1. Funding by a grant to Texas Christian University (R01DA025885, W.E.K. Lehman, Principal Investigator) from the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency. CRIMINAL THINKING AND WAYSAFE Aaron Cherry, M.S. INSTITUTE OF BEHAVIORAL RESEARCH TEXAS CHRISTIAN UNIVERSITY

2. INTRODUCTION Treatment components such as Engagement are related both to positive treatment outcomes as well as WaySafe performance Criminal Thinking has a negative relationship to important treatment components The current study evaluated the relationship of Criminal Thinking with performance in the WaySafe intervention

3. CRIMINAL THINKING Cognitions and attitudes related to the initiation and maintenance of criminal behavior  Justification  Criminal Rationalization  Personal Irresponsibility  Entitlement  Power Orientation  Cold Heartedness Cognitive Distortions Criminal Attitudes

4. TREATMENT COMPONENTS INFLUENCED BY CRIMINAL THINKING Treatment Engagement refers to an individual’s active involvement in the treatment process measured by program participation and therapeutic alliances. Engagement Scales Treatment Participation Treatment Satisfaction Counselor Rapport Peer Support

5. (-) CURRENT STUDY Criminal Thinking Waysafe Performance Treatment Engagement (-) (+) We hypothesized that Criminal Thinking would have a negative relationship with WaySafe Performance, but that these influences would be mediated by Treatment Engagement

6. STUDY MEASURES WaySafe performance WaySafe performance HIV Knowledge Confidence HIV Knowledge Confidence Avoiding Risky Sex Avoiding Risky Sex Avoiding Risky Drug Use Avoiding Risky Drug Use HIV Testing Awareness HIV Testing Awareness Risk Reduction Skills Risk Reduction Skills Criminal Thinking Criminal Thinking – Composite measure (alpha =.80) Treatment Engagement Treatment Engagement – Composite measure (alpha =.88)

7. CRIMINAL THINKING’S RELATIONSHIP TO WAYSAFE PERFORMANCE Criminal Thinking HIV Knowledge Confidence Treatment Engagement HIV Knowledge Confidence Path C -.173*** Path A -.339*** Path B.200*** Path C’ -.130** p <.05* p <.01** p <.001*** Note: Sobel test indicated significant mediation

8. CRIMINAL THINKING’S RELATIONSHIP TO WAYSAFE PERFORMANCE Criminal Thinking Avoiding Risky Sex Treatment Engagement Avoiding Risky Sex Path C -.127*** Path A -.339*** Path B.209*** Path C’ -.057 p <.05* p <.01** p <.001*** Note: Sobel test indicated significant mediation

9. CRIMINAL THINKING’S RELATIONSHIP TO WAYSAFE PERFORMANCE Criminal Thinking Avoiding Risky Drug Use Treatment Engagement Avoiding Risky Drug Use Path C -.130*** Path A -.339*** Path B.104** Path C’ -.095* p <.05* p <.01** p <.001*** Note: Sobel test indicated significant mediation

10. CRIMINAL THINKING’S RELATIONSHIP TO WAYSAFE PERFORMANCE Criminal Thinking HIV Testing Awareness Treatment Engagement HIV Testing Awareness Path C -.093** Path A -.339*** Path B.123*** Path C’ -.061 p <.05* p <.01** p <.001*** Note: Sobel test indicated significant mediation

11. CRIMINAL THINKING’S RELATIONSHIP TO WAYSAFE PERFORMANCE Criminal Thinking Risk Reduction Skills Treatment Engagement Risk Reduction Skills Path C -.125*** Path A -.339*** Path B.168*** Path C’ -.075* p <.05* p <.01** p <.001*** Note: Sobel test indicated significant mediation

12. CONCLUSION Individuals higher in engagement performed better in the WaySafe intervention. Criminal Thinking was negatively related to WaySafe performance. This relationship was mediated partially or fully by treatment engagement. Reducing Criminal Thinking appears to be important for a variety of treatment processes including the WaySafe Intervention. Although women tended to score lower in Criminal Thinking, there were no gender differences in the strength or direction of the relationship between Criminal Thinking and WaySafe performance. Future research should evaluate which Criminal Thinking dimensions are most amenable to change in order to reduce its negative influence on interventions such as WaySafe.