Editor’s note: Kim Gorgens, clinical associate professor at the Graduate School of Professional Psychology, is an internationally recognized expert on brain injuries. Her TEDxDU talk on the subject, “Mind Your Matter: What You Need to Know About Concussions,” was featured on TED.com, where it reached audiences from around the world. Her work on brain injuries, chronicled by the University of Denver Magazine, helped inform efforts to pass Colorado’s Jake Snakenberg Youth Concussion Act, legislation to help prevent concussions among school-aged kids.
A habitual prisoner in the Denver County Jail looked at Christina Aegerter and told her that whenever he’s released, he starts using drugs, gets in trouble and ends up right back behind bars.
A fourth-year doctoral student in the clinical psychology program at the University of Denver’s Graduate School of Professional Psychology (GSPP), Aegerter had a good hunch why the inmate kept landing back in jail: traumatic brain injury (TBI). When the prisoner was 18 years old, a truck hit him, tossing him 50 feet into the air. At age 25, he was mugged and hit in the back of the head with a tire iron.
“There was no question he had a traumatic brain injury,” Aegerter says. “So I classified it as moderate-to-severe, because he’d lost consciousness for more than 30 minutes during one of his head injuries.”
This small snippet of Aegerter’s work was part of a student-led service-learning project at DU that gives graduate psychology students experience conducting TBI screenings and accruing supervised clinical hours with Denver County Jail inmates.
Kim Gorgens, an associate professor at GSPP who helped create the program, says that when her students interviewed 80 inmates during the summers of 2013 and 2014, they expected they’d find above-average prevalence of brain trauma among prisoners. When they saw the actual numbers, however, even they were stunned: 96 percent had a TBI. The national average for prisoners is about 74 percent; the number is just 7 percent for the general population.
“This work is really about identifying problems and keeping them from getting worse,” Gorgens says. “Many of these folks fall through the cracks of society for reasons related to their brain injury.”
The project, initially intended to be a one-time effort, went well. So well, in fact, that it won state and federal grants worth about $1.5 million to develop programs in prisons along the Front Range that will feature classes for correctional staff and family members; mental health interventions to accommodate cognitive deficits; and community resources for more continuity of care. Now in its second year, the program has completed 250 of 1,200 screenings scheduled to take place over the course of four years. Gorgens presented data from the program at the National Association of State Head Injury Administration conference in October.
Judy Dettmer, director of the Colorado brain injury programs, helped DU get the grant money. “Dr. Gorgens is an amazing partner … and with her expertise in both forensics and assessment, we’ll put Colorado on the map in terms of this frontier work of identifying individuals with brain injury in the criminal justice system,” she says. “Most importantly, these individuals can receive the support they’ll need when they transition back to their community. Ultimately we hope to decrease the recidivism rate.”
DU students say the experience was rewarding. Marc Perkel, a second-year student in the doctorate of psychology program, says his feedback gave a female inmate an “aha” moment. “It really put the pieces together for her [and] allowed her to put her focus into future preparation instead of a lot of self-blame. It really made all the hard work and time put into the project worth it.”
Rachele Vogel, a third-year psychology doctorate student, says one inmate wanted to know why he kept losing interest in jobs and quitting them.
“Tests showed he had a very limited attention span and severe impairment of executive functioning,” Vogel says. “Many of his past jobs required sustained attention. We discussed his interests and positions that might accommodate his cognitive difficulties. We also discussed how his brain responds well to routine and the different places in his life where he could develop routines.”
Aegerter says she believes the impact of the project “is potentially further reaching than we can fathom. If we help even just one individual learn better impulse control, we might prevent them from getting in the car under the influence of substances again and potentially save lives. On a small scale, we hope to help the individual, but on a much larger scale, we hope to impact all of the people that they might one day influence.”
Aegerter reveals more about her habitual client: “I shared with him that his testing results showed he struggled with inhibition, to withhold automatic responses. The look of relief on his face in that moment was priceless; he finally understood that he was not a bad person … but had a neuropsychological deficit. Together we practiced the impulse-control strategy of stop-plan-choose to help him make less impulsive decisions in the future.”