PRISON SERVICE

JNovemberPRISON SERVICEOURNAL2010 No 192

Contents2Editorial CommentDr. Jennifer Fleetwood is a Lecturerin Criminology at the University ofKent.3Drug mules in the international cocaine trade:diversity and relative deprivationDr. Jennifer FleetwoodGail Jones is Deputy Chief ExecutiveOfficer and Kim Hindle is a ResearchOfficer, both working for RAPt, theRehabilitation for Addicted PrisonersTrust.9A Short-Term Evaluation of the RAPt AlcoholDependency Treatment ProgrammeGail Jones and Kim HindleDeirdre O’Neill is the co-ordinatorof Inside Film and is currently a PhDstudent at Ulster University.15Prison, Education and FilmDeirdre O’NeilShadd Maruna, is a Professor in theLaw School at Queen’s UniversityBelfast and the Directorof the Institute of Criminology andCriminal Justice.22Perrie Lectures 2010Why Our Beliefs Matter in Offender ManagementProfessor Shadd MarunaTrevor Williams is Director ofOffender Management for theEastern Region.28Perrie Lectures 2010The ‘Rehabilitation Revolution’Trevor WilliamsBeverley Thompson is the ActingChief Executive of NorthamptonshireProbation Trust.35 Perrie Lectures 2010Managing offenders through Probation ServicesBeverley ThompsonStephen Shaw was the Prisons andProbation Ombudsman for Englandand Wales from 1999 to 2010.Martin Kettle works for HMInspectorate of Prisons.38 Perrie Lectures 2010Interview: Stephen ShawMartin KettleMargaret AdamsPublic Sector Bids UnitMaggie BolgerPrison Service College, Newbold RevelAlan ConstableHMP WinchesterDr Ben CreweUniversity of CambridgePaul CrosseyHMYOI PortlandDr Michael FiddlerUniversity of GreenwichSteve HallSERCOEditorial BoardJamie Bennett (Editor)HMP Morton HallDr Karen HarrisonUniversity of HullProfessor Yvonne JewkesUniversity of LeicesterMartin KettleHM Inspectorate of PrisonsMonica LloydInterventions & Substance Misuse GroupAlan LongwellCriminal Justice Division, Northern Ireland Prison ServiceWilliam PaynePublic Sector Bids UnitDr Basia SpalekUniversity of BirminghamChristopher StaceyUnlockDr Azrini WahidinQueens University, BelfastMike WheatleyDirectorate of High SecurityRay Hazzard and Steve WilliamsHMP LeyhillPrison Service JournalIssue 192

November 201045Report on the first cohort of prisoners thatcompleted treatment in the Fens Unit,Dangerous and Severe Personality DisorderUnit at HMP WhitemoorJacqui Saradjian, Naomi Murphy and Helen CaseyJacqui Saradjian, Naomi Murphyand Helen Casey are all based on theFens Unit at HMP Whitemoor.55 Prison staff occupational health and safety and itsrelationship with inmate health: A reviewProfessor Michael W. RossProfessor Michael W. Ross is basedin the School of Public Health,University of Texas.60Book ReviewThe Dynamics of Desistance: Charting Pathwaysthrough changeSteve HallSteve Hall is a prison managercurrently working for SERCO.61Book ReviewRelease from Prison. European policy and practiceDr. Karen HarrisonDr. Karen Harrison is a Lecturer inLaw at the University of Hull.62Managing High-Risk Sex Offenders in theCommunityPhil JarvisPhil Jarvis is Sex Offender ProgrammeManager for Hertfordshire,Bedfordshire, Cambridgeshire andPeterborough Probation Trusts.63Book ReviewSex offenders and preventative detention:Politics, policy and practiceJamie BennettJamie Bennett is Governor of HMPMorton Hall.63 Book ReviewAnti-social behaviour orders: A culture of control?Jamie BennettCover photograph by Brian Locklin,Health Care Officer, HMP Gartree.The Editorial Board wishes to make clear that the views expressed by contributors are their own and donot necessarily reflect the official views or policies of the Prison Service.Printed at HMP Leyhill on 115 gsm Claro SilkSet in 10 on 13 pt Frutiger LightCirculation approx 6,000ISSN 0300-3558© Crown Copyright 2009Issue 192Prison Service Journal1

