Social distancing in a social therapy environment

Abstract

Purpose This paper aims to describe the impact of the COVID-19 pandemic on a prison-based therapeutic community (TC). Design/methodology/approach The paper takes the form of a case study where the authors reflect on their current practice, using the findings of research on social isolation and the overarching TC principles to explore the effect of the pandemic on the TC at HMP Grendon. The authors consider how the residents and staff adjusted to the change as the parameters changed when the social distancing rules were imposed and how they adapted to the prolonged break to therapy. Sections in the paper were written by a resident and an operational member of staff. The authors conclude with their thoughts on how to manage the consequences the lockdown has brought and start to think about what returning to “normality” might mean. Findings The paper describes the adjustments made by the residents and staff as the UK Government imposed the lockdown. The authors, including a resident and an operational member of staff comment on the psychological and practical impact these adjustments had. The thought is given to the idea of “recovery”, returning to “normality” and how this study can be best managed once restrictions are lifted. Research limitations/implications At the time of writing, there are no confirmed cases of COVID-19 at HMP Grendon. The measures and commitment from all staff and residents in the prison to keep the prison environment safe may in part account for this. This paper explores the effects of lockdown on the emotional environment in a TC and highlights the consequences that social isolation can have on any individual. To the authors’ knowledge, there is currently no research undertaken on the impact of lockdown/social isolation on a TC. This research would be useful, as the authors postulate from reflections on current practice that the effects of the lockdown will be greater in a social therapy environment. Originality/value HMP Grendon started in 1962, as this time there have been no significant events that have meant the suspension of therapy for such a sustained period. It is, therefore, important that the impact of such is considered and reflected upon.

Understanding the impact of Covid-19 on the delivery and receipt of prison healthcare: an international scoping review

“…However, there has been a shift in how such services are being delivered, with many consultations now taking place via telemedicine or telephone, as opposed to in-person (Blogg et al, 2021 ; Burton et al, 2021 ). Where the Covid-19 pandemic does appear to have had a particularly detrimental impact on prison mental health services is with regards to group therapies, with reports of therapeutic groups/community meetings either being significantly reduced or ceased altogether (Akerman et al, 2020 ; Burton et al, 2021 ; di Giacomo et al, 2020 ). This appeared to be especially problematic for the therapeutic community prison, where the cessation of behavioural group work and community meetings were suggested to have affected residents’ therapeutic work, and made the prison feel more ‘mainstream’, as opposed to a therapeutic community environment (Akerman et al, 2020 ).…”

“…Articles reported that healthcare services had adapted to accommodate physical distancing measures, both patient-to-patient interactions, and also those between patients and staff. For instance, where in-person, one-to-one consultations between clinicians and people in prison took place, and in the very few instances where small mental health groups continued, these were reported to be conducted in line with the physical distancing guidelines in place at the establishment (i.e., those involved in the consultations/group being at least two metres apart from one another) (Akerman et al, 2020 ; Burton et al, 2021 ). Additionally, there were reports in Luxembourg of dividing glass barriers being installed to keep drug treatment clinicians and people in prison physically distanced during consultations (Montanari et al, 2021 ).…”

“…Due to the cancellation of therapeutic work and because of the increased likelihood of feelings of isolation due to lockdown measures, there were reports of in-cell therapeutic and diversionary materials being provided to people in prison. For instance, Donelan et al ( 2021 ) reported people receiving drug treatment therapy being encouraged to work independently on recovery journals in the US, whilst in Australia and England, distraction packs covering aspects such as coping strategies and mindfulness techniques were distributed to people across the prison to support mental health (Akerman et al, 2020 ; Blogg et al, 2021 ).…”

“…One prison in the USA reported to the reassignment of staff roles for clinicians already delivering mental health services to deal with the increased demand for inpatient psychiatric care resulting from the curtailment of transfers of people in prison between establishments because of Covid-19 (Burton et al, 2021 ). Another prison in England made the decision to utilise non-custodial staff on the prison wings to provide emotional support to the therapeutic community residents residing at the prison (Akerman et al, 2020 ).…”

“…Another study looked across 15 European countries but concentrated on drug treatment services (Montanari et al, 2021 ). We were only able to include two papers from the UK and both of these were focused on England specifically, with one being a case study about the therapeutic environment of a male prison (Akerman et al, 2020 ) and the other being a national level commentary about the state of play of prison telehealth as a consequence of the pandemic (Edge et al, 2020 ). As previously stated, most studies tended to focus on the changes to drug treatment services or mental health services.…”