Research Findings

In a variety of randomized and non-randomized trials, MISSION has been shown to be successful for a myriad of populations, including criminal justice-involved veterans, female offenders returning to the community, and veteran and non-veteran clients who have experienced homelessness. Previous studies examining the efficacy of the MISSION approach have shown improved outcomes related to substance use, psychological functioning, housing, employment maintenance, treatment retention, and use of outpatient services. Below is a chronological list of published work regarding MISSION treatment outcomes and related findings.

Smelson, D. A., Losonczy, M. F., Castles-Fonseca, K., Sussner, B. D., Rodrigues, S., Kaune, M., & Ziedonis, D. (2005). Preliminary Outcomes from a Community Linkage Intervention for Individuals with Co-Occurring Substance Abuse and Serious Mental Illness. Journal of Dual Diagnosis, 1(3), 47-59. DOI: 10.1300/J374v01n03_05

Smelson, D. A., Losonczy, M. F., Ziedonis, D., Sussner, B. D., Castles-Fonseca, K., Rodrigues, S., & Kline, A. (2007). A brief community linkage intervention for veterans with a persistent mental illness and a co-occurring substance abuse disorder. European Journal of Psychiatry, 21(2), 143-152. DOI: 10.4321/S0213-61632007000200006

Kline, A., Callahan, L., Butler, M., St. Hill, L., Losonczy, M., & Smelson, D. (2009). The Relationship Between Military Eras Served and Psychosocial Treatment Needs Among Homeless Veterans with a Co-Occurring Substance Abuse and Mental Health Disorder. Journal of Dual Diagnosis, 5(3-4), 357-374. DOI: 10.1080/15504260903175882

Smelson, D., Kalman, D., Losonczy, M. F., Kline, A., Sambamoorthi, U., St. Hill, L., Castles-Fonseca, K., & Ziedonis, D. (2010). A Brief Treatment Engagement Intervention for Individuals with Co-occurring Mental Illness and Substance Use Disorders: Results of a Randomized Clinical Trial. Community Mental Health Journal, 48(2), 127-132. DOI 10.1007/s10597-010-9346-9

O’Connor, K., Kline, A., Sawh, L., Rodrigues, S., Fisher, W., Kane, V., Kuhn, J., Ellisson, M., & Smelson, D. (2013). Unemployment and Co-occurring Disorders among Homeless Veterans. Journal of Dual Diagnosis, 9(2), 134-138. DOI: 10.1080/15504263.2013.778804

Smelson, D. A., Kline, A., Rodrigues, S., O’Connor, K., Fisher, W., Sawh, L., & Kane, V. (2013). A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders. Psychological Services, 10(2), 161-167. DOI: 10.1037/a0030948

Smelson, D. A., Pinals, D. A., Sawh, L., Fulwiler, C., Singer, S., Guevremont, N., Fisher, W., Steadman, H. J., & Hartwell, S. (2015). An Alternative to Incarceration: Co-Occurring Disorders Treatment Intervention for Justice-Involved Veterans. World Medical and Health Policy, 7(4), 329-348. DOI: 10.1002/wmh3.168

Smelson, D. A., Chinman, M., McCarthy, S., Hannah, G., Sawh, L., & Glickman, M. (2015). A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs. Implementation Science, 10. DOI: 10.1186/s13012-015-0267-4

Smelson, D. A., Zaykowski, H., Guevermont, N., Siegfriedt, J., Sawh, L., Modzelewski, D., Tsemberis, S., & Kane, V. (2016). Integrating Permanent Supportive Housing and Co-Occurring Disorders Treatment for Individuals who are Homeless. Journal of Dual Diagnosis, 12(2), 193-201.  DOI: 10.1080/15504263.2016.1174010

Harnish, A., Corrigan, P., Byrne, T., Pinals, D. A., Rodrigues, S., & Smelson, D. (2016). Substance use and mental health stigma in veterans with co-occurring disorders. Journal of Dual Diagnosis, 12(3-4), 238-243. DOI: 10.1080/15504263.2016.1245066

