Effects of cognitive-behavioral therapy (CBT) and positive psychological intervention (PPI) on female offenders with psychological distress in Hong Kong

Abstract

Despite the rapid growth of the female prison population, research on the effectiveness of psychological interventions for incarcerated women is limited. The present study aims to fill this research gap by examining the treatment effectiveness of two major interventions, namely Cognitive Behavior Therapy (CBT) and Positive Psychology Intervention (PPI) for local female offenders in Hong Kong. The present study constitutes a major component of an institution-based psychological project, namely Psychological Gymnasium (PSY GYM), provided by the Hong Kong Correctional Services Department (HKCS). In addition to being the pioneer in addressing female rehabilitation needs in Hong Kong, PSY GYM is also the first to apply Positive Psychological Intervention (PPI) together with Cognitive Behavioral Therapy (CBT) in a forensic setting to not only address female offenders’ psychological distress, but also to enhance their psychological well-being. Forty Chinese female offenders attending CBT and PPI in PSY GYM were recruited as treatment subjects in this study. Half of the treatment subjects (n=20) received 8 sessions of CBT followed by 8 sessions of PPI, whereas the other half (n=20) received the same number of sessions of CBT and PPI in the reverse temporal order. Another thirty-five female offenders receiving treatment-as-usual participated as control subjects. A battery of clinical well-being. The effectiveness of CBT, PPI, and the combined treatment (CBT with PPI) was studied. The results showed that subjects in all of the treatment conditions showed significant improvement in reducing psychological distress and enhancing psychological well-being when compared to the control subjects. Specifically, treatment subjects’ depression, anxiety and stress symptoms, depressive automatic thoughts, negative cognition associated with anxiety, as well as negative outlook of life, were significantly reduced, while their hopeful style of thinking, sense of gratitude, self-perceived strength, positive cognition associated with depression, and positive outlook of life were remarkably increased. Further analysis revealed there was no significant difference in effectiveness between CBT and PPI. However, the combined treatment was more effective than either CBT or PPI alone in reducing depressive automatic thoughts and enhancing global judgment of life satisfaction, self-perceived strengths, and hopeful style of thinking.

These findings provide preliminary empirical support for the effectiveness of CBT and PPI, when administered alone or in combination, for improving psychological distress and well-being of local female offenders in Hong Kong. The present study also offers standardized protocols of the treatments applied for future refinement and development.