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  • 1.
    Karlsson, Marie E.
    et al.
    Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS). Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Zielinski, Melissa J.
    Psychiatric Research Institute, University of Arkansas for Medical Sciences, United States.
    Calvert, Maegan
    Department of Psychological Science, University of Arkansas, United States.
    Bridges, Ana J.
    Department of Psychological Science, University of Arkansas, United States.
    Decreases in psychiatric symptoms persist following exposure-based group therapy for sexual violence victimization among incarcerated women2022Ingår i: Psychological Services, ISSN 1541-1559, Vol. 19, nr 3, s. 534-540Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Survivors Healing from Abuse: Recovery through Exposure (SHARE) is a brief, exposure-based group treatment for incarcerated female survivors of sexual violence. Preliminary evaluations of SHARE showed declines in depression and posttraumatic stress disorder (PTSD) symptoms from pre- to posttreatment. However, prior investigations have not included a longitudinal follow-up period and thus knowledge of whether therapeutic benefits persist following the termination of the group is lacking. Here, we examined data from 57 incarcerated women who completed SHARE and provided follow-up data while still incarcerated (M = 95 days posttreatment). Results from a one-way repeated-measures ANOVA showed significant reductions in PTSD and depression symptoms from pre- to posttreatment (large effect sizes), with symptoms further reduced during the follow-up period. In addition, McNemar tests showed a significant reduction in the proportion of participants at or above the clinical cut-off for probable PTSD and depression from pre- to posttreatment as well as from posttreatment to the follow-up assessment. Together, results suggest that the therapeutic benefits of SHARE persist after treatment is completed. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

  • 2.
    Dueweke, Aubrey R.
    et al.
    East Tennessee State University, USA.
    Higuera, Danielle E.
    University of Arkansas, USA.
    Zielinski, Melissa J.
    University of Arkansas, USA.
    Karlsson, Marie E.
    Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS). Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Bridges, Ana J.
    University of Arkansas, USA.
    Does Group Size Matter? Group Size and Symptom Reduction among Incarcerated Women Receiving Psychotherapy following Sexual Violence Victimization2022Ingår i: International journal of group psychotherapy, ISSN 0020-7284, E-ISSN 1943-2836, Vol. 72, nr 1, s. 1-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an eight-week therapy group for incarcerated women who have experienced sexual violence victimization. SHARE requires each member to complete an imaginal exposure and to listen when others share their experiences of victimization. While trauma-focused group interventions including SHARE are associated with reductions in internalizing symptoms, little work has examined how group characteristics predict symptom decreases. The purpose of this study was to examine whether group size was associated with symptom changes pre- to posttreatment. Participants (n = 140 across 29 groups) completed self-report measures of posttraumatic stress symptoms before and after completing SHARE. Multilevel modeling revealed the majority of the variance in posttreatment symptoms was attributed to individual factors rather than group factors. Symptom change was comparable for groups of two to eight women; declines in symptom improvement were observed at a group size of 10 participants. 

  • 3.
    Zielinski, Melissa J.
    et al.
    University of Arkansas for Medical Sciences, USA; University of Arkansas, USA.
    Karlsson, Marie E.
    Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS). Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Bridges, Ana J.
    University of Arkansas, USA.
    “I’m not alone, my story matters”: Incarcerated women’s perspectives on the impact and acceptability of group psychotherapy involving imaginal exposure to sexual assault memories2021Ingår i: Health & Justice, ISSN 2194-7899, Vol. 9, nr 1, artikel-id 25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although it is clear that incarcerated women need access to effective therapies for trauma sequelae, some have argued that one of the most effective treatments - exposure therapy - should not be provided in carceral settings due to the presumed lack of safety and stability making such an intervention inappropriate. Group therapy, the typical mode of intervention in prisons, has also been presumed to be unacceptable for exposure-based processing due to assumptions that hearing others' trauma narratives would be traumatizing and unhelpful to listeners. However, there is a lack of data to support either of the aforementioned assumptions. This study examined the acceptability of an exposure-based group therapy for women survivors of sexual violence who were currently incarcerated (N = 61) by asking women themselves about their experiences completing an exposure-based group therapy protocol (SHARE; Survivors Healing from Abuse: Recovery through Exposure) while incarcerated. We assessed women's reasons for enrolling in the group, satisfaction with various therapy components (e.g., exposure, skill-building) and the treatment overall, and experiences of both sharing and listening to trauma narratives using a feedback survey that included a mix of multiple-choice and open-ended questions. Treatment dropout was examined as an additional index of acceptability.

    Results: Treatment completion was very high (88.8%). Nearly all women who completed the group reported that they would recommend it to other incarcerated women (96.7%, with the remaining 3.3% reporting "it depends"). Qualitative results revealed overwhelmingly positive feedback about the effect of the group and indicated that sharing and listening to trauma narratives in a group setting serve discrete but dually important functions. Specifically, women almost universally experienced listening to others' trauma narratives (i.e., exposures) in the SHARE group context as helpful-making them feel less alone and normalizing their experiences. Sharing one's own story primarily provided an emotional release and/or transformation (i.e., an intrapersonal rather than interpersonal function).

    Conclusions: Our findings challenge common concerns about the appropriateness of 1) prison as a context for trauma-focused treatments, including exposure and 2) sharing trauma narratives in a group setting. Unless empirical evidence demonstrating harm is uncovered, best practices for PTSD and other trauma-related sequelae-those recommended in reputable treatment guidelines and interventions like SHARE that incorporate components shown to be effective (e.g., cognitive challenging, exposure)-should be offered to incarcerated women as part of standard of care.

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