Reducing Recidivism After Traumatic Brain Injury: Results from the Reentry Continuum for Brain Injury (RCBI) Trial.

Abstract

To examine the effects of an intervention (Reentry Continuum for Brain Injury; (RCBI)), designed to support individuals with traumatic brain injury (TBI) pending release from prison. RCBI starts about six- months prior to release. Aims were to examine the impact of RCBI on: 1) recidivism up to 3 years post-release; and 2) participants' behavioral infractions, self-efficacy, aggression, negative attributions, and executive functioning while still incarcerated. Randomized controlled trial (RCT) comparing RCBI to treatment as usual (TAU). Assessments times: Time 1 (∼ 6 month from pre-release); Time 2 (near release); Time 3 (2 weeks post-release); and Times 3, 4, and 5 (1, 2, and 3 years post-release, respectively). Department of Corrections and Community setting. Males with TBI who were incarcerated and between eight and five months of release (n=91; RCBI=45; TAU=46). RCBI teaches brain injury coping skills and anger management while incarcerated, and 12-months of Resource Facilitation immediately following release. 1) Recidivism (reincarceration, arrests, and criminal charges) 2) Brain Injury Coping Skills Questionnaire (BICS-Q; self-efficacy; 3) Aggression Questionnaire (AQ); Ambiguous Intentions Hostility Questionnaire (AIHQ); Behavioral Rating Inventory of Executive Function-Adult Version (BRIEF-A). Compared to TAU, RCBI participants had significantly lower rates of returning to prison (46% vs 17%), arrests (86% vs 43%), and criminal charges resulting in prison or jail time (79% vs 42%) 3 years post-release. Behavioral infractions while in prison decreased over time for both groups but were significantly less for RCBI participants after the intervention compared to the TAU arm. While controlling for baseline scores, the RCBI arm had significantly better BICS-Q and BRIEF-A outcomes compared to TAU participants. No differences were observed on the AQ or AIHQ. Individuals with TBI are overrepresented in the justice system and susceptible to recidivism. RCBI improved successful community re-integration following prison in this TBI sample.