Trauma is overwhelmingly prevalent among justice-involved adults, significantly more so than in the general population, with its widespread impact contributing to criminal justice involvement and complicating rehabilitation efforts (Haas, 2024; Institute for Justice Research and Development, 2024; Levenson et al., 2022; R Street Institute, 2024; Skopp et al., 2020). The carceral environment itself can be re-traumatizing, exacerbating existing symptoms and creating new ones (Kubiak & Levenson, 2012; Rousseau, 2023; Seitanidou et al., 2024; Urban Institute, n.d.).

Trauma-informed group therapy (TI-GT), adapted for this population, demonstrates significant effectiveness in mitigating trauma's effects and fostering resilience (R Street Institute, 2024). Evidence-based models show positive impacts on core PTSD symptoms, co-occurring disorders, and institutional behaviors (California Department of Corrections and Rehabilitation, 2022; R Street Institute, 2024; Steinert et al., 2021). Benefits include reduced PTSD symptoms, decreased substance use, fewer disciplinary incidents, and, crucially, reduced recidivism (Hughes, 2023; National Center for PTSD, 2018; Rochester Institute of Technology, 2024; R Street Institute, 2024).

The core principles of trauma-informed care—Safety, Trustworthiness, Peer Support, Collaboration, Empowerment, and Cultural Responsiveness—are foundational and must be thoughtfully adapted to correctional contexts (Haas, 2024; International Society for Traumatic Stress Studies, 2024; Kubiak & Levenson, 2012; Levenson & Willis, 2018; National Center for PTSD, 2018; R Street Institute, 2024; Seitanidou et al., 2024). Specialized therapeutic models like Seeking Safety, TF-CBT, and phases of stabilization, processing, and integration are essential (California Department of Corrections and Rehabilitation, 2022; International Society for Traumatic Stress Studies, 2024; Skopp et al., 2020; Steinert et al., 2021).

Challenges in implementation include the re-traumatizing nature of correctional settings, the need for a systemic mindset shift among staff, and complexities around confidentiality (Crime and Justice Studies, n.d.; Haas, 2024; Kubiak & Levenson, 2012). Future directions emphasize integrated approaches, neurobiological insights, leveraging technology, and broad systemic focus on addressing collective and intergenerational trauma (International Society for Traumatic Stress Studies, 2024; R Street Institute, 2024; Seitanidou et al., 2024). Ultimately, adopting TI-GT is crucial for promoting public safety, reducing prison populations, and ensuring rehabilitation for justice-involved individuals (R Street Institute, 2024).

Trauma is a pervasive experience within the justice-involved adult population, with rates significantly exceeding those found in the general population (Haas, 2024; Institute for Justice Research and Development, 2024; Levenson et al., 2022; R Street Institute, 2024; Skopp et al., 2020). This high prevalence is a critical factor contributing to criminal justice involvement and poses substantial challenges for rehabilitation and successful societal reintegration (Haas, 2024; Levenson et al., 2022).

Research consistently highlights the overwhelming extent of trauma exposure:

• Over 95% of incarcerated adults have experienced at least one traumatic event, often multiple times (Institute for Justice Research and Development, 2024; Skopp et al., 2020).
• 98% of female offenders report histories of trauma, frequently involving interpersonal violence and domestic abuse (Haas, 2024; Kubiak & Levenson, 2012).
• A substantial portion of the prison population, 75%, has experienced four or more Adverse Childhood Experiences (ACEs), which are linked to a significantly higher risk of criminal behavior and incarceration (Haas, 2024; R Street Institute, 2024).
• 62% to 100% of incarcerated adult males have experienced trauma, with PTSD prevalence estimated to be 5-fold higher than in the general population (Skopp et al., 2020; News-Medical.net, n.d.).
• 69% of individuals in a county jail sample had a notable traumatic experience within the year prior to incarceration (Institute for Justice Research and Development, 2024).

