Journal article
Outcomes of psychological therapies for prisoners with mental health problems: a systematic review and meta-analysis
- Abstract:
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Objective
Prisoners worldwide have substantial mental health needs, but the efficacy of psychological therapy in prisons is unknown. We aimed to systematically review psychological therapies with mental health outcomes in prisoners and qualitatively summarise difficulties in conducting randomized clinical trials (RCTs).
Methods
Prisoners worldwide have substantial mental health needs, but the efficacy of psychological therapy in prisons is unknown. We aimed to systematically review psychological therapies with mental health outcomes in prisoners and qualitatively summarise difficulties in conducting randomized clinical trials (RCTs).
Results
In 37 identified studies, psychological therapies showed a medium effect size (0.50, 95% CI [0.34, 0.66]) with high levels of heterogeneity with the most evidence for CBT and mindfulness-based trials. Studies that used no treatment (0.77, 95% CI [0.50, 1.03]) or waitlist controls (0.71, 95% CI [0.43, 1.00]) had larger effect sizes than those that had treatment-as-usual or other psychological therapies as controls (0.21, 95% CI [0.01, 0.41]). Effects were not sustained on follow-up at 3 and 6 months. No differences were found between group and individual therapy, or different treatment types. The use of a fidelity measure was associated with lower effect sizes. Qualitative analysis identified difficulties with follow-up and institutional constraints on scheduling and implementation of trials.
Conclusions.
CBT and mindfulness-based therapies are modestly effective in prisoners for depression and anxiety outcomes. In prisons with existing psychological therapies, more evidence is required before additional therapies can be recommended.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 1.5MB, Terms of use)
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- Publisher copy:
- 10.1037/ccp0000214
Authors
- Publisher:
- American Psychological Association
- Journal:
- Journal of Consulting and Clinical Psychology More from this journal
- Volume:
- 85
- Issue:
- 8
- Pages:
- 783-802
- Publication date:
- 2017-03-01
- Acceptance date:
- 2017-03-27
- DOI:
- EISSN:
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1939-2117
- ISSN:
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0022-006X
- Keywords:
- Pubs id:
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pubs:687426
- UUID:
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uuid:27f3e056-152c-462e-ae03-5d21a0c1a6fe
- Local pid:
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pubs:687426
- Deposit date:
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2017-03-29
Terms of use
- Copyright holder:
- Yoon et al
- Copyright date:
- 2017
- Notes:
-
This article has been published under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/3.0/),
which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited. Copyright for
this article is retained by the author(s). Author(s) grant(s) the American
Psychological Association the exclusive right to publish the article and
identify itself as the original publisher.
- Licence:
- CC Attribution (CC BY)
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