Recidivism

Overall, the investigators hypothesize that participants assigned to the intervention group (Project ReBond) will demonstrate significantly greater improvements across all outcomes compared to the control group. Specifically, the investigators expect positive intervention effects on desistance and TPB outcomes to become evident as participants transition back into the community (i.e., across the at 1-2 months, 6-7 months, and 13-14 months post-release assessment waves), while workshop-specific outcomes will be evident at the end of the workshop. Overall Design The current study employs a two-arm, parallel-group randomized controlled trial (RCT) utilizing a mixed design. The between-subjects factor is the treatment condition (Project ReBond Intervention plus TAU versus TAU Control), and the within-subjects factor is time, with repeated measures assessed across multiple time points over a 13-month tracking period. Intervention Group (Project ReBond + TAU) Participants allocated to the intervention group will receive the multifaceted Project ReBond services alongside standard care (TAU) for up to two years, beginning during their incarceration and continuing post-release. It should be noted that the 13-month research tracking period is shorter than the full two-year service duration; this truncated follow-up is necessary due to anticipated challenges in recruiting the predefined sample size before the project's overall deadline. The TAU is provided by the collaborating non-governmental organization (NGO), SideBySide. The Project ReBond intervention consists of the following specific components: * Pre-Release (During Incarceration): Each participant will receive a 6-session pro-social habit workshop and career-life counselling as part of their pre-release preparation. Those requiring employment assistance will be provided with job interview opportunities prior to their release. * Post-Release: Based on their personal interests and the recommendations of their caseworker, participants can choose to engage in the following services: i) Subsidies for professional grooming and image building; ii) Peer mentorship provided by successful desisters; iii) Financial literacy training and counselling; iv) Ongoing career-life counselling; v) Routine workshops designed to cultivate and maintain pro-social hobbies; vi) Subsidies for further education or occupational training; vii) Family-based counselling involving the participant and their significant other(s); and viii) Volunteering and community outreach, sharing opportunities. TAU Control Group Participants in the control group will receive standard care (TAU) while incarcerated and remain free to utilize any existing social services post-release.

Addiction is a major public health issue. According to the World Health Organization (2024), approximately 400 million people worldwide suffer from alcohol- or drug-related disorders, resulting in nearly 3.2 million deaths per year. In France, the situation is also cause for concern: approximately three million people engage in risky alcohol consumption, thirteen million smoke daily, and nearly one and a half million use illicit drugs, primarily cannabis. Addiction, defined by the National Institute on Drug Abuse (NIDA) as a chronic, relapsing brain disorder, is characterized by the compulsive pursuit and use of a substance despite knowledge of its harmful effects. Its development depends on multiple factors: personal (trauma, psychiatric disorders, genetic predispositions), environmental (stress, isolation, family context), and those related to the substance itself (addictive potential). The diagnosis of substance use disorders is based on 11 criteria defined in the \*Diagnostic and Statistical Manual of Mental Disorders\* (DSM-5), the main ones being: loss of self-control, interference of substance use with academic or occupational activities, continued use despite awareness of the problems it causes, and a new central criterion, craving, defined as an irresistible urge to use, which serves as both a symptom and a diagnostic and prognostic marker because it is a predictor of relapse. The cumulative total of criteria allows the disorder to be classified as mild (2-3), moderate (4-5), or severe (≤ 6). Since the 2020 health crisis, researchers have observed an increase in the use of psychoactive substances, particularly among vulnerable populations. Despite public policy efforts and treatment programs, relapses remain common after treatment, affecting 60 to 70% of patients within six months of their hospitalization. This phenomenon is also observed at La Musse Hospital, where many patients admitted to the nutrition and alcoholism unit express a sense of emptiness upon returning home: a void in relationships, therapy, and daily activities. This feeling often contributes to a return to substance use. To address these relapses, this study aims to evaluate the impact of a post-hospitalization equine-assisted therapy program on the mental health and addictive behaviors of patients receiving addiction treatment. Already used at La Musse Hospital as part of the care pathway, equine-assisted therapy is based on the interaction between the patient and the horse in a therapeutic setting. Several studies have demonstrated the benefits of this approach on emotional regulation, self-confidence, stress management, and overall well-being. This prospective, single-center, interventional study will include twenty-two patients who have been hospitalized at least once in the nutrition and alcoholism unit at La Musse Hospital or another facility. Participants will be randomly assigned to either a group receiving post-hospitalization equine-assisted therapy or a control group.