This extensive exposure to trauma often begins in childhood and accumulates across the lifespan, leading to complex trauma and its associated negative outcomes, including mental health disorders, substance abuse, and difficulties with emotional regulation—all highly prevalent in justice-involved populations (Haas, 2024; Levenson et al., 2022; Skopp et al., 2020). Unaddressed trauma can lead to chronic health conditions, mental illness, and continued involvement with the justice system (Haas, 2024; Institute for Justice Research and Development, 2024).

The impact of trauma on justice-involved adults extends beyond pre-incarceration experiences; the carceral environment itself can be inherently re-traumatizing (Crime and Justice Studies, n.d.; Kubiak & Levenson, 2012; Rousseau, 2023; Urban Institute, n.d.). Prison settings, designed for security and control, often present conditions that can exacerbate existing trauma symptoms or create new ones (Kubiak & Levenson, 2012; Rousseau, 2023).

Key aspects of the carceral environment that can trigger or worsen trauma include:

• Physical and Emotional Safety: Prisons are often overcrowded, unsafe, and characterized by harsh disciplinary practices, making individuals feel perpetually on guard (Kubiak & Levenson, 2012; Skopp et al., 2020).
• Loss of Control and Agency: The rigid, impersonal discipline and restricted movement within prisons can mirror aspects of past abuse, stripping individuals of agency (Kubiak & Levenson, 2012; Urban Institute, n.d.).
• Trauma Triggers: Routine prison practices such as pat-downs, strip searches, restraints, isolation, and constant surveillance can directly trigger traumatic responses (California Department of Corrections and Rehabilitation, 2022; Crime and Justice Studies, n.d.; Kubiak & Levenson, 2012; Rousseau, 2023; Urban Institute, n.d.).
• Exposure to Violence: Incarcerated individuals may experience or witness violence, which can contribute to new traumatic exposures (Crime and Justice Studies, n.d.; Skopp et al., 2020).
• Separation from Support Networks: Incarceration restricts interaction with support networks, exacerbating isolation and potentially creating new trauma (Urban Institute, n.d.).

These conditions can lead to hypervigilance, interpersonal distrust, suspicion, alienation, diminished self-worth, and new or exacerbated PTSD symptoms (Illinois Criminal Justice Information Authority, n.d.; Rousseau, 2023; Urban Institute, n.d.). For women, incarceration can ironically offer a relative sense of safety from prior dangers (e.g., homelessness, violent partners), yet still presents re-traumatizing elements (Kubiak & Levenson, 2012; Urban Institute, n.d.).

The impact of trauma on justice-involved individuals directly influences their thinking, feeling, and behavior, affecting their ability to manage stressors and contributing to recidivism (California Department of Corrections and Rehabilitation, 2022; Illinois Criminal Justice Information Authority, n.d.; Levenson et al., 2022; Rochester Institute of Technology, 2024). Unaddressed trauma is linked to rearrest and post-incarceration drug use (International Society for Traumatic Stress Studies, 2024; Rochester Institute of Technology, 2024). This highlights the urgent need for justice systems to adopt trauma-informed practices to prevent re-traumatization and support recovery, thereby aiding rehabilitation and reintegration rather than perpetuating cycles of trauma (Haas, 2024; Seitanidou et al., 2024).

Given the profound prevalence and impact of trauma in justice-involved populations, trauma-informed group therapy (TI-GT) emerges as a critical and necessary intervention. The rationale for its application in these settings is multi-faceted:

• Addressing Widespread Need: The overwhelming rates of trauma exposure mean that nearly all individuals in correctional facilities could benefit from trauma-informed approaches (Institute for Justice Research and Development, 2024; International Society for Traumatic Stress Studies, 2024). TI-GT provides a scalable solution to address this pervasive need.
• Preventing Re-traumatization: A core goal of TI-GT is to actively prevent re-traumatization that can occur within the justice system due to its inherently activating environment (Haas, 2024; Kubiak & Levenson, 2012; R Street Institute, 2024; Seitanidou et al., 2024). By adopting trauma-informed principles, correctional systems can minimize harm and create a safer therapeutic container.
• Leveraging Peer Support: Group therapy uniquely provides peer support, which is invaluable for justice-involved individuals who often experience profound isolation and shame (International Society for Traumatic Stress Studies, 2024; Skopp et al., 2020). Shared experiences foster universality, reduce stigma, and build a sense of belonging, which can be particularly healing in a restrictive environment (Skopp et al., 2020).
• Building Healthy Relationships: Trauma often impairs interpersonal relationships (Skopp et al., 2020). Group settings offer a safe space to practice social skills, establish boundaries, and experience corrective relational dynamics (International Society for Traumatic Stress Studies, 2024; Skopp et al., 2020).
• Cost-Effectiveness and Scalability: Group therapy can be a more cost-effective and scalable method for delivering mental health services compared to individual therapy, allowing more individuals to receive needed treatment within resource-constrained correctional systems (Rochester Institute of Technology, 2024; Hughes, 2023). For instance, "Seeking Safety" is noted for being cost-effective (Rochester Institute of Technology, 2024).
• Promoting Rehabilitation and Reducing Recidivism: By addressing underlying trauma and teaching adaptive coping mechanisms, TI-GT can mitigate risk factors for reoffending, improve treatment participation, reduce disciplinary infractions, and ultimately contribute to successful rehabilitation and reintegration into society (Illinois Criminal Justice Information Authority, n.d.; Levenson et al., 2022; Rochester Institute of Technology, 2024; R Street Institute, 2024).

Therefore, implementing trauma-informed group therapy is not just a clinical best practice, but a strategic imperative for improving outcomes for justice-involved adults and enhancing public safety.

The six fundamental principles of trauma-informed care (TIC) established by SAMHSA are directly applicable to justice settings but require thoughtful adaptation to the unique context of correctional facilities and re-entry programs (CSG Justice Center, n.d.; Haas, 2024; International Society for Traumatic Stress Studies, 2024; Kubiak & Levenson, 2012; Levenson & Willis, 2018; National Center for PTSD, 2018; R Street Institute, 2024; Rousseau, 2023; Seitanidou et al., 2024). These adaptations aim to create a therapeutic environment that minimizes re-traumatization and supports healing within an inherently challenging system.

• Safety: Ensuring physical and emotional security is paramount in a potentially hostile environment (Kubiak & Levenson, 2012; R Street Institute, 2024; Rousseau, 2023). This involves minimizing triggers from institutional practices (e.g., adapting searches, restraints), fostering a predictable environment, and ensuring staff interactions promote feelings of security (CSG Justice Center, n.d.; Urban Institute, n.d.).
• Trustworthiness & Transparency: Building trust is crucial for individuals who may have experienced systemic betrayal (CSG Justice Center, n.d.; Kubiak & Levenson, 2012; R Street Institute, 2024). This means clear communication about rules, processes, and limits of confidentiality, even during challenging procedures like arrest or booking (CSG Justice Center, n.d.).
• Peer Support: Leveraging shared experiences among incarcerated individuals is vital to reduce isolation, build community, and inspire hope (International Society for Traumatic Stress Studies, 2024; R Street Institute, 2024; Safety and Justice Challenge, n.d.). This includes formal peer support programs and fostering natural peer connections (Safety and Justice Challenge, n.d.).
• Collaboration & Mutuality: Fostering shared decision-making where possible, involving individuals in their treatment plans, and leveling power dynamics between staff and incarcerated individuals is key (CSG Justice Center, n.d.; R Street Institute, 2024). This promotes engagement and reduces resistance (R Street Institute, 2024).
• Empowerment & Choice: Restoring a sense of control by offering choices (e.g., regarding treatment options, small daily decisions) and recognizing the resilience and strengths of individuals in restrictive environments is essential (CSG Justice Center, n.d.; R Street Institute, 2024). This counters the powerlessness often experienced (Levenson et al., 2022).
• Cultural, Historical, & Gender Awareness: Respecting diverse backgrounds, acknowledging the pervasive impact of systemic oppression (e.g., racism, poverty), and adapting care for the unique needs of men, women, and LGBTQ+ individuals in custody is critical (CSG Justice Center, n.d.; Haas, 2024; Kubiak & Levenson, 2012; Levenson et al., 2022; R Street Institute, 2024; Seitanidou et al., 2024). This includes gender-responsive strategies (California Department of Corrections and Rehabilitation, 2022).

These principles, when collectively integrated, create a "whole systems approach" within the justice environment, fostering collaborative working, supporting staff well-being, and establishing a safer healing environment (Seitanidou et al., 2024).

Several evidence-based therapeutic models are adapted for trauma-informed group therapy in justice settings, recognizing the unique challenges and contexts of this population.

• Seeking Safety: This manualized treatment is highly relevant and widely used for co-occurring PTSD and substance abuse, which is very common among justice-involved individuals (International Society for Traumatic Stress Studies, 2024; Rochester Institute of Technology, 2024; California Department of Corrections and Rehabilitation, 2022). It focuses on present-focused coping skills, establishing safety, and is adaptable for both individual and group settings (International Society for Traumatic Stress Studies, 2024; Rochester Institute of Technology, 2024). The California Department of Corrections and Rehabilitation (CDCR) has adopted "Helping Men Recover" and "Helping Women Recover," which are trauma-informed and offer specific trauma work within their Integrated Substance Use Disorder Treatment programs (California Department of Corrections and Rehabilitation, 2022).
• Cognitive Behavioral Therapy (CBT) and Trauma-Focused CBT (TF-CBT): CBT is frequently utilized in trauma-informed treatment programs for offenders, aiming to change antisocial thinking patterns and reduce psychological symptoms associated with trauma (Rochester Institute of Technology, 2024). Systemic reviews show CBT programs can be effective at reducing recidivism (Rochester Institute of Technology, 2024). TF-CBT, while primarily for children/adolescents, provides a framework for addressing trauma that can be adapted for older populations, focusing on psychoeducation, coping skills, and narrative processing (Skopp et al., 2020).
• Dialectical Behavior Therapy (DBT): DBT's focus on emotional regulation, distress tolerance, and interpersonal effectiveness makes it highly valuable for justice-involved individuals struggling with intense emotional dysregulation and complex trauma (StatPearls, 2024).
• The Sanctuary Model: This model is a blueprint for clinical and organizational change that promotes safety and recovery through the active creation of a trauma-informed community (Sanctuary Model, n.d.). It recognizes that trauma is pervasive and focuses not only on clients but also on the staff and systems providing treatment. It is being used in various settings, including juvenile justice and drug and alcohol treatment, promoting a trauma-informed culture (Sanctuary Model, n.d.).
• Skills Training in Affective and Interpersonal Regulation (STAIR): This two-phase cognitive-behavioral model helps individuals in group settings develop skills for affect regulation and interpersonal effectiveness, which is crucial for managing trauma responses and improving relational patterns (Skopp et al., 2020).

These models are often implemented with a phased approach to healing, particularly important in carceral settings where initial stabilization and safety are paramount before deeper trauma processing can occur (Skopp et al., 2020; Rousseau, 2023). This typically involves:

1. Stabilization and Safety: Building coping skills, emotional regulation, and a foundational sense of safety within the correctional environment.
2. Trauma Processing: Engaging in cognitive and somatic work to process traumatic memories once stability is established.
3. Integration and Reconnection: Focusing on integrating new insights, enhancing interpersonal skills for reentry, and reconnecting with community post-release.

The understanding of trauma has evolved to recognize its deep impact on the brain and body, necessitating the integration of neurobiological and relational approaches within trauma-informed group therapy for justice-involved adults.

• Neurobiological Integration (Polyvagal Theory): Polyvagal theory helps understand the physiological impact of trauma on the nervous system and its role in fight/flight/freeze responses (Kubiak & Levenson, 2012). Applying this knowledge allows therapists to help individuals regulate their nervous systems, reduce hyperarousal or dissociation, and access a "social engagement system" crucial for therapeutic work (Rochester Institute of Technology, 2024; Rousseau, 2023). Trauma-informed interactions themselves can help regulate the nervous system, enabling more effective reasoning and decision-making (R Street Institute, 2024).
• Somatic Approaches: Recognizing that trauma is "stored" in the body, somatic therapies focus on bodily sensations and movements to release trapped trauma energy (International Society for Traumatic Stress Studies, 2024; StatPearls, 2024). While often applied individually, group exercises can incorporate grounding techniques and body awareness to help individuals manage physiological distress (Kubiak & Levenson, 2012; StatPearls, 2024).
• Relational Focus (Attachment Theory): Many justice-involved individuals have histories of relational trauma and insecure attachment (Kubiak & Levenson, 2012). Group therapy provides a powerful corrective relational experience (International Society for Traumatic Stress Studies, 2024). Facilitators can model healthy relationships, fostering trust and empathy within the group, which helps members explore and repair their own relational patterns (Kubiak & Levenson, 2012; Levenson et al., 2022). The staff-inmate relationship is crucial for trauma recovery and can either facilitate healing or cause re-traumatization (Kubiak & Levenson, 2012).

By integrating these "bottom-up" (somatic, neurobiological) and "top-down" (cognitive, behavioral) approaches, TI-GT can address the complex, multifaceted nature of trauma, leading to more comprehensive and sustainable healing for justice-involved adults.

Research on trauma-informed group therapy in justice settings demonstrates its effectiveness in improving various outcomes for justice-involved adults, including symptom reduction, decreased substance use, improved institutional behavior, and reduced recidivism.

Trauma-informed care in correctional settings has shown significant promise in reducing common mental health challenges:

• PTSD Symptoms: Studies indicate that trauma-informed programs are effective at reducing PTSD symptoms among incarcerated individuals (R Street Institute, 2024; Steinert et al., 2021). While some research suggests individual therapy may show greater effect sizes for PTSD symptoms in prison settings, group therapy still provides a vital platform for addressing these issues (Hughes, 2023; StatPearls, 2024).
• Depression and Anxiety: Evidence-based trauma-informed models adapted for correctional settings lead to reductions in symptoms of anxiety and depression (California Department of Corrections and Rehabilitation, 2022; R Street Institute, 2024; Rochester Institute of Technology, 2024).
• Co-occurring Disorders: Given the high correlation between trauma, PTSD, and substance use disorders (SUDs) in this population (Skopp et al., 2020), trauma-informed approaches are crucial. Programs like "Seeking Safety" have shown effectiveness in decreasing PTSD and substance-use symptoms, which are significant risk factors for reoffending (Rochester Institute of Technology, 2024). CDCR's trauma-informed substance use disorder programs are improving outcomes for incarcerated individuals (California Department of Corrections and Rehabilitation, 2022).

Beyond clinical symptoms, TI-GT contributes to positive behavioral changes and reduced reoffending:

• Reduced Disciplinary Events: Trauma-informed practices have been linked to improved inmate attendance and participation in programs and services, and decreases in disciplinary infractions and conflicts among inmates (Illinois Criminal Justice Information Authority, n.d.; R Street Institute, 2024).
• Increased Program Completion: Studies suggest a trend toward higher program completion rates in trauma-informed care relative to "treatment as usual" (National Center for PTSD, 2018). For instance, Beyond Violence program participants in TIC completed more sessions (100% vs. 69%) (National Center for PTSD, 2018).
• Reduced Recidivism: This is a critical outcome. Research indicates that TI-GT can reduce the risk of reoffending:
  
  • One study found that the odds of being arrested or held in custody were 19% lower following TIC relative to treatment as usual (National Center for PTSD, 2018).
  • Recidivism rates (reconviction) were significantly lower in an EMDR therapy group (12%) compared to a group that opted out (33%) within five years of program completion (National Center for PTSD, 2018).
  • TIC programs are effective in rehabilitation because they address trauma-induced risk factors that could lead to reoffending, and research shows they improve participation and reduce disciplinary infractions (Rochester Institute of Technology, 2024).

While PTSD alone has not always been found to be associated with re-offending, the combination of PTSD and substance use disorders significantly increases the risk of rearrest (Skopp et al., 2020). By addressing both trauma and SUDs, TI-GT has a direct impact on reducing recidivism.

Despite growing evidence, implementing and evaluating TI-GT in justice settings presents challenges:

• Carceral Environment: Correctional settings pose inherent challenges due to unavoidable triggers (e.g., pat-downs, strip searches), limited privacy, and a focus on security over clinical needs (Crime and Justice Studies, n.d.; Kubiak & Levenson, 2012).
• Staff Training and Culture Shift: Successful implementation requires educating and training all staff, from correctional officers to clinical personnel, to adopt a trauma-informed lens and create an overall organizational culture of wellness (California Department of Corrections and Rehabilitation, 2022; Levenson & Willis, 2018; R Street Institute, 2024; Seitanidou et al., 2024). This represents a significant cultural shift (R Street Institute, 2024).
• Research Limitations: While findings are encouraging, there is a need for more high-quality Randomized Controlled Trials (RCTs) specifically measuring Complex PTSD and utilizing modular treatment approaches in prison settings (Steinert et al., 2021). Consistent outcome measures and robust evaluations are sometimes lacking (Hughes, 2023).
• Gender Differences: Women in prison often have higher rates of interpersonal and sexual violence histories (Kubiak & Levenson, 2012; Skopp et al., 2020). Gender-responsive strategies and trauma-informed services are being implemented to improve outcomes for both women and men (California Department of Corrections and Rehabilitation, 2022; Kubiak & Levenson, 2012).

The successful implementation of trauma-informed group therapy in justice settings requires strategic planning, tailored program design, and sensitive facilitation that addresses the unique environment.

Designing TI-GT programs for justice-involved adults requires specific considerations:

• Universal Precautions: Operate under the assumption that all individuals in the justice system have experienced trauma (R Street Institute, 2024). Lengthy trauma assessments might be unnecessary unless directly informing treatment (International Society for Traumatic Stress Studies, 2024).
• Phase-Based Approach: Prioritize stabilization, safety, and skills building before deeper trauma processing (Skopp et al., 2020; Rousseau, 2023). This helps manage strong emotional reactions and prevents re-traumatization (Rousseau, 2023).
• Safety and Environment: While prisons are challenging, design choices can minimize adverse effects. This includes creating spaces that are bright, warm, and safe, improving sleep and exercise access, and adapting operational decisions (STV Inc., n.d.; JUSTICE TRENDS Magazine, 2024). Correctional design informed by biophilic and salutogenic principles can support healing and well-being (JUSTICE TRENDS Magazine, 2024).
• Clear Boundaries and Expectations: Establish clear group rules, expectations, and limits of confidentiality, especially crucial in a controlled environment (Kubiak & Levenson, 2012).
• Tailored Interventions: Use evidence-based models adapted for this population, such as "Seeking Safety" for co-occurring disorders, and components of CBT that address trauma-induced risk factors (California Department of Corrections and Rehabilitation, 2022; Rochester Institute of Technology, 2024).
• Strengths-Based Approach: Focus on the resilience of justice-involved individuals, acknowledging their strengths and capacity for growth even amidst difficult circumstances (Levenson et al., 2022; Safety and Justice Challenge, n.d.).

Effective facilitation is central to TI-GT in justice settings:

• Non-Judgmental and Empathetic Stance: Facilitators must adopt an empathetic approach, recognizing that behaviors may be trauma responses rather than defiance (Rousseau, 2023; Crime and Justice Studies, n.d.). This helps regulate the nervous system and promotes effective reasoning (R Street Institute, 2024).
• Crisis De-escalation and Grounding: Therapists and staff must be trained in de-escalation techniques and able to teach grounding and self-regulation skills to manage overwhelming emotions and flashbacks (Kubiak & Levenson, 2012; Rousseau, 2023).
• Titration of Exposure: When addressing trauma narratives, facilitators must carefully control the pace and depth of disclosure to prevent re-traumatization (Rousseau, 2023).
• Managing Power Dynamics: Actively foster an inclusive environment where individuals feel heard and valued, leveling power differentials between staff and participants (CSG Justice Center, n.d.).
• Role of Staff-Inmate Relationships: Recognize that staff-inmate relationships are foundational to trauma recovery and can either facilitate healing or cause re-traumatization (Kubiak & Levenson, 2012).
• Co-leadership: Co-leadership can be beneficial in containing traumatic material and reducing vicarious traumatization for facilitators (Rousseau, 2023).

Ethical practice in TI-GT for justice-involved adults carries heightened complexities:

• Confidentiality Limitations: The inherent nature of institutional settings means that absolute confidentiality cannot be guaranteed, requiring clear communication about these limits to participants (Kubiak & Levenson, 2012).
• Risk of Re-traumatization from Institutional Practices: Policies like strip searches or solitary confinement, while for security, can be re-traumatizing. Ethical practice demands adapting custodial practices and minimizing these effects (Urban Institute, n.d.).
• Dual Roles: Correctional staff may have security roles that conflict with a purely therapeutic stance, requiring careful navigation and training (Kubiak & Levenson, 2012).
• Informed Consent: Ensuring genuinely informed consent can be challenging in coercive environments, requiring extra effort to explain the process and choices (National Center for PTSD, 2018).
• Vicarious Trauma for Staff: Correctional staff, due to constant exposure to trauma and challenging behaviors, are highly susceptible to vicarious trauma and burnout (R Street Institute, 2024; Rousseau, 2023). Supporting staff well-being and providing training on vicarious trauma is an ethical imperative (R Street Institute, 2024; Safety and Justice Challenge, n.d.).

The field of trauma-informed group therapy in justice settings is dynamic, with several emerging trends and crucial future directions.

• Integrated Approaches: Growing recognition of the mind-body connection in trauma is leading to increased integration of somatic therapies and nervous system regulation techniques into correctional treatment (International Society for Traumatic Stress Studies, 2024). This includes using approaches informed by Polyvagal Theory to help individuals regulate their physiological responses (Rochester Institute of Technology, 2024).
• Systemic Implementation: There's a push for a "whole systems approach" to trauma-informed care, moving beyond individual programs to embed TIC principles throughout the entire justice system, from arrest to reentry (CSG Justice Center, n.d.; Haas, 2024; R Street Institute, 2024; Seitanidou et al., 2024). This involves cross-sector collaboration between criminal justice and behavioral health professionals (CSG Justice Center, n.d.).
• Architectural Design: Emerging best practices include designing correctional facilities with trauma-informed principles. This involves creating environments that are bright, warm, provide access to natural light and exercise, and minimize oppressive features, to reduce fear and constant stress for both residents and staff (STV Inc., n.d.; JUSTICE TRENDS Magazine, 2024).
• Reentry Services: Trauma-informed reentry services are gaining prominence, recognizing that unaddressed trauma hinders successful reintegration. These services aim to provide wraparound support, often peer-led, addressing housing, employment, and mental health needs (Safety and Justice Challenge, n.d.).

Technology offers promising avenues for enhancing trauma-informed care in justice settings:

• Telehealth: Can increase accessibility to mental healthcare, especially for those in remote facilities or during reentry, allowing for continuity of care (International Society for Traumatic Stress Studies, 2024).
• Virtual Reality (VR): VR holds potential for controlled exposure therapy, allowing justice-involved individuals to safely confront trauma-related triggers in a therapeutic environment (International Society for Traumatic Stress Studies, 2024; R Street Institute, 2024). It can also be used for practicing coping and social skills (International Society for Traumatic Stress Studies, 2024).

• Further Research: Continued rigorous research, particularly high-quality randomized controlled trials, is needed to further establish the effectiveness of specific TI-GT models in diverse justice settings, especially for complex trauma (Hughes, 2023; Steinert et al., 2021).
• Policy Reform: There is an urgent need for policy reform that prioritizes trauma-informed approaches within the criminal justice system, shifting from punitive models to those focused on rehabilitation and prevention (Haas, 2024; Urban Institute, n.d.). This includes legal education for justice professionals on trauma (Haas, 2024; Clio, n.d.).
• Community Investment and Alternatives to Incarceration: A long-term future direction involves investing in community-based services and divesting from over-reliance on incarceration, recognizing that preventing criminal justice involvement in the first place, through addressing underlying trauma and social determinants of health, is the most effective trauma-informed approach (Urban Institute, n.d.).
• Workforce Development: Ongoing, comprehensive training for all justice professionals—from law enforcement to correctional officers and reentry staff—is critical to ensure consistent and effective trauma-informed practices (Haas, 2024; Levenson & Willis, 2018; R Street Institute, 2024; Safety and Justice Challenge, n.d.; Seitanidou et al., 2024).

The evidence unequivocally supports the critical need for and efficacy of trauma-informed group therapy for justice-involved adults. Given the profound impact of trauma on this population and the potential for re-traumatization within the justice system, a fundamental shift towards trauma-informed approaches is imperative for promoting healing, reducing recidivism, and enhancing public safety.

Key Conclusions:

• Pervasive Trauma: Trauma is nearly universal among justice-involved adults, significantly impacting their mental health, substance use, and behavior, often contributing to criminal justice involvement (Haas, 2024; Institute for Justice Research and Development, 2024; Skopp et al., 2020).
• Carceral Context: The correctional environment itself can exacerbate trauma, necessitating adapted trauma-informed practices to minimize re-traumatization (Kubiak & Levenson, 2012; Rousseau, 2023; Urban Institute, n.d.).
• Proven Efficacy: TI-GT is effective in reducing PTSD symptoms, anxiety, depression, substance use, disciplinary incidents, and recidivism in justice-involved adults (California Department of Corrections and Rehabilitation, 2022; R Street Institute, 2024; Rochester Institute of Technology, 2024).
• Tailored Principles & Models: Successful implementation requires adapting SAMHSA's core TIC principles and utilizing specialized models like Seeking Safety, delivered in a phased approach, to address the unique needs and context of this population (CSG Justice Center, n.d.; International Society for Traumatic Stress Studies, 2024; Skopp et al., 2020).
• Systemic and Ethical Imperative: Adopting TI-GT is not merely a clinical option but an ethical imperative for justice systems to move towards rehabilitation, prevent harm, and support the well-being of both individuals and staff (R Street Institute, 2024; Seitanidou et al., 2024).

Recommendations:

1. Mandate Trauma-Informed Training: Implement universal, comprehensive trauma-informed training for all personnel across the justice system—from law enforcement to correctional officers, judges, lawyers, and reentry staff (Haas, 2024; Levenson & Willis, 2018; R Street Institute, 2024).
2. Systemic Integration of TIC Principles: Embed the six core TIC principles into all policies, procedures, and physical environments within correctional facilities and justice agencies (CSG Justice Center, n.d.; R Street Institute, 2024; STV Inc., n.d.). This includes adapting custodial practices to be trauma-sensitive (Urban Institute, n.d.).
3. Expand Evidence-Based Group Therapy Programs: Increase the availability and funding for evidence-based trauma-informed group therapy models tailored for justice-involved adults, such as Seeking Safety and adapted CBT programs, ensuring they are culturally responsive and gender-specific (California Department of Corrections and Rehabilitation, 2022; Rochester Institute of Technology, 2024).
4. Prioritize Phased Treatment & Relational Approaches: Design group therapy protocols that emphasize initial stabilization and skills-building before trauma processing, integrating neurobiological and relational interventions (Skopp et al., 2020; Rousseau, 2023). Foster positive staff-inmate relationships as a therapeutic tool (Kubiak & Levenson, 2012).
5. Enhance Reentry Support with a Trauma Lens: Develop and fund robust, trauma-informed reentry services that provide wraparound support, including housing, employment, and mental health treatment, ideally peer-led and easily accessible (Safety and Justice Challenge, n.d.).
6. Invest in Research and Technology: Support ongoing research into the effectiveness of TI-GT in various justice settings, exploring new methodologies and the integration of technology like telehealth and virtual reality to expand access and enhance treatment (International Society for Traumatic Stress Studies, 2024; Hughes, 2023).
7. Advocate for Policy Reform and Community Alternatives: Champion policy changes that shift the justice system away from punitive models towards rehabilitation and prevention, and advocate for increased investment in community-based services and alternatives to incarceration (Urban Institute, n.d.).

By embracing these recommendations, justice systems can move towards a more humane, effective, and rehabilitative approach, breaking cycles of trauma and fostering healing for countless individuals and communities.