Reducing Stigma Associated with Substance Use and Criminal Involvement

Stigma creates significant barriers to accessing addiction treatment within the criminal legal system. New research led by Dr. Kelly Moore, and including Portland Psychotherapy’s Jason Luoma, PhD, aims to address this issue by testing a multi-level intervention called CSTARR (Combatting Stigma to Aid Reentry and Recovery). CSTARR involves training for criminal legal system staff to reduce stigmatizing attitudes and group therapy using Acceptance and Commitment Therapy (ACT) for clients to cope with self-stigma.  

The CSTARR staff training focuses on substance use and criminal involvement stigma. It teaches skills for interacting with clients in a more validating way and facilitates contact with a person in recovery who shares their experiences. This is meant to improve staff attitudes and behaviors that can undermine treatment. The ACT groups help clients accept difficult thoughts and feelings stemming from stigma and build skills for staying engaged in meaningful activities despite stigma stressors. 

CSTARR is being tested in Tennessee across court, probation, and treatment staff working with shared clients in a drug recovery court program. Around 70 staff will complete the training and 70 of their mutual clients will engage in the ACT groups. The study will look at how feasible it is to implement CSTARR in real-world legal settings. It will also gather initial data on whether CSTARR impacts important outcomes.   

For staff, the research will analyze if the training changes stigmatizing attitudes, beliefs about treatment, and social distancing from people with criminal records. For clients, it will evaluate whether ACT reduces self-stigma, shame, and isolation while improving efficacy and coping skills. At the systems level, the study will look at impacts on client retention in mandated treatment and legal infractions during the program. 

The results will inform revisions to the CSTARR manual and survey measures. They will also provide key insights into implementing multi-level stigma reduction in criminal legal settings. This research addresses an important gap, as most existing interventions have not focused on substance use and criminal involvement stigma simultaneously or been designed for legal contexts.  

The criminal legal system presents unique challenges for stigma reduction that require creative solutions. People involved in the criminal legal system often face compounded stigma, yet legal settings have historically perpetuated stigmatizing attitudes. Initiatives like CSTARR that recognize the harm of stigma and include contact with people who have lived experience have promise for making these systems more just.  

We are eager to see the results of this groundbreaking work by Dr. Moore and our colleague Dr. Luoma. Findings will elucidate strategies for reducing stigma among staff and clients in incarceration diversion programs. They will also demonstrate whether multi-level approaches that target stigma at public and self-levels can improve legal and recovery outcomes. We hope this spurs broader interest in dismantling unjust societal stigma and increasing access to unbiased, compassionate addiction care. 

Read the full article Here

Recovery from Schizophrenia? Yes, it’s Possible!

If you live in a major city you have probably encountered a person who is dressed strangely, mumbling to himself, not making eye contact, and perhaps pacing back and forth or engaging in some other repetitive behavior. You may have sighed and felt a twinge of sympathy mixed with a sense of resignation, “this person … Read more

The Courage to Survive, Thrive, and Tell About It: Marsha Linehan’s Journey

Marsha Linehan, Ph.D. is easily one of the most influential psychologists of the past thirty years. She is a giant in the field. I remember the first time I met her — she seemed  to eclipse the other, also very prominent psychologists who were sitting next to her. Her presence is powerful and imposing. And … Read more

What Makes Us Unique

Portland Psychotherapy is a clinic, research & training center with a unique business model that funds scientific research. This results in a team of therapists who are exceptionally well-trained and knowledgeable about their areas of specialty.