Development and implementation of trauma-informed training for women's corrections facilities in Aotearoa New Zealand

Kirsty Dempster-Rivett
Consultant Clinical Psychologist

Author Biography:
Kirsty Dempster-Rivett is a clinical psychologist with nearly 20 years’ experience working with young offenders with significant trauma histories. She is currently a PhD candidate researching the mechanisms behind the link between childhood maltreatment and the perpetration of family harm. Kirsty was responsible for delivering the pilot trauma-informed training to staff at Auckland Region Women’s Corrections Facility.

Acknowledgments
The trauma-informed training outlined in this article was collaboratively designed by: Kerry Consedine, Principal Practice Adviser – Office of The Chief Probation Officer; Bryony Jackson, Learning and Development Designer; Hannah McGlue, Principal Adviser Women's Strategy; and three clinical psychologists with expertise in trauma; Sonya Bakker, Kirsty Dempster-Rivett and Dr Jane Freeman-Brown.


Introduction

In 2017, the Department launched a four-year Women’s Strategy, Wahine – E rere ki te Pae Hou [1] . The Strategy acknowledges that the majority of women managed by the Department of Corrections have chronic histories of trauma as evidenced by recent research (Bevan, 2017; Indig, Gear & Wilhelm 2016). The overarching goal is to create environments where women feel safe and therefore can focus on the interventions and activities they need to build offence free lives. This article summarises the one-day pilot training package that has been delivered to all women’s prisons in Aotearoa New Zealand.

Trauma-informed practices have existed for some time in mental health services and more recently within care and protection spaces. However, it is a relatively new approach within correctional settings both nationally (McGlue, 2016) and internationally (Miller & Najavits, 2012; Benedict, 2014; Tam & Derkzen, 2014). The move towards trauma-informed care within the British Isles has been gaining momentum (Miller & Najavits, 2012). Hannah McGlue (personal communication, May 11, 2018) met with the Women’s Strategy Team in the Scottish Prison Service and investigated how they have implemented trauma-informed practice. In summary, they provide day-long training for all staff and ongoing support to prison management teams. In the United States, a trauma-informed approach has been employed by The Rhode Island Department of Corrections Women's Facilities (Benedict, 2014). The data emerging from this project is promising and suggests significant improvement for both the women and staff. For example, between 2011 and 2012 there was a 62% drop in inmate on staff assaults and a 54% drop in inmate on inmate assaults and a 60% drop in suicide attempts (Bissonette, 2013; as cited in Benedict, 2014).

Trauma effects can arise from a woman's personal experience and can be cumulative across generations. The ongoing effects of intergenerational and historical trauma are of particular relevance for indigenous populations (Pihama, et al., 2014). In response to the disproportionate representation of native Hawaiian women, the Women's Community Correctional Centre developed a Trauma Informed Care Initiative based on an indigenous concept of “pu‘uhonua’ – a place of refuge” (Patterson, Uchigakiuchi & Bissen, 2013). The guiding principle of this approach was to focus on creating a safe space that nurtures healing from a personal, family and community perspective.

For some, the concept of trauma-informed practice seems vague and hard to link to the everyday running of prison life. This is complicated by the fact that the term trauma is often used in everyday language to reflect a variety of experiences from a “traumatic staff meeting” to a “devastating earthquake”. However, when it is broken down to its purest form, trauma-informed practice reflects the desire for staff to feel more confident in responding to people experiencing the ongoing effects of trauma, so the wellbeing and safety of all is improved. The trauma-informed practice values derived from the International Programmes outlined above provided the foundation of this training from start to finish. The similarity of these principles is closely linked to the Te Tokorima a Māui – Kaupapa Māori Values that are already part of Corrections’ language and practice (Table 1).

Table 1: Similarities between trauma-informed practice principles and Te Tokorima a Māui – Kaupapa Māori values

Trauma-Informed Practice Principles

Te Tokorima a Māui –Kaupapa Māori Values

Safety: The activities and the physical settings ensure the physical, emotional and cultural safety of prisoners.

