Program Profile: Daily Automated Telephony With a Brief Cognitive Intervention for Persons on Parole (Sweden)

This was an automated telephony program designed for those recently paroled in Sweden that provided immediate feedback to participants and sent daily reports to their parole officers. The program is rated Promising. Treatment group participants reported statistically significantly less alcohol use, drug use, and internalizing behaviors at the 1-month follow-up, compared with control group participants.

A Promising rating implies that implementing the program may result in the intended outcome(s).

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals/Target Population

Common risk factors that individuals face following release from prison that could increase their risk of recidivism include stress, substance abuse cravings, and avoidance-oriented coping strategies (Phillips and Lindsay, 2011). The Daily Automated Telephony With a Brief Cognitive Intervention was a program in Sweden that used automatic telephone calls to monitor and intervene on the daily development of recently paroled individuals’ dynamic risk factors associated with recidivism. The program aimed to ease the process of reentry for those on parole through a brief cognitive intervention that involved feedback based on participants’ responses to certain questions they were asked during the telephone call. The goal was to reduce negative behavior and risk factors for recidivism, such as alcohol and drug use. This program was targeted at individuals who were recently paroled, as research suggests the immediate reentry period is important for both short- and long-term success (Vasiljevic et al., 2017).

Program Components

The first part of the program was a daily automated assessment (by a telephone call) of the recently paroled individual. A central computer was programmed to perform two attempts to reach a participant by phone each hour from noon to 9 p.m. every day, until the phone call was answered. Assessments were designed to be brief and asked the participant to rate themself on different measures of stress, alcohol and drug use, and mental health using their telephone keypad.

Following this assessment, the next part of the program was the brief cognitive intervention. The intervention included four steps: 1) calculation of the current result; 2) feedback on the current result; 3) confirmation of the current result; and 4) recommendation. For Step 1, feedback and recommendation were automatically provided to participants based on their responses to the assessments. This feedback calculated how the assessment compared with previous assessments the participant completed. For Step 2, the participant was informed whether the change was positive, negative, or neutral. For Step 3, the automated system asked the participant if they felt “better,” “about the same,” or “worse,” compared with the previous assessments. For Step 4, if the participant answered positively or neutral, the result was confirmed, and the feedback ended. If the participant answered negatively, the feedback provided recommendations to the participant to talk to someone trusted, such as the participant’s parole officer.

The calls to participants were brief, usually lasting under 60 seconds. The call would end with a quick reminder about the next scheduled call.

In addition to the immediate feedback provided to participants, the intervention involved an email report sent to the participant’s parole officer. These reports were intended to improve decisions on the individual needs of each paroled individual and included a total score on each completed assessment; whether the overall direction was positive, negative, or neutral; and whether there were any missing responses. These reports contained only a summary of the scores, so the parole officer was not informed of specific responses, such as the use of alcohol or drugs (Andersson et al., 2020).

Study

Andersson and colleagues (2020) conducted a randomized controlled trial to examine the impact of daily automated telephony (with feedback) on individuals recently paroled. Participants were recruited from the Swedish Prison and Probation Service between December 2009 and August 2010 and were recruited from a general population of individuals while they were still in prison. Recruitment took place in 13 open-and-closed prisons, 9 of which were in the southern region of Sweden and 4 in the eastern region. Participants were paroled to 30 different offices out of 34 total potential offices. Eligibility criteria were fluency in Swedish and the ability to register a telephone number no later than the date of parole.

A total of 108 participants were included in the final sample and randomized into either the treatment group (n = 52) or the control group (n = 56). The treatment group received daily assessment telephone calls with feedback, recommendations in response to the phone call, and daily reports to the participants’ respective parole officers. The control group received only daily automated telephone calls. A majority of the participants were male (97.2 percent) and ranged in age from 18 to 61 years, with an average age of 36.2 years. No other demographic information was provided by the study authors. There were no statistically significant differences between the groups in baseline characteristics. The study consisted of 93 total parole officers (49 from the southern and eastern regions, and 44 from other regions).

The study examined the impact of the program on measures of internalizing behaviors (including stress, depression, and anxiety), craving for alcohol and drugs, and stressful daily events. The CrimeSolutions review of this study focused on measures of self-reported alcohol use, drug use, and depression and anxiety. Current alcohol and drug use were measured by asking the participant whether they either drank alcohol or used drugs the previous day. Internalizing behavior was measured by an eight-item dichotomized version of the Symptoms Check List, which assesses symptoms of anxiety and depression.

All participants reported their answers pre-assessment and during 30 consecutive days after parole. These outcomes were analyzed using a repeated-measures linear mixed-growth model, in which group and day were entered as fixed effects and subjects as random effects. The study authors did not conduct subgroup analyses.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Phillips, Lindsay A., and Mary Lindsay. 2011. Prison to Society: A Mixed-Methods Analysis of Coping With Reentry.” International Journal of Offender Therapy and Comparative Criminology 55:136–54.

Vasiljevic, Zoran, Mats Berglund, Agneta Öjehagen, Peter Höglund, and Claes Andersson. 2017. “Daily Assessment of Acute Dynamic Risk in Paroled Offenders: Prediction, Predictive Accuracy, and Intervention Effect.” Psychiatry, Psychology, and Law 24(5):715–29.

Following are CrimeSolutions-rated programs that are related to this practice:

Adult Reentry Programs

This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?