Substance Abuse and Trauma in Incarcerated Women

• PTSD checklist (change from baseline at one week post treatment) [ Time Frame: one-week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  17 item post traumatic stress disorder symptoms checklist will be administered pre treatment and one week following 4 month treatment completion.
• Trauma Related Nightmare Survey (change from baseline at one week post treatment) [ Time Frame: one week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  brief assessment of nightmare frequency and severity to be administered pre-treatment and one week following 4 month treatment completion.
• Posttraumatic Cognitions Inventory (change from baseline at one week post treatment) [ Time Frame: one week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  36 item assesment of cognitions related to world, self and blame to be administered pre-treatment and one week following 4 month treatment completion.
• CES-D, NIMH (change from baseline at one week post treatment) [ Time Frame: one week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  Center for Epidemiologic Studies Depression Scale (CES-D), NIMH is a 20 item depression inventory to be administered pre-treatment and one week following 4 month treatment completion.
• Drug-Taking Confidence Questionnaire (change from baseline at one week post treatment) [ Time Frame: one week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  50 item assessment of alcohol and drugs self efficacy to be administered pre-treatment and one week following 4 month treatment completion.
• Trauma Symptoms Inventory (change from baseline at one week post treatment) [ Time Frame: one week before treatment, one week post treatment ] [ Designated as safety issue: No ]
  100 item trauma symptoms questionnaire to be administered pre-treatment and one week following 4 month treatment completion.

The proposed study will evaluate Covington's Helping Women Recover (HWR) plus Beyond Trauma (BT) curriculum with female offenders at Eddie Warrior Correctional Facility in Taft, Oklahoma. The purpose of the proposed study is to expand previous findings by including a comparison group of women that are not receiving treatment but are otherwise eligible, and by using outside evaluators to conduct the assessments. Furthermore, this study will extend the outcomes measured in previous evaluations by including measures of sleep disturbance, posttraumatic cognitions, and a more extensive assessment of trauma-related symptoms. The hypotheses for this study are listed below:

1. Incarcerated women with substance use disorders and history of trauma enrolled in the integrated treatment program (HWR plus BT) will report significantly fewer symptoms on measures of posttraumatic stress and associated cognitions, substance use, depression, and related symptoms following treatment than those in the comparison group.
2. Those in the treatment group will improve significantly more than those in the comparison group on the symptoms listed above.

• Substance Abuse
• Trauma
• Post Traumatic Stress Disorder
• Integrated Treatment
• Incarcerated Women

• Experimental: cognitive behavioral group treatment
  Helping Women Recover/Beyond Trauma integrated substance abuse and trauma treatment group. (Dr. Covington)
  Intervention: Behavioral: Helping Women Recover/Beyond Trauma
• No Intervention: comparison group
  a comparison group of incarcerated women will receive the pre and post assessments with no interventions.

Inclusion Criteria:

• Incarcerated women at Eddie Warrior Correctional Center (EWCC) in Taft, Oklahoma

• The following 6 criteria are then employed at EWCC for HWR/BT treatment eligibility:

  1. An Level of Service Inventory (LSI) score of 30 or greater
  2. An LSI protective score of 15 or less
  3. 1.5 years or less remaining in prison
  4. A Case Plan identifying substance abuse treatment need
  5. Ability to read and comprehend
  6. 18 years of age or older

Exclusion Criteria:

• Under age 18
• Not incarcerated
• More than 1.5 years remaining in prison
• LSI score less than 30 or a protective of more than 15
• No identified substance abuse need
• Inability to read and comprehend