Symptom Management Group for Prisoners with Indicators of PTSD

Forensic Therapies receives a significant number of referrals for individuals symptomatic of Post Traumatic Stress Disorder (PTSD). Research shows that there is a higher incidence of PTSD among the prison population than among the general population. In response, we have devised a symptom management programme and at present this provision is available in HMP Pentonville.

The programme ‘LIVE LIFE’ uses a group treatment modality comprising 16 sessions over an eight-week period. Participants are required to attend two sessions each week.

Individuals can self refer or be referred by a professional working with them. The intervention operates in a closed group with intakes possible three times per year.

Screening and Assessment

This comprises a short structured clinical interview to assess PTSD traits as defined in DSM IV. We use the DAPS screening tool. Assessment also includes a brief description of the programmes and aims and expectations as well as assessing motivation, risk and suitability for group intervention. Treatment goals are set and focus on five ‘quality of life’ domains.

Inclusion Criteria

Prospective clients need to meet a minimum of two indicators for full threshold PTSD criteria, one of which must be difficulties with intrusion (e.g. intrusive thoughts, flashbacks, seeing images, experiencing smells etc.). Other relevant symptoms include nightmares, disturbed sleep patterns, feelings of numbness and being detached, arousal problems including hyper-vigilance, anger, generally feeling unsafe in the world, avoidance of thoughts, places etc. associated with a traumatic event and relationship problems.

Exclusion Criteria

  • Lifetime diagnosis of schizophrenia or bipolar affective disorder
  • Current symptoms of active mental illness including severe depression
  • Inability to communicate in English
  • Cognitive impairment
  • Medical or social issues which will impair ability to attend and work in a group setting

The Programme

The programme does not expect participants to explore past traumatic experiences. Instead, programme content focuses on symptom management with the aim of reducing distressing affect and improving self-management techniques. To achieve this, the programme uses methods from DBT, cognitive restructuring and art therapy.

Monitoring and Research

The programme makes use of pre and post treatment evaluation scales including self-report questionnaires, CORE and a PTSD assessment tool (DAPS). Findings are shared as appropriate. The programme is interested in identifying prisoners who have developed PTSD symptoms as a consequence of their offending behaviour. This will form part of a research project and appropriate ethical approval will be sought.

Facilitators

A team of three clinicians is involved in assessment and programme delivery.