Drug mules in the international cocaine trade:diversity and relative deprivationDr. Jennifer Fleetwood is a Lecturer in Criminology at the University of Kent.IntroductionThe film ‘Maria Full of Grace’ 1 follows a youngColombian girl, through her journey as a drugsmule. The film begins in the rose factory whereMaria works. We see her rising early to work longhours in a menial job to support her family. It isclear that she (like so many of us) longs for a betterlife. This ‘better life’ is implicitly western andindividualistic. After Maria quits her job shediscovers she is pregnant. On her way to Bogotá(the capital) to find a job, she encounters a friendof a friend who offers her work as a mule. Hermotivations are clear: to escape from poverty forherself and her family no matter how slim thechances of success.These same stereotypical images of the drugsmule dominate popular media and politics. Theresearch reported sought to look beyond the mediaimage of drug mules to better understand whatmotivates men and women to work as drug mules. Thistopic is pertinent given recent policy interest in sentencereform for drug mules. 2 Although some good researchhas been done on drug mules (which is outlined in thefollowing section), it has mainly focussed on womenfrom developing nations. This is problematic given thatrecent research has noted a ‘diversification in the social,national and ethnic composition of cocaine couriers, forexample old men, entire families with children, youngblonde students and European tourists’. 3 The purposeof this research was to look at the motivations of agroup of mules who are representative of thisdiversification. In order to do this, research wasconducted in prisons in Ecuador. The men and womenencountered were from diverse national, cultural, classand ethnic backgrounds. Some were of pensionableage; others were young students who were under 20when they were arrested. Some had drug habits, otherswere in employment. I also encountered several coupleswho were travelling together (although often onepartner was unaware their partner was traffickingdrugs). I also met two women who were unknowinglycarrying drugs. Unfortunately there is not space toinclude their experiences here.What is known about drug mules?The practice of sending drugs concealed in aperson’s body (either in the stomach or other orifices),strapped to their body or packed into luggage was firstnoted in the 1970’s. 4 This practice almost certainlydeveloped in response to increased border security.Research in the area broadly agrees that mules carrydrugs which have been paid for by someone else acrossinternational borders. They may or may not receivematerial payment. 5 Since the early 1980’s knowledgeabout drug mules has come from two main sources:arrest data and interviews with drug mules themselves.Contrary to the media stereotype, most mules aremen. The largest research project analysed data aboutpeople arrested for drugs offences at Heathrow airportbetween 1991 and 1997. 6 They found that 70 per centwere men and that that the most typical method ofconcealment was in luggage. This data must beinterpreted with care as it includes not only drug mulesbut also people carrying their own drugs (who areconsidered to be entrepreneurs rather than mules).Nonetheless, similar gender ratios can be encountered inarrest data internationally and in hospital admissions fortreatment resulting from complications in swallowingcapsules of cocaine. 7 In the UK most mules come fromdeveloping world countries such as Colombia, Jamaica1. Maria Full of Grace (dir. J. Maston Col/US 2005).2. Sentencing Advisory Panel (2010). Advice to the sentencing guidelines council: Sentencing for Drug Offences. London, SentencingAdvisory Panel.3. Zaitch, D. (2002). Trafficking cocaine: Colombian drug entrepreneurs in the Netherlands. The Hague; London, Kluwer LawInternational. P. 144.4. For example, see Sabbag, R. (1999 [1976]). Snowblind. Edinburgh, Rebel Inc.5. Fleetwood, J. (2010). Drug Trade. Encyclopedia of women in today’s world. London, Sage.6. Harper, R., L, G. C. Harper, et al. (2000). “The Role and Sentencing of Women in Drug Trafficking Crime.” Legal and CriminologicalPsychology 7(1).7. Albrecht, H.-J. (1996). Drug Couriers: The Response of the German Criminal Justice System. Drug Couriers: A New Perspective. P. Green.London, Quartet, Dorn, T., M. Ceelan, et al. (2008). Prevalence of drug body packing in Amsterdam, the Netherlands. Poster presentedat the European Conference of Criminology, Edinburgh. Green, P., C. Mills, et al. (1994). “The Characteristics and Sentencing of IllegalDrug Importers.” British Journal of Criminology 34(4): 479-486. Dorn, T., M. Ceelan, et al. (2008). Prevalence of drug body packing inAmsterdam, the Netherlands. Poster presented at the European Conference of Criminology, Edinburgh. Beer, S. A. d., G. Spiessens, et al.(2008). “Surgery for Body Packing in the Caribbean: A Retrospective Study of 70 Patients.” World Journal of Surgery 28.Issue 192 Prison Service Journal3

and Nigeria. 8 This varies according to national context:for example a large portion of drug mules in Australiaare from Thailand and Vietnam. 9 Research in the USAfinds a high portion of women mules are from Jamaicaand South America. 10 A significant portion of womenmules are single parents. Research on Colombianwomen mules in prison in Europe found that 85 per centwere single parents. 11 This is also true of women mulesfrom Jamaica imprisoned in the UK and the USA. 12To an extent, these demographics can be interpretedto explain the phenomenon of drug mules. The firstresearch on the subject, conducted by Rosa del Olmo inVenezuela, concluded that economic crisisdisproportionately affected women and contributed totheir entry into the international cocaine trade as mules. 13This hypothesis has been largely borne out in researchwhich asks mules about their motivations. Research withfemale Colombian mules found that many weremotivated by financial concerns connected to women’srole as the head of the household. 14 Likewise, researchwith Jamaican mules found that most women weremotivated by economic need. 15 Writing twenty years afterRosa del Olmo, Julia Sudbury similarly concludes that neoliberaleconomic globalisation has exacerbated developingworld poverty and women continue to bedisproportionately affected as the financial heads of thehouseholds. 16Penny Green conducted research with Nigerian menand women imprisoned in the UK. She concludes that forboth: ‘relative poverty, a sense of desperation andopportunity to rise above the grinding misery of economichardship in the developing world all contribute to arational explanation of the phenomenon’. 17 Her researchwith British mules found that they were motivated bysimilar concerns as those mules from the developingworld: debt, economic distress and (in the 6 cases of 130female couriers which she presents) ‘external pressure’from older, more powerful men. 18 In addition she foundthat six (of the 18 couriers she interviewed) were ‘the veryyoung who see it as part of an exciting lifestyle and/or ameans to another better way of life’. 19Lastly, some research has highlighted the role ofcoercion and threat in motivating drug mules. 20 This claimremains contentious as it is extremely difficult for mules toprove that they were coerced. On the other hand, there isa widespread belief that mules may ‘cry wolf’ in the hopeof a more lenient sentence but on the other hand mulesmay not speak to the authorities for fear of retribution.In sum, existing research shows that deprivation isundoubtedly an important context in mules’ motivations.However, since research has tended to focus only mulesfrom the developing world, it is hardly surprising that theyshould cite poverty as a motive when they find themselvesimprisoned in the developed world. Furthermore, to saythat people commit crime because of poverty issomewhat simplistic: it does not explain why peopleoffend at a particular time, why one type of crime iscommitted over another, or why more men than womenare mules, if women are disproportionately affected byeconomic crisis. Lastly, existing research has mostlysidelined the possibility alternative or simultaneousmotives for offending. Research on women drug dealersuncovered a much wider variety of motivations thanresisting poverty such as autonomy, respect, gaining asense of control over their lives, achieving respectability aswell as enjoyment. 21 Thus the purpose of this research wasto re-examine the motives of a diverse group of mulesand in particular to consider what the role of povertymight be.Methodology and participantsData for this research was collected through 15months of ethnographic research in women’s and men’sprisons in Quito, Ecuador. The researcher spent 4-5 days aweek in prison with convicted drug traffickers in order to8. Sudbury, J. (2005). ‘Mules,’ ‘Yardies’ and other folk devils: Mapping cross border imprisonment in Britain. Global lockdown: race,gender, and the prison-industrial complex. J. Sudbury. New York, N.Y. ; London, Routledge: xxviii, 323 p.Green (1994).9. Australian Bureau of Statistics (2010), Prisoner Characteristics: Australia, available online:http://www.abs.gov.au/ausstats/abs@.nsf/Products/4517.0~2009~Chapter~Prisoner+characteristics,+Australia?OpenDocument#21302313271899535399213023132718995010. Huling, T. (1995). “Women drug couriers: Sentencing reform needed for prisoners of war.” Criminal Justice 9(15).11. Dorado, M.-C. (2005). Desventajas del castigo penal ‘exclusivo’ a las colombianas, mensajeras de drogas en Europa [Disadvantages ofthe ‘exclusive’ penal punishment of columbian drug messengers in Europe]. Delitos y Fronteras:Mujeres extranjeras en prisión [Crimesand Borders: Foreign women in prison]. M. T. Martín Palomo, M. J. Miranda López and C. Vega Solís. Madrid, Editorial Complutense.12. Sudbury (2005, see also Huling, T. (1995). “Women drug couriers: Sentencing reform needed for prisoners of war.” Criminal Justice9(15).13. Olmo, R. D. (1990). “The Economic-Crisis and the Criminalization of Latin-American Women.” Social Justice-a Journal of CrimeConflict and World Order 17(2): 40-53.14. Dorado, ibid.15. Sudbury (2005).16. Ibid.17. Green, P. (1998). Drugs, trafficking and criminal policy: the scapegoat strategy. Winchester, Waterside Press.. p. 18.18. Ibid.19. Ibid, p.93.20. Sudbury (2005).21. Denton, B. (2001). Dealing: Women in the Drug Economy. Sydney, Australia, University of New South Wales Press.4 Prison Service JournalIssue 192

