Book Review: Psychological Therapy in Prisons

Harvey, J. and Smedley, K. (eds.) (2010) Psychological Therapy in Prisons and Other Secure Settings, Abingdon, Willan.

This book will be of particular interest to those counsellors and psychotherapists working within the criminal justice system. It contains an introduction and ten very well written chapters on therapy in prisons and secure institutions.

The early chapters describe a prison system struggling to cope with very high levels of psychological distress amongst an expanding prison population. The consequences of increasing demand and the reforms introduced to improve mental health services are expertly discussed in chapter two of the book.

The next four chapters describe how specific therapies can be used in secure settings. There are chapters on attachment-based psychodynamic psychotherapy, cognitive behavioural therapy with adolescents, cognitive analytic therapy with young adults and systemic therapy. Each chapter provides an outline of the model being used, its evidence base and its application. A case example is used to demonstrate the strengths of each approach and are a particularly interesting read. The problems inherent in providing therapy in prisons are discussed. One author describes prison as an ‘anti-therapeutic’ environment. The tension between security and care is a theme throughout the book.

The remainder of the book focuses on trauma work in prisons, there is a critical examination of therapeutic communities and an excellent final chapter evaluating the effectiveness of offender programmes. The chapters on therapeutic practice with women and therapy with black and minority ethnic people raise important issues that go beyond the context of prisons and secure hospitals. The chapter on race and the failure of the prison service to recognise the needs of black and minority ethnic prisoners is extremely powerful.

The book gives a particular view of psychotherapy in prisons as something practised by psychologists if it’s practised at all. The approaches discussed tend to be cognitive or psychodynamic. Neither Counsellors nor the humanistic approach feature in the book and Carl Rogers is mentioned once only - on page 250 – the book is 254 pages long! There’s no mention either of the work done by the chaplaincy or the listeners service - prisoners trained by the Samaritans to support their peers – which is currently under threat because of cuts in the prison budget. The book lacks a concluding chapter, which could have brought the key issues together and reflected on the overall picture. Despite these criticisms the book is an extremely interesting read and highly recommended for those interested in the health and care of prisoners or therapy with forensic populations.