ClinicalTrials.gg
CompletedNCT04373954Updated May 25, 2022

Proposing Forgiveness Therapy Within Prison

An interventional study of Forgiveness Therapy and Carey Guides in Forgiveness, sponsored by University of Wisconsin, Madison. Completed at 1 site in United States. Open to male participants, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-05-25.

Sponsored by University of Wisconsin, Madison · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 1 year 9 months after the study started (first participant enrolled Jul 2018, registered Apr 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Randomized
Sex
Male
01

Study summary

Previous studies found that a large number of prisoners experienced unjust treatment from others, which can lead to deep inner pain or anger, prior to criminal perpetration. Such unresolved anger can deepen and linger, be turning to resentment (excessive anger) or rage (very intense, potentially violent anger), compromising one's psychological health and behavior and even contributing to their choice of crime. However, Forgiveness Therapy, as an empirically-verified treatment, can help reduce and even eliminate the excessive anger. Its positive effects have been scientifically supported by numerous studies within diverse populations. Therefore, in the prison context, similarly, the investigator hypothesizes that Forgiveness Therapy will lower rates of anger, depression, and anxiety and raise the levels of forgiveness, empathy, hope, and self-esteem for the experimental (Forgiveness Therapy) group as compared to the alternative treatment control group. This is based upon numerous studies that demonstrate the efficacy of Forgiveness Therapy with comparisons to other treatment methods. Further, the study team expects behavioral change by the men within the correctional institution, as measured by officers' observations as well as the number of misconducts in conduct reports on each participant and the time spent in restrictive housing.

This study is the second part of a two-tiered research project to propose a novel approach--Forgiveness Therapy--to corrections and aims to demonstrate the effectiveness of Forgiveness Therapy in reducing resentment and other negative psychological symptoms such as excessive anger, anxiety, and depression for the prison inmates.

A random sample of 24 participants, who have not participated in forgiveness workshops or forgiveness therapy, were taken from the Study 1(the investigator's previous research from the maximum-security prison of Columbia Correctional Institution "Examining Prison Inmates' Attitudes and Internal Emotional States"). These participants became 12 matched pairs (matched by the type of abuse, the severity of the abuse, and age at which the injustice occurred) with each member of the matched pair randomly assigned to the experimental group or control group. Each inmate participated voluntarily in this study.

Since this study is a continuation of Study 1, the investigator named this study as Study 2.

02

Conditions studied

  • Forgiveness

Keywords

  • Forgiveness
03

In context

Lead sponsor

University of Wisconsin, Madison is the lead sponsor of 1,182 studies on the registry; 180 are open to participants now.

Of its 156 completed or terminated interventional studies of FDA-regulated products, 118 (76%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
Male
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Participants who enrolled in Study 1 and need to satisfy the criteria of:

    1. most serious stories of abuse against them; 2. the least forgiving; and 3. the most psychologically compromised. 4. Also, given the duration of psychological treatments, participants' release date will also be considered.

Exclusion criteria

Exclusion Criteria:

  • Inmates who have received Forgiveness Therapy before.
  • Inmates would be released or transferred to other institutions during the 12-month treatment.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Participant)
Enrollment
24 participants (actual)

Study arms

  • Experimental
    Forgiveness Therapy

    6-month Forgiveness Therapy; Participants meet once per week, in group setting.

    Other: Forgiveness Therapy

  • Active comparator
    Carey Guides

    6-month Carey Guides; Participants meet once per week, in group setting.

    Other: Forgiveness Therapy · Other: Carey Guides

Interventions

  • OtherForgiveness Therapy

    The Forgiveness Therapy model mainly includes four stages: uncovering, decision, work and deepening. The book 8 Keys to Forgiveness (2015, a forgiveness therapy manual authored by Dr. Enright) is the basis for the therapy as a way to ensure that the treatment is uniformly founded on the forgiveness process developed at the University of Wisconsin-Madison.

  • OtherCarey Guides

    The Carey Guides is a primary educational program deliberately chosen and approved by the Department of Corrections in Wisconsin, in which all inmates are encouraged (not required) to complete as they work toward custody reduction. Some aspects emphasized in it include anti-social thinking, emotional regulation, moral reasoning, and so on. It is the basis for the control group therapy as a way to ensure that the treatment has a uniform process as it is taught in the Department of Corrections (DOC) prison system.

