Mindfulness-Based Stress Reduction in Massachusetts Correctional Facilities

• Author: Marlene Samuelson,Jon Kabat-Zinn,Michael A. Bratt,James Carmody
• Published date: 01 June 2007
• Date: 01 June 2007
• DOI: http://doi.org/10.1177/0032885507303753
• Subject Matter: Articles

The Prison Journal
Volume 87 Number 2
June 2007 254-268
© 2007 Sage Publications
Mindfulness-Based Stress
10.1177/0032885507303753
http://tpj.sagepub.com
Reduction in Massachusetts
hosted at
http://online.sagepub.com
Correctional Facilities
Marlene Samuelson
Curry College, Milton, MA
James Carmody
Jon Kabat-Zinn
Michael A. Bratt
University of Massachusetts Medical School, Worchester
Mindfulness-based stress-reduction courses were offered in drug units in six
Massachusetts Department of Corrections prisons. A total of 1,350 inmates
completed the 113 courses. Evaluation assessments were held before and
after each course, and highly significant pre- to post-course improvements
were found on widely accepted self-report measures of hostility, self-esteem,
and mood disturbance. Improvements for women were greater than those for
men, and improvements were also greater for men in a minimum-security,
pre-release facility than for those in four medium-security facilities. The
results encourage further study and wider use of mindfulness-based stress
reduction in correctional facilities.
Keywords:
mindfulness-based stress reduction; meditation; stress reduction;
substance abuse
Individual criminal behavior has been attributed to an inadequate ability
to effectively deal with severe stress, deprivation, and low self-esteem,
and with peer pressure and the codes of behavior of groups such as gangs.
These factors can be severely compounded by the injection or ingestion of
drugs and alcohol, which offer the user relief from emotional discomfort by
impairing or eliminating normal levels of awareness and impulse control.
Authors’ Note: The authors would like to acknowledge Yunsheng, MA, PhD Anne Skillings,
MS Timothy Light, Tamara Parvizi, MA Joseph Kappel, Diana Kamila, MA and Joanna Bratt,
JD, for their involvement in analyzing or working with the data and Saki Santorelli, EdD, for
commenting on the article.
254

---

Samuelson et al. / Mindfulness-Based Stress Reduction
255
Under such circumstances, intense feelings such as fear, frustration, anger,
and greed can rapidly result in antisocial behaviors, and the resultant incar-
ceration in correctional institutions brings additional stress, with the possi-
bility of further exacerbating these conditions (Fogel, 1993; Perkins, 1998).
The regular practice of meditation has been shown to help individuals cul-
tivate deep and long-lasting experiences of inner calm, well-being, self-
worth, and self-respect (Kabat-Zinn, 1993). For this reason, there has been
increasing interest in recent years in the efficacy of meditation-based inter-
ventions in correctional institutions as a means of helping inmates deal with
the stress of incarceration and to acquire life-long inner resources to decrease
the likelihood of continuing criminal behavior and recidivism. The rationale
is that through the regular practice of meditation, inmates can grow to be less
reactive to intense emotional states without resorting to the use of drugs or
other chemical substances (Kabat-Zinn, 1993). There are reports of prison-
based studies of Vipassana meditation (Anonymous, 2000; Marlatt et al.,
2004; Parks et al., 2003), transcendental meditation (TM; Alexander et al.,
2003; Hawkins et al., 2003; Orme-Johnson & Moore, 2003; Shanmugam,
1992), and mindfulness meditation (Murphy, 1995; Perkins, 1998). The pre-
sent study is based on a program of mindfulness meditation.
Mindfulness is a sustained nonreactive attention to one’s ongoing mental
contents and processes (physical sensations, perceptions, affective states,
thoughts, and imagery) (Grossman, Niemann, Schmidt, & Walach, 2004;
Kabat-Zinn, 2005; Miller, Fletcher, & Kabat-Zinn, 1995). Mindfulness is
traditionally cultivated through formal training in mindfulness meditation,
and the resultant stable, nonreactive awareness appears to act as a resource
for more creative responding by bringing mental processes into greater con-
scious awareness and under greater voluntary control (Shapiro & Walsh,
2002). Moreover, because this natural capacity is under the individual’s
direct control, it can provide an experience of mastery (self-efficacy), so
that thoughts and intense feelings no longer threaten to overwhelm
(Teasdale, 1999; Teasdale et al., 2000). For many inmates, this may be their
first experience of inner control of mind or body states.
Mindfulness-based stress reduction (MBSR) is an 8-week program of
intensive training in mindfulness (moment-to-moment awareness) and its
integration into everyday life. MBSR was developed at the University of
Massachusetts (UMass) Medical Center in 1979 by Dr. Jon Kabat-Zinn
(1990) to provide a coping resource for patients dealing with intense
physical symptoms, chronic medical conditions, and difficult emotional
situations (Kabat-Zinn, 1994). Since that time, more than 16,000 people
with a wide range of disorders and difficult life situations have completed

