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Introduction
This is the first multi-site controlled trial of Anger Management training in Caribbean prisons. It was conducted in 2012-2015 across four correctional facilities on the island of Trinidad (estimated population 1.3m in 2014). As far as we have been able to ascertain, this may be the first controlled trial of any cognitive behavioural therapy (CBT)-based intervention within the Caribbean region.
CBT-based Anger Management programmes for offenders are now well established in developed-world Anglophone countries (e.g. Heseltine, Day and Sarre, 2011). These CBT programmes have generally been shown to be effective in decreasing inappropriate expression of anger (Howells et al., 2005; Schamborg, Tully and Browne, 2015), even when taking account of demographic variables such as age, gender, type of offence and ethnicity (Buttell and Carney, 2005; Cameron and Telfer, 2004; Goldstein et al., 2013; Ireland, 2004; Sorensen and Cunningham, 2010) or when categorized by setting, comorbidities and methods of delivery (Davey, Day and Howells, 2005; Day, Kozar and Davey, 2013; Hornsveld, 2005; Wilson et al., 2013; Wydo, DiGiuseppe and Unger, 2013). The quality of these studies is, in general, not high. Applying the quality framework proposed by Downs and Black (1998), a systematic review identified 10 trials published between 1997 and 2014, which achieved scores ranging between 11 and 15 out of a total of 26: a mean of around 50% (see online Supplementary Materials).
There were two motivations underlying this project. The first was to have a positive impact on some of the underlying behavioural problems likely to be at the base of the great social concern caused by violent crime in Trinidad and Tobago. The United States Department of State Bureau of Diplomatic Security (2015) ". . . considers crime in Trinidad and Tobago to be rated at a Critical level. Crime is the principal threat to visitors. . . . Violent crime is a concern for local security services and the general population. . . . The murder rate for Trinidad and Tobago is 31 per 100,000 inhabitants". Crimes against the person that are primary due to uncontrolled anger and aggression - murders, manslaughter, wounding (felonious), woundings and assaults causing bodily harm and other crimes against the person - continue to be dramatically high in Trinidad and Tobago (e.g. 3,550 in 2005:...