OBJECTIVE Moral reconation therapy (MRT) is a cognitive-behavioral intervention to reduce risk for criminal recidivism. Despite being implemented widely in correctional settings, there are no randomized controlled trials of MRT, and its effectiveness for reducing recidivism among justice-involved adults in noncorrectional settings is unknown. METHOD In a pragmatic trial, 341 justice-involved patients (95.3% male; 57.8% White/non-Hispanic) admitted to one of three mental health residential treatment programs were randomly assigned to usual care (UC) or UC plus two MRT groups per week for 12 weeks. Follow-ups were conducted at 6- and 12-month postbaseline (71.3% and 74.8% retention, respectively). Primary outcomes were criminal thinking and criminal associates. Secondary outcomes were legal problem severity, days incarcerated in the past 30, rearrested/charged (per official records), substance use, and employment and family/social problems. The study design, analysis, and outcomes were preregistered (ClinicalTrials.gov; ID: NCT02524171). RESULTS Patients in both conditions improved over time on most outcomes. In intent-to-treat analyses, the rate of change in outcomes over time did not differ by condition, nor did the prevalence of being rearrested and charged within 1 year of baseline (UC = 20.2%, MRT = 24.9%; OR = 1.14; 95% CI [0.67, 1.94], p = .63). MRT engagement was low; 37% of those randomized to MRT received a minimum dose-that is, completed at least Step 3. In per-protocol analyses, this subgroup, relative to UC, improved more on criminal associates, days incarcerated, legal problem severity, and alcohol use severity. CONCLUSIONS In this study, MRT was not more effective than UC at reducing recidivism risk for patients in mental health residential treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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一项关于道德重建疗法的随机对照试验，旨在降低心理健康住院治疗中涉及司法的成年人的再犯风险。

目的 道德修复疗法 (MRT) 是一种认知行为干预，旨在降低再犯风险。尽管在惩教环境中广泛实施，但没有 MRT 的随机对照试验，其在非惩教环境中减少参与司法的成年人再犯的有效性尚不清楚。方法 在一项实用性试验中，341 名涉及司法的患者（95.3% 男性；57.8% 白人/非西班牙裔）被随机分配到三个心理健康住院治疗计划之一的常规护理 (UC) 或 UC 加两个 MRT 组每周 12 周。在基线后 6 个月和 12 个月进行随访（保留率分别为 71.3% 和 74.8%）。主要成果是犯罪思维和犯罪同伙。次要结果是法律问题的严重程度、过去 30 天内被监禁的天数、重新逮捕/起诉（根据官方记录）、物质使用、就业和家庭/社会问题。研究设计、分析和结果已预先注册（ClinicalTrials.gov；ID：NCT02524171）。结果 两种情况下的患者在大多数结果上都随着时间的推移而改善。在意向治疗分析中，随着时间的推移，结果的变化率没有因病情而异，基线 1 年内再次被捕和被起诉的发生率也没有差异（UC = 20.2%，MRT = 24.9%；OR = 1.14 ；95% CI [0.67，1.94]，p = .63）。捷运参与度低；37% 的随机接受 MRT 的人接受了最低剂量——即至少完成了第 3 步。在符合方案分析中，相对于 UC，该亚组在犯罪同伙、监禁天数、法律问题严重性和饮酒方面改善更多严重性。结论 在这项研究中，在降低心理健康住院治疗患者的再犯风险方面，MRT 并不比 UC 更有效。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。