Psychologists have a part to play in many aspects of prison life, from officers’ training to decisions about the release of prisoners. The range of psychological techniques employed within the prison service is wide. It stretches from an assessment using psychological instruments to the delivery of therapy. Modern prison services are likely to have tailored cognitive behavioural programmes to treat sex offenders and some violent offenders. This paper will begin by examining the effect of prison on inmates and whether there are realistic alternatives to incarceration. Then, it will explore the use of cognitive behavioural therapy in the treatment of sex offenders and anger management therapy for violent offenders.
There is no consensus about the purpose of prison. The three major views about prison are retribution, utilitarianism, and humanitarianism. Retributionists regard the purpose of prison as delivering punishments; utilitarians see prison as part of a process of bringing about changes that reduce the probability of re-offending, and humanitarians see that prisoners often come from backgrounds of deprivation and victimization so are deserving of rehabilitation. There has been researching into whether the experiences of inmates have a regressive impact on mental health. The need for this research stems from alarming figures regarding prison life. For instance, there are higher rates of suicide among prison populations. The risk is especially high during the early stages of imprisonment, as is the risk for psychotic episodes. In the United Kingdom, for instance, the average suicide rate is two per week (Howitt, 2006).
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One of the most disturbing features of suicide in prison is that those awaiting trial, who have not been sentenced, are at very high risk of suicide. Serious self-injury is also more common in prison than among the general public, as are stress-related disorders and acute physical ailments. In addition, depression and anxiety seem to develop as imprisonment continues. While there is ample evidence to suggest a higher incidence of mental health difficulties among prison populations, there is a dispute over whether these problems are due to imprisonment or whether the prisoners bring the problems “in with them.” The reasoning behind this theory is that the incidence of mental disorders among criminals is no higher than that from the subpopulations they belong to: the poor, the undereducated, and the socially and culturally deprived.
The often-heard anecdotal observations about prisoners’ adjustment patterns in confinement were confirmed by a study by Bukstel and Kilman, cited in Blackburn (1995). When first incarcerated, prisoners usually show an increase in distress stemming from the shock of the conditions of confinement and the struggle of adapting to these conditions. As inmates develop coping strategies, there is a return to more or less usual personality and behaviour. Then, as a time of release approaches, there is an increase in anxiety and distress, characterized as “short-timer’s syndrome.”
The very fact of being detained and following an imposed routine can have negative mental effects on prisoners. Institutional neurosis is a syndrome of difficulties that Barton (1959) observed developing in response to institutionalization. Symptoms include apathy, lack of initiative, loss of interest in things and events not of immediate relevance, deterioration of personal habits, lack of interest in the future, and a loss of individuality (Milan & Evans, 1987). It is caused by a lack of contact with the outside world and the enforced idleness that being imprisoned implies. The general atmosphere of deprivation, sterility, and disrepair characteristic of many institutions also contribute to the institutionalization process.
The American Association of Correctional Psychologists (AACP) has established 57 standards for delivering psychological services in adult prisons. In general, these standards state that the treatment inmates receive should be no less than that of the general public, psychological staff should have professional autonomy within the correctional system, the same principles of consent apply to prisoners, and all inmates must be screened for past and present mental disturbances and their current mental state. This screening is necessary to prevent new arrivals from hurting themselves or hurting others (Blackburn, 1995).
Because so many freed prisoners re-offend, there have always been alternatives sought for confinement. In recent years, this has revolved around placing offenders in programs and facilities around the community. This most frequently takes the form of probation or parole. Probation is intended as a combination of treatment and punishment. Although according to Hood and Sparks (1970), for many offenders, a period of probation is likely to be as effective in preventing re-offending as an institutional sentence, fines are more effective than imprisonment or probation for first-time offenders, and longer prison sentences do not reduce the reconviction rate.
Currently, there is optimism that psychologists working within the prison system can reduce crime (Howitt, 2006). Some interventions have a positive effect in reducing re-offending, and this is more likely if interventions are well designed, targeted, and systematically delivered (Blud et al., 2003). The most widely run and effective programmes in prisons are two cognitive skills programmes – Reasoning and Rehabilitation (R&R) and Enhanced Thinking Skills (ETS). The theory on which cognitive skills programmes are based involves an assumption that for some offenders, their offending behaviour is linked to a lack of thinking skills, such as interpersonal problem solving, social perspective-taking and self-control (Wilson et al., 2003). Research conducted by Ross and Fabiano showed that persistent offenders appeared to lack cognitive skills compared with less persistent and non-offenders.
The two programmes mentioned above have similar objectives and use comparable methods. The curriculum includes teaching problem-solving skills, perspective taking and social skills, creative thinking, moral reasoning, management of emotions, and critical reasoning’ (Blud et al., 2003). To pass through the first stage of selection for a cognitive skills programme in HM Prison Service, offenders should either have a current or previous conviction for a sexual, violent or drug-related offence, or they should demonstrate a lifestyle factor such as serious drug abuse or low-income family relationships which indicate they may benefit from the programme. One study conducted by the Canadian Correctional Service showed modest outcome effects at best, with 47% of the sample being readmitted to prison.
