The Effectiveness of Trauma-Focused Interventions in Prison Settings: A Systematic Review and Meta-Analysis

被引:29
作者
Malik, Nabeela [1 ,2 ]
Facer-Irwin, Emma [1 ,3 ]
Dickson, Hannah [1 ]
Bird, Annie [1 ]
MacManus, Deirdre [1 ,4 ]
机构
[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Forens & Neurodev Sci Dept, London, England
[2] North East London Fdn NHS Trust, Older Adults Psychiat, London, England
[3] Univ Essex, Sch Hlth & Social Care, Dept Clin Psychol, Colchester, Essex, England
[4] South London & Maudsley NHS Trust, HMP Wandsworth, London, England
基金
美国国家卫生研究院;
关键词
posttraumatic stress disorder; trauma-focused interventions; trauma processing; prison; interventions; complex PTSD; psychological therapy; trauma-informed care; POSTTRAUMATIC-STRESS-DISORDER; INCARCERATED WOMEN; COMPLEX PTSD; SUBSTANCE-ABUSE; SEEKING SAFETY; THERAPY; SYMPTOMS; HEALTH; BIAS; INSTRUMENT;
D O I
10.1177/15248380211043890
中图分类号
DF [法律]; D9 [法律];
学科分类号
0301 ;
摘要
Background: Posttraumatic stress disorder (PTSD) is overrepresented in prison relative to community populations and can be difficult to manage in an environment which can inherently exacerbate trauma-related symptomology. Little is known about the effectiveness of trauma-focused interventions in prison and less is known about factors that moderate the effectiveness of these interventions. Aim/Methods: We examined the effectiveness of trauma-focused interventions in prison relative to prison controls using meta-analytic techniques. We further used meta-regression analysis to examine treatment, methodological and participant-level moderators to determine factors that increased the effectiveness of these interventions. Results: From 16 studies eligible for the meta-analysis, we found a small but significant effect size for trauma-focused interventions. Phase 2 trauma processing interventions and interventions delivered individually led to greater reductions in PTSD symptoms. Studies utilizing an active treatment control resulted in smaller effect sizes than those using waitlist or no contact controls. Treatment length, study quality, outcome type, and gender were not significant moderators of treatment effectiveness. Conclusion: Findings from this review are encouraging but should be interpreted with caution. Results suggest that trauma processing therapies, and individual modality trauma-focused interventions can be effective and delivered successfully in prison. However, inadequate comparison groups do not allow a firm conclusion to be drawn. There is a need for high quality Randomized Controlled Trial's that additionally measure Complex PTSD, utilize a modular treatment approach, and include treatments recommended in the National Institute for health and Care Excellence (NICE) guidelines such as Trauma-focused CBT and Eye Movement Desensitization Reprocessing (EMDR).
引用
收藏
页码:844 / 857
页数:14
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