects for persons with addiction and mental disorders, but there has been remarkably little empirical attention to this assumption. Objectives: This review aims are: (1) to describe existing literature on treatment programs for offenders with addiction and mental disorders in the reentry process, and, (2) to add to the literature on this topic by evaluating the impact of booster interventions upon maintenance of treatment effects and outcomes - specifically, a reduction in symptoms, reduced substance abuse, medication adherence, coping, independent functioning and decreased depressive symptoms. Methods: Electronic databases were searched for systematic reviews from January 2004 through January 2014 to include: CINAHL PubMed, and PsycINFO using selected keywords. Inclusion criteria were adult offenders, a treatment intervention in prison, jail, or forensic psychiatric hospital with a reentry focus for offenders with addiction and mental disorder. The AMSTAR was utilized to assess quality of the reviews. Results: Three systematic reviews were identified to examine treatment interventions for offenders with addiction and mental disorders. Little empirical evidence is available to demonstrate the contribution of booster interventions to overall treatment effects among justice-involved persons. Conclusion: Although evidence is not available, clinically it seems reasonable to expect booster interventions for offenders to reinforce treatment gains, strengthen self-care skills, and manage symptoms. Implications: Research designed specifically to study booster interventions are needed. Keywords: offender reentry, correctional institutions, offenders, treatment programs, mental illness, booster program

Core curricular priorities for professional development of nurses in correctional systems: a Delphi study

Objective: To identify the core curricular elements to assure competency and professional development of registered nurses working with justice-involved populations. Background: Numerous assessments of education priorities have been articulated for nurses working with patients who interface with justice systems. But no consensus of what comprises the core elements of a curriculum for nurses employed by justice systems has been published. Guidance from correctional nurse education experts is needed. Design: A web-based Delphi survey methodology was used. Three de-identified surveys were sent to academic and clinical correctional nurse educators two weeks apart by email following an invitation and voluntary agreement to participate. An IRB waiver was sought and obtained. Setting and participants: Expert educator participants were identified through internet searches of publications, grants and referrals. Participants include 14 nurse academicians who teach correctional health topics, 5 clinical nurse educators employed in correctional settings across the US, and 1 international academician. Results: Thirteen core curricular elements were identified, prioritized and clustered under sub-headings of knowledge, attitudes, and skills. Two types of programming were identified: professional development for new nurses entering correctional systems; and, maintenance of clinical competency. Use of evidence-based educational materials were identified as important. Conclusion: There is consensus that a core curriculum is needed to bring standardization to educational programming for correctional nursing. Identification of a core curricula is a fundamental step toward recognition of the professional expertise required in this forensic nursing sub-specialty. Targeted competency development curricula can reduce costs associated with high rates of attrition, delayed readiness for clinical service, poor quality of care and high error rates and missed care omissions

Using Simulation With Nursing Students To Promote Affirmative Practice Toward The Lesbian, Gay, Bisexual, And Transgender Population: A Multisite Study

AIM The aim of this research was to evaluate the impact of a transgender simulation on nursing students\u27 affirmative practice when caring for a transgender person. BACKGROUND There is a paucity of research that assesses the attitudes of nursing students toward lesbian, gay, bisexual, and transgender (LGBT) persons and a deficit in nursing curricula regarding LGBT content. METHOD A nonexperimental, pretest-posttest design was used to evaluate nursing students\u27 affirmative practice when caring for a transgender patient using the Gay Affirmative Practice Scale. RESULTS A Wilcoxon signed-rank test revealed a statistical significance in Gay Affirmative Practice scores after the simulation with a small effect size. These results suggest that the transgender simulation supported nursing students\u27 attitudes and affirmative practice when providing nursing care to a transgender person. CONCLUSION Experiential learning in nursing education is an effective approach to teach cultural competence and sensitivity in caring for vulnerable populations

Using Simulation To Address Care Of The Transgender Patient In Nursing Curricula

This descriptive study explored the use of simulation as a means to increase cognitive and reflective practice as well as determining if simulation can alter perceptions and attitudes related to the lesbian, gay, bisexual and transgender (LGBT) community. This manuscript describes how student nurses perceive their role when providing care to and, more specifically, the care of transgender patients. The research question asks: How does a transgender simulation impact the attitudes and beliefs of nursing students related to the LGBT community? One-hundred and fifty-nine students, with a subset of 120 students attending a school in central Florida and 50 students attending a Connecticut programme, participated in the completion of the instruments. The Gender Affirmative Practice (GAP) scale was used to evaluate their attitudes and practice concerning LGBT issues. Findings suggest that the majority of the students rarely or never discuss pertinent sexual orientation issues. Students are not comfortable creating a climate that allows for self-identification by gay/ lesbians, despite admitting to being open and accepting the LGBT community with their faculty. Limitations were based on multisite location and the use of the GAP. It is important for nursing students, and healthcare providers, to acknowledge and recognise the unique vulnerabilities of transgender persons who are seeking healthcare. The exposure to transgender individuals in a clinical setting may be limited; therefore, the use of simulation will offer the opportunity to examine their beliefs and reflect on their attitudes towards this population. Simulation incorporating mental health issues is a newer training technique in which psychosocial aspects of healthcare are addressed

Enhancing Empathy in Undergraduate Nursing Students: An Experiential Ostomate Simulation.

aim The aim of this study was to implement and evaluate an experiential learning simulation created to enhance nursing students\u27 empathy during patient care encounters. background The investigators proposed that an ostomy simulation experience would be an efficient method for providing this educational content. method Content analysis was conducted on essays using Krippendorff\u27s technique to quantify the simulation. results Each unit of measure, or paper, contained between 1 to 14 empathie comments. Of the total sample, 22.8 percent had three or five empathie comments; 10 percent had four, and 9 percent had six or more comments per paper. Eighty-five percent of participants felt this simulation experience was beneficial for enhancing empathy in clinical practice. conclusion The assignment was an effective, objective method that utilized simulation to teach empathy to baccalaureate nursing students

Significance of self-care management as persons prepare to reintegrate into the community.

Introduction Persons reentering the community after incarceration often confront a range of challenges that influence their ability to engage in self-care. This study sought to gain insight and understanding of how persons recently released from an incarceration experience perceive their preparedness for reentry and how this affects their ability to engage in self-care management.Method Using focus group methodology, four male, two female, and one mixed focus groups (N = 31) were held at a syringe access program, a medication-assisted recovery clinic, and a postincarceration support service. The Rediscovery of Self-Care (RSC) model served as the framework. The a priori RSC constructs guided data analysis.Findings Participants defined self-care as basic hygiene, eating well, engaging with family, and managing mental health and their substance use issues. Depending on the interview location, self-care also included using clean injection materials, taking prescribed medications, or adhering to treatment programs. Reported challenges to self-care included transportation, substance addiction, job and housing instability, and mental illness. Our results indicate that there is value in applying the RSC model to guide nursing interventions in promoting self-care for persons with an incarceration experience.Conclusion There is a need for reskilling, especially pertaining to sober environments, mental health services, syringe access programs, and continuity of care. Self-care ability, self-efficacy, motivation, sense of internal control, and social support were identified as critical to the successful transition to full reentry after incarceration