Opening the proverbial 'can of worms' on trauma-specific treatment in prison: The association of adverse childhood experiences to treatment outcomes.

Abstract

A large body of research has shown that incarcerated populations have a high prevalence of adverse childhood experiences (ACEs), increasing their risk for associated mental health problems and violent and aggressive behaviours. Emerging research on treatment for trauma survivors shows evidence that incarcerated women and men, with the most complex histories of trauma and abuse, can be responsive to trauma-specific treatment. Current research assessing two gender-responsive and trauma-specific brief interventions (e.g., Healing Trauma for Women and Exploring Trauma for Men) have demonstrated feasibility, consistency and efficacy among incarcerated populations. The current study uses secondary data analysis to explore the relationship between cumulative ACEs and the impact of the Healing Trauma and Exploring Trauma on participant's (682 women and 624 men) mental health, aggression and anger outcomes. The mixed-method regression results show that the impact of ACEs on treatment outcomes is strong and cumulative (i.e., greater exposure to childhood traumatic events increased the likelihood of participant programme gain on all the mental health and aggression outcomes, ranging from .13 to 1.2 for women and .15 to .77 for the men). The lowest significant coefficient for both women and men was for verbal anger and the largest was for current trauma symptoms. The association of ACEs on anger outcomes varied between women and men (revealing more association among the men). The findings show a strong positive impact for the trauma-specific brief interventions, particularly for those with the highest levels of trauma, whom otherwise might not have been ineligible for any programme participation.