learn about their experiences from their own perspective.Ecuador is situated geographically between Colombia andPeru where most of the world’s cocaine is grown. 22Although very little cocaine is grown or processed inEcuador, it is an important point of export to the rest ofthe globe. 23 This is reflected in the prison population: inthe women’s prison 70 per cent of inmates are convicteddrug offenders; in the men’s prison the figure is 28 percent. 24 Inmates convicted of drug trafficking came from allover South and Latin America (but especially Colombia),North America, Europe, West Africa, the Middle East,West and Eastern Europe, Russia, China and South EastAsia. I interviewed over 30 traffickers, of which 23 hadworked as a mule at least once (9 men and 14 women).Not much research has beendone on drug mules: they are ahidden population and mostmules will not get caught. Almostall research on drug mules hasbeen done in prison and thisproject is no different. It is difficultto say how representative theserespondents are, nonethelessresearch of this type is importantas it ‘does show what can anddoes exist’. 25 Finally, note thatmules’ ages and nationalitiescannot be included as it wouldidentify them.Motivations for working as a drugs’ muleMules were motivated by a broad range ofcircumstances, pressures and desires. The remainder ofthe paper examines these in detail. This research finds thatrespondents were motivated by a wide variety ofcircumstances and desires along a continuum fromcoercion to free choice.Threat and coercion from traffickersPrevious research has found that some mules arerecruited through violent threat. 26 Two respondents hadbeen recruited through threat by people that they knewnonetheless threat was not a common experience of themules I interviewed. Marina was threatened by her expartnerand father of her daughter. He kidnapped herdaughter and gave her an ultimatum:He came to my house and told me you willtravel for me to Ecuador and you bring me thatMules weremotivated by abroad range ofcircumstances,pressures anddesires.shit [cocaine] so that you will get your daughterback. If [you do] not, you will never see heralive… I can expect anything from him: whenhe is saying he wanted to kill her, I will believe it.For real. (Marina, European, employed).Marina contacted the social services, however sinceher ex-partner was a legal guardian they could offer littleassistance. She had experienced violence from himpreviously and saw no choice but to do what he asked.Similarly, Howard was threatened by the brother ofan old colleague. Howard worked in the music businessin the 1970’s and 80’s and toured with Latin bands inColombia and had encountered people on theperipheries of the drugs trade.Twenty years later, Howard wasworking in Ecuador. He wasapproached with an offer ofmule-work. He was asked severaltimes; each time he refused thewage increased. After Howardrefused to traffic drugs severaltimes, his contact made an excuseto come to Ecuador whereHoward was visiting. Once hiscontact arrived, he told Howardthe ‘material’ was on its way. Theyfought. Shortly after, Howard’swife received threatening phonecalls. When the drugs arrived with packaged in asuitcase, his contact had a 9mm pistol tucked into thewaistband of his trousers. Although Howard’s contactmade no explicit verbal threat, the presence of a pistoland threats to his wife, backed up with Howard’sfirsthand knowledge of the drugs industry made thethreat plausible:[My wife and I] weighed up the idea of going tothe police but to me, the immediate image I gotwas of cocaine cowboys. And gunfire and… [inthe 70’s and 80’s] we would have to perform atthe cartel headquarters and I would see all theTommy guns and machine guns and AK-47sand everybody armed to the teeth. So… thatwas my mindset. That’s who I think they are.(Howard, North American, self employed).Coercion and debtAlthough Howard and Marina’s cases are clearexamples of direct interpersonal threat, coercion through22. UNODC (2008). World Drug Report. Vienna, United Nations Office on Drugs and Crime.23. Rivera, V., Fredy (2005). Ecuador: Untangling the drug war. Drugs and democracy in Latin America: the impact of U.S. policy. C.Youngers and E. Rosin. Boulder, Colo. ; London, L. Rienner: xi, 414 p.24. Nuñez, J. and C. Gallardo (2006). Una lectura cuantativa del sistema de cárceles en Ecuador [A quantative reading of the prison systemin Ecuador]. Quito, Programa de estudios de la cuidad, FLACSO.25. Denton, B. (2001). Dealing: Women in the Drug Economy. Sydney, Australia, University of New South Wales Press. P. 18.26. Sudbury (2005).Issue 192 Prison Service Journal5