06

What researchers measure

Primary outcomes

  1. Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anger

    National Institutes of Health PROMIS Measures of Anger (five items) was used. Items are statements about the frequency of feeling angry in the past seven days. An example is "In the past 7 days, I felt like I was ready to explode." Participants need to respond to each item on a 5-point scale from "Never" to "Always." The total scores for the anger scale range from 5 to 25. The higher scores a participant rated in one scale, the angrier participant was, in contrast with those who scored lower.

    Time frame: Baseline, 6 months, 12 months, 24 months

  2. Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anxiety

    National Institutes of Health PROMIS Measures of Anxiety (seven items) was used. Items are statements about the frequency of feeling anxious in the past seven days. An example is "In the past seven days, I found it hard to focus on anything other than my anxiety." Participants need to respond to each item on a 5-point scale from "Never" to "Always." The total scores for the anxiety scale range from 5 to 35. The higher scores a participant rated in one scale, the more anxious participant was, in contrast with those who scored lower.

    Time frame: Baseline, 6 months, 12 months, 24 months

  3. Change in Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Depression

    National Institutes of Health PROMIS Measures of Depression (eight items) was used. Items are statements about the frequency of feeling depressed in the past seven days. An example is "In the past seven days, I felt like a failure." Participants need to respond to each item on a 5-point scale from "Never" to "Always." The total scores for the anxiety scale range from 5 to 40. The higher scores a participant rated in one scale, the more depressed participant was, in contrast with those who scored lower.

    Time frame: Baseline, 6 months, 12 months, 24 months

  4. Change in Score on Herth Hope Index

    The Herth Hope Index was used as an instrument. It has 12 items and assesses optimism toward the future with questions, such as "I have a positive outlook on life"; "I believe that each day has potential". These questions assess connectedness to positive expectations for the future, inter-connectedness with other people, and inner positive expectancy. Participants responded on a 4-point scale ranging from "strongly disagree" to "strongly agree." Two items need to be reversely coded, and the total hope score ranges from 12 to 48. A higher score means more hopefulness toward the future.

    Time frame: Baseline, 6 months, 12 months, 24 months

  5. Change in Score on Enright Forgiveness Inventory

    Enright Forgiveness Inventory Short Form (30 items) was used as a measurement of forgiveness. It includes three subscales: affect, behavior, and cognition, with 10 items in each subscale. The introductory material at the beginning asks participants to focus on the worst injustice they experienced before their first imprisonment, and to indicate the person who unfairly treated them, time to event, degree of hurt and a brief description of the experience. Then participants were asked to think about the person who hurt them and rate the 30 items on a 6-point Likert scale ranging from "strongly disagree" to "strongly agree." Half of the items are negative statements, and reverse coding is done in the data analysis. An example of the positive items is "I feel warm toward him/her," and a negative one is "Regarding this person, I disapprove of him/her." The total forgiveness scores range from 30 to 180, with each subscale scores in the range of 10 to 60. A higher score means more forgiving.

    Time frame: Baseline, 6 months, 12 months, 24 months

  6. Change in Score on Coopersmith Self-Esteem Inventory

    The Coopersmith Self-Esteem Inventory Form B (Adult Version), consisting of 25 true-false statements evaluating attitudes toward the self in the following domains: general self, social self, self and peers, self and parents, such as "I can make up my mind without too much trouble"; "I have a low opinion of myself". Whereas the original inventory was developed for use with children, Form B has been successfully modified and applied for adults both in college and industry. A participant gets 1 point for each "True" response and 0 point for each "False" response to 8 positive self-esteem statements, and the reverse points to 17 negative statements. Scores range from 0 to 25. A higher score means a higher self-esteem a participant has.

    Time frame: Baseline, 6 months, 12 months, 24 months

  7. Change in Toronto Empathy Questionnaire Score

    The Toronto Empathy Questionnaire (TEQ) developed in partnership with the University of Toronto contains 16 items that cover both positive and absent responses of emotional empathy, such as "It upsets me to see someone being treated disrespectfully." "I enjoy making other people feel better." Participants responded on a 5-point scale ranging from "never" to "always." Half of the items need to be reversely coded, and the total empathy score ranges from 16 to 90. A higher score means a higher level of empathy.

