No Lost Causes: Bringing Cognitive Behavioral Therapy and Trauma Informed Care into Prisons

Abstract

The United States incarceration rate has become a significant public health crisis, with marginalized communities disproportionately impacted and mental health challenges exacerbated within correctional facilities. With approximately 2.2 million individuals incarcerated annually in the U.S. and 5.4 million under correctional supervision, the financial and human costs are immense. Mental illnesses such as post-traumatic stress disorder, depression, and substance use disorders are prevalent, especially among women, and far exceed rates seen in the general population. Despite the urgent need for mental health support, many correctional facilities continue to rely on punitive measures rather than trauma-informed care (TIC), perpetuating untreated mental health issues. This proposed pilot program in Washington State aims to provide group CBT therapy for inmates and mandatory TIC training for prison staff, focusing on enhancing coping skills, reducing maladaptive behaviors, and fostering a rehabilitative, supportive environment. The program's success will be measured through improvements in inmate mental health using the PHQ-9, GAD-7, and Personality Belief Questionnaire (PBQ), as well as by evaluating prison staff attitudes using the Attitudes Regarding Trauma Informed Care (ARTIC) scale. The goal is to create a safer, more supportive environment for incarcerated individuals and prison staff, ultimately improving their mental health outcomes and facilitating successful reentry into society and a reduction in recidivism rates.