Trojano, M. L., Christopher, P. P., Pinals, D. A., Harnish, A., & Smelson, D. (2017). Perceptions of voluntary consent among jail diverted veterans with co-occurring disorders. Behavioral Sciences and the Law, 1-10. DOI: 10.1002/bsl.2299

Smelson, D.A., Chinman, M., Hannah, G., Byrne, T., & McCarthy, S. (2018). An evidence-based co-occurring disorder intervention in VA homeless programs: Outcomes from a hybrid III trial. BMC Health Services Research, 18, 332. doi: 10.1186/s12913-018-3123-9

Smelson, D., Farquhar, I., Fisher, W., Pressman, K., Pinals, D.A., Samek, B., Duffy, M.K., & Sawh, L. (2019). Integrating a co-occurring disorders intervention in drug courts: An open pilot trial. Community Mental Health Journal, 55(2), 222-231. DOI: 10.1007/s10597-018-0255-7

Smelson, D., Kennedy Perez, C., Farquhar, I., Byrne, T., & Colegrove, A. (2018). Permanent supportive housing and specialized co-occurring disorders wraparound services for homeless individuals. Journal of Dual Diagnosis, 14(4), 247-256. 1-10. DOI:10.1080/15504263.2018.1506195

Zaykowski, H., Smelson, D.A., & DeCamp, W. (2019). Reducing victimization among chronically homeless adults with co-occurring mental health and substance use disorders: An examination of housing placement and risky lifestyles. Victims & Offenders, 14(6), 712-726. DOI: 10.1080/15564886.2019.1628142

Pinals, D.A., Gaba, A., Clary, K.M., Barber, J., Reiss, J., & Smelson, D. (2019). Implementation of MISSION-Criminal Justice in a treatment court: Preliminary outcomes among individuals with co-occurring disorders. Psychiatric Services, 70(11), 1044-1048. https://doi.org/10.1176/appi.ps.201800570

Hanna, J., Kubiak, S., Pasman, E., Gaba, A., Andre, M., Smelson, D., & Pinals, D.A. (2019). Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative. Journal of Substance Abuse Treatment, 108, 104-114. https://doi.org/10.1016/j.jsat.2019.06.012

Holzhauer, C.G., Byrne, T., Simmons, M.M., Smelson, D., & Epstein, E.E. (2019). Profiles of clinical need among homeless individuals with dual diagnoses. Community Mental Health Journal, 55(8), 1305-1312. doi: 10.1007/s10597-019-00432-6

Clary, K.M., Shaffer, P.M., Gaba, A., Pinals, D.A., & Smelson, D. (2019, in press). Comparing the treatment needs of participants with co-occurring mental health and substance use disorders in drug and veterans treatment courts. Journal of Substance Use. DOI: 10.1080/14659891.2019.1683905

Ellison, M.L., Schutt, R., Yuan, L., Mitchell-Miland, C., Glickman, M.E., McCarthy, S., Smelson, D., Schultz, M.R., & Chinman, M. (2019, in press). Impact of peer specialist services on residential stability and behavioral health status among formerly homeless veterans with co-occurring mental health and substance use conditions. Medical Care.

Smelson, D.A., Gaba, A., Pressman, K., Clary, K.M., Shaffer, P.M., & Pinals, D.A. (2020). Embedding a co-occurring disorders rehabilitation intervention in veterans courts: A pilot study with male veterans. Accepted for Publication. Community Mental Health Journal.

Shaffer, P. M., Gaba, A., Sprinckmoller, S.P., Starratt, E.L., & Smelson, D.A. (2020). Treatment needs and gender differences among clients entering a rural drug treatment court with a co-occurring disorder. Accepted for Publication. Drug Court Review. 

Smelson D.A., Gaba A., Pressman K., Clary K.M., Shaffer P.M., Pinals D.A. (2020). Embedding a Co-occurring Disorders Rehabilitation Intervention in Veterans Courts: A Pilot Study with Male Veterans. Community Mental Health Journal.DOI:10.1007/s10597-020-00565-z.

Carreiro, S., & Chintha, K., & Shrestha, S., & Chapman, B., & Smelson, D., & Indic, P. (2020). Wearable sensor-based detection of stress and craving in patients during treatment for substance use disorder: A mixed methods pilot study. Drug and Alcohol Dependence.