---

256
The Prison Journal
the ongoing program at UMass, and programs based on Kabat-Zinn’s
model are now widely available throughout the United States and in other
countries. The MBSR program has also been used in stressful inner-city
community settings (Roth & Creaser, 1997; Roth & Stanley, 2002) and in
a therapeutic community for substance abuse treatment (Marcus et al.,
2003). Reports have demonstrated a high level of adherence or compliance
with the behavioral demands of MBSR (Kabat-Zinn & Chapman-Waldrop,
1988; Speca, Carlson, Goodey, & Angen, 2000; Williams, Kolar, Reger, &
Pearson, 2001), with about 85% of enrollees completing the program. A
number of studies have demonstrated positive attitudinal, health, and
behavioral changes associated with MBSR (Kabat-Zinn, 1982; Kabat-Zinn,
Lipworth, & Burney, 1985; Miller et al., 1995). These changes include
improvements in psychological and physical well-being and reductions in
anxiety and depression (Kabat-Zinn, 1992; Kaplan, Goldenberg, & Galvin-
Nadeau, 1993; Teasdale et al., 2000). The changes have been found to
endure at 3-month follow-up (Williams et al., 2001), 6-month follow-up
(Carlson, Ursuliak, Goodey, Angen, & Speca, 2001) and 4-year follow-up
(Kabat-Zinn, Lipworth, Burney, & Sellers, 1987). The MBSR program has
also been adapted and integrated into a variety of other clinical and
nonclinical settings (Kristeller & Hallett, 1999; Linehan, 1993; Saxe et al.,
2001; Teasdale et al., 2000).
Based on the belief that some of the psychological factors that lead to
criminal behavior may be changed through the practice of mindfulness
(Kabat-Zinn, 1993), the UMass Stress Reduction Clinic and the Massachusetts
Council on Criminal Justice agreed to conduct a program of MBSR in pris-
ons in the Massachusetts Department of Corrections system. The MBSR
program was one of several options offered in a rehabilitation program for
inmates incarcerated as a result of drug-related convictions. The program
was not designed or conducted as a formal research study, and limitations
imposed by administrative constraints, and the need to adapt to differences
among the various prison settings, necessitated some modifications from
the way in which MBSR programs are usually conducted at UMass (Kabat-
Zinn, 1990) and elsewhere.
Method
MBSR
The foundations and methodology of MBSR have been described in detail
elsewhere (Kabat-Zinn, 1990; Santorelli, 1999). Briefly, in the more usual

---

Samuelson et al. / Mindfulness-Based Stress Reduction
257
clinical setting, approximately 20 participants attend 8 weekly, 2.5-hour
classes and an all-day, mostly silent retreat or intensive experience during the
sixth week. During these sessions, participants receive training in mindful-
ness through a body scan meditation, sitting meditation, and mindful stretch-
ing exercises. There is a good deal of group discussion on the integration of
mindfulness into everyday life and the application of mindfulness as a
method for noticing habitual reactions to stressful situations and more cre-
atively responding (Kabat-Zinn, 1990). Some...