Evaluating a Brief Sexual Violence Therapy Group for Incarcerated Women

Incarcerated women report higher rates of sexual victimization and mental illness than the average woman and incarcerated men. Researchers have argued that sexual victimization is a pathway to prison for women, and that there is a lack of trauma-focused treatments in prisons. Some researchers have evaluated trauma-focused group treatments for incarcerated women (Bradley & Follingstad, 2003; Cole et al., 2007; Ford, Chang, Levine, & Zhang, 2013; Kubiak, Kim, Fedock, & Bybee, 2012; Paquin, Kivlighan, & Drogosz, 2013; Roe-Sepowitz, Bedard, Pate, & Hedberg, 2014; Zlotnick, Johnson, & Najavits, 2009), with mixed results and several limitations. Most of these treatments are lengthy and resource intensive (cf. Ford et al., 2013) and they provide few, if any, additional benefits compared to treatment as usual or support groups. They also do not include exposure therapy, despite research supporting exposure’s efficacy (Foa, Hembree, & Rothbaum, 2007). Future studies could benefit from evaluating briefer treatments that target specific mechanism known to maintain posttraumatic stress disorder (PTSD) and other common trauma outcomes. Although there are empirically-supported treatments (ESTs) for PTSD that would fit these criteria, the prison context might provide several unique contextual factors that are likely to make it difficult to implement and/or may impact the efficacy of these treatments. The current group treatment for incarcerated women was designed to overcome concerns with implementing ESTs in this population as well as limitations with previous studies evaluating trauma treatments among female prisoners. Results from 58 incarcerated women showed significant reductions in PTSD, depression, and anxiety/worry symptoms as well as trauma-related cognitions from pre-to post-treatment. Approximately 4050% of participants who were above the clinical cutoff for possible PTSD (n = 30), depression (n = 25), and generalized anxiety disorder (GAD; n = 26) at pre-treatment were below at posttreatment (PTSD: n = 14; depression: n = 18; GAD: n = 18). Additionally, 40-60% reported a clinically significant improvement (reliable change index > 1.96; Jacobsen & Truax, 1991) in depression (n = 21) and GAD symptom severity (n = 13). Results suggest that it is feasible to implement a brief exposure-based group treatment with incarcerated women. ACKNOWLEDGEMENTS This project would not have been possible without the help of several people. I wish to thank the Northwest Arkansas Community Corrections Center and the Arkansas Community Correction for their involvement in this project. Many thanks to the staff, especially to Maggie Capel and Kenitra Brown for their support and assistance. Special thanks to all the brave women who participated in the group treatment and the research project. Thanks for sharing your life stories and allowing the group leaders to be part of your therapeutic journey. Gratitude also goes to the staff at Peace at Home Family Shelter Inc., especially to Teresa Mills, Aurora Vicari, and Jessica Bell. Thanks for being part of developing this project and committing to a continuous sponsorship. The dedicated mentorship of Dr. Ana J. Bridges has been instrumental in shaping this project. I wish to thank her for the countless hours spent in supervision and guidance. My appreciation also goes to Jessica Bell and Lauren Milner who agreed to serve as the co-leaders of the group treatment. Thanks to the advisor and chair of my dissertation committee, Dr. Patricia A. Petretic, and to the dissertation committee members: Drs. Jeffrey M. Lohr and Ellen W. Leen-Feldner. The final acknowledgement is for my uncle, Ole Bredberg, who has been one of my greatest supporters during my educational journey. DEDICATION This dissertation is first and foremost dedicated to my parents. Your love and support has been crucial in this process and throughout my life. This dissertation is also dedicated to my life companion and best friend, Claudio. TABLE OF CONTENTS