# data[].attributes.body
The name of the group is to be Incarceration and Anxiety. Being new to jail is a somewhat stressful experience as inmates have to adjust to their new lifestyle, which may take months or even years. Generalized anxiety disorders are somewhat common in prison (Stawinska-Witoszynska et al., 2021). The group's main topic is to be focused on learning about how anxiety works and how to manage it while incarcerated using coping skills such as mindfulness, deep breathing, and cognitive restructuring in the best way they can, with or without medications. This group will be focused on young male inmates from the age of 18-25 who have been incarcerated for less than 1 year. The group will also consist of those who are on the mental health caseload, which is defined as being on mental health medications or engaging in counseling.

# data[].attributes.body
Mindset standards that the inmates will reach through the completion of the group counseling program.

Awareness of the many coping skills used for dealing with stress and anxiety (Algorani & Gupta, 2023).

Development of a growth mindset that is essential for managing anxiety (Schroder et al., 2017)

# data[].attributes.body
To inform the unit of openings for the group counseling program, flyers will be posted in the unit clinic with information on contacting the mental health staff if they are interested. To do this, the patients' inmates will write their identification details and reasons for asking to be seen, and then they will drop off these forms at locations across the jail that accept these documents. These documents are collected daily early in the morning. The mental health clinicians can also inform the inmates of the program during sessions.

To spread the information about the group therapy progress and results, I plan to contact the director of mental health services, Dr. Penn. Being an employee allows me to email the director directly and any managers below him. Discussing the project with Dr.Penn will allow me to discuss the program results with Dr. Murray, the senior vice president of the University of Texas Medical Branch's correctional managed care program (UTMB CMC). Gaining their approval is the best option for getting the attention of the University of Texas Medical Branch, who may wish to discuss further details of implementing the program.

# data[].attributes.body
All patients will be required to sign a consent form before every session that will be given to them by the QMHP to be seen to inform the inmates that their privacy is safe with mental health staff and their discussions are to remain confidential within the group. However, issues such as suicidal ideations/plans, homicidal ideations/plans, and any form of threats from other inmates or staff are to be reported. These consent forms will come from UTMB, the medical care group in charge of the mental health department. Confidentiality will be addressed with a reminder of the policy about confidentiality being discussed before every session starts.

# data[].attributes.body
UTMB CMC will provide the guidelines and consent regarding the group program. While I do not have personal access to the consent guidelines or consent form at this time, the guidelines would likely follow the rules provided below.

Respect the privacy of those in the program by not discussing what those in the group discussed during the session if any information regarding this is brought to the attention of mental health staff.

Ensure that the group's volume does not exceed an appropriate amount for the session.

No disrespecting other participants' statements or behaviors such as laughing, disrupting, talking over, or harassing any of the participants while they are talking.

Participants who become irritable to the point of concern will be escorted out by security and discontinued from treatment.

Those considered too disruptive or disrespectful toward the counselor or their fellow participants will be removed from future group counseling sessions and must be met individually.

Any statements regarding suicidal ideations/ plans or homicidal ideations/ plans will be reported to the mental health manager.

Those who admit to being threatened or harassed by others in the jail will be referred to security for further assistance.

# data[].attributes.body
Stage 1

To start the first initial session, the participants will be given a confidentiality form to agree to the rules of the session. These rules will also be stated before every session to ensure that the participants remember the rules before every session. Examples of acting disrespectfully or disruptively will be given, and participants will be reminded that if necessary, they will be escorted out of the session and discontinue group counseling. The participants will then be able to discuss why they enrolled in the program and then help the participants normalize their feelings with one another.

Stage 2

The participants will be encouraged to talk to the counselor to encourage participants to speak on their concerns. Those who are resistant or do not feel comfortable providing information will have the chance to meet with the counselor to discuss what could be done to make them feel more comfortable. To ensure that the participants are productive, several assignments will be given to participants at the end of each session that discuss some of the other aspects of anxiety, which they will be expected to bring to the following session. Participants will gauge their progress by completing an STAI assessment before the session to monitor their progress in the program.

Stage 3

After the group counseling sessions, each participant will be reminded of their access to further treatment. One week after the last session, each participant will be met individually to discuss their progress with the program and the need for further treatment. At the beginning of the last session, the participants will again be informed of confidentiality, which will be discussed in the follow-up meeting after group counseling has ended.

