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Psychological Therapy in Prisons and other Secure Settings

PsychologicalTherapy by Joel Harvey & Kirsty Smedley, eds., (2010). Portland, OR: Willan Publishing. 272 + xxvii pages.

Health and mental health care services are possibly among the less discussed, but potentially most important aspects of criminal justice and correctional interventions, whether through custody- or community-based programming. In this collection of 11 articles, British and Canadian authors explore therapeutic options such as cognitive0behavioral therapy, cognitive-analytic therapy, attachment-based psychodynamic psychotherapy, and systemic psychotherapy. These articles focus on therapy given in prisons and other secure settings, mental health in-reach teams, working with women prisoners, therapy with therapeutic orisons, and therapy with black and other so-called minority communities. Contextually, these articles expand our thinking about rehabilitation-oriented programs, speaking about non-criminogenic needs as well as criminogenic ones.

Some years back, Craig Haney noted that the use of psychology within prisons tends more toward the individual than the holistic context. In this volume, Harvey and Smedley argue that psychologists and psychotherapists must consider the context of prison in prisoners' lives for their interventions to have much influence. They note seven points for "keeping context central to therapy provision" or understanding why understanding incarceration helps understand those persons being held under correctional custody:

  • Therapists gain an enhanced understanding of how psychological problems emerge or expand while a person is in custody;
  • Therapists gain an understanding of the power imbalance that exists between prisoners and prison-based "helpers":
  • Therapists gain an understanding of the differences between practicing in a non-prison environment and a prison setting;
  • Therapists gain an understanding of the barriers or impediments that are in place within prison setting;
  • Therapists gain an understanding that the trust integral to therapist-client relationships is shaped not only by the prisoners pre-prison experiences but also by his prison experiences, or even his or her expectations of the prison experience; in other words, therapists gain an appreciation of the contradictions as well as the conditions of high-trust relationships in low-trust environments;
  • Therapists gain an understanding of how prison incidents such as physical altercations or suicide attempts affect therapeutic relationships or how therapy sessions affect prisoners returning to essentially non-therapeutic settings, such as isolation or crowded quarters;
  • Therapists gain an understanding of how it is possible (or not) to work with prison officials; and
  • Therapists gain an understanding of to shift from a pathological model of emotion and behavior to one that challenges the prison system itself.

Possessing such understandings does not necessarily mean that program intervention will work. As one example, Alison Mills and Kathleen Kendall examined mental health in-reach teams, which are now present in most British prisons to serve the function of referring prisoners to the same range of services as would be available to them in community settings. Prisoners have responded well: they appreciate the services offered, prisons themselves seem to have become more humane, and mental health in-reach team members even serve as advocates for prisoners. Such services have other advantages, too, but there are also drawbacks of great importance:

  • Tensions between therapeutic and non-therapeutic staff;
  • Conflicts between therapeutic and custodial purposes of incarceration;
  • Dominance of security- over service-centered features of prison interventions;
  • Suppression of interventions that challenge security-related features of prison life; and
  • Failure to recognize achievements of successful therapeutic interventions.




Posted Mon, Jun 20 2011 10:31 AM by Tracey Vessels
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