Clinical trial NCT04373954: Proposing Forgiveness Therapy Within Prison
Official title: Proposing Forgiveness Therapy for Those in Prison: An Intervention for Reducing Anger and Promoting Psychological Health
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Forgiveness
Keywords: Forgiveness
Lead sponsor: University of Wisconsin, Madison
Sponsor class: OTHER
Collaborators: name: Department of Corrections, State of Wisconsin
First posted: 2020-05-05
Enrollment: 24
Sex: MALE
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: It is a cross-over design. For the first period of treatment, after the pretest, the experimental group received 6-month Forgiveness Therapy and the control group received 6-month alternative treatment-Carey Guides. The Carey Guides is a primary educational program deliberately picked by the Department of Corrections in Wisconsin. Some aspects emphasized in it include anti-social thinking, emotional regulation, moral reasoning, and so on. For the second period of treatment, after the post-test, the control group turned to the second experimental group and received 6-month Forgiveness Therapy, while the first experimental group had a rest for 6-month and then they finished the follow-up test or second post-test. For both experimental group and control group, they met once per week, one hour in a group setting. The remaining participants will be remeasured 12 months after the second period of treatment for one-year follow-up test.
Primary purpose: TREATMENT

Brief summary: Previous studies found that a large number of prisoners experienced unjust treatment from others, which can lead to deep inner pain or anger, prior to criminal perpetration. Such unresolved anger can deepen and linger, be turning to resentment (excessive anger) or rage (very intense, potentially violent anger), compromising one's psychological health and behavior and even contributing to their choice of crime. However, Forgiveness Therapy, as an empirically-verified treatment, can help reduce and even eliminate the excessive anger. Its positive effects have been scientifically supported by numerous studies within diverse populations. Therefore, in the prison context, similarly, the investigator hypothesizes that Forgiveness Therapy will lower rates of anger, depression, and anxiety and raise the levels of forgiveness, empathy, hope, and self-esteem for the experimental (Forgiveness Therapy) group as compared to the alternative treatment control group. This is based upon numerous studies that demonstrate the efficacy of Forgiveness Therapy with comparisons to other treatment methods. Further, the study team expects behavioral change by the men within the correctional institution, as measured by officers' observations as well as the number of misconducts in conduct reports on each participant and the time spent in restrictive housing.

This study is the second part of a two-tiered research project to propose a novel approach--Forgiveness Therapy--to corrections and aims to demonstrate the effectiveness of Forgiveness Therapy in reducing resentment and other negative psychological symptoms such as excessive anger, anxiety, and depression for the prison inmates.

A random sample of 24 participants, who have not participated in forgiveness workshops or forgiveness therapy, were taken from the Study 1(the investigator's previous research from the maximum-security prison of Columbia Correctional Institution "Examining Prison Inmates' Attitudes and Internal Emotional States"). These participants became 12 matched pairs (matched by the type of abuse, the severity of the abuse, and age at which the injustice occurred) with each member of the matched pair randomly assigned to the experimental group or control group. Each inmate participated voluntarily in this study.

Since this study is a continuation of Study 1, the investigator named this study as Study 2.


Eligibility criteria: Inclusion Criteria:

* Participants who enrolled in Study 1 and need to satisfy the criteria of:

  1. most serious stories of abuse against them; 2. the least forgiving; and 3. the most psychologically compromised. 4. Also, given the duration of psychological treatments, participants' release date will also be considered.

Exclusion Criteria:

* Inmates who have received Forgiveness Therapy before.
* Inmates would be released or transferred to other institutions during the 12-month treatment.

Primary outcomes:
measure: Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anger
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anxiety
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Depression
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Herth Hope Index
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Enright Forgiveness Inventory
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Coopersmith Self-Esteem Inventory
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Toronto Empathy Questionnaire Score
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Change in Score on Marlowe-Crowne Social Desirability Scale
timeFrame: Baseline, 6 months, 12 months, 24 months
measure: Score on Maltreatment and Abuse Chronology of Exposure (MACE) Scale
timeFrame: Baseline
Secondary outcomes:
Other outcomes:
Locations:
city: Portage
country: United States
facility: Columbia Correctional Institution
state: Wisconsin
Study officials:
affiliation: University of Wisconsin, Madison
name: Robert Enright, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Erzar T, Yu L, Enright RD, Kompan Erzar K. Childhood Victimization, Recent Injustice, Anger, and Forgiveness in a Sample of Imprisoned Male Offenders. Int J Offender Ther Comp Criminol. 2019 Jan;63(1):18-31. doi: 10.1177/0306624X18781782. Epub 2018 Jun 21.
citation: Lee YR, Enright RD. A Forgiveness Intervention for Women With Fibromyalgia Who Were Abused in Childhood: A Pilot Study. Spiritual Clin Pract (Wash D C ). 2014 Sep;1(3):203-217. doi: 10.1037/scp0000025. Epub 2014 Aug 25.
citation: Waltman MA, Russell DC, Coyle CT, Enright RD, Holter AC, M Swoboda C. The effects of a forgiveness intervention on patients with coronary artery disease. Psychol Health. 2009 Jan;24(1):11-27. doi: 10.1080/08870440903126371.
citation: Hansen MJ, Enright RD, Baskin TW, Klatt J. A palliative care intervention in forgiveness therapy for elderly terminally ill cancer patients. J Palliat Care. 2009 Spring;25(1):51-60.
citation: Reed GL, Enright RD. The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. J Consult Clin Psychol. 2006 Oct;74(5):920-9. doi: 10.1037/0022-006X.74.5.920.
citation: Lin WF, Mack D, Enright RD, Krahn D, Baskin TW. Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. J Consult Clin Psychol. 2004 Dec;72(6):1114-21. doi: 10.1037/0022-006X.72.6.1114.
citation: McKay KM, Hill MS, Freedman SR, Enright RD. Towards a feminist empowerment model of forgiveness psychotherapy. Psychotherapy (Chic). 2007 Mar;44(1):14-29. doi: 10.1037/0033-3204.44.1.14.
citation: Enright, R. D., Erzar, T., Gambaro, M., Komoski, M. C., O'Boyle, J., Reed, G., & ... Yu, L. (2016). Proposing Forgiveness Therapy for those in Prison: An Intervention Strategy for Reducing Anger and Promoting Psychological Health. Journal of Forensic Psychology, 1, 116. DOI: 10.4172/2475-319X.1000116.
citation: Yu, L., Gambaro, M., Komoski, M. C., Song, M. J., Song, M., Teslik, M., Wollner, B., & Enright, R. D. (2018). The Silent Injustices against Men in Maximum Security Prison and the Need for Forgiveness Therapy: Two Case Studies. Journal of Forensic Psychology, 3, 137. DOI: 10.4172/2475-319X.1000137.