Empowering Through Embodied Awareness: Evaluation of a Peer-Facilitated Trauma-Informed Mindfulness Curriculum in a Woman’s Prison
| DOI | 10.1177/0032885519860546 |
| Date | 01 September 2019 |
| Published date | 01 September 2019 |
| Subject Matter | Articles |
research-article2019
Article
The Prison Journal
2019, Vol. 99(4S) 14S –37S
Empowering Through
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https://doi.org/10.1177/0032885519860546
DOI: 10.1177/0032885519860546
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Evaluation of a
Peer-Facilitated
Trauma-Informed
Mindfulness Curriculum
in a Woman’s Prison
Danielle Rousseau1, Nicole Long2,
Elizabeth Jackson3, and James Jurgensen4
Note: A video link is available for viewing the program highlights:
https://youtu.be/B6P51HYnbyY
Abstract
The cumulative effects of trauma, violence, and substance abuse both define
women’s pathways into the correctional system and contribute to their unique
needs within it. This research offers a case study of the implementation of a
gender-responsive, trauma-informed integrated mindfulness program within
a women’s prison. Applying a yoga-based psycho-educational approach, the
manualized curriculum was presented in a 16-session, closed-group format
with peer-facilitation and pre- and postprogramming assessments. Overall,
outcomes of this study were promising. Program participants demonstrated
improvements in the use of healthy coping skills, experience of traumatic stress,
symptoms of anxiety and depression, self-compassion, sense of connection,
ability to relate to others, emotional awareness, and self-regulation.
1Boston University, MA, USA
2Independent Researcher, Fort Collins, CO, USA
3Independent Researcher, Falmouth, ME, USA
4Independent Researcher, Boston, MA, USA
Corresponding Author:
Danielle Rousseau, Boston University, 1010 Commonwealth Avenue, Room 510, Boston,
MA 02215, USA.
Email: danrou@bu.edu
Rousseau et al.
15S
Keywords
yoga, mindfulness, trauma, gender, women in prison
Introduction
The experience of women within the criminal justice system is unique and
their pathways to justice involvement distinct. Since 1980, the rate of growth
for number of individuals incarcerated in women’s prisons has been twice as
high as that of men (The Sentencing Project, 2017). Upon entering prison,
individuals incarcerated in women’s prisons bring distinct physical and men-
tal health needs. According to a report on by the MacArthur Foundation and
the Vera Institute, 86% of individuals incarcerated in women’s prisons have
experienced sexual assault, 32% have a serious mental illness, and 82% have
a drug or alcohol dependence (Swavola, Riley, & Subramanian, 2016). The
cumulative effects of trauma, violence, and substance abuse both define these
individuals’ pathways into the correctional system and contribute to their
unique needs within it (Bloom, Owen, & Covington, 2003; Covington &
Bloom, 2006, 2008; Green, Miranda, Daroowalla, & Siddique, 2005).
It is critical to develop trauma-sensitive systems of health care within
women’s prisons based on their unique needs. Maintaining an overall healthy
sense of being requires attentiveness to both physiological and psychological
health (Brown & Ryan, 2003). Currently, the correctional system offers a
variety of mental health care options within women’s prisons, including psy-
chiatric medication as well as individual and group therapy. However, the
availability of these options is only the first step; the programming imple-
mentation must be responsive to the dynamic needs of the women in these
facilities. Therefore, resources for programming should be allocated based on
the greatest areas of need—in the case of women’s prisons, this being physi-
ological and psychological distress resulting from experiences of trauma,
violence, and substance dependence. Once those areas of need are identified
and resources are appropriately allocated, programming must be delivered in
a way that responds to the unique requirements and strengths of the inmates
in attendance. For example, the experience of individuals likely to be housed
within women’s prisons—both for cisgender women and gender minorities—
is different than that of individuals likely to be incarcerated within men’s
prisons. Effective programming acknowledges the significance of gender by
considering how it has shaped individuals’ life experiences, their sense of
embodiment, and their likeliness to benefit from various forms of engage-
ment. The delivery of programming is then adjusted accordingly. Thus,
trauma-informed, gender-responsive programming seeks to not only identify
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The Prison Journal 99(4S)
the greatest areas of need but also to tailor the way those needs are addressed
in consideration of gender and how it shapes experiences, embodiment, and
engagement.
