1st National PD Congress

ICC Birmingham
19 November 2009

Michael Brookes
Director of Therapeutic Communities
Visiting Professor: Birmingham City University
 Presentation

Supporting uniformed officers

delivering therapy within a prison
therapeutic community setting with
complex needs offenders who have
committed serious sexual offences.
 HMP Grendon
• East & Hubert Report (1939) recommended
establishment for the psychological treatment of
prisoners not qualifying under the mental health
act
• 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
 Referral Criteria
• Has more than 18 months to serve
• Has been off Category A status for the
last 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)
 Prisoner Characteristics
• 75% serving life sentences (30%
mandatory lifer, 53% discretionary lifer,
17% IPP).
• 5% serving 4 - 7 years, 5% serving 7 - 10
years, 15% serving 10 years or more.
• 10% aged 21-30, 32% aged 31-40, 38%
41-50, 20% over 50.
 Sexual Offences Committed
Against adults, adolescents and children
• Murder and rape
• Rape
• Buggery
• Stalking
• Kidnapping and sexual assault
• Excessive violence and sexual assault.
 Personality Profiles
Using PAI (Personality Assessment Inventory)
• 21% have elevated scores on the Antisocial
Features (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 patients
with personality disorders (15.7)
• Sufficiently motivated
• Necessary insight & psychological
mindedness
• IQ criteria (29 or over on the Raven’s
Progressive Matrices or 80 and above on
the WAIS/WASI)
• 46% score greater than 25 on PCL-R
• Assault rate & rates of self harm 6x fewer
than previously
• Fully accredited CSAP intervention
A Wing Multi-Disciplinary Team

• One Wing Therapist

• One Psychologist
• One P/T Group Facilitator
• 2 Senior Prison Officers
• 10 Prison Officers
 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)
 Clinicians views
“Every effort is made by non-uniform staff to consider the
difficulties inherent in the role of uniformed staff and to
minimise these where possible”.
“Uniformed members of staff who have facilitated groups
are given priority in feedback/supervision/debrief sessions
so that they are able to work through issues arising from
groups before returning to more traditional prison roles”
“By working as a team we can support each other and be
aware of potential difficulties and manage them sooner
rather than later when they could become more
entrenched.”
 Prison Officer views (1)
“My wing has a very coherent and supportive staff
team. We take great pain to look after each other.
Feedback and staff sensitivity sessions are very
important to us in keeping our mental health safe”.
“My wing has a very coherent and supportive staff
team. We take great pain to look after each other.
Feedback and staff sensitivity sessions are very
important to us in keeping our mental health safe”.
 Prison Officer views (2)
“Staff talk to each other about the impact of therapy
upon them. During staff feedback if one member of
staff is deeply affected by the content of that group,
then the whole of the time will be given over to that
officer. It leaves them feeing valued.”
“Prisoners look out for me by observing how I am
when I come on duty. They may say ‘you seem
tired and not your usual bouncy self’. Then they will
not see me about small things that need sorting out
on the wing but go and speak with another officer”.
 Prison Officer views (3)
“If I can say how I feel, especially if there are any
feelings of animosity towards a prisoner, it is out in
the open, out of my system. It never seems so bad
afterwards. These feelings are dealt with and go
away. They dissipate. Staff are not condemned for
their feelings as when these are expressed it
enables us to go about our normal duties as we
usually do, in a proper and professional way. Just
as prisoners are encouraged to say how they feel,
so are staff. Problems arise when staff do not
express their feelings or concerns and keep them
bottled up.”
 Prison Officer views (4)
“If it looks like a member of staff is not coping other
staff members will speak with them and, if felt
necessary, advise them to ask for another
supervision session, or to see Care First. Managers
may also temporarily remove them from groups
until whatever is troubling them is dealt with.”
“The staff team is proactive. We look out for one
another. If someone is going through a difficult time,
we support them. All of us, at some point, will have
difficulties with this work.”
 Prison Officer views (5)
“Prisoners understand if staff are going
through a hard time. If a group is cancelled
because of this they do not get annoyed in
the same way they would if we are simply
short of staff.”
“Prisoners send staff get well cards if we are
off-sick for any length of time.”
 Prisoner views (1)
“I think it is important that we as a community
recognise that staff, being part of the community we
live in, have their own life experiences (good and
bad) and like us will be affected by what they listen
to, in our day to day sharing. Therefore an
appreciation of where they “are at” at any given
time is important. The concept of inclusion rather
than exclusion is, and should be, a fundamental
part of community living at Grendon, where both
staff and inmates can express themselves openly”.
 Prisoner views (2)
“I would encourage staff to share how they feel. I
remember pointing out to one of the staff, after
observing his response to one of the lads in the
office, that for the past couple of days he was
sounding a bit abrupt in his responses and seemed
a little stressed. I took him to the side and
mentioned this, to which he readily agreed and
thanked me for pointing this out. I think that it is
important to consider where staff are at and not just
ourselves. To be supportive also means making
allowances for someone having a ‘bad day’”.
 Staff Support Climate
The wing therapist with clinical responsibility for this
community, along with the other clinical staff in the staff
team, has developed then a therapeutic climate in which
support 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 in
community meetings if they consider that any member of
staff may be in an unsafe position. A key element in the
creation of such a culture is the importance attached to
everybody being able to share knowledge, feelings and
concerns, especially if anyone, staff or resident, is at risk of
harm.
E-mail address: michael.brookes@hmps.gsi.gov.uk
References

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