 Debra A. Pinals, & Ayorkor Gaba, & Paige M. Shaffer, & Michael A. Andre, & David A. Smelson (2021). Risk–need–responsivity and its application in behavioral health settings: A feasibility study of a treatment planning support tool. Behavioral Sciences & The Law.

Shaffer, P. M., Smelson, D. A., Gaba, A., & Casey, S. C (2020) Integrating a Co-occurring Disorders Intervention in a Rural Drug Treatment Court: Preliminary 6-Month Outcomes and Policy Implications. International Journal of Mental Health and Addiction; 17(1).

Shaffer, P.M., Posada, C., Gaba, A., Smelson, D. (2021). Engaging Vulnerable Populations in Drug Treatment Court: Six Month Outcomes from a Co-Occurring Disorder Wraparound Intervention. International Journal of Law and Psychiatry.

Macia, K. S., Blonigen, D. M., Shaffer, P. M., Cloitre, M., & Smelson, D. A. (2021). Trauma-Related Differences in Socio-Emotional Functioning Predict Housing and Employment Outcomes in Homeless Veterans. Social Science & Medicine, 114096.

Leach, R., Carreiro, S., Shaffer, P., Gaba, A., Smelson, D. (2021) Digital Health Interventions for Mental Health, Substance Use, and Co-Occurring Disorders in the Criminal Justice Population: A Scoping Review. Frontiers Psychiatry.

Blonigen, D. M., Cucciare, M. A., Byrne, T., Shaffer, P. M., Giordano, B., Smith, J. S., Timko, C., Rosenthal, J., & Smelson, D. (2022). A randomized controlled trial of moral reconation therapy to reduce risk for criminal recidivism among justice-involved adults in mental health residential treatment. Journal of Consulting and Clinical Psychology.

Gaba A, Shaffer PM, Andre M, Pinals DA, Drawbridge D, Smelson D. (2022). Racial and ethnic differences in behavioral health, criminal legal system involvement, and service needs among mental health court participants: Implications for service delivery. Psychol Serv.

Rodriguez, C., Shaffer, P., Gaba, A., Drawbridge, D., Smelson, D., (2022). Re-entry needs amount a population with co-occurring opioid use and mental health disorders in Massachusetts USA Jails: Part of a National Plan to Address the Opioid Epidemic.

Bruzios, K. E., Shaffer, P. M., Byrne, T., Pinals, D. A., Trojano, M., Pressman, K., & Smelson, D. (2023). Examining Perceived Coercion in Drug Treatment Courts. International Journal of Offender Therapy and Comparative Criminology, 67(1), 53-65.

Blonigen, D. M., Shaffer, P. M., Baldwin, N., & Smelson, D. (2023). Disentangling the relationship between posttraumatic stress disorder, criminogenic risk, and criminal history among veterans. Law and Human Behavior.

Gaba, A., Helm, A., Shaffer, P. M., Pridgen, B., Drawbridge, D., & Smelson, D. (2023). Community reentry: Racial/ethnic differences in unmet needs among adults with co-occurring opioid use and mental health disorder. International Journal of Law and Psychiatry, 91, 101924.

Shaffer, P.M., Helm, A., Andre M., Reaves H., Bruzios K., Harter J., Smelson D., Shaffer H.J. (2023). Rapidly Adapting a Multicomponent Treatment for Persons Experiencing Chronic Homelessness with Comorbid Substance Use and Mental Health Disorders During The COVID-19 Pandemic. Medical Research Archives, European Society of Medicine.

Shaffer, P.M., Smelson, D., Helm, A., Gaba, A., Marcus, S., Shaffer, H.J., (2023). Reentry Service Engagement Among Offenders with Co-occurring Mental Health and Opioid Use Disorders in Massachusetts Jails. Journal of Psychology and Psychotherapy Research.

Bowdring, M., Macia, K. Shaffer, P.M., Smelson, D., Blonigen, D. (2023). Criminogenic needs and legal problem severity among legal system involved veterans. Military Medicine.