Reducing depression, anxiety, and trauma of male inmates: An HIV/AIDS psychoeducational group intervention

Although the growth rate for HIV/AIDS for incarcerated people is nearly six times the rate of the U.S. population, AIDS education programs within the corrections system have been slow to develop. A quasi-experimental research study found that a 1 O-session psychoeducational group intervention was effective in increasing knowledge of AIDS and decreasing depression, anxiety, and trauma symptoms among male inmates in a large southeastern jail facility. The group intervention consisted of both AIDS education topics and psychological support. Results indicated significant differences between the experimental and comparison group participants. Implications for future research and practice are discussed. Keywords: group intervention; HIV/AIDS; incarcerated people; jails; psychoeducation Over the past two decades, there has been a 600 percent increase in the number of people incarcerated in U.S. jails and prisons (Bureau of Justice Statistics, 1996). This growth equates to a nationwide need for approximately 1,143 bed spaces per week (Gilliard, 1992). The jail and prison populations are increasing, and detainees axe held for longer periods, thus maintaining the increase in this population. The sources of difficulty for the prison and jail system encompass budgetary problems, overcrowding, and violence (McShane & Williams, 1989). With an increase in the incarcerated population, there is a corresponding need for effective rehabilitation programs. One main obstacle to improvement of the system is the dearth of suitable training programs and effective interventions (Gendrau, 1996). There have been some efforts to supply rehabilitation programs to offenders (that is, restitution, victim--offender mediation); however, the provision of psychosocial interventions has been a low funding priority to jail administrations. Immarigeon (1995) recommended "putting offenders in programs that address problems they actually have and choose programs that fit into what's known about the most effective way to impact a given problem" (p. 7). The majority of rehabilitation programs in jails and prisons focus on academic education and vocational training rather than mental health interventions (Gendrau & Andrews, 1994). A myriad of emotional and social issues confront inmates residing in correctional facilities in the United States (Anderson, 2000). Inmates entering a correctional facility are likely to be overwhelmed by the severely, restrictive environment, loss of personal freedom, and need to adapt to new cultural norms. This shock coupled with histories of childhood physical and emotional abuse, substances abuse, and often dysfunctional or traumatic relationship experiences of inmates creates depressive cognitions and affects that can potentially develop into suicidal ideation if not treated (Boterrell, 1984). "Hopelessness, despair, and negative feelings about the future" are some of the underlying factors resulting in depression, low self-esteem, and increased anger (Rees, 1989, p. 4). The majority of incarcerated men suffer from this psychological distress related to trauma, depression, and anxiety requiring mental health services and psychotropic medication (Morris, Steadman, & Veysey, 1997). In addition, high levels of depression and anxiety are often manifested by aggressive and hostile behavior in jail. These difficulties are further believed to have a causal relationship with offenders' criminal and antisocial behavior in the jail, leading to an increase in violence in correctional facilities (Blackburn, 1986). These high-risk behaviors, violent in nature, increase the likelihood of transmission of HIV infection. Ironically, HIV education and risk-reduction programs in correctional facilities often are brief lectures given to inmates during the first few days of incarceration when they are least able to absorb the information (Gendrau, 1996). The first week of incarceration is considered the most stressful for inmates and accounts for the majority of successful suicides carried out by new arrestees (Rees, 1989). …