Texarkana

Researchers are evaluating trauma-focused group therapy called Cognitive Processing Therapy adapted for prisons (CPT-CJ) to see if it helps reduce drug and alcohol use, mental health problems, and drug-related crime after people leave prison. The trial focuses on people in prison who have posttraumatic stress symptoms (PTSS) and substance use disorders (SUD), conditions common among incarcerated populations. The study also looks at ways to support therapy use in prisons and assesses the cost of these treatments and support strategies to plan for wider use. Participants will receive either CPT-CJ group therapy or trauma-focused self-help therapy using a workbook. CPT group sessions last 90 minutes and happen 1-2 times weekly, with no more than 10 participants per group, over a period that can last from 6 weeks up to 3 months. The self-help group independently works through a workbook with exercises to develop trauma recovery skills. The active treatment period is expected to span about 1.5 years at each site. Participants will complete surveys and assessments up to five times: before treatment, after treatment, before release from prison, and 3 and 6 months after release. They will also provide urine samples at 3 and 6 months post-release. Researchers will measure drug use frequency, drug use presence, posttraumatic stress symptom severity, and treatment fidelity during the active treatment. Additionally, prison staff and officials will participate in some surveys to support therapy implementation.