Counselling OffendersCounselling Offenders| Links |
This site draws attention to, and provides a focus for, the disparate bodies and individuals interested in the subject of counselling offenders, both whilst the latter are within prison and beyond. The aim is to act as a forum for those who work within the prison service and those who are interested in counselling in prisons in the UK. Please check back regularly as I am adding more content at frequent intervals. [Last updated June 29th, 2008]
My name is Lee Partis and I am a qualified and BACP accredited Integrative Counsellor/Psychotherapist committed to the development of counselling and psychotherapy within the UK prison system. I worked as a volunteer counsellor in HMP Lewes for more than four years under the aegis of Mankind UK, a charitable support and resource service for men who have been sexually abused, assaulted or raped. I was moved by my experience there and convinced that counselling provision is a necessity within our prisons. My experience is solely with male offenders, so please excuse the absence of a female perspective on this website.
I recently moved to the north of England and hoped to continue my work in prisons, but found it extremely difficult, partly due to the change in healthcare provision in prisons going over to the Primary Care Trusts and partly due to the ad hoc nature of counselling provision within the prison system as a whole. After some time I managed to get into contact with someone who shared my vision of counselling and psychotherapy within the prison service and I am now employed by the NHS to work as a counsellor in a prison in the NW of England.
My priority is to develop a coherent policy which develops counselling and psychotherapy within our prisons. I would like counselling to be an integral part of our mental health policy for offenders which follows their time in prison and continues after their release. It has a vital part to play in improving the mental health of offenders and developing their capacity not to re-offend. (Also see 'News'.)
"It's the relationship that heals, the relationship that heals, the relationship that heals - my professional rosary." Yalom, I. (1989),Love's Executioner, London: Penguin Books, p.91 |
Counselling suits the needs of a high percentage of the prison population, many of whom fall below the threshold of prison mental-health care, which is generally designed for more severe problems. Many inmates suffer from relatively low-level psychological disturbances - depression, anxiety and so on - and early intervention can prevent these clients from developing more deep-seated mental health problems. The Sainsbury Centre for Mental Health has just completed (November 2007) a paper entitled, 'Getting the Basics Right' in which it states, "Very little support is available to prisoners with common mental health problems, such as depression, anxiety and sleeping disorders. These problems are the business of primary care in the wider community but not, it would appear, in prisons." (See 'News' for latest SCMH bulletins).
Other inmates have what are termed 'personality disorders', many of which are accessible to medium to long-term psychotherapy. Incarceration can be seen as an opportunity to deal with a client group which otherwise might not seek or have access to a talking therapy. These offenders are particularly suited to a therapy based around the primacy of relationship, as a positive experience of relationship is often what they lack. I do not seek to minimise the responsibility of the offender for their offence, but my experience leads me to conclude that a number of the clients whom I saw in prison had been traumatised as children; that is, they were abused - physically, sexually or psychologically, or all three - leading to alienation and a distrust of authority. The template for their masculinity was their parental upbringing, particularly that of the father, and this template is projected onto other figures of authority, culminating in subsequent anti-social and criminal behaviour. Armed with the faulty map which their parents provided, they are left with an inability to successfully navigate their way through society.
| "Self-narratives are shaped by experience and then reflected in behaviour. In order to explain why individuals commit crime an analysis is required to understand these internal states. One level is to explore the narrative identity or self-concept. It is suggested that traits give only the beginning of the 'whole personality.' To fully understand offending there is a need to move beyond 'stable traits' to explore the 'whole person.' Previous approaches to understanding crime do not take into account understanding of the criminal and this must be supplemented with offenders' perspectives and a review of their unique personal histories to give . . . . a full-blooded portrait." Day, J. (2007) 'Psychological Theories of Criminality', in Parker, M. (ed.) Dynamic Security, (London and Philadelphia: JKP), pp.55-6. |
Is that what our prison system seeks to do? Do we really want to understand the offender? If we do, then counselling must be an integral part of a coherent and long-term strategy for the mental health treatment of offenders; a system that begins as soon as someone is sentenced and continues throughout their incarceration and then, importantly, out into the community. Can we afford to understand the offender? We cannot afford not to.
Police, prison governors, prison officers, and so on, have a role which, understandably, includes an element of judgment, because they have a relationship with an offender as a consequence of the particular crime for which s/he was imprisoned. They can, therefore, only ever have a conditional relationship with an offender. A counsellor can afford to have a non-judgmental relationship with a person based around the reasons that brought her/him to commit crime. As such, the value of counselling and the reason it 'plugs the gap' is because, as someone who deals with the causes of criminality, and does not have the particular sentence as a focal point, the counsellor in prison can form the bridge between before, during, and the aftermath of an offender's sentence.
Some argue it may be useless and even unethical to provide psychotherapy within the prison system, as the environment mitigates against therapeutic change. Who is the counsellor working for? For the prison system? The client? The NHS? Society? Her/himself? Perhaps the counsellor is working for a putative future victim. And what are the necessary conditions for effective psychotherapy? Confidentiality is a prime ingredient of the therapeutic relationship: how might the issue of client confidentiality work within the prison system?
"I am always reminded of the story I heard about the choking man who needed an emergency tracheotomy and was far from any medical attention. A hollow ballpoint pen was driven in to his trachea, and his life was saved. I know I am not operating under ideal conditions, but my clients often learn to breathe more easily. They live through the ordeal despite (or because of) my blunted instruments. Sometimes they learn to ask for help, to seek help, and to use help. Perhaps I show them an internal door they can later open. This is a form of success, jointly created. This success comes both from having a frame and overcoming the frame we have. Trust may be slow to come but it can only follow hope." Huffman, E.G., 'Psychotherapy in Prison: the Frame Imprisoned', Clinical Social Work Journal.(Springer) 34(3) (Sept. 2006), pp.319-333. |
Perhaps the effectiveness of psychotherapeutic techniques in prisons can be measured simply by rates of recidivism? So which particular techniques should be used? Cognitive Behavioural Therapy has a robust research base and is very accessible to evaluation, which places it in pole position in the race for evidence-based commissioning from PCTs. I believe that the therapeutic relationship is of immense importance as a predictor of therapeutic change, yet it (as well as other therapeutic approaches) are less accessible to quantitative research and randomised control trials. For that reason, I believe the technique utilised is of less importance than the skill of the therapist and their capacity to develop a good working alliance.* Certain approaches will suit some clients at specific times. That is where early assessment and a skilful referral procedure is of immense importance.
Although I know of many (usually voluntary) counsellors working in relative isolation within the prison service in various parts of the country, HMP Ryehill is one prison that I know of where there is an organised counselling service. There are also a few therapeutic community prisons (apart from drug and alcohol based units); large ones such as Grendon and Dovegate and smaller communities within regular prisons such as Send (women only), Aylesbury, Gartree, Wymott, Whitemoor and Blundeston. There is also a counselling service at HMP Woodhill that has just had its funding removed, so will close July 2008. Various other prisons have voluntary counselling on some basis, Lancaster Castle being one of them. Please let me know of any others that I have not listed.
From the start of my career I was not sure what to call myself. I found that when I was talking to most clients I would call myself a counsellor and when dealing with institutions or people in authority, I would call myself a psychotherapist. A psychotherapist seems a more impressive title; they perform therapy on your psyche. The therapist is quite clearly an expert with years of training and skills that enable them to go deep within. Counselling, on the other hand, seems more mundane. It implies a relationship of parity, perhaps with less formality. It is more likely to take place around a kitchen table than in an office. |
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