Thomas B. Sease’s research while affiliated with Texas Christian University and other places

Purpose and method: The association between illegal activity and substance use (SU) is prominent in juvenile populations, underscoring the importance of gaining a better understanding about SU treatment as a strategy to reduce recidivism. Youth records (N = 9165) from 12 juvenile justice programs in JJ-TRIALS examined the impact of treatment on the relationship between treatment need and time to recidivism. Results: The 4-step mediation analysis demonstrated: (1) treatment need significantly relates to time to recidivism (p < .0002); (2) treatment need positively predicts treatment length (p ≤ .0001); (3) treatment length positively predicts time to recidivism (p < .0001); and (4), full mediation. Specifically, more treatment significantly predicted a longer time to recidivism such that youth with an identified need receiving treatment (Group A) had a longer time to recidivism than youth with a treatment need who did not receive services (Group B). A survival distribution curve illustrates that 14 % of youth in Group A had a recidivism event during the study, compared to 98 % of youth in Group B. Conclusions: Outcomes point to the benefit of expanded treatment services for youth in juvenile justice. Services include early identification of treatment needs, treatment referrals, and treatment receipt to reduce recidivism risk.

This study investigated the effect of therapeutic community programming and aftercare treatment completion on rearrest rates in the Southwest United States across 25 years. The asymptote of rearrest trajectories did not occur until 10 years post-release, although this varied by risk classification. Treatment receipt was not related to 25-year rearrest trajectories. However, people classified as higher risk were more likely to be rearrested than those classified a low risk while controlling for treatment receipt. Aftercare completion extended the time to arrest; individuals completing an aftercare program were less likely to be arrested, and high-risk participants that completed aftercare showed a similar rearrest trajectory as low-risk participants.

The current study examined the construct of State of Surrender (SoS)—defined as a willingness to accept, without resistance, what is to come—and investigated SoS as a statistical mediator of the relationship between engagement in substance use treatment and meaning in life (MIL). Using a cross-sectional design, participants were 123 people involved with the legal system participating in a 6-month residential treatment program for substance use. Results showed that measures of treatment engagement, including treatment participation, counselor rapport, and peer support, were all positively associated with SoS scores (R²s ≥ 21.16). Moreover, while controlling for time spent in treatment, SoS statistically mediated the positive association between aspects of treatment engagement and MIL. State of Surrender may be a targetable process in substance use treatment that aids in recovery by orienting clients toward what they find meaningful in life. Future directions and practical considerations are discussed.

Loneliness arises when there is a discrepancy between one’s desired and actual social connection with others. Studies examining the effects of loneliness in romantic relationships show that people who are lonely are less satisfied and committed to their romantic relationships. The present study explored the association between loneliness and romantic relationship well-being. Using a cross-sectional design, loneliness was correlated with relationship commitment, trust, and conflict. Relationship awareness, but not relationship distraction, statistically mediated the association between loneliness, relationship conflict, and relationship trust. The indirect effect of loneliness on relationship well-being was only present in people reporting low and medium levels of psychological inflexibility. Implications are discussed for acceptance- and mindfulness-based interventions for persons in romantic relationships.

This study used latent profile analysis to classify legally-involved persons in substance use treatment into mutually exclusive groups based on their clinical presentation of substance use and post-traumatic stress. Predictors of group membership were tested, and group classification was evaluated as a predictor of engagement in substance use treatment. There was a significant amount of variability in substance use and post-traumatic stress symptomatology at the start of treatment. Clients’ symptoms were classified into four groups: (1) high substance use, low trauma, (2) low substance use high trauma, (3) high substance use, high trauma, and (4) low substance use, low trauma. Psychological distress was the primary predictor of group classification and profile membership was differentially related to treatment engagement. Together, these results can be used to inform screening tools, assessment protocols, and adaptive treatment models to better serve people in the legal system experiencing comorbid substance use and post-traumatic stress.

Vulnerability is emphasized in a number of theoretical models of intimacy (e.g., Intimacy Process Model), including from behavioral and contextual behavioral perspectives. Vulnerability is generally defined as susceptibility to harm and involves behaviors that have been historically met with aversive social consequences. From these perspectives, intimacy is fostered when vulnerable behavior is met with reinforcement. For example, interventions have trained intimacy by building skills in emotional expression and responsiveness with promising results. Vulnerability has divergent functions, however, depending on the interpersonal context in which it occurs. Functional intimacy is explored through the lens of functional relations, which play a key role in interpersonal processes of power, privilege, and consent. This conceptualization suggests that vulnerability must be under appetitive functional relations, consensual, and empowered for safe intimacy to emerge. The responsibility to promote appetitive learning of consensual, empowered vulnerability to foster intimacy falls to the person with more power in a particular interaction and relationship. Recommendations are offered for guiding this process.

Justice-involved people with substance use disorders are an at-risk population for health risk behaviors, particularly those related to Human Immunodeficiency Virus (HIV) and other sexually transmitted infections. Risk-reduction programs provide correctional agencies with a practical solution in to reducing HIV-related health risks in justice-involved populations. This study compared two interventions (in-prison, group-based WaySafe with self-adminstered, tablet-based StaySafe for people on probation) to determine whether one intervention was more effective than the other in terms of common outcomes. Multi-level analyses compared effect sizes from outcome studies testing WaySafe and StaySafe. Results showed the interventions had similar effects with regard to measures of HIV Knowledge, HIV Services and Testing, and Risk Reduction Skills. Collectively, this study suggests the StaySafe intervention can be used in situations where the more intensive WaySafe intervention is not feasible and affords correctional agencies the flexibility to implement the curriculum that best meets their organization’s goals and needs.

With the widespread incidence of childhood abuse and neglect, understanding modifiable processes moderating the relationship between Adverse Childhood Experiences (ACEs) and their negative consequences affords researchers and therapists information about appropriate therapeutic targets. Using a cross-sectional design, this study explored the relationship between ACEs and negative automatic thoughts using psychological inflexibility as a moderator. There was a significant 2-way interaction between ACEs and psychological inflexibility when predicting negative automatic thoughts in this sample of college students. When psychological inflexibility was high (1 SD above the mean), ACEs were associated with more negative automatic thoughts. Conversely, the association between ACEs and negative automatic thoughts was non-significant when examined at low levels of psychological inflexibility (1 SD below the mean). In short, psychological inflexibility exacerbated the positive association between childhood adversity and negative automatic thoughts. The current study adds to our understanding of the relation between ACEs and their deleterious outcomes, while supporting the implementation of acceptance-based interventions intended to foster psychological flexibility in the face of childhood adversity.

Adolescent substance use (SU) is associated with risky sex behavior and sexually transmitted infections and is a risk factor for subsequent risky sex decisions. Based on a sample of 1,580 youth in residential SU treatment, this study investigated how a static factor (race) and two dynamic personal factors (risk-taking, assertiveness) contributed to adolescents' perceived ability to avoid high-risk SU and sex behavior (avoidance self-efficacy). Results showed that race correlated with risk-taking and assertiveness, with White youth reporting higher ratings of assertiveness and risk-taking. Self-reported assertiveness and risk-taking also predicted SU and risky sex avoidance. This study underscores the importance of race and personal factors in relation to adolescents' confidence in avoiding high-risk situations.