"I Don't Know How to Live Sober": Trauma-Informed Treatment in Carceral Settings

Background and Purpose: The Grand Challenge of smart decarceration responds to the high rate of incarceration in the United States, which disproportionately affects persons of color and those living in poverty.  Women are the fastest-growing group in carceral settings.  High recidivism rates, however, indicate this penal system may not work effectively.  Prior research has found high rates of trauma histories and substance use disorders (SUDs) in women who are incarcerated; this suggests an opportunity for increased research and improved practice with this population.  This study sought to explore the experiences of women in a county detention center who were enrolled in a trauma-informed recidivism-prevention program.

Methods: This descriptive phenomenological analysis used in-depth semi-structured interviews with 35 individuals.  Participants included women who are incarcerated (n = 35) and key informants who led the program (n = 5).  Thematic analysis was used to identify overarching themes and codes.  Member checking was used with key informants to ensure accuracy of data.  Analyst triangulation was used to ensure reliability of analysis. 

Results: This study presents evidence supporting the use of trauma-informed programming during incarceration.  A common theme revealed participants interpreted their current incarceration to be a turning point in their lives.  Responses to probing questions indicated many participants felt supported and empowered through the treatment program, particularly in regard to its focus on factors contributing to incarceration.  Primary themes included the experience of trauma and its link to substance use.  Nearly half of the participants experienced trauma (n = 17, 48.6%), while 25 participants (71.4%) indicated substance use to contribute to their current incarceration.  Prior to release, 100% (N = 27) of the participants indicated they would recommend participation in this program to other individuals who are incarcerated.  Participants reported benefitting from classes on substance use, therapy, yoga, and knitting as mechanisms through which they learned to address longstanding trauma, build resilience, and embrace self-love and mindfulness.

Conclusions and implications: Most participants in this study (n = 31) were incarcerated due to nonviolent drug offenses with histories of significant prior criminal justice involvement/incarceration.  At the same time, they linked their participation in the treatment program to expecting better decarceration and lowered recidivism.  These findings corroborate and extend prior research regarding the incarceration of women.  Themes elicited specifically buttressed the utility of trauma-focused SUD programs in carceral settings; implications include the need for additional research, policy considerations, and practice with women who are incarcerated.