Post-Traumatic Stress Disorder (PTSD) Therapy for Wisconsin Prison Inmates

At a Glance

Despite the pressing need for post-traumatic stress disorder (PTSD) treatment within the jail and prison population, there is virtually no research examining the efficacy of such therapies in incarcerated adults. Researchers at UW – Madison partnered with the Wisconsin Department of Corrections (DOC) to implement and evaluate cognitive processing therapy (CPT) for prison inmates, a promising PTSD intervention due to the cost- and time-effectiveness of its group format. Overall, study data indicated that group CPT in state prisons is feasible, acceptable and effective.

The Challenge

Many of Wisconsin’s prison inmates have PTSD, a mental health disorder that develops in people who have experienced emotionally traumatic events, such as neglect or abuse. In fact, rates of PTSD among prison inmates are estimated to be more than 10-fold higher than in the general population. Untreated PTSD is linked to dire outcomes like higher rates of suicide, victimization and recidivism. Thus, better treatment is needed to improve mental health and ensure better outcomes for inmates.

Project Goals

The long-term goal of this program is to increase the delivery of evidence-based treatment for PTSD in the prison setting. This project addressed three specific aims:

1. Establish the feasibility of delivering CPT to incarcerated individuals with PTSD.
2. Determine the effectiveness of CPT in reducing PTSD symptom severity.
3. Identify reputed psychological mechanisms of response to CPT.

Results

The project team recruited men and women in Wisconsin state prisons to complete a 12-session group CPT course. In the first phase of the study, therapists from the UW research team provided treatment to six CPT groups in a women’s prison and six groups in a men’s prison. Participants’ retention and satisfaction were high, and they experienced no significant safety concerns related to the treatment. In addition, there was a strong and clinically significant reduction in PTSD symptoms after completing CPT. In the second phase of the study, DOC psychologists provided treatment in collaboration with the UW research team for six CPT groups at a women’s prison and one group at a men’s prison. Results from these groups were similarly positive to the first phase. Moreover, DOC therapists were highly satisfied with the treatment, noted numerous positive changes among participants after completing CPT and recommended providing the treatment to their colleagues.

The success of this project has allowed the team to obtain external funding to expand group CPT to at least six prison sites in Wisconsin and provide treatment to over 600 incarcerated individuals.