Forensic Psychology For Dummies (128 page)

Maintaining integrity:
Provision is needed to monitor how well the programme functions, as well as a system to modify aspects of it that don’t perform as expected.

Ongoing evaluation:
Provision needs to be built into the programme to evaluate its efficacy. Checks must be done to ensure that staff are properly selected, trained and supervised and that the programme is run as intended. Given the challenges of carrying out therapeutic treatment in prisons, this list of ten requirements for effective interventions is a very tall order indeed, and they’re unlikely all to be achieved all the time. But at least these points give targets to aim for. If they aren’t achieved, people shouldn’t be surprised that the relevant interventions fail to reach their goal of reducing re-offending.

Acknowledging the Challenges to Treatment

When a person walks into a doctor’s consulting room and asks for treatment, the only limits are those that come from the doctor’s professional situation and what the patient needs. Psychological interventions with convicted criminals, in contrast, are constrained by legal, confidentiality and institutional factors.

Facing up to legal constraints

In democracies and other open societies persons convicted of a crime still have the same human rights as anyone else. Their liberty may be restricted or they may be required to fulfil community service, but beyond that in theory they have access to the full assistance of the law. As a result, they can claim legal support for certain aspects of their activities that aren’t compatible with obtaining appropriate treatment to help reduce the likelihood of their re-offending.

Like everyone else, prisoners have the right to refuse medical intervention as long as such refusal doesn’t cause anyone else harm. For example, inmates with a very infectious disease, such as tuberculosis, may not be allowed to continue to associate with others in prison unless they accept treatment to cure the disease. But the situation becomes more complicated in relation to psychological interventions. These interventions may open up legal implications that confound the possibility of treatment.

The prison environment may compromise the professional requirement known as
informed consent,
which demands that any interaction with a professional, especially in therapy, is based on the patient willingly accepting the treatment and knowing the implications of that treatment. But in a prison, coercion often takes place (as I note in the nearby sidebar ‘The legal complexities of treatment for inmates’). The requirement to attend treatment may be implicitly or explicitly associated with how the person is dealt with in prison, such as the privileges they’re allowed or their opportunities for parole.

Handling constraints of confidentiality

A sacrosanct necessity of privacy and confidentiality exists in conversations between therapist and client, which can be compromised by legal necessities. For instance, when the client is an offender, the person may reveal incriminating information relating to past or intended criminal activity. And yet this sort of information is precisely what a therapist needs to work with.

Dealing with denial

You may be surprised how many people in prison claim to be innocent! I regularly get letters from prisoners who claim that they were wrongly convicted, asking my help to reveal the truth. Whether they really are innocent or not, a problem clearly exists when setting up any treatment scheme to help them if they deny any wrongdoing. Of course, many people who claim to be innocent simply refuse to enrol on any sort of therapeutic programme, but where individuals are required to attend a programme, and strong evidence exists that they were at least some way involved in the crime, dealing with their denial can be a very important part of a therapeutic intervention.

This problem can be dealt with by exploring the reasons why the inmate thinks he was convicted and then considering various interpretations of his actions that may have convinced others of his guilt. This process can be harrowing for all concerned, but at the very least may enable the offender to see his actions from other people’s points of view and so consider the circumstances that he needs to avoid in the future.

Needing to work around institutional constraints

Providing treatment programmes in prison can be problematic because of conflicting demands from the institution, including:

Prisoner’s sentence is too short to complete any designated programme and so they refuse to start it.