Critics of this treatment suggest that focusing on developing compensatory strategies to repair ‘deficits’ in thinking does not allow sufficient account to be taken of the predisposition, choices, opportunities and motivations of the individual and that it would be more useful to design interventions that focus on providing opportunities to change and develop. However, there are alternatives to cognitive therapy within the prison system. One of these is the therapeutic institutional regime, which has the aim of ‘providing offenders with an institutional environment that will encourage their development as members of an effective community, which may then lead to more effective participation in their community on release’ (Howitt, 2006, p. 366).
The effective treatment of sex offenders originated in the behavioural therapies common in the 1960s. However, the treatment of sex offenders was not a priority in prison services until the last few years. Sex offenders typically have both sexual and nonsexual problems (Blackburn, 1995), so assessment needs to cover social, cognitive, affective, and physiological levels of functioning. Treatment for sexual offenders differentiates between types of offence, such as child molestation, exhibitionism, rape, and sexual assault (Hollin, 1989). Behavioural therapists consider the assessment of sexual arousal patterns to be necessary. Changing deviant sexual preference is a major target of cognitive-behavioural programmes. There are several ways of doing this, such as covert sensitization, shame aversion therapy, masturbatory or orgasmic reconditioning and shaping and fading (Blackburn, 1995).
However, there are several questions about their use. For example, the assumption that deviant preference predicts re-offending remains largely untested. There are also attempts to improve social competence. Cognitive distortions are targeted in this approach. These distortions include beliefs about sex roles, rape myths, the acceptability of child-adult sex, and the minimization of harmful effects of sexual assault. According to Blackburn (1995), offenders who commit serious crimes against the person are likely to display multiple psychological dysfunctions. Blackburn states four types of murderers: paranoid-aggressive, depressive, psychopathic, and over-controlled repressors (of aggression). In one study using the MMPI (Minnesota Multiphasic Personality Inventory), Biro et al. (1992) found that 49% of homicide convicts were hypersensitive-aggressive.
This category consists of people with the characteristic of ‘being easily offended, prone to impulsive aggressive outbursts and intolerant of frustration. They are very rigid, uncooperative and permanently dissatisfied thing things. However, the causes of antisocial behaviour in psychotic offenders are often the same as those in the non-disordered. Psychological treatment for dangerous offenders is most frequently carried out in forensic psychiatric facilities. While pharmacological treatment is frequently the best strategy for treating acute psychotic disorders, psychological interventions are a more durable alternative for emotional problems such as depression or anxiety and are critical in rehabilitation. There are few demonstrably effective treatment or intervention programmes for adult violent offenders in maximum-security prisons, particularly for those diagnosable as psychopaths. They have very high recidivism rates and are often involved in institutional violent behaviour (Belfrage at al, ).
Large numbers of offenders who are not extremely dangerous are still perceived to have difficulties dealing with anger, aggression and hostility. These offenders are often placed in anger management programs to reduce the frequency and intensity of anger reactions. These involve cognitive restructuring and coping skills training. The client is made aware of the relationship between anger and self-statements through diaries and learns how to discriminate between justified and unjustified anger. Relaxation training is also given as a further self-control skill, and skills of communication and assertion are taught using the modelling and role-play (Blackburn, 1995). However, some studies indicate that while anger management programs reduce aggression in the short term, their effect on violent criminals and its longer-term impact on aggressive offending are inconclusive.
Risk assessment within the legal system is a major issue. Traditionally, recidivism has been a crucial topic, particularly about violent offenders. However, there is an important distinction between predictors and causes of dangerousness and risk. Predictors can comprise simple things such as age, criminal history, or social background. Causes of crime are multiple and complexly interrelated. The HCR-20 violence risk assessment scheme has attracted a great deal of attention. One study examined whether institutional violence could be prevented through comprehensive risk assessments followed by adequate risk management. They concluded that while there was no significant reduction in the risk factors for violence, the number of violent incidents showed a marked decrease. However, no matter how useful risk assessment is within the prison system, its major downfall is that there is no evidence that it is possible to predict serious criminal violence by individuals who have not already committed a violent crime.
There appears to be no broad-spectrum, systematic, longitudinal program of study designed to answers the questions regarding the mental state of prisoners during their confinement. The affective, behavioural, and cognitive impact of imprisonment must be examined. Consequently, little can be concluded about the contribution of imprisonment to a prisoner. Within the prison service, cognitive behavioural treatments seem to affect both sex offenders and violent offenders positively. According to Redondo (2002), criminology has demonstrated that punishment may not affect all offenders. Many factors contribute to crime, including social factors and individual psychological factors. Punishment is unlikely to have much of an influence on such factors. However, there is every reason to believe that prison can have a limited but significant impact on crime, so long as appropriate services are provided.