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Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative
Melissa J Zielinski1,2, M Kathryn Allison1, Mollee K Steely Smith1
1Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Journal of Traumatic Stress
|December 5, 2022
Summary
Cognitive Processing Therapy (CPT) shows promise for treating trauma and posttraumatic stress disorder (PTSD) in incarcerated individuals. Addressing implementation barriers is crucial for successful integration into correctional settings.
Area of Science:
- Correctional health
- Mental health services in prisons
- Trauma-informed care
Background:
- High prevalence of trauma and posttraumatic stress disorder (PTSD) among incarcerated populations.
- Untreated PTSD contributes to substance use disorders and recidivism, creating a cycle of trauma, addiction, and incarceration.
- Limited availability of evidence-based trauma-focused therapies within correctional facilities.
Purpose of the Study:
- To conduct a formative evaluation for an effectiveness-implementation trial of group-delivered Cognitive Processing Therapy (CPT) in prisons.
- To assess the feasibility and acceptability of implementing CPT among correctional stakeholders and incarcerated individuals.
- To identify potential barriers and facilitators to CPT implementation in a correctional setting.
Main Methods:
- Utilized the Consolidated Framework for Implementation Research (CFIR) for structured interviews.
- Conducted interviews with correctional leadership, treatment staff, healthcare staff, security staff (n=22), and incarcerated individuals (n=14).
- Gathered qualitative data on perceived compatibility, acceptability, resources, culture, and workflow related to CPT.
Main Results:
- Cognitive Processing Therapy (CPT) demonstrated high compatibility with incarcerated individuals' needs and correctional center resources, culture, and workflow.
- CPT was found to be acceptable to all interviewed stakeholders.
- Identified potential barriers including lower priority compared to system-supported programs, limited staff time and knowledge, and countertherapeutic environmental factors.
Conclusions:
- Cognitive Processing Therapy (CPT) is a promising trauma-focused intervention for correctional settings.
- Successful implementation requires proactively addressing identified barriers and aligning with policy for sustainability.
- Further research and strategic planning are needed to integrate CPT effectively into prison-based mental health services.
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