Behind Locked Doors: An Exploration of Therapeutic Processes Within a Prison Therapeutic Community

Abstract

Supervision work in a prison Therapeutic Community is used to explore countertransference implications for staff engaging with residents' disturbed states of mind. Parallel process (a psychoanalytic concept supported by contemporary neurological findings and particularly relevant to supervisory relationships) is used to explore vulnerabilities within the staff group towards acting out the dynamics they are working with therapeutically such as attacks on linking, feelings of helplessness and cynicism, and the denial of aggression. Conversely, the development and reinforcement of the staff group's capacity to generate and preserve a thinking space while under threat has a therapeutic effect upon residents' states of mind, again through the workings of parallel process. The establishment of this benign parallel process is a central task of the Therapeutic Community, and underpins its effectiveness. Its relevance for effective therapy with disturbed states of minds in other settings is also considered.

Working in a therapeutic community: exploring the impact on staff

“…Similarly, the staff were struck by the strengths and aptitude of the members. Working therapeutically with this client group can evoke strong emotional responses in staff (Polden, 2010) which was seen in participants' comments. The ability of the members to be reflective and make use of the treatment was noticeable throughout interviews and held in high regard, "the way they expressed themselves was at a higher level than other patients I've worked with before".…”

“…This could be understood using the lens of containmenta concept well-established as being critical to a therapeutic environment (Winnicott, 1953;Bion, 1959;Casement, 1985). Polden (2010) identified that in seeking containment those working in a TC can be sometimes drawn into a position of disagreement with the system as a whole.…”

“…Existing research and literature has highlighted the significance of exploring the parallel process specifically in TCs (Turley et al, 2013;Bond and Gemmell, 2014). A notable example of research within a prison TC environment was published by Polden (2010) who spoke of the potential transference and parallel processes that can occur between clients and staff. As the clients within the TC are often struggling to manage their emotions, distress and relationships, for this process to occur could potentially be very difficult to manage for staff.…”

“…As the clients within the TC are often struggling to manage their emotions, distress and relationships, for this process to occur could potentially be very difficult to manage for staff. However, again, with the right containing features (maintaining the "culture of enquiry" for staff; using supervision and feedback), staff sickness and absenteeism decreased in addition to improved staff attitudes, selfesteem and sense of adequacy in their roles (Mistral et al, 2002;Polden, 2010).…”

Outcomes of therapeutic community treatment for personality disorder

“…For example, modifications to TC principles, such as democratization, are mandated within forensic environments to ensure the safety of patients and staff (Polden, 2010). Problems in defining DTCs have raised further questions as to treatment integrity.…”