supporting uniformed officers in delivering therapy within a prison therapeutic community setting...

8/9/2019 Supporting uniformed officers in delivering therapy within a prison therapeutic community setting with complex needs offenders who have committed serious sexual offences

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1st National PD CongressICC Birmingham

19 November 2009

Michael BrookesDirector of Therapeutic Communities

Visiting Professor: Birmingham City University


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HMP Grendon

East & Hubert Report (1939) recommendedestablishment for the psychological treatment ofprisoners not qualifying under the mental healthact

240 bed Category B prison No Segregation Unit Therapeutic regime based on the Henderson

Hospital with each of the six wings being an

individual therapeutic community Opened in 1962


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Referral Criteria

Has more than 18 months to serve Has been off Category A status for thelast 6 months

Meets drug free criteria (within 2 months)

No diagnosis of major mental illness Comprehension of rules & signs compact Accepts responsibility for offence

Meets self harm criteria (within 2 months)


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Prisoner Characteristics

75% serving life sentences (30%mandatory lifer, 53% discretionary lifer,17% IPP).

5% serving 4 - 7 years, 5% serving 7 - 10years, 15% serving 10 years or more.

10% aged 21-30, 32% aged 31-40, 38%41-50, 20% over 50.


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Sexual Offences Committed

Against adults, adolescents and children Murder and rape Rape Buggery Stalking Kidnapping and sexual assault Excessive violence and sexual assault.


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Personality Profiles

Using PAI (Personality Assessment Inventory) 21% have elevated scores on the AntisocialFeatures (ANT) scale

26% have elevated score on the Borderline

Features (BOR) scale 21% have elevated score on the Suicidal Ideation(SUI) scale

Mean EPQ-R Neuroticism score (13.1) higher than

normal male population (9.8) & closer to patientswith personality disorders (15.7)


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Sufficiently motivated Necessary insight & psychological

mindedness IQ criteria (29 or over on the Ravens

Progressive Matrices or 80 and above onthe WAIS/WASI)

46% score greater than 25 on PCL-R Assault rate & rates of self harm 6x fewer

than previously

Fully accredited CSAP intervention


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A Wing Multi-Disciplinary Team

One Wing Therapist One Psychologist

One P/T Group Facilitator 2 Senior Prison Officers 10 Prison Officers


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Staff Support Mechanisms

Pre-group/community meeting briefing Post group supervision/de-briefing Post community meeting de-briefing Weekly sensitivity meetings

Individual supervision (contracted) Group supervision Informal (and if necessary formal)

individual/group peer and/or clinical team

discussions (particularly if distressed)


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Clinicians views

Every effort is made by non-uniform staff to consider the

difficulties inherent in the role of uniformed staff and tominimise these where possible.Uniformed members of staff who have facilitated groupsare given priority in feedback/supervision/debrief sessions

so that they are able to work through issues arising fromgroups before returning to more traditional prison rolesBy working as a team we can support each other and beaware of potential difficulties and manage them soonerrather than later when they could become more

entrenched.


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Prison Officer views (1)

My wing has a very coherent and supportive staffteam. We take great pain to look after each other.Feedback and staff sensitivity sessions are veryimportant to us in keeping our mental health safe.My wing has a very coherent and supportive staffteam. We take great pain to look after each other.Feedback and staff sensitivity sessions are veryimportant to us in keeping our mental health safe.


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Prison Officer views (2)Staff talk to each other about the impact of therapy

upon them. During staff feedback if one member ofstaff is deeply affected by the content of that group,then the whole of the time will be given over to thatofficer. It leaves them feeing valued.

Prisoners look out for me by observing how I amwhen I come on duty. They may say you seemtired and not your usual bouncy self. Then they willnot see me about small things that need sorting out

on the wing but go and speak with another officer.


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If I can say how I feel, especially if there are any

feelings of animosity towards a prisoner, it is out inthe open, out of my system. It never seems so badafterwards. These feelings are dealt with and goaway. They dissipate. Staff are not condemned for

their feelings as when these are expressed itenables us to go about our normal duties as weusually do, in a proper and professional way. Justas prisoners are encouraged to say how they feel,

so are staff. Problems arise when staff do notexpress their feelings or concerns and keep thembottled up.


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Prison Officer views (4)If it looks like a member of staff is not coping other

staff members will speak with them and, if feltnecessary, advise them to ask for anothersupervision session, or to see Care First. Managersmay also temporarily remove them from groups

until whatever is troubling them is dealt with.The staff team is proactive. We look out for oneanother. If someone is going through a difficult time,we support them. All of us, at some point, will have

difficulties with this work.


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Prisoners understand if staff are goingthrough a hard time. If a group is cancelledbecause of this they do not get annoyed inthe same way they would if we are simply

short of staff.Prisoners send staff get well cards if we areoff-sick for any length of time.


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Prisoner views (1)

I think it is important that we as a community

recognise that staff, being part of the community welive in, have their own life experiences (good andbad) and like us will be affected by what they listento, in our day to day sharing. Therefore an

appreciation of where they are at at any giventime is important. The concept of inclusion ratherthan exclusion is, and should be, a fundamentalpart of community living at Grendon, where both

staff and inmates can express themselves openly.


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Prisoner views (2)

I would encourage staff to share how they feel. I

remember pointing out to one of the staff, afterobserving his response to one of the lads in theoffice, that for the past couple of days he wassounding a bit abrupt in his responses and seemed

a little stressed. I took him to the side andmentioned this, to which he readily agreed andthanked me for pointing this out. I think that it isimportant to consider where staff are at and not just

ourselves. To be supportive also means makingallowances for someone having a bad day.


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Staff Support Climate

The wing therapist with clinical responsibility for this

community, along with the other clinical staff in the staffteam, has developed then a therapeutic climate in whichsupport for staff is an integral element of the daily culture.This is sufficiently robust to facilitate service users(prisoners) raising concerns in their small groups and incommunity meetings if they consider that any member ofstaff may be in an unsafe position. A key element in thecreation of such a culture is the importance attached toeverybody being able to share knowledge, feelings and

concerns, especially if anyone, staff or resident, is at risk ofharm.


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E-mail address: [email protected]

East, W.N. and Hubert, W.H. de B. (1939) Report On The Psychological Treatment OfCrime. London: HMSO.

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