Author ORCID Identifier

https://orcid.org/0000-0001-9112-5359

Date Available

7-20-2025

Year of Publication

2025

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Arts and Sciences

Department/School/Program

Psychology

Faculty

Dr. Christal Badour

Abstract

Rates of trauma and PTSD as well as histories of opioid use are high among justice-involved women, particularly in Kentucky. However, there are many barriers to receiving treatment. There is a pressing need for brief, trauma-focused interventions that can be more feasibly delivered in jail or prison settings as well as by community clinicians serving women on probation or parole. This study explores the acceptability of treatment for PTSD, particularly Written Exposure Therapy (WET), among justice-involved women on probation or parole with a history of illicit or nonmedical prescription opioid use. The research aims to deepen our understanding of factors influencing the engagement in PTSD treatment from the perspective of 269 Kentucky women with histories of incarceration. Results showed that: 1) rates of trauma and current PTSD symptomatology among the sample were high; 2) engagement in substance use treatment was common while engagement in trauma-related treatment was low; 3) participants perceived there to be an association between their opioid use and both trauma and PTSD symptoms; and 4) participants reported interest in receiving treatment for PTSD and offered preliminary support for WET as a viable treatment option but endorsed both stigma- and non-stigma-related barriers to accessing mental health services. Findings underscore the importance of developing accessible and acceptable PTSD treatments that address the unique mental health needs of justice-involved women with histories of opioid use. Opportunities to address barriers to care while offering effective trauma-related treatments within the system of care for this population are discussed.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2025.273

Funding Information

This study was supported by the Center for Clinical and Translational Science and Center for Research on Violence Against Women at the University of Kentucky (UL1TR001998) from 2022 to 2023.

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