debt was a more common experience. Graham wasmotivated to work as a mule through pressure to pay offdebts to the drug traffickers who recruited him. Beforeworking as a mule he received and sold packages ofcocaine. His brother received the package, sold the drugsand spent the money. His contact demanded that thedebt be paid off and asked that Graham’s brother work asa mule to pay off the debts:I wasn’t forced to do it but my conscienceforced me. It was either me or my brotherwould come down [to Ecuador] and I knew hecould get killed. I made the choice that I had thebetter chance of returning. Itwas either that or seeing mynephew grow up without hisfather and his wife withouthim. I had less to risk.(Graham, North American,employed)Graham describes how hewas pressured not only by thedebt, but also by his socialobligations in relation to his family.Graham could have paid the debtoff through selling his possessionsbut he decided to make the trip asit would also enable him tomaintain the standard of livingthat he had built for himself and to have a small amountof money for the future.Economic motivesAlthough a few mules worked under threat orcoercion, most were motivated (at least in part) by themoney that they would earn by working as a mule. Thissection looks at the diversity of economic motivations.Several women mules cited providing for their familyas the most important motivation, either in response to apending crisis such as debts or as a generalised wish fortheir family to have better. Several respondents worked asa mule as a way to resolve pending financial crises. Afterlosing her job and splitting up with her partner, Amandawas deep in debt which had serious consequences for herand her family:I had to pay my rent in a week or the marshalwas gonna come n padlock my door, I hadnowhere to go. My mother was being evictedtoo so if I was gonna go live with my mum, shewas gonna get kicked out also so… everybodywould be in the doghouse. (Amanda, NorthAmerican, unemployed).Although a fewmules workedunder threat orcoercion, most weremotivated . . . bythe money that theywould earn byworking as a mule.When she agreed to work as a mule, she was paid$2,000 in advance which she used to pay off part of herdebts immediately.Several women mules were motivated not by crisesbut by the opportunity to gain some improvement in theliving conditions of themselves and their family:I wanted to move, you know, I needed moneyand I was thinking of taking an opportunity justonce to make some money, just once. I wantedto because I never did it before […] I wanted tomake for another house. I just wanted to moveso that she (daughter) could have her ownroom. (Anika, European, fulltime carer).For me, I’m not educated solike my dream was alwaysthat my children must bebetter than me… The first tripI got good money, I boughtme a plot and I was thinkingthis is good cause like themoney you make in 2 weeks,two months you make in 10years. […] It’s a lot of money[…], it’s a lot of money for ablack woman, for a domesticworker to have that money.’(Angela, African, employed).Furthermore, providing for children was animportant aspect of positive self-identity as a parent.Marta was unemployed when she decided to work as amule:Being a mother costs money and it really hurtswhen you can’t give them what they want.Before, in a way, yeah, I could buy her toys, noteverything but like when I would get paid I’dbuy her some clothes or whatever and shealways had what she needed. [not being able todo that] I kind of felt helpless, insecure. (Marta,African, unemployed).These different accounts show the differentmeanings of providing for the family. The above quotesindicate the social circumstances in which acquiring betterfor the family was meaningful: unemployment, oremployment in low paid labour made getting somethingbetter for one’s family particularly appealing. The mulesabove were from a diverse set of national and socialcircumstances. As such, it was not poverty but ratherrelative deprivation that was important. 27 Mules were not27. Young, J. (1999). The exclusive society : social exclusion, crime and difference in late modernity. London, SAGE.6 Prison Service JournalIssue 192

motivated by the first world ‘dream’ but rather to havewhat their neighbours, colleagues and friends had.Men’s economic motives were similar to women’salthough they were much less likely be motivated byproviding for their family (reflecting the fact that few wereparents). Echoing the above accounts, men in thisresearch generally saw working as a mule as anopportunity to improve their living circumstances. Frankwas motivated to work as a mule by:The usual reasons, short of cash, ill health,things that I needed to redecorate my councilflat etc. etc… and somebody said ‘Do you wantto do this?’ ‘Yeah. Why not?Nothing to lose.’ ‘We’ll payyou [$10,000] a kilo’. (Frank,European, unemployed).Frank was living on meagrestate benefits before working as amule. He was suffering from longterm ill health which meant thathe was in a situation of general,long term hardship which showedlittle sign of improving. 28 AlthoughFrank was living in the developedworld, working as a mule was away to fulfil otherwiseunattainable goals. Like thewomen above, he aspired to afairly average standard of living linked to his local context.Although mules’ motives were mainly tied to localcircumstances and ideals, these were also shaped byconditions of globalisation. Michael (a student in his earlytwenties) had been involved in overland drug traffickingwithin and across borders in Europe before working as amule. He first got involved in the drugs market throughthe party scene at his University. He first became involvedin drug smuggling as a way to ‘maintain his style of life’.Michael’s context is important: he grew up in an EasternEuropean country which was emerging from itscommunist past. He was influenced in part by the influxof young tourists, bringing western culture and idealswith them. Unlike his parents’ generation, he enjoyed anactive social life that centred on travelling internationallyand partying. Working as a mule enabled him to maintainthis style of live independent from his parents.Non economic motivesMules cited a number of reasons for working as amule that were not solely about material gain. These wereAlthough mules’motives were mainlytied to localcircumstances andideals, these werealso shaped byconditions ofglobalisation.rarely primary motivations but were part of a complex mixof needs and desires. Mules motives were usuallymultiple: economic need could be coupled withexcitement about travel; others hoped to pay off a debtand be able to build a better future. Furthermore, as theexamples above also show motives were often formed inrelation to others: this was especially so where mules citedlove as an important motive.Romantic love and partnershipLove was an important aspect of some female mules’motivation. 29 Manuela worked as a prostitute before shemet her boyfriend. He became jealous about her workingas a prostitute and suggested thatshe work as a mule so that theycould settle down together. Withthe money she would earn, shecould gain the traditional materialtrappings of a traditional familyand respectable femininity:I was getting older. I wanted aman and to get married andhave a good family. To have areal job and a family. [...] I washappy. Thinking that I’d foundthe right man and I wasbelieving in him. (Manuela,European)Although demonstrating love and commitment toher boyfriend were important motives, being loved isalso tied up with Manuela’s desire to have a ‘normal’domestic arrangement. For her (as for many otherwomen) being single was not an attractiveproposition. 30 In contrast to the material realties ofstigma and poverty which she had already experiencedin an irregular and disreputable ‘job’, attaining a familyand upholding the normal tenets of femininity were away to symbolically and materially improve her socialstatus and long term prospects. 31 Furthermore,Manuela’s desire for respectability echoes the accountsby women above who wanted to achieve a respectableform of motherhood (for example, that the child shouldhave its own room).An alternative reading of Manuela’s experience isthat she was manipulated by her boyfriend. Indeed, this ishow Manuela interpreted her experience when Iinterviewed her in prison where she was serving an 8 yearsentence. Nonetheless, Manuela also remembered howhappy and excited she felt when he took her to the28. Green (1991) p. 23.29. See also Torres, A. (2008). Drogas, cárcel y género en Ecuador: la experiencia de mujeres mulas [Drugs, prison and gender in Ecuador:the experience of women mules]. Quito, Ecuador, FLACSO.30. Fraser, H. (2005). “Women, love and intimacy ‘gone wrong’: Fire, wind and ice.” Affilia 20(1): 10-20.p. 16.31. Richie, B. (1996). Compelled to crime : the gender entrapment of battered Black women. New York, Routledge. P. 135.Issue 192 Prison Service Journal7

