Forensic Psychology Meets DBT: Treating Complex Trauma in Incarcerated Populations

Complex trauma refers to prolonged or repeated exposure to traumatic events, often beginning in early childhood. This might include physical abuse, sexual abuse, neglect, community violence, or chronic instability. For many individuals who end up incarcerated, trauma isn’t just part of their history—it’s a major driver of their current behavior.

Studies consistently show that incarcerated populations report high rates of trauma exposure. A study found that up to 85% of incarcerated women and 70% of incarcerated men have experienced at least one significant traumatic event in their lives. Many meet the criteria for Post-Traumatic Stress Disorder (PTSD) or display symptoms of emotional dysregulation, impulsivity, and dissociation. These are precisely the domains where DBT is most effective.

Forensic psychology seeks to understand how psychological patterns affect criminal behavior and legal outcomes. Within that framework, DBT serves as both a treatment and a preventative intervention, helping individuals learn how to manage trauma-related symptoms that could otherwise lead to violence, recidivism, or self-harm.

DBT offers a structured and skills-based approach to emotional regulation, making it highly effective in the context of correctional settings. While other therapies like Cognitive Behavioral Therapy (CBT) aim to challenge distorted thinking, DBT goes further by helping individuals tolerate distress, regulate extreme emotions, and navigate interpersonal conflict—skills that are critical in high-stress environments like jails and prisons.

The core philosophy of DBT balances two seemingly opposing forces: acceptance and change. Clients are taught to accept themselves and their emotions without judgment while also committing to changing harmful behaviors. This dialectical approach resonates with justice-involved individuals, many of whom struggle with shame, anger, or hopelessness due to past trauma or criminal actions.

DBT is also adaptable. Modified versions of the standard program have been successfully implemented in various forensic settings, including short-term jails, juvenile detention centers, and maximum-security psychiatric units. These adaptations often emphasize DBT’s four skill modules:

• Mindfulness: Staying present and aware of internal experiences
  
  
• Distress Tolerance: Managing crises without resorting to self-destructive behavior
  
  
• Emotional Regulation: Understanding and modulating intense emotions
  
  
• Interpersonal Effectiveness: Building healthy communication and relationship strategies

Implementing DBT in correctional settings requires adjustments to account for security, scheduling limitations, and the unique culture of incarceration. However, the structure of DBT is highly compatible with the needs of forensic systems. Group-based DBT skills training, for example, can be delivered in weekly sessions that accommodate lockdowns and institutional routines. Individual therapy may be offered where staffing allows, but even stand-alone skills groups have been shown to be effective.

DBT also encourages participants to apply their skills in real time. In prison settings, where individuals face frequent interpersonal challenges and emotional triggers, these tools can immediately reduce aggression, self-harm, and disciplinary infractions.

Research continues to support the use of DBT in forensic environments. One study conducted in a women’s prison in Connecticut found that participants in a DBT-Corrections Modified (DBT-CM) program had significantly lower levels of impulsive aggression and self-harm compared to controls. In a forensic psychiatric hospital, DBT reduced incidents of physical aggression and PRN medication use while improving emotional regulation over a six-month period.

Juvenile justice systems have also reported success. A program in a secure facility for adolescent girls found that participants demonstrated improved emotional awareness, reduced reactivity, and fewer behavioral infractions. These changes were often sustained beyond the program’s completion.

The therapeutic alliance, even in custodial environments, plays a large role in DBT’s success. When participants feel validated and supported, they are more likely to engage meaningfully with treatment.

Complex trauma often shows up as chronic emotional dysregulation, unstable relationships, and harmful coping strategies like avoidance, aggression, or substance use. DBT responds to these challenges with structured, skills-based interventions that promote self-awareness, resilience, and behavioral control. 

Clients learn to recognize trauma triggers and stay grounded in the moment, find safer ways to manage distress, and build emotional vocabulary to reduce impulsive reactions. Just as important, DBT equips them to navigate relationships more effectively—particularly in environments where authority dynamics and trust are difficult to manage, such as correctional settings.

Together, these skills offer a framework for healing that is especially well-suited to the realities of incarceration.

The increasing integration of DBT into forensic psychology reflects a broader shift in how the justice system approaches mental health and rehabilitation. Rather than focusing solely on containment or control, forward-looking institutions are adopting trauma-informed practices that recognize the root causes of criminal behavior.

Behavioral health professionals trained in DBT bring unique value to correctional teams. They not only deliver therapy but also help shape institutional culture through advising on de-escalation strategies, supporting reentry planning, and training staff in DBT principles. These efforts contribute to more stable environments, lower staff burnout, and improved outcomes for incarcerated individuals.

Importantly, DBT doesn’t stop working at the prison gate. Clients who develop these skills inside correctional facilities often carry them into reentry, improving their chances of maintaining employment, relationships, and sobriety on the outside. By treating trauma as a central factor in rehabilitation, DBT promotes long-term behavioral change beyond temporary compliance.

As evidence continues to mount, the case for DBT in forensic psychology becomes increasingly compelling. This application is not just about providing therapy to incarcerated populations; it's about changing the trajectory of lives shaped by trauma, adversity, and emotional pain.

DBT’s structured, practical, and emotionally intelligent approach gives incarcerated individuals a rare opportunity: the chance to develop self-awareness, emotional resilience, and interpersonal skills that many never had the opportunity to learn.

In the process, forensic systems benefit too due to fewer incidents, less recidivism, and more meaningful pathways to rehabilitation. The fusion of DBT and forensic psychology may not solve every challenge in the justice system, but it offers a clear, evidence-based direction for reform rooted in healing rather than harm.

Training

• 2025 Cohort | Comprehensive Dialectical Behavioral Therapy (DBT)
• Introduction to Dialectical Behavior Therapy (DBT)
• AAFP: Ethics in Forensic Psychology
• AAFP: Cultural Considerations in Forensic Psychology
  
  

Blog Post

• Adapting Dialectical Behavior Therapy (DBT) for Correctional Settings: A Path to Rehabilitation and Emotional Well-Being
• The Evolution of Deindividuation
• What Is Forensic Psychology?
• Do I Need To Be A Clinical Psychologist To Be A Forensic Psychologist?
  
  

Research

• Dialectical Behavioral Therapy Skills in a Correctional Facility

• Dialectical Behavioral Therapy within the Risk Need Responsivity Framework Reduces Recidivism