Working with Emotionally Disturbed Prisoners: Experiences in a Prison Treatment Program for Youthful Offenders

Article excerpt

The Prisoners

As Phelan (2002) has pointed out, psychotherapists can, in some instances, receive vicarious traumatization, as a result of the kinds of clients they work with. Others have also discussed the issue of the problem of working with difficult clients, including criminals, prisoners, or others whose behavior is largely resistant to change (Ashford, Sales, & Reid, 2002; Eisenman, 1990, 1991, 2000; Denny, 1994; Hail, 2001; Hall & Pritchard, 1996; Herron, 1999; Hodgins, 2000; Holmes & Holmes, 2002; Huff, 2002; Hunter & Dantzker, 2002; McGauley, 2002; Milner, 2000; Rasmussen, 2002; Stamm, 1995, 1997; Travers, 1995; Truell & Sharp, 2002; Wilson & Forrester, 2002). From an evolutionary psychology standpoint, there may be some advantage for the person who regularly engages in deception, cheating, or crime, as they can achieve desired goals that otherwise might be mined by them, or would require much more work and effort (Buss, 1999; Daly & Wilson, 1988; Mealy, 1995; Rowe, 1995; Wilson, 1995). Thus, criminal or deceptive behavior may be very difficult to change, given that it provides sufficient rewards for the person.

I worked at a very unusual prison. In most prisons, the prisoners receive no therapy. But, I was working at a prison treatment program, designed by the state of California to provide prisoners with therapy services. The prisoners in the treatment program received individual and group psychotherapy from clinical psychologists, social workers, and a psychiatrist. Although all were dedicated therapists, working with prisoners can be quite difficult. Some might think of people working at a state facility as being somehow inferior to others at more prestigious settings. However, the staff was not composed of rejects from other settings: they were, in my opinion, high quality professionals.

The prisoners were juvenile delinquents, through 17 years old, and some young adults 18 to 25 years old. The latter were ones deemed inappropriate for the state's adult prison system. Often this was because the prisoner was too weak or immature to fit in with the adults. Since we bad one of the few treatment programs in the state, our prisoners had to be judged emotionally disturbed to get into the facility. The youngest prisoner in our program during my almost two years there was 14 years old, and the oldest was 28, the latter being an exception to the usual 25-year old limit. He was a weak, partially deaf, probably brain damaged child molester, who could fit into no other program in the state and who had failed parole at least twice. The modal age in our facility was 16 or 18 years old (different at different times: 18 during my first year, 16 during my second).

This was a difficult group to treat successfully. Not only were they criminals, but they were seriously emotionally disturbed, with a full range of mental disorders. About one-third were psychotic. Early on I had heard reports of an 85 per cent recidivism rate for prisoners in the state's three intensive treatment programs (which our treatment program was officially known as), but I tried not to think about that too much.

I wondered, how could I succeed where others had failed? In the end, the low probability of preventing a return to crime was frustrating to me. But, the major source of stress was the way I was treated by the prisoners. These were antisocial, anti-authority youths who had built their lives on manipulating others. They treated me similarly, even though I was often kind to them. To some extent kindness was reciprocated, but usually was misinterpreted as weakness. Never had I been lied to or been the victim of attempted manipulations so often. These prisoners were real pros.

Even worse than the constant dishonesty and manipulations was the undercurrent of hostility. These were angry, aggressive individuals. With few exceptions, their orientation was one of violence for problem solving. …