Program Profile: Power Source

This is a group-based, cognitive-behavioral therapy and mindfulness training intervention targeted at male youth in high-security correctional facilities. The program is rated Promising. Results indicated a statistically significant reduction in the decline of attention skills for the treatment group, measured as accuracy and response variability on the Attention Network Test; however, there was no statistically significant effect on response time.

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

Program Goals/Target Population

Power Source (PS) is a group-based, cognitive-behavioral therapy and mindfulness training (CBT/MT) intervention that targets males, ages 16 to18, who are incarcerated in high-security correctional facilities. PS blends the problem-solving and change components of CBT with the attentional and response modification elements of MT. By combining traditional CBT practices with MT, PS was designed to assist in modulating physiological responses to stressful and risky situations, to encourage prosocial behavioral responses.

Program Theory

The intervention is based on the process model of emotional regulation (Gross 1998), which identifies five points at which emotions can be regulated. These points are 1) situation selection, 2) situation modification (tailoring a situation to modify its emotional impact), 3) attention deployment and appraisal (selecting the aspects of a situation to focus on), 4) cognitive change (selecting meanings to attach to the situation), and 5) response modulation (influencing response tendencies). The PS intervention targets all five points by combining elements of CBT with the attentional and response modification elements of MT.

Program Components

Attention is a cognitive system that is necessary for managing cognitive demands and regulating emotions. Yet, persistent or intensive demands, such as those that may be experienced during high-stress periods of incarceration, may deplete a youth’s attention, which can result in cognitive failures, emotional disturbances, and impulsive behaviors. CBT/MT was designed to help protect against the degradation in attention that youth may experience while incarcerated (Leonard et al. 2013).

In the PS intervention, youth are trained to choose prosocial peers and low-risk situations to decrease the likelihood of offending behavior. Youth are also taught to build skills that can help to change situations that might lead to risk-taking behavior. Attentional training teaches youth to appraise high-risk situations; identify environmental, social, emotional, and physiological triggers for risk-taking behavior; and direct their attention to parts of the situation that encourage prosocial behavior.

Cognitive change is achieved in part through MT, which is an important technique in the emotion regulation process. MT trains youth to control their focus of attention and reappraise a situation in a way that alters its emotional impact. MT also helps youth change their responses to emotionally charged situations, teaching them to choose behavioral responses that are more socially appropriate and adaptive.

PS includes both formal meditation practice and cognitive-behavioral exercises. Program leaders deliver the intervention with a manual and use videos to demonstrate specific skills, including meditation techniques. These include sitting meditation, body scans, and walking meditation. PS groups meet for a total of 750 minutes over 3 to 5 weeks, with each session lasting approximately 75 minutes. Each group typically has 8 to 12 participants.

Youth are given reading assignments after each session from a companion book, which reiterates the important aspects of the lessons in the form of role model stories. Youth are also encouraged to record the amount of time they spend meditating outside of the sessions. When possible, makeup sessions are offered to youth who miss meetings for official reasons.

Key Personnel

Each PS session is led by two to four trained clinicians. The clinicians receive weekly clinical supervision on implementation and fidelity by completing quality assurance forms after every session and having audiotapes of each session reviewed. The clinicians receive training in mindfulness meditation.

Study

Leonard and colleagues (2013) conducted a randomized trial to examine the effects of the Power Source (PS) program. The study recruited 267 incarcerated males (average age 17.4 years) from a large, urban correctional complex in New York City, which was mostly populated by adult prisoners. A final subset (n = 191) was included in the analyses due to participant transfer, refusal, deportation, or missing release dates. Most of the participants (98 percent) were Black or Latino, which reflected the overall makeup of the facility. Seventy-four percent of participants self-reported engaging in nonviolent offenses, and 54 percent self-reported engaging in violent offenses. No official reports on offending behavior were available. Participants were recruited from seven dormitories and were randomized by dormitory to receive the PS intervention (n = 147 youth, 4 dormitories) or an active control intervention (n = 117 youth, 3 dormitories). Only those who had at least 6 weeks left in their sentence were eligible.