airport. Manuela’s experience demonstrates that the linebetween free choice and coercion is a very fine one.Travel, excitement and a free holidayIn addition to the above motives, both women andmen identified a number of fringe benefits that were anadditional draw although not in themselves motivations.The prospect of travel was often met with excitement,particularly for those who had no passport or had neverbeen abroad. This was felt strongly by Catalina. She grewup under communism and had never travelled before:It was the first time when I felt like a propertourist, like I’d seen on the TV.Like before I was thinkinghow can I? I don’t havemoney and in my country it’sreally hard to leave. Before Ithought only business people[could travel], I never thoughtabout young peopletravelling. I felt cool; dressinglike a tourist, visiting differentcountries, speaking differentlanguages. (Catalina,European, employed).DiscussionThis research builds on what is known about drugmules’ motives. Whereas previous studies conducted inthe UK and USA have tended to focus on drug mulesfrom the developing world, the diversity of respondentsencountered appears to lend support for the thesis thatthe profile of drug mules is more varied than in previousdecades. This diversity was reflected in mules’ motives.There are many more stories and much moreinterpretations than can be described here andunfortunately any attempt to generalise inevitably ironsout much of the complexity. Nonetheless, some commonthemes underpinned mules’ motives.This research found that both men and women maybe threatened or coerced into working as a drugs mule.These were a minority however and many mules foundthemselves pressured into working by debts andcircumstances of deprivation. However, some mules wereThese findingschallenge thestereotype of thethird world mulemotivated byfinancialdesperation.not pressured, but saw working as a mule as a way toimprove their material circumstances in ways which wereotherwise attainable.Like previous research, this project found that manymules were motivated by economic concerns. Due to thediversity in the group of participants, this research has hadto take a complex view of poverty and its localisedmeanings. The data presented above shows that whilstdeprivation was an important context, listening to mules’own account demonstrates that it was their sense ofrelative deprivation that was important. Long termdeprivation itself was sometimes a motive (note forexample how Frank and Anika wanted to improve theirliving circumstances in ways thatwere otherwise unattainable).Many respondents wereprompted to work as a mule by acrisis situation. It was at thesetimes (for example when Amandalost her job and was facingeviction) that deprivation wasstrongly felt as they had noresources to draw on at times ofcrisis. Furthermore, deprivationwas strongly felt in relation tosocial obligations to others,particularly children. Althoughwomen often oriented theirmotivations towards their family (and partners), men alsomade decisions on the basis of collective benefit. Formost respondents, working as a mule was a way torelieve debts or temporarily improve their circumstancesin the short term only rather than as a long term strategy.Furthermore, although financial and economic concernswere important, it was not always the only or the mostimportant motive: romantic love, travel and excitementwere added attractions, although they were rarely thesole motivation. Indeed, excitement and travel may bean important reason for choosing to work as a mule overother kinds of deviant or criminal ways to make endsmeet (for example prostitution), although these cannotbe explored in depth here.These findings challenge the stereotype of the thirdworld mule motivated by financial desperation. Currentcircumstances of economic crisis across the globe mayresult in a wider group of people working as drug mulesthan previously. This remains to be seen.8 Prison Service JournalIssue 192

A Short-Term Evaluation of the RAPtAlcohol Dependency TreatmentProgrammeGail Jones is Deputy Chief Executive Officer and Kim Hindle is a Research Officer, both working for RAPt,the Rehabilitation for Addicted Prisoners Trust.IntroductionAlcohol use has a strong link with crime and hasfrequently been linked with violent crime 1 . Jonesand Hoffman 2 reported that almost 40 per cent ofmale offenders were found to be alcoholdependent and the majority were severelydependent, meeting six or more of the sevenDSM-IV diagnostic criteria. These findings weresupported by analysis of Offender AssessmentSystem (OASys) assessments conducted between2004 and 2005 which revealed that between 32-38per cent of offenders had alcohol misuseproblems, violent behaviour related to alcohol useand/or criminogenic needs related to alcoholmisuse 3 .In 2003 the Prime Minister’s Strategy Unitestimated that there are 1.2 million incidents of alcoholrelated violence, 360,000 alcohol related incidents ofdomestic violence and 85,000 cases of drink-driving perannum 4 . The British Medical Association has estimatedthat either the offender or victim had consumed alcoholin 65 per cent of homicides, 75 per cent of stabbings,70 per cent of assaults and half of all domestic assaults.The financial cost of alcohol-related crime issimilarly alarming. In 2003 the Prime Minister’s StrategyUnit estimated cost for alcohol-related crime and antisocialbehaviour at £7.3 billion per year. By comparison,the amount that alcohol misuse costs the NationalHealth Service was estimated at around £1.7 billion peryear 5 .Treatment which effectively enables alcoholdependentoffenders to cease alcohol misuse istherefore expected to reduce alcohol-related offendingbehaviour. However a lack of specialist treatmentservices accredited by CSAP means that opportunitiesfor providing interventions within the criminal justicesystem, and thereby reducing re-offending, are oftenmissed 6 . McSweeney et al. 7 report that there were highlevels of largely unmet alcohol-related need withinNational Probation Service caseloads at a national level.McSweeney et al. recommends that there shouldbe a significant increase in the use of evidence basedalcohol interventions for offenders whose crimes arerelated to their use of alcohol. There is a body ofevidence suggesting that participation in offendingbehaviour programmes leads to reduced rates ofreconviction 8 . Martin and Player’s reconviction analysisof men who had undertaken the RAPt SubstanceDependency Treatment Programme (SDTP) found it tobe highly effective: only 18 per cent of these graduateswhose drug of choice was alcohol had re-offendedwithin a year of release, a significantly lower figure thanpredicted through risk assessment 9 .1. See for example Richardson, A. and T. Budd (2003). Alcohol, crime and disorder: a study of young adults. H. Office. London, Home Office,Walker, A., C. Kershaw, et al. (2006). Crime in England and Wales 2005/2006. Statistical Bulletin 12/06 London, Home Office, Lancet, The(1999) Alcohol and Violence. The Lancet, 336 (8725), 1223-1224, Alcohol Concern (2001), www.alcoholconcern.org.uk/, Day, A.,Howells, K., Heseltine, K. and Casey, S. (2003) Alcohol use and negative affect in the offence cycle. Criminal Behaviour and Mental Health,13, 45-58 and Zamble, E. and Quinsey, V.L. (2001) The Criminal Recidivism Process. Cambridge, UK: Cambridge University Press.2. ones, G.Y. and Hoffman, N.G. (2006) Alcohol dependence: International policy implications for prison populations. Substance AbuseTreatment, Prevention and Policy, 26, 211-223.3. Howard, P. D., Clark, D. A., et al. (2004). An evaluation of the Offender Assessment System (OASys) in three pilots, 1999-2001. H.Office. London, Home Office, Bonds, C. and R. Stanbury (2009). Data challenges and opportunities: Offenders in custody and thecommunity. London, Ministry of Justice.4. PMSU (2003). Interim Analytical Report. London, Prime Minister’s Strategy Unit. Online:http://www.cabinetoffice.gov.uk/media/cabinetoffice/strategy/assets/su%20interim_report2.pdf5. Ibid.6. Alcohol Concern (2000) Britain’s Ruin: meeting government objectives via a national alcohol strategy. London, UK: Alcohol Concern.7. McSweeney, T., Webster, R., Turnbull, P. J. and Duffy, M. (2009). Evidence-based practice? The National Probation Service’s work withalcohol misusing offenders. Ministry of Justice Research Series, 13/09, Sep 09.8. Hollin, C., Palmer, E., McGuire, J., Hounsome, J., Hatcher, R., Bilby, C. and Clark, C. (2004) Pathfinder programmes in the ProbationService: a retrospective analysis. Home Office Online Report 66/04. London: Home Office, Hollis, V. (2007) Reconviction Analysis ofProgramme Data using Interim Accredited Programmes Software (IAPS). London: RDS/NOMS, and McCulloch, A. and McMurran, M.(2008) ‘Evaluation of a treatment programme for alcohol-related aggression’, Criminal Behaviour and Mental Health, 18 (4): 224–231.9. Martin, C., Player, E. and Liriano, S. (2003) Results of evaluations of the RAPt drug treatment programme. In Ramsay, M. (Ed.),Prisoners’ Drug Use and Treatment: Seven Research Studies: Home Office Research Study 267. London, UK: Home Office.Issue 192 Prison Service Journal9