Alternative and complementary treatment methods for mental health,
including yoga and other mindfulness-based approaches, have recently been
integrated into correctional practice. There is a growing body of evidence
supporting the impact of mindfulness for an inmate population (Auty, Cope,
& Liebling, 2015; Epstein & Gonzalez, 2017). Furthermore, in addition to
being a generally effective treatment method within the context of incarcera-
tion, studies have also found that mindfulness-based approaches can be an
valuable means of addressing specific health issues that are prevalent in
women’s prisons, such as posttraumatic stress disorder (PTSD; for a recent
clinical study examining the benefits of yoga in a PTSD population see van
der Kolk et al., 2014). Given such evidence, mindfulness-based treatment
programs appear to be uniquely well-positioned to serve the health care needs
of individuals incarcerated in women’s prisons.
This research offers a case study of the implementation of a gender-
responsive, trauma-informed integrated mindfulness program within a wom-
en’s prison. The program represents a yoga-based psycho-educational
approach to helping women understand and respond to the emotional and
embodied physical impacts of trauma and traumatic stress. The current case
study represents a manualized curriculum presented in a 16-session, closed-
group format with peer-facilitated implementation.
Background
Women in the Prison System
Historically, since incarcerated women have made up such a small percent-
age of the overall prison population, their specific physical and mental health
needs often receive less attention. That individuals incarcerated within wom-
en’s prisons comprise only 7% of the total U.S. prison population does not
serve as an accurate gauge for resource allocation. In comparison to those
incarcerated in men’s prisons, women in prison more often show significant
signs of serious psychological distress and are more likely to have been diag-
nosed with a mental health disorder by a mental health professional (Bureau
of Justice Statistics, 2017b, 2018). Specifically, imprisoned women show
higher rates of physical and sexual abuse, display communicable diseases
and ailments, more likely meet the Diagnostic and Statistical Manual of
Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association,
1994) criteria for drug abuse or dependence, and have children to care for as
Rousseau et al.
17S
single parents (Bureau of Justice Statistics, 2017a; Swavola et al., 2016).
Furthermore, female inmates experience a higher rate of mental disorders—
mainly depression, PTSD and substance abuse—than females in the general
population (Bloom et al., 2003). Therefore, individuals incarcerated in wom-
en’s prisons demonstrate a greater need for health services—both generally
and within specific facets of physical and mental health—than both women
in the general population and men who are incarcerated.
Practitioners and researchers have developed a variety of trauma-
informed programs to meet women’s treatment needs. These programs are
frequently psycho-educational and seek to provide empowerment through
education and connection through group cohesion. A variety of reputable
manual-based programs are currently in existence, and trauma-informed
programming is being implemented in both prison settings and the commu-
nity. Examples include Lisa Najavits’s Seeking Safety, Maryland Mental
Hygiene Administration’s Trauma, Addiction, Mental Health, and Recovery
(TAMAR) and Stephanie Covington’s Beyond Trauma: A Healing Journey
for Women (Covington, 2003/2016; Najavits, 2002; Substance Abuse
Mental Health Services Administration, 2018). To date, there is a strong
body of evidence demonstrating the positive impacts of these programs
(Messina, Calhoun, & Braithwaite, 2014; Najavits & Hien, 2013; Oklahoma
Department of Corrections, Evaluation and Analysis Unit, 2013; Sacks,
2004; Saxena, Messina, & Grella, 2014; Zlotnick, Najavits, & Rohsenow,
2003). Expanding the scope of gender-responsive trauma-informed treat-
ment protocols to include alternative and complementary treatment
approaches could provide additional benefit to women and gender minori-
ties in the correctional setting.
Yoga as a Complementary Therapeutic Tool
Having origins in Indian philosophy, yoga and mindfulness programs have
begun to receive attention and validation as legitimate therapeutic interven-
tions (Salmon, Lush, Jablonski, & Sephton, 2009). Yoga has multiple health
benefits, incorporating and improving both emotional and physical strengths
(Garfinkel & Schumacher, 2000). Specifically in terms of psychological
outcomes, yoga and mindfulness have been shown to reduce symptoms of
PTSD (van der Kolk et al., 2014), anxiety (Smith, Hancock, Blake-Mortimer,
& Eckert,...
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