Trauma, Power, and Intimate Relationships Among Women in Prison

Reimbursing incarcerated individuals for participation in research: A scoping review

BACKGROUND

Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices.

METHODS

We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided.

RESULTS

A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9).

CONCLUSIONS

The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.

Contextualizing Cisgender Women's Histories of Intimate Partner Violence Victimization With Men and Women

Sexual minoritized women (SMW) are more likely than exclusively heterosexual women to experience intimate partner violence (IPV). We conducted in-depth interviews with a clinic-based sample of plurisexual SMW (n = 25) ages 18 to 34 about the gender of their perpetrators. Participants primarily experienced physical and sexual IPV in relationships with men and emotional abuse in relationships with women. IPV perpetrated by men often included weapons with women fearing for their lives. Offering patients information about IPV resources and supports that do not make assumptions about women's sexualities may create more opportunity for empathic and effective communication with SMW experiencing IPV.

Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison

Incarcerated women report high rates of sexual victimization. Interviews with 63 previously incarcerated women survivors of sexual violence explored perceptions toward receiving trauma-focused therapy while incarcerated and postrelease trauma-focused therapy utilization. Nearly all participants (97%) recommended that trauma-focused therapy be available to incarcerated women. Most believed that prisons are acceptable places to receive trauma-focused therapy, without qualification (65%); some reported mixed feelings or indicated acceptability but identified factors that would increase acceptability (33%). Notably, most were currently experiencing trauma-related symptoms, but few had attended trauma-focused therapy following release. Findings indicate that access to prison-based trauma-focused therapy is necessary and acceptable.

PROTOCOL: Domestic abuse interventions for mothers in or exiting prison: An evidence and gap map

This is the protocol for a evidence and gap map. The objectives are as follows: to identify existing research and gaps in evidence according to the types of interventions, settings, study design and outcomes; to use the EGM findings to inform subsequent systematic reviews and to identify gaps in evidence to inform future research, policy or practice.

Women's Lived Experience of the Interconnectedness of Trauma, Substance Use, and Prison

The aim of the study was to explore women's experience of Icelandic prisons and of the interconnectedness of trauma, substance use, and prison. Nine incarcerated women, 20-45 years old, participated in this phenomenological study. One or two in-depth interviews were conducted with each participant, in all 16 interviews. The interconnectedness of trauma, substance use, and prison was evident in the participants' accounts. The participants had experienced severe traumas, in childhood and/or in adult life, most of it caused by recurrent experience of violence, bullying, neglect, and beatings and later violent relationships. For the participants, substance use was an unhelpful coping strategy intended to numb severe emotional distress. Most of the participants used substances intravenously that had progressed incredibly fast from initial drug use. They had tried most of the addiction treatments available to them, none of which were trauma based. Participants struggled with complex physical and mental health problems related to substance use and previous traumas but often felt prejudged when they sought healthcare services. They experienced being in prison as depersonalizing and dehumanizing. Most of them were mothers and had lost custody of their children because of substance use causing some of them deep grief. Participants called for more active substance treatment programs in prisons and complained about idleness that they felt increased their addiction. As a conclusion, we call for a trauma-informed care approach in prisons for women to prevent revictimization as well as to assist with mental health issues and substance use.

"I'm not alone, my story matters": Incarcerated women's perspectives on the impact and acceptability of group psychotherapy involving imaginal exposure to sexual assault memories

BACKGROUND

Although it is clear that incarcerated women need access to effective therapies for trauma sequelae, some have argued that one of the most effective treatments - exposure therapy - should not be provided in carceral settings due to the presumed lack of safety and stability making such an intervention inappropriate. Group therapy, the typical mode of intervention in prisons, has also been presumed to be unacceptable for exposure-based processing due to assumptions that hearing others' trauma narratives would be traumatizing and unhelpful to listeners. However, there is a lack of data to support either of the aforementioned assumptions. This study examined the acceptability of an exposure-based group therapy for women survivors of sexual violence who were currently incarcerated (N = 61) by asking women themselves about their experiences completing an exposure-based group therapy protocol (SHARE; Survivors Healing from Abuse: Recovery through Exposure) while incarcerated. We assessed women's reasons for enrolling in the group, satisfaction with various therapy components (e.g., exposure, skill-building) and the treatment overall, and experiences of both sharing and listening to trauma narratives using a feedback survey that included a mix of multiple-choice and open-ended questions. Treatment dropout was examined as an additional index of acceptability.

RESULTS

Treatment completion was very high (88.8%). Nearly all women who completed the group reported that they would recommend it to other incarcerated women (96.7%, with the remaining 3.3% reporting "it depends"). Qualitative results revealed overwhelmingly positive feedback about the effect of the group and indicated that sharing and listening to trauma narratives in a group setting serve discrete but dually important functions. Specifically, women almost universally experienced listening to others' trauma narratives (i.e., exposures) in the SHARE group context as helpful-making them feel less alone and normalizing their experiences. Sharing one's own story primarily provided an emotional release and/or transformation (i.e., an intrapersonal rather than interpersonal function).

CONCLUSIONS

Our findings challenge common concerns about the appropriateness of 1) prison as a context for trauma-focused treatments, including exposure and 2) sharing trauma narratives in a group setting. Unless empirical evidence demonstrating harm is uncovered, best practices for PTSD and other trauma-related sequelae-those recommended in reputable treatment guidelines and interventions like SHARE that incorporate components shown to be effective (e.g., cognitive challenging, exposure)-should be offered to incarcerated women as part of standard of care.