Kaitiaki/Guardianship: Care, protect, guardianship, following our practices and processes.

Trustworthiness: The activities and physical settings maximise trustworthiness through task clarity, consistency (over time and staff), transparency re expectations and processes, honesty, and interpersonal boundaries.

Manaaki/Respect: Care, respect, safety for all people.

Choice: The activities and physical settings maximise prisoner choice and control over factors that impact on them.

Rangatira/Leadership: Leadership, bringing people together.

Collaboration: The activities and physical settings maximise power-sharing and the participation of prisoners in decisions that impact on them.

Wairua/Spirituality: Anchors us to a point in time, helps connect us to others, links to resilience.

Empowerment: The activities and physical settings maximise prisoner autonomy and self-determination and support them building skills to achieve this.

Whānau/Relationships: Connectedness, family.

Core components of the Trauma-Informed Practice Training Package

Becoming trauma-informed does not mean staff will be expected to “treat” trauma symptoms, but rather identify the ongoing effects and interrupt and de-escalate when they occur (based on the concept of psychological first aid). An early part of the training focused on introducing the difference between a traumatic event and ongoing trauma experiences. For example, being in a car accident is a traumatic event but it does not automatically mean a person will develop post traumatic stress disorder. However, symptoms of ongoing trauma reactions can be varied, including: unwanted and distressing memories of the trauma event, distressing dreams, and flashbacks where the individual feels as if the trauma event is recurring. Participants were encouraged to think about ways people attempt to cope with the ongoing experience of trauma that can impair their ability to engage fully in everyday life. For example, people can go to lengths to avoid being reminded of an event or even the negative feelings associated with the event. These coping strategies do serve a function but can cause harm themselves, such as: using substances to reduce flashbacks, acting out to go to a secure unit to avoid being around people, self-harm to stop emotional pain, or zoning out of reality and missing important information.

The prison environment can readily trigger trauma-related responses in ways which can be confusing and difficult to manage for both the women and staff. Introducing a basic understanding of the brain’s response to the threat was used to help explain the individual and varied trauma reactions (basic neuropsychology). The potential link between a woman’s strong emotional reactions to a seemingly neutral situation was discussed in relation to the triggering of memories. Common prison procedures such as strip searches, double bunking, and night-time safety checks were presented as understandable times when women’s trauma-responses might be triggered. Exposure to multiple events from a young age can have an adverse effect on the development of the areas of the brain responsible for emotional and behavioural regulation. Interpersonal challenges staff faced were discussed in the context of the ongoing negative impacts, such as social relationships, interactions with authority figures, and issues with attachment.

The section on historical trauma provided a launch-pad for staff to think about practical ways traditional Māori healing processes could be integrated into day to day life in prison. To develop a sense of what can be done, Wirihana's (2014) three key areas that promote healing and wellbeing were introduced. Firstly, the use of traditional protective factors in the context of nurturing intergenerational family environments. Secondly, Māori methods of healing such as waiata, motoeatea, haka, and whakanoa. Thirdly, the use of traditional stories to support historical collective and individual trauma. The focus on what “can” be achieved despite the confines of prison regulations aimed to provide hope and a sense of empowerment for staff. Groups were encouraged to reflect on themes and practical activities that emerged and take these back to the managers and teams.

A fictional case study, based on common experiences of women in prison, was used to highlight how past traumatic events can impact on current emotions and behaviours. Staff were encouraged to think about how routine prison activities may trigger trauma responses (cell confinement, being handcuffed) and identify practical strategies that could be used to reduce the likelihood of subsequent trauma reactions (see Table 2 for examples).

Table 2: Examples of practical strategies that can be employed to enhance trauma-informed practice.

Common Effects of Trauma/Potential Triggers in Prison Context

Trauma-Informed Strategies for Staff

Safety: women are often hyper-aware of possible danger. They may have a sense that all people are potentially dangerous or feeling trapped in confinement like they did when their abuse was occurring.

