A Feasibility Study of a Guided Self-help Programme for Male Offenders Serving a Long-term Prison Sentence
Condition: Anxiety; Depression
MeSH terms: Depression
Study type: Interventional

Summary: 
      Background: Prisoners have complex mental health needs, and there is a disproportionately
      higher incidence of mental health problems compared with the general population. Although
      research indicates that psychological interventions are effective in treating prisoners with
      anxiety and depression, medication is often the only treatment available in prisons. Living
      Life To The Full (LLTTF) is a life skills programme teaching skills to cope with life
      stresses, and has been shown to reduce anxiety and depression in individuals in the
      community.

      Research Questions

        1. Will prisoners take part in and engage with LLTTF?

        2. Do LLTTF booklets need to be adapted for prisoners?

        3. Does LLTTF show an effect of reducing anxiety and/or depression?

        4. Does history of HI reduce responsivity to LLTTF?

        5. Does LLTTF reduce number of breaches of prison rules?

      What did the study involve?: Prison Officers in HMP Shotts were invited to take part and
      attend LLTTF training. Male prisoners aged 21 and above in HMP Shotts were recruited using
      posters. Assessment of anxiety, depression, perceived functioning, and history of head injury
      was carried out. Prisoners' work attendance and breaches of prison rules for the month prior
      to and month during LLTTF was collected. Prison Officers and prisoners provided feedback of
      LLTTF at end of treatment.

      Results: Six (6%) Prison Officers attended LLTTF training and two (33%) withdrew prior to
      prisoner recruitment. 6% (n=15) of prisoners invited to take part volunteered and were
      eligible. Seven prisoners completed LLTTF.

      There was a sign of a treatment effect with reductions in depression following LLTTF. Anxiety
      reduced at the last session and increased at post-treatment, which reflects the deterioration
      in a minority of prisoners. Due to the small sample size, history of HI and responsivity was
      not explored. Prisoners were not on report the month prior to LLTTF, therefore impact on
      breached rules was not explored.

      Feedback from Prison Officers and prisoners indicated materials required adaptation for
      prison, such as including activities feasible in prison. Prison Officers highlighted
      practical barriers to delivery of LLTTF, including limited time.

      Conclusions: Guided self-help in prison is worth pursuing. Revision of materials with Prison
      Officers and prisoners is recommended, and evaluated in future research. Due to practical
      barriers reported by Prison Officers, designated guided self-help workers may be better
      placed to deliver this intervention.
    


Intervention name(s): Guided Self Help
Intervention type(s): Other
Intervention description(s): Guided self help appointments with prison staff - 4x 30 minute appointments.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Feasibility study; Prisoners; Male offenders; Guided self help; Anxiety; Low mood