Breaking the Cycle (BTC) is an innovative program designed to restructure the lives of incarcerated women who were domestically trafficked for sex.
Dr. Brown, Faculty University of Pennsylvania School of Nursing, believes that a well -designed innovative nursing based program can make a real difference in the lives of these very special women, a forgotten part of the American human landscape, by helping them develop entirely new lives. This program also reduces unnecessary confinement.
Twenty women are being recruited (7 thus far) from a large urban jail, provided housing for 12 months, given mental health and physical health treatment, treatment for addictions and job training. The first three months in residence focuses on mental and physical stability and addiction treatment. During this orientation phase, the ladies work together each morning seeking recovery from addictions via an addictions outpatient program; every afternoon via trauma specific group work; every evening via group activities obtaining life skills.
After three months, each woman begins an entry-level job on a part time basis, while group therapy continues and GED is obtained if needed. By the end of one year, each woman will have a self-sustaining job via completion of a Philadelphia based job certification program.
The overwhelming problem of mass incarceration in America must be approached from many different directions. Determining who, among the population of non violent incarcerated offenders can be transferred to more appropriate facilities is challenging from a human rights perspective and an economic perspective.
Victims of domestic human trafficking for sex comprise a population in need of complex treatment not provided in America’s jails. Trafficked victims are not a threat to the general public and they require intensive multidiscipline trauma informed and trauma - specific services that offer promise for re-connection with self and with society.
“The most insidious and common pattern appears to be young women convinced to exploit themselves for the financial benefit of someone else. Betrayals by the people closest to prostituted women appeared to be only the first injustice in a path . . . rife with violence, degradation, and extreme physical stress” (Bullough & Bullough, 1996).
The design and overall management of the program is the responsibility of Dr. Kathleen Brown, University of Pennsylvania School of Nursing. Reverend Michelle Simmonds, Founder of Why Not Prosper a 501c3 is the Program Director. The partnership between these two women is a winner for the women they serve. Rev. Michelle, an ex-offender, worked in the community for ten years and knows it well. Dr Brown offers the project’ s conception including measurable outcomes in kind. Penn’s Wharton School provides expertise for the job-training portion of the project and the job certification portion of the program in kind. Penn Medicine, including Penn Psychiatry, assumes the responsibility for assessment of the ladies and creation of a mental and physical health treatment plan. Bruce Herdman, PhD Chief Medical Operations, Philadelphia Prison Systems provides access to the population for recruitment. Dr. Herdman’s staff assists qualified women residing in the jail to apply.
There are currently seven women in the program. Most are in the three-month orientation program.
Funding for the project is provided by two sources. Mrs. Buffet, The Sunshine Lady, provides the rent for one year. Her generous support allows the women to focus on helping themselves toward the long-term goal of sustainable employment after twelve months of participation. The City of Philadelphia funds the staffing of the project. Application has been made to the Hillman Foundation for funding of outcomes research.
With city funding secured for staff positions, this program can grow. It is important that this nurse-based project include as many Penn nursing students as possible. Graduate students can participate in treatment groups. All students can work with the ladies on an individual basis. There is much students can learn from the ladies, and much the ladies can learn from the students. Student volunteers and community volunteers are welcome
Trauma exposure occurs along a continuum of “complexity,” from the less complex single, adult- onset incident where all else is stable in a person’s life, to the repeated and intrusive trauma frequently of an interpersonal nature, often involving a significant amount of stigma or shame and vulnerability. It is on this far end of the continuum where victims of human trafficking, especially sex trafficking, can be placed.
Successfully combining trauma treatment with addictions treatment while providing housing and life skills creates a program that can be replicated with other populations of non-violent offenders residing in jails throughout America. Incarcerated individuals suffer from symptoms of complex trauma the jail system is not prepared to treat. Successfully treating trauma and addictions leading to sustainable jobs has the potential to reduce recidivism of many people in the revolving door cycle of jail and criminality.
The project will serve as an exemplar that can be evaluated empirically and replicated in other locations. Penn Nursing will develop outcome data. Outcomes will be measured using paper and pencil tests, interview data, city data and chart review every three months for a three-year period. Outcome data will be collected during one year of housing and two years after graduation. Measurable outcomes include mental health and physical health, drug free time, labor force participation, contact with police, contact with psychiatric hospitalizations and cost effectiveness of the program. A control group will be formed with the same measures obtained including, if lost to follow –up, data from city mental health, social securit, and the criminal justice system. Dr. Sommers will shepherd this project through Penn’s IRB process. Penn School of Nursing students will collect data from the participants in the program and from the control group.