Research on the mental health of incarcerated adolescents suggests that they suffer from alarmingly high rates of mental health challenges. Studies have estimated rates of trauma at 90% (Arroyo, 2001), and another study revealed that two-thirds of boys and three-quarters of girls in detention met diagnostic criteria for one or more psychiatric disorders (Teplin et al., 2002).
Despite a clear need to address these concerns, there is a paucity of effective mental health interventions for this population (e.g., US Department of Justice, 2005), and few programs incorporate youth-centered agendas, which have been associated with better outcomes. Further, research has revealed the under-utilization of mental health treatments within this population, with studies finding that only one-third of incarcerated youth with documented psychiatric disorders receive services (Novins et al., 1999).
Though it has not been systematically implemented or evaluated in juvenile justice-involved youth, regular written self-disclosure has been consistently linked to improvements in physical and mental health outcomes (e.g., Pennebaker & Chung, 2011). Collectively, the literature suggests that engagement in meaning-making through the written narrativization of experience is associated with therapeutic benefits, including reductions in depression, trauma-related symptoms, and physical pain.
In light of these realities, the C.O.R.E. research team (PI: Shabnam Javdani) initiated a collaboration with the New York City Division of Youth and Family Justice in the summer of 2014 with the goal of creating an intervention well-suited to the needs of underserved incarcerated youth. An important product of this work was the development of a writing-based intervention program called WRITE ON, which stands for Writing and Reflecting on Identity To Empower Ourselves as Narrators. This intervention integrates components of evidence-based therapies, uses an original, youth-centered curriculum, and employs a quasi-experimental evaluation protocol.
WRITE ON is a six-week-long intervention, with sessions taking place twice a week. Each week carries a different theme, such as relationships, emotions, and future self. Every workshop begins with community-building activities that lead to the main event: the individual writing. Writing prompts are in accordance with weekly themes and were designed to elicit reflection, self-expression, and the emotional and cognitive processing of trauma. Group and individual feedback are also incorporated into the workshops.
Through providing a space for incarcerated youth to reflect and express themselves creatively, we seek to give voice to socially and physically isolated individuals. WRITE ON has an explicit social justice framework, emphasizes youth voice and choice, and acknowledges oppression in youth’s lives (e.g., through specific writing prompts).
In terms of individual-level outcomes, WRITE ON seeks to reduce negative mental health outcomes such as depression and anxiety, increase positive health outcomes such as self-efficacy and resilience, and encourage adaptive coping skills. At the site level, we seek to enhance peer relationships within the detention facilities.
With the support of the SCRA Mini Grant, WRITE ON was successfully piloted in 4 non-secure detention facilities in New York City in the summer of 2014. The aims of the pilot evaluation were twofold: First, we sought to compare the mental health outcomes of youth receiving WRITE ON to those of a matched control group. To this end, we analyzed quantitative outcome data. The second aim was to assess how youth received the intervention and explore the mechanisms that are responsible for changes they experienced. Toward this aim, we analyzed satisfaction surveys after each workshop and qualitative interview data.
SCRA Community Mini-Grant Proposal
I applied for an SCRA Community Mini-Grant to support the costs of analyzing post-intervention interviews with youth participants and of publishing the participants’ writing. Through the interviews, we sought to explore 1) how individuals experienced the intervention (i.e., process), 2) what is responsible for the changes they experienced (i.e., mechanisms), and 3) what changes they would like to see in future implementations of the intervention. This qualitative data is intended to expand upon and enrich the quantitative data we collected. Further, the grant supported costs of publishing youth’s writing into booklets for them to keep. These booklets were a tangible product for youth to work toward and bring home with them upon their release.
Satisfaction surveys for youth in WRITE ON indicated that 80% of participants stated that they had fun and learned something, and 90% reported being satisfied with the intervention (See Figure 1 in PDF).
We are in the final stages of analyzing the qualitative data using Consensual Qualitative Research. Thus far, one theme that has emerged is self-expression’s positive effects on youth’s mood. For example, one female participant stated,
“Before I did the WRITE ON program, I probably… would be like maybe more sad or more angry because I’m in NSD…basically what the WRITE ON program does for me is really takes me out of that state of mind and puts me in a place where I feel like I can be free…more open.”
Another theme that has emerged is positive self-evaluation due to WRITE ON. One male participant said,
“[WRITE ON] makes me feel like I’m actually doing something with myself… it’s a good program, everyone should have [it].”
Quantitative findings indicate that youth receiving the WRITE ON intervention demonstrated significant gains in resilience as compared to those in a matched control group (p < .05). We are currently preparing for publication of the complete pilot findings.
A Take-Home Message about Community-Based Research
In conducting community-based research, I’m reminded of an anecdote that Dr. Ernesto Sirolli, a sustainable development expert, relayed in his aptly titled TEDx talk, “Want to help someone? Shut up and listen!” At the start of his career, he worked for an NGO, and his first task was to teach villagers in Zambia to grow tomatoes. He recounts, “Everything in Africa grew beautifully. We had these magnificent tomatoes…we were telling the Zambians, ‘Look how easy agriculture is.’ When the tomatoes were nice and ripe and red, overnight, some 200 hippos came out from the river and they ate everything. And we said to the Zambians, ‘My God, the hippos!’ And the Zambians said, ‘Yes, that’s why we have no agriculture here.’ [We said,] ‘Why didn’t you tell us?’ ‘You never asked’” (Sirolli, 2012).
As interventionists and researchers, we often approach projects with a priori hypotheses and theories about what will work. Though it is valuable to have guiding principles and notions, we cannot fail to seek and incorporate feedback from our community partners and the individuals we serve. WRITE ON’s impact was undoubtedly strengthened by building relationships with detention center staff members, actively seeking their feedback on our work, and consistently seeking formal and informal input from youth participants.
The development and implementation of WRITE ON would have been impossible without the support of the New York City Division of Youth and Family Justice, non-secure detention facility directors and staff members, Dr. Shabnam Javdani, and a deeply committed team of NYU undergraduate and Master’s students. I am truly grateful for their contributions. Lastly, I’d like to extend my appreciation to the Society for Community Research and Action, whose support has been integral to enhancing an intervention positioned to promote healthy creative expression for incarcerated youth.
To conclude, I’d like to share a piece of writing generated by a 15-year-old male in WRITE ON last summer, who goes by the pen name Hunzo.
The Good Power of Writing
If I was to write something to someone it should be something for them to look back on.
Something that would inspire black people.
Something that could end war.
Something that would bring hope for a brighter future.
Something that would leave an everlasting footprint.
Something that you wouldn't mind showing your kids saying, "The 21st century wasn't all bad, it had its ups and plenty of downs, but this is what preserved us.”
I would want to open their eyes to a new life.
One with no pain or despair.
One with world peace.
One where there won't be minorities and where everyone would get along.
That's what I would write.
Chloe Greenbaum, New York University (New York City, NY, USA)
Eds. Kyrah K. Brown, PhD and Jasmine A. Douglas, MA