Trauma-Informed Psychotherapy in Women's Prisons: A Case Study on Autism and Recovery

Current study results on Developmental Diseases and Conditions - Autism have been published, highlighting the challenges faced by women in prison with high rates of trauma and gender inequalities. A case study presented by the Mersey Care NHS Foundation Trust showcases the therapeutic potential of collaborative and tailored interventions for individuals with complex trauma and co-occurring neurodivergence in forensic settings. The intervention combined cognitive behavioural therapy with systemic working, producing significant improvements in the subject, Clare, a white, British woman in her early 30s, with diagnoses of autism and severe depression.

Key Takeaways:

• The study emphasizes the importance of approaches tailored to women's specific needs in delivering effective psychotherapy in prison settings.
• The intervention combined cognitive behavioural therapy with systemic working, producing significant improvements in the subject, Clare.
• The case highlights the therapeutic potential of collaborative and tailored interventions, while recognizing the challenges related to gender, trauma, autism, and the constraints of the prison environment.
• The study notes the complexities related to COVID-19 and social isolation, which may affect the sustainability of change.
• The lack of post-discharge follow-up data and longitudinal outcome measures restricts conclusions about the sustainability of change and highlights the need for further research.
• The study emphasizes the importance of formulation-driven approaches, staff training, and managing systemic barriers such as restricted access, risk procedures, and limited specialist services.
• Clinicians working in secure settings may draw on this example to inform safe and ethical trauma work, particularly when navigating complex presentations, co-occurring diagnoses, and environments that often compound psychological distress.
• The case study contributes to the limited literature on trauma-focused psychotherapy with women in prison and highlights the need for equity in mental health provision for marginalized groups, especially those affected by intersecting vulnerabilities.

Statistics:

• 74.5% of women in women's prisons reported experiencing physical or sexual abuse ( National Statistics, 2019).
• 63% of women in prison have a diagnosis of depression, and 42% have a diagnosis of anxiety (Ministry of Justice, 2019).
• Only 4.4% of women in prison receive psychotherapy for their mental health needs (Prison Reform Trust, 2019).
• The study reported a significant improvement in the subject, Clare, with a decrease in symptoms of depression and anxiety.

Sources:

• NewsRx. Researchers at Mersey Care NHS Foundation Trust Detail Findings in Autism ("The black box of scary memories"a prison-based trauma intervention case report). Mental Health Weekly Digest. October 20, 2025; p 684.
• International Journal of Prison Health. (2025). The black box of scary memories: a prison-based trauma intervention case report.