START NOW integrates research, theory and clinical experience. This strengths-based approach focuses on an accepting and collaborative clinical style while placing the primary responsibility for change on the participant. It also accounts for the limited treatment resources available various care delivery settings.
- 32 sessions divided into four skill-based units
- Twice weekly for 16 weeks (recommended) or one time per week for 32 weeks
START NOW is designed specifically for psychiatric settings:
- Concepts and language are simplified given potential cognitive or educational limitations
- Numerous images included in the participant workbook—especially useful with TBI or verbally limited participants
- Illustrative examples and coping behaviors are contextually relevant
- Detailed session-by-session facilitator manual includes numerous tips for engaging difficult-to-engage participants: e.g., shaping by reinforcing any movement toward the desired behavioral change
Learn about Carilion Clinic’s START NOW approach to teach skill-building to those with impairments of impulse control, emotion regulation and management of interpersonal relationships. The comprehensive program training is intended for facilitators.
Sampl, S., Wakai, S., Trestman, R.L., Keeney, E.M. (2008). Functional Analysis of Behavior in Corrections: Empowering Inmates in Skills Training Groups. Journal of Behavioral Analysis of Offender and Victim Treatment and Prevention, 1(4), 42-51. Available at: http://psycnet.apa.org/fulltext/2014-55092-004.html
Shelton, D., Sampl, S, Kesten, K., Zhang, W., Trestman, R.L. Treatment of Impulsive Aggression in Correctional Settings. Behavioral Sciences and the Law, 27:787-800, 2009. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19784944
Kersten, L., Cislo, A.M., Lynch, M., Shea, K., Le, H., Trestman, R.L. Evaluating START NOW: A Skills-Based Psychotherapy for Inmates with Behavioral Disorders. Psychiatric Services in Advance (doi: 10.1176/appi.ps.201400471). Published online August 17, 2015. Available at: https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201400471
Cislo, A., Trestman, R.L. Psychiatric Hospitalization after Participation in START NOW. Letters to the Editor. Psychiatric Services 2016; 67:143; doi: 10.1176/appi.ps.201500456. Published online January 4, 2016. Available online at: https://doi.org/10.1176/appi.ps.201500456
Frisman, L. K., Lin, H.J., Rodis, E.T., Grzelak, J., and Aiello, M. (2017). Evaluation of CT's ASIST program: Specialized services to divert higher risk defendants. Behavioral sciences and the law, 35(5-6), 550-561. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28881041
Kersten, L. (2018). Aggression and Antisocial Behavior in Underserved Populations: Towards a Comprehensive Treatment Approach (Doctoral dissertation, University of Basel). Available at: https://edoc.unibas.ch/63964/
Truong et al. (2021). Systematic Content Analysis of Patient Evaluations of START NOW Psychotherapy Reveals Practical Strategies for Improving the Treatment of Opioid Use Disorder. BMC Psychiatry, 1-13. Available at: https://doi.org/10.1186/s12888-020-03024-x