The Alcohol Dependency Treatment Programme(ADTP) is a six-week, intensive offending behaviourprogramme aimed at medium — to high-risk maleoffenders with a history of alcohol dependence. TheADTP introduces coping and relapse-preventions skills,addresses skills deficits that underlie both alcoholdependence and violent offending; the programmeactively links participants to ongoing sources of supportsuch as Alcoholics Anonymous (AA), and guidesparticipants in need of ongoing support on release intoappropriate community programme. The ADTP wasdeveloped by the Rehabilitation for Addicted PrisonersTrust (RAPt) and accredited by the Correctional ServiceAccreditation Panel (CSAP) in 2008.A twelve-step approach forms the basis of theADTP because this approach has been shown to beparticular effective for offenders with severe levels ofdependence and low levels of social support 10 .Additionally, the approach has been shown to increasethe likelihood of successful engagement withAlcoholics Anonymous (AA) 11 Alcoholics Anonymousprovides an ongoing, free, nationwide, readily availablenetwork of support which is independent of thecriminal justice system, yet accessible both in prison andin the community. Such support is a crucial source ofsupport, offering continuity between treatment, prisonand the transition back into the community. It is alsoimportant for alcohol dependent offenders because itprovides a network of sober friends outside of prison ina society which is otherwise widely accepting of alcoholuse.The source of data used in this paper comes fromtwelve consecutive cohorts of participants on the ADTPat HMP Bullingdon between April 2007 and January2009. There were a total of 134 participants during thisperiod; 107 graduated and 27 were de-selected.Despite the small sample size, the findings areencouraging: A comparison of pre- and post-treatmentpsychometric scores indicates the programme producessignificant changes across a range of dynamic riskfactors for re-offending. Participants’ post-treatmentfeedback also indicates the programme is effective inlinking offenders to peer and professional support andincreasing the likelihood of affiliation with thefellowship of Alcoholics Anonymous (AA).MethodParticipant SelectionAll applicants undergo a ComprehensiveSubstance Misuse Assessment (CSMA) prior to beingassessed further for the ADTP. This includesquestionnaires covering the offender’s drug and alcoholhistory, social support, history of mental healthproblems and other treatment-related needs.Applicants’ eligibility for the ADTP is then assessedaccording to the following criteria: Medium-high risk of re-offending A history of alcohol dependence Alcohol dependence as a significant risk factor forre-offendingRisk of re-offending is assessed through the OASysassessment where it is operational within theestablishment. Alternatively, the sentence planningprocess using the sentence planning risk predictor willbe used.History of alcohol dependence is assessed usingRAPt’s Substance Dependence Assessment and theCSMA. The RAPt Substance Dependence Assessmentevaluates whether an offender meets DSM-IV-TRcriteria for alcohol dependence. The CSMA providesmore general information, through open-endedquestions, about the offender’s use of alcohol.Where someone has been assessed as meetingDSM-IV criteria for alcohol dependence, theirdependence will be assumed to be a significant riskfactor for re-offending even if it was not a factor in anyof their previous crimes. However, applicants with aclear history of alcohol-related offending are givenpriority.A range of measures are used to assessparticipants before they begin treatment: Prison and Probation Offender AssessmentSystem (OASys) CARAT’s Comprehensive Substance MisuseAssessment (CSMA) The RAPt Assessment and Mental Health Screen(RAPt Assessment) Part One: Participant Information(Demographic information, offending historyand drug use history) Part Two: Substance DependenceAssessment Part Three: Mental Health Screen University of Rhode Island Change Assessment(URICA) — Administered pre- and post-treatment Alcohol Taking Confidence Questionnaire (ATCQ)— Administered pre- and post-treatment Drug Taking Confidence Questionnaire (DTCQ) —Administered pre- and post-treatment10. Project MATCH Research Group (1997) Matching alcoholism treatments to client heterogeneity: Project MATCH post-treatmentoutcomes. Journal of Studies on Alcohol, 58, 7-29.11. For example see Fiorentine, R. and Hillhouse, M.P. (2000) Drug treatment and 12-step program participation: The additive effects ofintegrated recovery activites. Journal of Substance Abuse Treatment, 18, 65-74 and Kelly, J.F. (2003) Self-help for substance-usedisorders: History, effectiveness, knowledge gaps, and research opportunities. Clinical Psychology Review, 23, 639-663.10 Prison Service JournalIssue 192

