Research confirms that more than one-third of women are childhood trauma survivors. We understand our clients' presentations, in great part, as adaptations to severe neglect and abuse. However, despite the wealth of research and clinical expertise, an underserved and misunderstood population still exists. This article offers an overview of a collaborative effort that is successfully shaping a trauma framework within an unlikely setting - a jail.

The number of incarcerated women has tripled over the last decade (Bloom, Chesney-Lind, & Owen, 1994). Nearly 80 percent are sentenced for nonviolent drug offenses, prostitution and property crimes (Covington, 1998). An alarming 75 to 88 percent have severe childhood and adult histories of physical and sexual abuse and neglect (DeCou, Haven, & Vivian, 1998; Covington, 1998). In addition to profound relational and intrapsychic effects of traumatic experiences, abuse histories are associated with early and more extensive involvement in the correctional system and the propensity to engage in sex-for-fee crimes (DeCou, Haven, & Vivian, 1998). Risking Connection: A Training Curriculum for Working with Trauma Survivors (Saakvitne et al., 2000) states, "We believe a trauma framework can be applied in every work setting." The jails "housing" women with trauma histories clearly are settings where those connections must be risked.

I am involved in one such "risk," both as a relational trauma therapist and director of a community mental-health clinic. This ever-evolving, six-year process between Valley Psychiatric Service and the Hampden County Massachusetts Correctional System has required both systems to embrace many obstacles to change, including mission and purpose, trust, power, safety and funding. Equally important and as empowering has been the mutual respect of the correctional staff and community therapists - the willingness to learn and work with each other's experiences, competencies and challenges.

A cornerstone of this collaborative effort is the "Breaking Silence Trauma Survivors Group" (Haven, 1996), a gender-specific treatment group conducted in jail by community clinicians trained in relational trauma theory. The goals for Breaking Silence are to:

  • normalize women's adaptations by introducing psychoeducation about the development/manifestation of trauma reactions;
  • provide opportunity to engage in exploration, introspection and expression related to unique meanings and adaptations of traumatic experiences; and
  • accomplish these goals within a therapeutic framework informed by constructivist self-development theory of trauma (McCann & Pearlman, 1990) and a holistic model of addiction (Covington, 1998).

Almost 200 women have completed this trauma group while incarcerated - a first trauma treatment experience for more than 70 percent of them. More than 80 women have continued trauma therapy after returning to the community. The Breaking Silence group model now also is utilized within a community corrections project providing alternatives to incarceration.

Trauma theories, research and treatment models would simply lie dormant, however, if not for the courage and inner wisdom of the women who risk letting us take part in their healing. One participant said, "The jail inside of me is tougher than anything they can do to me in here…I think maybe it's more important too. So could you help me break out of the inside of me?"

Where are women incarcerated in your community? Does the system understand the consequences of trauma? I invite you to join in breaking silence so that incarcerated women trauma survivors are more visible, better served, and better understood. The transformation is worth the risks.

Terri J. Haven, LICSW, of Springfield, Mass., is a psychotherapist in private practice, an adjunct professor at Springfield College School of Social Work, and vice president of Clinical Operations at Valley Psychiatric Service.

References
Bloom, B., Chesney-Lind, M., & Owen, B. (1994). Women in California Prison: Hidden Victims of the War on Drugs. San Francisco: Center of Juvenile and Criminal Justice.

Covington, S. (1998). Creating Gender-Specific Treatment for Substance-Abusing Women and Girls in Community Correctional Settings. New York: Haworth Press Inc.

DeCou, K., Haven, T., & Vivian, J. (1998). Who Are These Women? Hampden County Intermediate Sanctions Project for National Institute of Corrections, Washington, D.C.

Haven, T. (1996). Breaking Silence Trauma Survivors Group: A Curriculum for Women in the Criminal Justice System. Unpublished.

McCann, L. & Pearlman, L.A. (1990). Psychological Trauma and the Adult Survivor. New York:

Brunner/ Mazel. Saakvitne, K., Gamble, S., Pearlman, L.A., & Tabor Lev, B. (2000). Risking Connection: A Training Curriculum for Working with Survivors of Childhood Abuse. Lutherville, Md.: Sidran Press.