Participants reported demographic information and offending history using an audio computer-assisted self-interview format. Offending history was measured using the Self Report of Offending, where youth reported if they had engaged in any of 10 antisocial behaviors, including violent and nonviolent offenses. At both pre- and posttest, participants completed the Attention Network Test (ANT) to test the efficiency of three attentional networks: alerting, orienting, and executive control. The efficiency of the alerting network is measured by changes in reaction time resulting from a warning signal. The efficiency of the orienting network is measured by changes in the reaction time when given cues indicate where the target will occur. The efficiency of the executive network is measured when the participant responds to the direction of a central arrow by pressing one of two keys. More specifically, in the study participants focused on a fixation cross in the center of the screen, and warning cues provided spatial and temporal information about a target. The four conditions varying in the predictivity of the cues were 1) no-cue (no cue given, target can appear above or below fixation cross); double-cue (cues appear both above and below fixation cross, and target can appear either above or below cross); center-cue (cue appears in the center of the fixation cross, and target can appear above or below); and spatial-cue (the cue can appear above or below the fixation cross, and the target can appear above or below). The spatial-cue condition was 100 percent predictive of where the target would appear. The targets that appeared also varied, as follows: five arrows in the same direction (congruent), central arrow pointing in the opposite direction (incongruent), or a solitary arrow (neutral). Participants were instructed to indicate the direction of the central arrow using the left or right click of the mouse.

In addition, at posttest, participants in the PS condition reported how many times they meditated outside of intervention sessions on a 5-point Likert scale. The authors also measured response variability by calculating the intra-individual coefficient of variation (ICV), which has been previously shown to decrease after mindfulness training.

A bivariate analysis was performed at pretest on response times for correct trials and accuracy (percentage correct). There were no significant pretest differences between the PS group and the control group on response times for correct trials and accuracy. A repeated measures ANOVA was conducted to determine if overall accuracy was influenced by time and treatment group. The study authors conducted subgroup analyses of participants who practiced mindfulness outside of the PS group and those who did not practice mindfulness outside of the PS group. They also conducted subgroup analyses on 1) those who were released at posttest, 2) those who were still detained at posttest, and 3) based on the buildings in which youth were housed.

Power Source is a manual-based intervention that includes videos for demonstrating meditation and mindfulness techniques. The intervention is led by two trained clinicians who receive weekly clinical supervision on fidelity and implementation tactics (Leonard et al. 2013).

Subgroup Analysis

Leonard and colleagues (2013) conducted subgroup analyses of participants who practiced mindfulness outside of the Power Source (PS) group, those who did not practice mindfulness outside of the PS group, and those in the control group. Accounting for baseline differences across the groups, analyses revealed that those who practiced outside of the group had better accuracy, compared with those who did not practice and those in the control group. No significant effects were observed for response time.

The study authors also conducted subgroup analyses on those who were released at posttest and those who were still detained at posttest. They found that release status did not impact participants’ overall accuracy or response time scores at posttest. The study authors also conducted subgroup analyses based on the facility in which youth were housed for accuracy, response time, and intra-individual coefficient of variation (ICV). The facility did not impact the participants’ response time but did positively influence their accuracy and ICV.

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

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

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

Cognitive Behavioral Therapy (CBT) for Antisocial Behavior in Youth in Residential Treatment

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns that contribute to their problem behaviors. This variant of CBT focuses specifically on youth in residential settings. This practice is rated No Effects for reducing recidivism, at the 24-month follow-up period.

Evidence Ratings for Outcomes

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Cognitive Behavioral Therapy (CBT) for Anger-Related Problems in Children and Adolescents

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns that contribute to their problem behaviors. This variant of CBT focuses specifically on children and adolescents who have anger-related problems. The practice is rated Effective for reducing aggression and anger expression, and improving self-control, problem-solving, and social competencies.

Evidence Ratings for Outcomes

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	Mental Health & Behavioral Health - Social Competencies

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