- Ask women what makes them feel unsafe and put measures in place where you can

- Explain searching processes before they happen

- Knock on doors before entering cells

- Limit loud noises where you can.

Trust: women may have difficulty trusting others, even those who are trying to help them. This can stem from abuse from caregivers who they once trusted, or experiences of grooming where someone was initially kind but this resulted in abuse.

- Follow through on promises

- Allow women to decide what personal information to disclose, and when

- Discuss confidentiality with women – and when you do have to share what they tell you

- Be patient as it may take time before they trust.

Choice: traumatic events often take away choice and if a choice is continued to be taken away women could withdraw.

- Provide opportunities for choice where you can, even if it is as simple as where they sit in a room

- Provide women with programme options and let them choose what to do

- Where there is no choice in a situation, explain why.

Collaboration: women who have suffered violence and abuse have usually been treated as “less” than others around them. This can lead to feelings of helplessness or defensiveness when told what to do.

- Ask for women’s input on decisions about them – offender plans, parole reports

- Remain calm during incidents, use a conversational tone

- Seek input from a range of people that work with them.

Empowerment: women need skills to break away from their former lives, and should be encouraged to figure out what they can do for themselves (in prison and in the future).

- Refer to a woman’s strengths when you can

- Celebrate accomplishments as part of routine interactions with women

- Ask women what they need, and provide it where you can.

The facilitators gave high priority to taking care of staff throughout the training due to the sensitive nature of the topic. The training ended with a section on staff welfare that ensured staff knew about additional options such as the Employee Assistance Programme, Welfare Officers, and peer support. Benefits of self-care were also discussed in terms of enhancing staff emotional resiliency so they can continue to react in a trauma-informed manner.

Summary

The overall goal of this training was to help staff understand that some of the more difficult behaviour displayed by women in prison could be explained as trauma survival behaviours. While it is not possible to remove all triggers from a prison environment, the ability to recognise when a woman has a trauma response and respond to it in a trauma-informed way can help de-escalate situations and teach emotion regulation skills. By taking a trauma-informed approach in the work with all women, we seek to avoid re-traumatisation and provide a safe space for them to focus on enhancing their wellbeing and reducing their chance of re-offending.

[1] Corrections Women's Strategy Wahine - E rer ki te Pae Hou, August 2017

References

Benedict, A (2014). Using Trauma-Informed Practices to Enhance Safety and Security in Women’s Correctional Facilities. National Resource Centre on Justice Involved Women: CORE Associates.

Bevan, M. (2017). New Zealand Prisoners Prior Exposure to Trauma, New Zealand Department of Corrections.

Indig, D., Gear, C., & Wilhelm, K. (2016). Comorbid Substance Use Disorders and Mental Health Disorders among New Zealand Prisoners. New Zealand prisoners, Department of Corrections, 2016.

Miller, N., & Najavits, L. (2012). Creating trauma-informed correctional care: a balance of goals and environment. European Journal of Psychotraumatology. Volume 3, 2012.

McGlue, H. (2016). Trauma Hiding in Plain View: The Case for Trauma-Informed Practice in Women’s Prisons. Practice: The New Zealand Corrections Journal, 4(2), December 2016.

Patterson, M., Uchigakiuchi, P., & Bissen, T. (2013). Can Prison be a Place of Healing? The Trauma Informed Care Initiative at the Women’s Community Correctional Centre. Hūlili, Volume 9, 2013.

Pihama, L., Reynolds, P., Smith, C., Reid, J., Smith, L., & Te Nana, R. (2014). Positioning Historical Trauma Theory within Aotearoa New Zealand. Alternative, Volume 10, Number 3, 2014.

Tam, K., & Derkzen, D. (2014). Exposure to Trauma among Women Offenders: A Review of the Literature. Correctional Service of Canada.

Wirihana, R. (2014). Historical Trauma, Healing and Wellbeing in Māori Communities. Mai Journal, Volume 3, Issue 3, 2014.