The COVID Shift: Comparing Hybrid Telehealth to In-Person Group Therapy for Incarcerated Women Survivors of Sexual Violence Victimization

Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted.