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Trauma-Informed Care for Adults Involved in the Correctional System: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: October 5, 2018
Project Number: RC1028-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of trauma-informed care for adults involved in the correctional system?
  2. What is the cost-effectiveness of trauma-informed care for adults involved in the correctional system?
  3. What are the evidence-based guidelines regarding the use of trauma-informed care for adults involved in the correctional system?

Key Message

One single centre randomized controlled trial and one prospective, nested non-randomized study were found that addressed the clinical effectiveness of trauma-informed care for adults in the correctional system. The results of these studies suggest that there was a trend toward higher program completion rate and lower incidence of recidivism with trauma-informed care relative to treatment as usual (or program as usual). Trauma-informed care appeared to have no impact on admission into community-based treatment and no clear patterns emerged regarding the impact of trauma-informed care on substance use relapse. No information was found on change in symptoms, safety, or harms associated with trauma-informed care. No relevant studies reported on cost-effectiveness of trauma-informed care for adults in the correctional system and no relevant evidence-based guidelines were found.The limited number of studies, important methodological limitations of the available studies, and differences in the interventions, comparators, and the reported outcomes limits confidence in the findings on clinical effectiveness. Generalizability of the evidence to the Canadian context is limited given that all of the evidence came from studies that were conducted in the United States. Additional RCTs or prospective non-randomized studies that evaluate mutual TIC programs and outcomes in Canada would enhance the evidence regarding the effectiveness of TIC.