Social Problem Solving Skills Inventory—Revised(SPSI-R) — Administered pre- and post-treatmentCrime-Pics II — Administered pre- and posttreatmentSPSI-R, and Crime-Pics II As with pre-treatmentassessment data, the data from psychometrics collectedon completion are also recorded in individuals’ ADTPfiles and post-programme reports.RAPt Assessment and Mental Health ScreenThe RAPt Assessment and Mental Health Screenwas developed by RAPt and is based on DSM-IV-TRcriteria for Alcohol Dependence and a range of otherAxis I and Axis II disorders. It is designed to assesswhether an offender meets DSM-IV criteria for alcoholdependence. The incorporated mental health screen isdesigned to screen offenders for symptoms ofdepression, anxiety, mania, psychosis,obsessive/compulsive disorders, eating disorders, posttraumaticstress disorder and personality disorders andassess whether offenders haveany history of mental healthproblems, including self-harmand suicide. This latter section isnot intended as a diagnostic toolbut simply as an aid to highlightpotential mental healthsymptoms and needs. It isadministered as part of the ADTPselection process and beforeadmission to the programme.Mental health difficulties areknown to be prevalent inprisoners and to impact ontreatment engagement. There isevidence to suggest that theactive treatment of co-morbid mental health problemsmay improve substance misuse outcomes 12 . This hasimportant implications for ADTP participants whomaintain abstinence but whose relapse risk is high dueto inadequately treated mental health needs. RAPt staffwork closely with Mental Health in-reach teams tosupport participants with mental health needs.Pre- and Post-Treatment PsychometricsA number of the psychometric measuresadministered at the pre-treatment stage are readministeredon completion. As well as helping toevaluate the programme’s overall impact on theunderlying factors targeted, changes in pre- and posttreatmentscores also help inform the throughcareprocess by providing a fuller picture of each individual’sclinical needs on discharge. The questionnaires readministeredon completion are: URICA, ATCQ, DTCQ,Mental healthdifficulties areknown to beprevalent inprisoners and toimpact on treatmentengagement.University of Rhode Island Change Assessment(URICA)The URICA is administered to participants on thefirst day of the ADTP and then re-administered on thelast day. It is used to measure participants’ level ofcommitment to achieving sobriety and effecting changein their lives generally. The measure uses the ‘cycle ofchange’ concept to assess readiness. Participants withlow scores fall into the ‘pre-contemplation’ or‘contemplation’ stages while more motivatedparticipants’ scores should place them in the ‘action’and ‘maintenance’ phases.Alcohol Taking ConfidenceQuestionnaire (ATCQ)The ATCQ measures aperson’s confidence in their abilityto resist drinking alcohol inresponse to a range of differentrecognised ‘risk’ circumstances —unpleasant emotions, physicaldiscomfort, conflict with others,pleasant times with others,pleasantemotions,urges/cravings to use, and socialpressure to use. It also containsquestions relating to the desireon the part of the offender to ‘test’ their ability toconsume alcohol in a controlled fashion and resist socialand other pressures to drink.Social Problem Solving Skills Inventory —Revised (SPSI-R)The SPSI-R is administered to participants on thefirst day of the ADTP and then re-administered on thelast day. The SPSI-R is designed to measure problemsolving skills and deficits. A positive impact on thisfactor would be expected to be reflected in positivechanges in participants’ scores on this measure. Itconsists of 25 items, which make up five sub-scales: Positive problem orientation Negative problem orientation Rational problem solving Impulsive / careless style Avoidance style12. Charney, D. A., Paraherakis, A. M. & Gill, K. J. (2001) Integrated treatment of comorbid depression and substance use disorders.Journal of Clinical Psychiatry, 62, 672–677, Hesse, M. (2004) Achieving abstinence by treating depression in the presence of substanceusedisorders. Addictive Behaviors, 29, 1137–1141, and Watkins, K. E., Paddock, S. M., Zhang, L., et al. (2006) Improving care fordepression in patients with comorbid substance misuse. American Journal of Psychiatry, 163, 125–132.Issue 192 Prison Service Journal11

Crime-Pics IICrime-Pics II is designed to measure changes inoffenders’ attitudes to offending. It is administeredbefore and after participation in the ADTP in order toevaluate the extent of the programme’s impact on‘dysfunctional or anti-social attitudes, cognitions andbeliefs related to re-offending,’ ‘strong ties to andidentification with, anti-social/criminal models,’ ‘weakties to, and lack of identification with, pro-social/anticriminalmodels’ and ‘weak commitment to avoidingre-offending.’ Positive changes in these factors areexpected to be reflected in participants’ scores on thispsychometric measure.Limitations of Psychometric AssessmentsThe psychometric assessments detailed above donot measure all of the factors targeted by theprogramme (it does not include, for example, a measureof ‘social support systems for tackling drug/alcohol use’).Despite their limitations, these psychometric assessmentshave been selected based on their quality and establishedusefulness as indicators of change in factors which areinevitably difficult to quantify. It is thus possible toconclude that ‘positive’ changes in participants’ scoreswould suggestive that the ADTP has a positive impact onseveral of the key factors it targets.Participant Feedback and Focal Counsellor AssessmentsAs a twelve-step organisation with more than 50per cent of staff in recovery from addiction, RAPt hasalways recognised the importance of programmeparticipants’ perspectives. Whether they are de-selected,choose to leave treatment or graduate, all participantsare asked to complete a Participant FeedbackQuestionnaire. These ask participants to rate variousaspects of treatment and their subjective perceptions ofpersonal change using a five-point Likert Scale.Participant feedback forms are administered ontreatment completion. Participants who are de-selectedare also asked, but not compelled, to complete theforms.ResultsDemographic ProfileThe mean age for all participants was 29.2 (Min:21, Max 55). The ethnic mix on the programme and theethnic mix of the prison was undertaken and indicatedthat the programme participants reflected well theethnic mix of the prison and that no ethic group wasunder-represented. Participants’ age and ethnicity werenot related to treatment completion.Offending ProfileHalf of ADTP participants’ current main offenceswere violent offences (murder, violence, violentrobbery). A further 27.7 per cent had committedacquisitive main offences (robbery, theft, fraud orburglary). 14.3 per cent were serving sentences fordrug-related offences and the remaining 8 per cent forother crimes.Alcohol DependenceADTP participants are assessed against the sevencore DSM-IV-TR criteria for alcohol dependence. Thosewho do not meet any criteria are not considereddependent and are therefore not eligible for theprogramme. Those meeting 1-3* criteria are consideredto have low level dependence; those who meet 4-5*criteria are considered to have a medium level ofdependence and those who meet 6-7* criteria areconsidered highly dependent (and by necessity meet atleast one criteria of physical dependence). Theprogramme is intended for those with medium to highlevels of dependence.61.2 per cent of participants were highlydependent. 29.8 per cent of participants had a mediumlevel of alcohol dependence. Just 9 per cent ofparticipants had only low level dependence.Participants reported an average of 8.7 years ofproblematic alcohol use prior to treatmentMental Health ScreenParticipants on the ADTP reported high rates ofinsomnia, self-harm and past suicide attempts.Graduates and deselected participants were equally aslikely to have self harmed (24.3 per cent of graduates,24.0 per cent of deselected participants).Over 50 per cent of participants had been treatedfor a mental health disorder prior to engagement withthe programme, the most frequently reported disorderwas Depression followed by Anxiety and Panic Attacks.Results:Pre- and Post-PsychometricQuestionnaire ResultsAlcohol Taking Confidence Questionnaire (ATCQ)Participants’ confidence in their abilities to remainsober across high-risk situations was measured with theAlcohol Taking Confidence Questionnaire (ATCQ). TheATCQ is a psychometric measure of self-efficacy withregard to alcohol use.Improvements in ATCQ scores after treatmentGraduates’ mean ATCQ scores increased from 50.3per cent pre-treatment to 76.0 per cent post-treatment.This increase is highly significant and indicated thatparticipants who engage with the programme are moreconfident in their ability to remain sober post-treatmentInterestingly, 12.1 per cent of graduates showedreductions in confidence; the majority of these12 Prison Service JournalIssue 192

