Trauma-informed Correctional Services for Female Offenders

1. Trauma-informed Correctional Services for Female Offenders Massachusetts Department of Correction 2009

2. Trauma “Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence or death. They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe. The common denominator of trauma is a feeling of intense fear, helplessness, loss of control, and threat of annihilation (Judith Herman, MD, Trauma and Recovery, 1992)

3. Trauma The Institute of Health and Recovery describes trauma as: • Extreme stress that overwhelms a person’s ability to cope. • The subjective experience of a threat to life, bodily integrity or sanity. • A normal response to an abnormal event that results in a disruption of equilibrium.

4. Trauma and Female Offenders • A majority of women in custody have substance abuse issues and/or mental health disorders and/or histories as victims of violence (Sacks 2004) • SAMHSA’s Women, Co-Occurring Disorders and Violence Study demonstrated that services based on understanding of trauma were more effective. (Coccozza, 2005)

5. CMHS found that such services result in fewer injuries to staff and clients and increased job satisfaction in inpatient mental health settings (DHHS 2005).

6. Why does trauma matter? The number of childhood traumas for female offenders are associated with: • Prostitution • Eating disorders • Mental Health disorders • Sexually transmitted diseases • Alcohol and drug abuse • Early onset of criminal behavior (Institute of Health and Recovery: Messina and Grella 2006)

7. Trauma Relates to Abuse • Sexual abuse • Physical abuse • Emotional abuse • Domestic violence • Witnessing abuse/violence • Self-inflicted violence

8. Co-occurring Disorders There is a high level of co-morbidity between post-traumatic stress disorder and: • Depression • Anxiety • Panic Disorder • Phobic Disorder • Substance Abuse • Physical Disorders” “Gender Responsive Strategies: “Research, Practice and Guiding Principles for Women Offenders: Covington & Bloom (2001)”

9. Pathways of Co-Occurrence Pathways can begin anywhere on the continuum of: • Victimization • Trauma sequelae/mental health problems • Self medication • Addiction • Criminal Behavior/Unsafe Choices (Institute of Health and Recovery for MA DOC 2008)

10. Trauma Triggers A “trigger” is an event that reminds a trauma survivor of the traumatic event(s). When a trigger is encountered, the survivor may have a flashback or become emotionally dysregulated. (Institute of Health and Recovery 2008)

11. When trauma survivors are dysregulated, some or all of the following may occur: • They may distort that they hear or see. • Hear only 3 out of every 7 words spoken. • Not be able to think things through. • Behave impulsively. • Use the same behavior that helped them to cope with the traumatic event.

12. Establishing a Safe Environment Minimize re-victimization by avoiding strategies such as: • Shaming • Putting women down • Disrespectful behavior • Unnecessary intrusions • Power struggles

13. Instead, there are helpful strategies on how to reduce situations which trigger trauma? • Establish good boundaries. • Be fair and consistent with treatment. • Provide as much information as possible-actually knowing what is going to happen will reduce a person’s anxiety. • Say what you are going to do before you actually do it. (Institute of Health and Recovery 2008)

14. Understanding the trauma experience • The behaviors that trauma victims present are attempts to cope. • They should not be personalized by the observer. • Power struggles should be avoided in order to reduce escalation. • “Backing off” or “giving space” may be the safest choice as consequences can be given later.

15. Mission Change “The mission of the Department’s Female Offender Services Division is to reinforce and develop innovative and comprehensive gender-responsive strategies to create a continuum of integrated trauma informed programs and services that address the multi-dimensional needs of female offenders.”

16. Steps to Implement the Mission Change • Female Offender Services Policy outlining the roles of the Director of Female Offender Services and the Female Offender Services Advisory Group. • Mental Health, Medical, Program Services (including parent and domestic violence, and substance abuse) and reentry contracts which provide an integrated approach using trauma-informed models. • Gender specific staff training with trauma education for all staff working with female offenders. • Education for female offenders. • Educate other stakeholders.

17. Mapping Progress Overall, the successful operations and leadership at MCI-Framingham, the new training initiatives, the change in mission utilizing trauma-informed models include but are not limited to the following key milestones: • Use of Force incidences went from 89 in FY 2003 to 49 in FY 2007 (about an 86% reduction) to only 17 in FY 2008 (representing a further reduction of 65%). • Assaults on Staff simultaneously decreased from 48 in FY 2007 to 32 in FY 2008 (representing a 32% decrease).

18. Inmate Grievances decreased from 239 in FY 2007 to 163 in FY 2008 (representing a 31% decrease). • Employee misconduct complaints were reduced from 299 in FY 2007 to 198 in FY 2008 (representing about a 33% reduction).