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Published on: January 20, 2023
Reducing Recidivism After Traumatic Brain Injury: Results From the Re-entry Continuum for Brain Injury (RCBI) Trial
Devan Parrott1, Dawn Neumann2, Anthony Laffoon1
1Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN.
Objectives:
To examine the effects of an intervention (Re-entry Continuum for Brain Injury [RCBI]) designed to support individuals with traumatic brain injury (TBI) pending release from prison. RCBI started about 6 months prior to release. The aims were to examine the impact of RCBI on (1) recidivism up to 3 years postrelease and (2) participants' behavioral infractions, self-efficacy, aggression, negative attributions, and executive functioning while still incarcerated.
Design:
Randomized controlled trial comparing RCBI with treatment as usual (TAU). Assessment times were: time 1 (∼6 months before prerelease); time 2 (near release); time 3 (2 weeks postrelease); and times 3-5 (1, 2, and 3 years postrelease, respectively).
Setting:
Department of Corrections and community setting.
Participants:
Men with TBI who were incarcerated and between 5 and 8 months of release (N=91; RCBI=45; TAU=46).
Interventions:
RCBI intervention teaching brain injury coping skills and anger management while incarcerated, and 12 months of resource facilitation immediately after release.
Main Outcome Measures:
(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), and Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A).
Results:
Compared with 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 postrelease. Behavioral infractions while in prison decreased over time in both groups, but were significantly lower for RCBI participants after the intervention than for TAU participants. After controlling for baseline scores, RCBI participants had significantly better BICS-Q and BRIEF-A outcomes than TAU participants. No differences were observed in AQ or AIHQ outcomes.
Conclusions:
Individuals with TBI are overrepresented in the justice system and susceptible to recidivism. RCBI improved successful community reintegration after incarceration in this TBI sample.