    Time frame: Baseline, 6 months, 12 months, 24 months

  8. Change in Score on Marlowe-Crowne Social Desirability Scale

    The Marlowe-Crowne Social Desirability Scale (20-item short version) was used here to measure if a participant is "faking good" to meet the social desirability in psychological tests. It also assesses the degree to which each participant is taking this set of questionnaires seriously or not. This 20-item short version of the Marlowe-Crowne Social Desirability Scale was developed by Strahan and Gerbasi, with 20 statements using a true/false response format. An example is "I never hesitate to go out of my way to help someone in trouble." A participant gets 1 point for each "True" response and 0 point for each "False" response to 10 socially desired statements, and the reverse points to 10 not socially desired statements. Scores range from 0 to 20. A higher score represents a higher tendency of "faking good" in the test.

    Time frame: Baseline, 6 months, 12 months, 24 months

  9. Score on Maltreatment and Abuse Chronology of Exposure (MACE) Scale

    The MACE scale includes 52 items and measures retrospectively ten types of maltreatment during each year of childhood from 1 to 18 years old. The ten subscales or types of maltreatment measured include: emotional neglect, non-verbal emotional abuse, parental physical maltreatment, parental verbal abuse, peer emotional abuse, peer physical bullying, physical neglect, sexual abuse, witnessing interparental violence, and witnessing violence to siblings.

    Time frame: Baseline

07

Study locations

1 site
  • Columbia Correctional Institution
    Portage, Wisconsin 53901, United States
08

References and documents

Publications

  • Erzar T, Yu L, Enright RD, Kompan Erzar K. Childhood Victimization, Recent Injustice, Anger, and Forgiveness in a Sample of Imprisoned Male Offenders. Int J Offender Ther Comp Criminol. 2019 Jan;63(1):18-31. doi: 10.1177/0306624X18781782. Epub 2018 Jun 21. PubMed 29926759 ↗
  • Lee YR, Enright RD. A Forgiveness Intervention for Women With Fibromyalgia Who Were Abused in Childhood: A Pilot Study. Spiritual Clin Pract (Wash D C ). 2014 Sep;1(3):203-217. doi: 10.1037/scp0000025. Epub 2014 Aug 25. PubMed 25914886 ↗
  • Waltman MA, Russell DC, Coyle CT, Enright RD, Holter AC, M Swoboda C. The effects of a forgiveness intervention on patients with coronary artery disease. Psychol Health. 2009 Jan;24(1):11-27. doi: 10.1080/08870440903126371. PubMed 20186637 ↗
  • Hansen MJ, Enright RD, Baskin TW, Klatt J. A palliative care intervention in forgiveness therapy for elderly terminally ill cancer patients. J Palliat Care. 2009 Spring;25(1):51-60. PubMed 19445342 ↗
  • Reed GL, Enright RD. The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. J Consult Clin Psychol. 2006 Oct;74(5):920-9. doi: 10.1037/0022-006X.74.5.920. PubMed 17032096 ↗
  • Lin WF, Mack D, Enright RD, Krahn D, Baskin TW. Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. J Consult Clin Psychol. 2004 Dec;72(6):1114-21. doi: 10.1037/0022-006X.72.6.1114. PubMed 15612857 ↗
  • McKay KM, Hill MS, Freedman SR, Enright RD. Towards a feminist empowerment model of forgiveness psychotherapy. Psychotherapy (Chic). 2007 Mar;44(1):14-29. doi: 10.1037/0033-3204.44.1.14. PubMed 22122165 ↗
  • Enright, R. D., Erzar, T., Gambaro, M., Komoski, M. C., O'Boyle, J., Reed, G., & ... Yu, L. (2016). Proposing Forgiveness Therapy for those in Prison: An Intervention Strategy for Reducing Anger and Promoting Psychological Health. Journal of Forensic Psychology, 1, 116. DOI: 10.4172/2475-319X.1000116.
  • Yu, L., Gambaro, M., Komoski, M. C., Song, M. J., Song, M., Teslik, M., Wollner, B., & Enright, R. D. (2018). The Silent Injustices against Men in Maximum Security Prison and the Need for Forgiveness Therapy: Two Case Studies. Journal of Forensic Psychology, 3, 137. DOI: 10.4172/2475-319X.1000137.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 25, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04373954
Collaborators
Department of Corrections, State of Wisconsin
Responsible party
Sponsor
First posted
May 5, 2020
Start date
Jul 13, 2018
Primary completion
Sep 6, 2019
Completion
Sep 6, 2019
Last update
May 25, 2022

Study contacts

Robert Enright, PhD
principal investigator · University of Wisconsin, Madison

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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