• February 2021 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
Prior to incarceration, both women and men report a history of significant traumatic experience (95.5% and 88.6% respectively). That is before arrest and conviction which can provide additional trauma. Trauma care is a major focus of the work that L.A. CADA does with people in the criminal justice system who have behavioral health issues.
Jails and prisons are designed to house perpetrators, not victims. Inmates arrive shackled and are crammed into overcrowded housing units, lights are on all night, speakers blare without warning, and privacy is severely limited. Security staff, focused on maintaining order, must assume that each inmate is potentially violent. Therefore, the correctional environment is full of unavoidable trauma triggers — pat downs and strip searches, frequent discipline from authority figures, and restricted movement. For people serving time, this is likely to increase trauma-related behaviors and symptoms that corrections systems are not equipped to manage.
Staff working in criminal justice settings – pre/post-release — can play a major role in minimizing triggers, stabilizing offenders, reducing critical incidents, de-escalating situations, and avoiding restraint, seclusion or other measures that may repeat aspects of past abuse. The tool is a trauma-informed system.
Understanding trauma can be complicated. Trauma can stem from an isolated incident (experiencing or witnessing violence, sexual assault, stalking, emotional abuse, child abuse, and many other things) and from repeated incidents over a lifetime. It can be compounded by multi-generational and/or historical trauma. This happens when an already devastating memory is compounded by “cumulative emotional and psychological wounding over the lifespan and across generations, emanating from group trauma experiences”. Things like colonization, war, or genocide. Due to historical trauma, many survivors of violent crime, for example, African Americans, American Indian communities, and immigrants, must confront multiple layers of traumatic experiences as they recover and heal.
The good news is that any system can help by becoming trauma informed. Safety is the overarching goal — safety from harm, re-victimization (however unintentional), and abuse. It’s achieved by implementing a victim-focused approach. The federal Substance Abuse and Mental Health Services Administration (SAMSHA) cites six principles of trauma-informed care:
- Trustworthiness and Transparency
- Peer Support
- Collaboration and Mutuality
- Empowerment, Survivor Voice and Choice
- Attention to Cultural, Historical, and Gender Issues
Learn how attention to trauma has helped youth in the criminal justice system.
“I didn’t know the word trauma before I got into recovery. I called it pain . . . pain from being an unwanted foster kid, being moving around a lot., being abused in every way possible. Feeling like somebody’s trash. At 13, I found out I could make the pain fade by drinking. So, alcohol was definitely my best friend. I stole it, got it from older people. Anyway I could, I got booze. Then drugs. Ending with the heroin addiction that got me into prison. But, you know, drugs and alcohol caused me just as much pain. More. The worst was being in prison for eight years – talk about trauma. You don’t go to prison; you go to trauma. I was lucky to be placed in a great recovery program when I got out. That’s where I learned what was really behind all my drug abuse and alcoholism. I learned to talk about my traumatic experiences with people who really understand what it was like. I learned to recover and be a survivor. Today, I’m helping other people with addiction recover from trauma by being a mentor. Don’t let anyone tell you it’s impossible to recovery. I’m the proof”.
SPOTLIGHT – THE EVIDENCE IS IN:
Trauma-Focused Cognitive Behavioral Therapy
Trauma-focused Cognitive Behavioral Therapy (TF-CBT) is a useful intervention within a trauma-informed system of care. As the name implies, this is a form of cognitive behavioral therapy. It specifically addresses the emotional and mental health needs of people — children, adolescents, adult survivors, and families — who are struggling to overcome the destructive effects of early trauma. Trauma-focused CBT is especially sensitive to the unique problems of youth with post-traumatic stress and mood disorders resulting from abuse, violence, or grief. It can be used to help youth traumatized in criminal justice or foster care systems by assisting them with identifying and talking about their experiences. Non-offending parents and caregivers can be included in the treatment process using principles of family therapy. TF-CBT is a manualized trauma-informed care intervention that helps children and care givers process thoughts and feelings related to traumatic life events. It helps them manage and resolve distressing thoughts, feelings, and behaviors and enhances safety, growth, parenting skills, and family communication. This EBP incorporates trauma care with cognitive behavioral, family, and humanistic techniques. In controlled studies, over 80% of traumatized youth who received TF-CBT experienced significant improvement after 12 to 16 weeks of treatment.
Learn more about: TF-CBT