Counseling in Corrections

Behavioral Health at Central New Mexico Correctional Facility (MHTC)

Gail A. Robertson, LMHC, CPRP

First Impressions

Working on healthy and

consistent boundaries

Remembering that clients

are inmates

Being able to separate the

person from the crime

Being able to leave work

at work

Specific Rules

NO cameras, NO cell phones

NO touching or shaking hands

NO buying items (colored pencils, workbooks) personally

and giving to inmates

Remembering that Clients are Inmates

Acute Unit – Inmates in

Crisis and always

handcuffed when meeting

with therapist

B Pod – Less acute, able

to program, still

handcuffed when meeting

with therapist

Remembering the Clients are Inmates

Chronic Care Unit (CCU) 3 Pods

Inmates able to come to therapist’s office

No longer handcuffed when meeting

Inmates are eligible for Porter work

Inmates tend to be more open, less acute

Lock Downs – impact on meeting

Being able to Separate the Person from the Crime

Transcend past the crime, judgment has already

been made, it cannot be part of the counseling

process if therapist expects to be effective, unless

the behavior continues and is untherapeutic

Still need to be VERY aware of manipulation

from the inmate and maintain consistent

professional boundaries

Countertransference

It’s easy to dislike and judge someone who has been convicted of child molestation, murder, rape or other severe or violent crime

Need to continually be aware of own prejudices and distance own emotion from crime while trying to help the inmate understand why boundaries are so important

Leave home at home – be professional and realize that you can’t fix someone

When Situations Change

LOCKDOWN

• Inmates can’t meet while

locked down so they are

frustrated

• Monitor and do check-ins

at the cell door for A/B Pods

• For CCU – unable to see IM

Psychosocial Skills

Some inmates are ready to learn while others are

not

Focus on teaching new skills

– Self-respect/self-esteem/self-worth/self-love

– Effective Communication

– Healthy Boundaries

– Successful Relationships

– Appropriate Social interaction

Self-Respect, Self-Esteem, Self-Worth

Ability to respect the inmate without being

vulnerable to manipulation

Ability to understand that bad behavior can be

influenced by poor self-perception and poor

development of social skills

Positive self image and forgiveness are the

foundation of learning and applying healthy

psychosocial skills

Effective Communication Skills

What does good

communication look

like?

Honest

Active Listening

Willing to hear

feedback

Speaking with respect

Healthy and Consistent Boundaries and what happens when they are Crossed

Boundaries between

inmate to inmate

Inmates need to be

consistent with their

encounters to establish &

maintain safety zones

When inmates cross a

boundary in prison, it can

lead to disciplinary action

Boundaries between

staff and inmates

Undue familiarity that can

lead to termination of job

Sets an unhealthy

precedent

Undermines authority of

other staff

Manipulation

Successful Relationships

Understand the most

Important relationship

-YOU-

If you do not begin to like

and accept yourself, it is

very difficult to expect

someone else to accept

and like you

Groups

Anger Management

group using SAMHSA

material

Communication group

Depression/Anxiety

groups

Grief and loss group

Release &

Reintegration

Assessments, Treatment Plans, Testing, Treatment Guardians

Legal paperwork, Initial

Assessment

Initial Treatment Plan

Testing

– MOCA (Montreal

Cognitive Assessment)

– M-FAST for Malingering

– Beck Hopelessness Scale

– Beck Scale for Suicidal

Ideation

Treatment Guardians

– Appointed by the

courts

– Inmates that are unable

to make medical

decisions for

themselves, go to court

during this process.

Personality Disorders

Man,

do we

have lots!!!

Cluster A Personality Disorders

Paranoid Personality

Disorder

Schizoid Personality

Disorder

Schizotypal Personality

Disorder

Pattern of distrust and

suspiciousness

Pattern of detachment

from social relationships

Pattern of acute

discomfort in close

relationships, cognitive or

perceptual distortions,

eccentricities of behavior

Cluster B Personality Disorders

Antisocial Personality

Disorder

Borderline Personality

Disorder

Pattern of disregard for,

and violation of the rights

of others

Pattern of instability in

interpersonal

relationships, self-image,

and affects , and marked

impulsivity

Cluster B Personality Disorders

Histrionic Personality

Disorder

Narcissistic

Personality Disorder

Pattern of excessive

emotionality and

attention seeking

Pattern of grandiosity,

need for admiration,

and lack of empathy

Cluster C Personality Disorders

Avoidant Personality

Disorder

Dependent Personality

Disorder

Obsessive-

Compulsive

Personality Disorder

Pattern of social inhibition,

feelings of inadequacy, and

hypersensitivity to negative

evaluation

Pattern of submissive and

clinging behavior related to an

excessive need to be taken care of

Pattern of preoccupation with

orderliness, perfectionism, and

control

Guess which Type????????

Guess which

Cluster we see

the most of in the

men’s prison?

Other DSM Diagnoses we See

Major Depressive D/O with

and without psychotic

features

Schizophrenia

Autism Spectrum D/O

Disruptive, Impulse-Control,

and Conduct Disorder

Bipolar Disorder

Dual Diagnosis with many

different substances, many

times in controlled

environment (CE)

Paraphilic Disorders

PTSD

OCD

Dementia

Techniques and Tools

Mindfulness

– Being aware of

environment

– Focus on the moment

– Focus on positive energy

rather than negative

– Figuring out “Are you

stuck?”

More tools…

Separating emotion

from event

Using “time outs”

Taking advantage of

exercise and yard time

Listening to music

Playing cards

When Meeting in Therapist’s Office

Use guided imagery

depending on the

inmate

Illustrate REBT model

Use Genogram to help

better visualize roles

Practice OCD tracking

& reduction techniques

Sometimes there is little for the prisoners to do..so

Read books from the prison library

Watch television

Write letters to send out

Rewards

It is rewarding to

watch an inmate go

from being psychotic

or suicidal to really

wanting to change and

improve his quality of

life.

Every life is worth

saving

Every life touches other

lives

Questions…