|Meditation and Mindfulness: Treatment for Incarcerated Women|
|By Stephanie N. Williams, PhD|
Women worldwide continue to have higher rates of serious mental illness, depression, and PTSD when compared to their male counterparts (Tolin & Foa, 2006). Issues of poverty, socioeconomic disadvantage, and discrimination exacerbate the risk for mental health problems with women (WHO, 2014); which has increasingly lead to issues of incarceration. In order to improve the availability and effectiveness of mental health services within forensic settings, researchers should focus on creating gender-specific best practices as a way to reduce risk (Covington & Bloom, 2006). As meditation and mindfulness research continues to grow, its implementation within clinical settings expands and the ever increasing need to study the gender-specific impact of meditation and mindfulness with incarcerated women (Kabat-Zinn, 2003).
Incarceration rates of women with MH issues
Between 1980 and 2014 the number of incarcerated women has increased 700%, which equates to a rate of 50% more growth when compares to incarcerated males (sentencing project, 2015). According to recent research, women make up between 17-18% of all offenders under the jurisdiction of the criminal justice system (Bloom, Owen, Covington, 2004; US department of justice, 2013). Statistics provided from the Bureau of Justice suggest that 74% of incarcerated women have mental health issues; 60% of women experienced physical or sexual abuse and 70% of women under correctional sanction have minor children (James & Glaze, 2006; US Department of Justice, 1999).
A large study of pretrial women detainees found that 13.7% of women have major depressive episodes, 23.9% experience alcohol abuse/dependence, 52.4% are diagnosed with drug abuse/dependence and 33.5% have Post Traumatic Stress Disorder (PTSD) (Teplin, Abram, & McClellan, 1996). Another study reviewed lifetime prevalence rates of incarcerated women and found similar results with 13% percent of women experiencing major depressive episodes, 38.6% from alcohol abuse/dependence, and 44.2% from drug abuse/dependence. (Jordan, Schlenger, Fairbank, & Caddell, 1996) Twenty percent of women offenders have borderline personality disorder, which is ten times higher than that found within the community; additionally, detained pretrial women are more likely to attempt and die by suicide when compared to their male counterparts (Steadman, Osher, Robbins, Case, & Samuels, 2009; WHO, 2007)
Despite the recent rise in female incarceration and the overrepresentation of mental health issues within this population when compared to men, criminal justice policy continues to primarily focus on the rehabilitation and treatment of men (Wald, 2001). As a result of the aforementioned issues, there continues to be an unmet need for gender-specific treatment (Covington & Bloom, 2006). One empirically supported treatment for women diagnosed with PTSD, depression, or anxiety is meditation and mindfulness. These techniques have routinely been incorporated within Dialectal Behavior Therapy (DBT) (e.g. Linehan, 1993) and Acceptance and Commitment Therapy (ACT) (Hays, 1999). Mindful awareness helps maintain continuity of present moment attention and diffusion from thoughts and feelings (Murray-Swank & Waelde, 2013).
Meditation and Mindfulness Research
Exploratory research on the effectiveness of meditation and mindfulness with women has produced promising results (Coulter, 2002; Waelde, Thompson & Gallagher-Thompson, 2004; Butler et al., 2008). In a randomized trial, Butler et al. (2008) investigated reductions in depression diagnosis with three types of treatment modalities; Inner Resources Mindfulness Meditation (IR) with Yoga versus Group therapy with Hypnosis versus Psychoeducation among a predominately female sample of persons with chronic depression. The findings supported a trend for the use of Meditation (IR) and Hypnosis for reducing the severity of depressive symptoms as compared to psychoeducation. Furthermore, the 9-month follow-up showed that the meditation group produced more remissions than the psychoeducation group.
The IR meditation intervention was also found useful with the reduction of posttraumatic stress disorder (PTSD) symptoms in a sample of largely female mental health workers after Hurricane Katrina in New Orleans (Waelde et al., 2008). Results indicated that participants in this program experienced pre/post treatment reductions in PTSD and anxiety symptoms, with a strong relationship found between the amount of practice time and the level of symptom improvement. This study supported the clinical utility of meditation treatment in lowering hyperarousal, avoidance, anxiety and re-experiencing trauma. Similar to other research, these findings support the use of meditation and mindfulness with trauma-related dissociation in PTSD (Walede, Silvern, Carlson, Faibank & Kletter, 2009) as well as assisting clients with developing the capacity to deal with their trauma (Urbanowski & Miller, 1996) as well as prevent dissociation (Waelde et al., 2009; Waelde, 2014).
Mindfulness and Meditation techniques have also shown promising results within correctional settings (Coulter, 2002; Derezotes, 2000; Gillespie et al., 2012; Perelman et al., 2012). Vipassana meditation is currently being used in Seattle state prisons to reduce drug and alcohol use, recidivism rates, and increase self-awareness, self-efficacy and hope (Coulter, 2002). A longitudinal study performed from this program has shown that meditation has reduced recidivism rates in 45% of incarcerated women when compared to a control group over 14 years (Coulter, 2002).
Meditation and Mindfulness with Juveniles
A nonrandomized control study of meditation and mindfulness with detained male adolescents (Parkins, Williams, & Waelde, 2013) has shown that IR increases youth’s overall awareness and mindfulness. Due to the limited research in juvenile settings in correctional settings coupled with the lack of evidenced based treatment and policy for women (Bloom, Owen, & Covington, 2004), researchers have set out to study the implications of meditation and mindfulness with detained female adolescents in the future. Researchers believe that meditation and mindfulness will have similar treatment success when employed with an all female detained juvenile group.
In the Future
As women are the fastest growing group of people with mental illness within correctional facilities, they are in need of competent treatment to assist in their rehabilitative process. Moving forward, we hope that researchers will increasingly study the usefulness of mindfulness and meditation with incarcerated females to create diverse treatment options for this growing group. Practices that effectively address gender-specific issues through research-informed programming and policy are clearly needed in order to improve women’s outcomes throughout all of the criminal justices phases. (Covington & Bloom, 2006).
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Stephanie N. Williams, PhD obtained her Masters of Arts in Forensic Psychology from the Chicago Shool of Professional Psychology and her Doctorate from Palo Alto University. She has been employed by California Department of Corrections and Rehabilitation (CDCR)-Salinas Valley Psychiatric Inpatient Program(PIP), formally Department of State Hospitals (DSH)-Salinas Valley, as a staff psychologist since September 2015. In addition to her psychologist position she is the chair of the Suicide Prevention Committee, consulting psychologist for individual and cultural diversity supervision to a youth outreach agency and is the co-chair of the forensic committee of Santa Clara county psychological association. She specializes in suicide risk, forensic evaluations, and personality assessment of ethnic minorities.
"The information contained in this report reflects the author's views and not necessarily the views of the California Department of Corrections and Rehabilitation. Correspondence concerning this article should be addressed to Stephanie N. Williams, California Department of Corrections and Rehabilitation, Salinas Valley Psychiatric Inpatient Program, 31625 U.S. 101, Soledad, CA 93960. Email: Stephanie.Williams1@cdcr.ca.gov"
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