An intervention to improve coping strategies in adult male prisoners with a history of traumatic brain injury: A pilot randomised clinical trial

Abstract

Objective: To determine whether a psychological intervention improves coping, post-concussion symptoms and decreases in-prison infractions in adult males with a history of traumatic brain injury. Design: A single centre, randomised, wait-list, pilot study. Setting: A high security prison in New Zealand. Subjects: Fifty-five adult male participants who had experienced at least one traumatic brain injury in their lifetime (mean age 37.29 +/−9.81 years). Intervention: A manualised ten session, in-person, group based combined Cognitive Behavioural Therapy /Mindfulness Based Stress Reduction intervention versus wait list control. Main measures: The Negative Affect Repair Questionnaire and Rivermead Post-concussion Symptom Questionnaire were completed at baseline, post-intervention (five weeks) and at 12 week follow up. In-prison misconduct charges and negative file notes were reviewed for the previous five weeks at each assessment time point. Results: There was an improvement in the use of calming and distraction strategies in the intervention group from baseline ( x̄ = 17.38, SD = 3.57) to post-intervention ( x̄ = 18.67, SD = 3.84) and 12-week follow up ( x̄ = 18.13, SD = 2.63). Participants in the intervention group had significantly higher negative affect repair on the calming and distractive strategies subscale following completion of the intervention, compared to wait-list controls ( F = 4.69, P = 0.04) with a moderate effect size (ηp2 = 0.11). Improvements in use of calming and distractive strategies was not sustained at the twelve-week follow-up ( F = 0.87, P = 0.36). There was no-significant improvement on other negative affect subscales or for post-concussion symptoms or decrease in-prison infractions. Conclusion: A manualised psychological intervention may have the potential to facilitate the development of positive coping strategies in prisoners with a history of traumatic brain injury.

Rehabilitation among individuals with traumatic brain injury who intersect with the criminal justice system: A scoping review

“…The articles included in this review were published between 1991 and 2021. Eight articles (33.3%) described rehabilitation interventions specifically for individuals with TBI who intersect with the CJS (49)(50)(51)(52)(53)(54)(55)(56), three of which were behavior-focused interventions (37.5%) (49)(50)(51) and the remainder (N = 5, 55.5%) described interventions that connected individuals to necessary supports to facilitate engagement, rehabilitation, and community re-integration (herein referred to as "linkage programs") (52)(53)(54)(55)(56). Sixteen articles (66.7%) were health servicesrelated articles that described the use of rehabilitation health services without specific information on the rehabilitation interventions (57-72).…”

“…Eight articles described rehabilitation interventions that were developed or implemented specifically for individuals who experienced TBI and are involved with the CJS ( 49 – 56 ). These articles were further categorized based on the overarching goal(s) of the rehabilitation programs or interventions: (1) behavior-focused interventions ( N = 3) ( 49 – 51 ) and (2) linkage programs ( N = 5) ( 52 – 56 ).…”

“…Three articles described rehabilitation interventions that aimed to improve coping strategies ( 51 ), manage sexually intrusive behavior ( 49 ), and address bullying ( 50 ) through behavioral ( 49 ) or cognitive-behavioral interventions, ( 49 , 51 ) integrating mindfulness-based stress reduction ( 51 ) and building pro-social skills focused on anger management and moral development ( 50 ). Psychoeducation ( 49 ) and pharmacological interventions ( 49 ) were also considered, where appropriate.…”

“…Psychoeducation ( 49 ) and pharmacological interventions ( 49 ) were also considered, where appropriate. These interventions were delivered in individual ( 49 ) or group formats, ( 50 , 51 ) which may include family members ( 49 , 50 ) within a prison ( 51 ), psychiatric and residential treatment facility ( 49 ), and community-based neuro-behavioral rehabilitation unit ( 50 ). Psychologists ( 51 ), psychosocial counselors, education specialists, neuropsychiatric consultants ( 49 ), and community placement personnel ( 49 ) were involved in the interventions.…”

“…This scoping review explored the extent to which rehabilitation, including the types of rehabilitation programs or interventions, is available to, or used by, individuals with TBI who intersected with the CJS. A systematic search of the literature identified 22 primary research articles and 2 gray literature reports describing programs/interventions specifically for individuals with TBI who intersect with the CJS (49)(50)(51)(52)(53)(54)(55)(56) or health services-related articles that described the use of rehabilitation health services without specific information on the rehabilitation intervention (57-72). Only 8 articles reported health professionals who contributed to the rehabilitation programs/interventions (51-56, 67, 70).…”