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Enrolling by invitationNCT05109689Updated Dec 30, 2024

A Randomized Controlled Trial of ACT-P Versus T4C for Community Reentry

An interventional study of ACT-P and T4C in Criminal Behavior and Violence, sponsored by Iowa State University. Enrolling by invitation at 1 site in United States. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-12-30.

Sponsored by Iowa State University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
400
Allocation
Randomized
Ages
18 Years and older
Sex
Male
01

Study summary

The purpose of the proposed study is to determine the efficacy of Acceptance and Commitment Therapy for prisons (ACT-P) and Thinking for a Change (T4C) as reentry programs in a randomized controlled trial (RCT).

Read the detailed description

The proposed study will focus on medium to high risk adult males, currently institutionalized and approaching release, who will be randomized to Acceptance and Commitment Therapy for prisons (ACT-P) or the Thinking for a Change (T4C) program. ACT-P is a cognitive behavioral treatment that targets acceptance and mindfulness processes to reduce criminal behavior, and has been adapted for the prison setting. T4C is a widely used and well-established traditional cognitive behavioral program that targets changing criminal thinking.

The first aim of the study is to test the relative efficacy of the ACT-P intervention, compared to T4C, on recidivism. Recidivism will be measured in 3 ways: rearrests, reconvictions, and reincarceration during the 3 years post-release. A secondary aim is to test the theory of change and the proposed mechanisms of ACT-P and T4C. By focusing on the mechanisms that account for program success, it will provide insight into the theory of change underlying each program. Based on the theories underlying each treatment, we hypothesize differences in mechanisms of action between the two treatments. Given the emphasis in T4C on cognitive change, we predict stronger mediation effects in T4C for reductions in antisocial/criminal thinking. In contrast, we hypothesize that increases in psychological flexibility would be stronger mediators for ACT-P than for T4C.

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Conditions studied

  • Criminal Behavior
  • Violence

Keywords

  • Cognitive behavior therapy
  • Community reentry
  • Recidivism
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In context

Lead sponsor

Iowa State University is the lead sponsor of 36 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • deemed medium or high risk according to the Iowa Risk Revised
  • eligible and appropriate for cognitive programming as determined by normal operating procedures

Exclusion criteria

Exclusion Criteria:

  • court-mandated to either program
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
400 participants (estimated)

Study arms

  • Experimental
    ACT-P

    ACT-P is a cognitive behavioral program based on acceptance and commitment therapy, and it has been modified for use in the prison setting.

    Behavioral: ACT-P

  • Active comparator
    T4C

    Thinking for Change (T4C) is an evidence-based cognitive behavioral program focused on changing criminal thinking.

    Behavioral: T4C

Interventions

  • BehavioralACT-P

    ACT-P consists of five modules. The Big Picture sessions are interwoven throughout the 24 sessions to introduce the main concepts of the curriculum, such as values identification and awareness of criminal behaviors. The Emotion Regulation and Cognitive Skills modules focus on awareness of internal experiences; learning new ways to respond to internal experiences; identifying and stepping back from problematic/criminal thoughts and beliefs; awareness of behaviors in service of values versus behaviors in service of control/avoidance; and identifying steps for behavior change. The Behavioral Skills module focuses on practicing prosocial behaviors, such as speaking and listening effectively and conflict resolution. Finally, the Barriers to Change module addresses environmental or life circumstances that can hinder successful behavior change (e.g., toxic masculinity, substance use, and parenting difficulties).

  • BehavioralT4C

    T4C is an integrated cognitive behavioral change program authored by Drs. Jack Bush, Barry Glick, and Juliana Taymans under a cooperative agreement with the National Institute of Corrections (NIC). The program is based on the principle that thinking controls how people act, and that to change the way people act, they have to control their thinking. T4C systematically presents the concept that thoughts cause one's behavior, and offenders learn to identify their own thought patterns that lead to risky behavior, and then to replace those maladaptive thoughts with new ones. T4C incorporates research from cognitive restructuring theory, social skills development, and the learning and use of problem solving skills.

    Also known as: Thinking for a Change

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What researchers measure

Primary outcomes

  1. Rearrests, convictions, and reincarcerations

    Criminal activity

    Time frame: 3 years post-release

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Study locations

1 site
  • Fort Dodge Correctional Facility
    Fort Dodge, Iowa 50501, United States
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References and documents

Individual participant data

Plan to share: Undecided — The investigators are undecided right now.

No publications or documents are linked to this record.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 30, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05109689
Lead sponsor
Iowa State University
Responsible party
Amie Zarling (Associate Professor, Iowa State University) — Principal investigator
First posted
Nov 5, 2021
Start date
Feb 21, 2022
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Dec 30, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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