# data[].attributes.body
Of the leadership styles noted, I believe the Democratic style would be best for a group counseling setting. This would allow the participants to each have time to give their input on anxiety discussions and help encourage them to engage in the program. Democratic leadership has also been effective in many types of group counseling situations (Foels et al., 2000). I also believe that when working with an inmate population, taking more authoritative approaches may cause stress as the inmates already live in an environment where they are constantly ordered to live by security rules.

# data[].attributes.body
Two of Yalom’s curative factors for group treatment are universality and direct advice. Universality is to be done by showing the participants how common their concerns may be to help normalize their feelings and help them not feel alone. The participants can give direct advice, and the counselor can advise on problems they may all face while incarcerated.

# data[].attributes.body
One ethical requirement to be discussed at the beginning of each session is the inmate's access to care. In the correctional managed health care policy manual above, the inmates must have access to medical services, including several procedures such as writing sick calls, emergency services, and specialty clinics. The inmates will be informed of this policy and how these services also apply to mental health care.  Inmates are required to be informed of the policy with an initial consent form and access to the policy manual will be provided to those requesting it via TDCJ staff.

# data[].attributes.body
Inmates, before every session, will also be informed of their rights to the Prison Rape Elimination Act (PREA). This law discusses the inmate's right to report sexual assaults and have them investigated by a PREA officer at that unit.  Inmate during the sessions may discuss their history of sexual abuse while in session, so inmates must be reminded of their rights and be informed that any sexual abuse reported towards themselves will need to be reported to security.

# data[].attributes.body
The participants must drop off a sick call to meet with the mental health staff to be evaluated for the program. They will then be signed up for three initial counseling sessions once a week for three weeks. Participant's will then discuss their stressors or concerns regarding their feelings of anxiety. These sessions will also monitor their compliance with attending the counseling sessions, as those who miss two appointments in a row will not be considered without a legitimate excuse. Using clinical judgment and the STAI scale, the patients will be monitored on the severity of their anxiety. Those who present as needing further treatment will be evaluated and monitored before, during, and after group counseling closes after six weeks. Once the preassessment is completed, the participants will be informed of the goals, topics, and tasks discussed in the group sessions—as well as the rules for participating and the confidentiality of the program. Then, participants will be divided into groups of eight depending on when they signed up, with participants who signed up first getting access to the first group that will be scheduled. After the initial eight have been chosen, the participants will be called to medical to inform them of the program's dates, times, and locations. The dates, time, and locations would likely be Every Monday for six weeks at 10 AM in one of the education building classrooms. More sessions will be planned depending on the amount of applications. They will also be informed of compliance, confidentiality, and guidelines once they have been informed of their planned sessions.

# data[].attributes.body
Foels, R., Driskell, J. E., Mullen, B., & Salas, E. (2000a). The effects of Democratic leadership on group member satisfaction. Small Group Research, 31(6), 676–701. https://doi.org/10.1177/104649640003100603

Muralidhar, D., Ezhumalai, S., Dhanasekarapandian, R., & Nikketha, B. (2018). Group interventions. Indian Journal of Psychiatry, 60(8), 514. https://doi.org/10.4103/psychiatry.indianjpsychiatry_42_18

Julian, L. J. (2011). Measures of anxiety: State‐trait anxiety inventory (STAI), Beck anxiety inventory (BAI), and hospital anxiety and depression scale‐anxiety (hads‐a). Arthritis Care &amp; Research, 63(S11). https://doi.org/10.1002/acr.20561

Maxwell, J. C. (1998). Substance Abuse and Crime in Texas: A Summary of Prison and Probation Surveys Conducted by the Texas Commission on Alcohol and Drug Abuse and Evaluations of the Texas Criminal Justice Treatment Initiative. U.S. Department of Justice, 1–32.

Substance Abuse and Mental Health Services Administration, S. (2015). Substance abuse treatment: Group therapy. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.

Stawinska-Witoszynska, B., Czechowska, K., Moryson, W., & Wieckowska, B. (2021). The prevalence of generalised anxiety disorder among prisoners of the penitentiary institution in north-eastern Poland. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.671019

Texas Administrative Code, Title 37, Part 9. (2025). Texas Commission on Jail Standards. Retrieved from https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?pt=9&ti=37

Texas Government Code § 501.172 (2023). Prison Rape Elimination Act. Retrieved from https://statutes.capitol.texas.gov/