(including all those with decreases greater than 15) hadreported unusually high pre-treatment levels ofconfidence (75-100). In these cases (high pre-treatmentscores), it is conceivable that lower post-treatmentconfidence reflects participants gaining more realisticviews of alcoholism and greater awareness of their ownpersonally relevant risk factors.The Social Problem Solving Inventory Revised (SPSI-R)The Social Problem Solving Inventory Revised(SPSI-R) is a questionnaire designed to assess problemsolving skills. Comparison of pre- and post-treatmentSPSI-R scores suggestedsubstantial improvementsamong graduates; particularlyfor positive problem solvingorientations and rationalproblem solving. It was foundthat most participants’ SPSI-Rtotal scores improved, somequite dramatically. Graduates’mean SPSI-R total scoresincreased from 90.1 pretreatmentto 100.6 posttreatment.This increase ishighly significant. Deselectedparticipants’ mean SPSI-R totalscores increased from 86.6 pretreatmentto 94.6 posttreatment.While this is notstatistically significant it doesindicate that all participantsincreased their Social ProblemSolving skills even if they did notsuccessfully completetreatment.Crime-Pics IICrime-Pics II is a questionnaire designed to assessdysfunctional or anti-social attitudes; cognitions andbeliefs related to re-offending; victim awareness andcommitment to avoiding re-offending. Participants areassessed before treatment and on completion.Attitudes are assessed on three dimensions: G-It was found thatthe majority ofparticipants’ preandpost-treatmentscores showedsignificantimprovements intheir generalattitudes tooffending andanticipation ofre-offending.General Attitude to Offending, V- Victim Hurt Denialand A- Anticipation of Re-Offending. Decreases inpost-treatment scores indicate positive changes:A low G score (Min 7, Max 35) indicates anegative general attitude to offending.A low V score (Min 3, Max 15) indicates a highlevel of victim hurt awareness.A low A score (Min 10, Max 50) indicates astrong resolve not to offend again.Table 1, below, presents a summary of participants’pre- and post-treatment Crime Pics II scores on each ofthe dimensions.It was found that themajority of participants’ pre- andpost-treatment scores showedsignificant improvements in theirgeneral attitudes to offendingand anticipation of re-offending.This suggests that after treatmentmost participants felt morestrongly that offending was notan acceptable way of life forthem.Graduates’ mean G scoresdecreased from 17.3 pretreatmentto 15.6 post-treatment(Representing a positive changein attitude). This decrease ishighly significant.Improvements in Victim HurtDenial (V) scores were less clear.While the post-treatment meanscore was slightly lower (meanchange = -0.4417), the pretreatmentmean score wasalready low (the mean pre-treatment V score was 5.15,the minimum score on this dimension is 3 and themaximum is 15) indicating that many participantsalready had high levels of victim awareness. This may bewhy most participants’ scores remained largelyunchanged. It was found that there was no statisticallysignificant change between the mean pre- and posttreatmentV scores for either graduates or de-selectedparticipants.Table 1:Summary of pre- and post-treatment Crime-Pics II scoresPRE POST PRE POST PRE POSTGeneral Attitude General Attitude Victim Hurt Victim Hurt Anticipation of Anticipation ofto Offending to Offending Denial Denia Re-Offendingl Re-Offending(G) (G) (V) (V) (A) (A)N 134 120 134 120 134 120Minimum 7 7 3 3 10 10Maximum 35 31 15 15 44 41Mean 17.31 15.66 5.15 4.73 23.34 19.68Issue 192 Prison Service Journal13

Graduates’ mean A scores decreased from 23.7pre-treatment to 19.4 post-treatment (Representing adecreased anticipation of re-offending). This decrease ishighly significantParticipants’ post-treatment feedbackPost-treatment feedback using a 5-point Likertscale revealed that 37.5 per cent of graduates ratedtheir risk of relapse in the next year as ‘Very low’ andthe same proportion (37.5 per cent) rated their risk as‘Low’. 21.9 per cent rated their risk as ‘Medium.’ Only3.1 per cent of graduates rated their risk as ‘High’ andnone of the graduates considered their risk ‘Very high.’These responses fit well with thehigh levels of confidence foundin post-treatment Alcohol TakingConfidence scores.Participants’ post-treatmentfeedback provides anencouraging indication that theADTP is effectively linkingparticipants to peer andprofessional support and leadingto affiliation with AA, 81 per centof participants rated their level ofsupport for staying sober inprison as ‘High’ or ‘Very High’and 75.0 per cent rated theircommunity support similarly. Inaddition, post-treatmentfeedback from graduatesindicated high levels of perceivedsupport with regard to avoiding re-offending postrelease.The majority of participants also reported highlevels of commitment to attending twelve-step AAmeetings indicating that one of the chief objectives ofthe ADTP’s programme to encourage AA affiliation ismet effectively. ADTP counsellors report the majority ofgraduates who remain in custody do continue to attendAA meetings and outside speaker meetings, suggestingthat the ratings reflect actual levels of affiliation.DiscussionIn February, 2010 HM Inspectorate of Prisonsproduced a short thematic review of Alcohol services inprisons. Their report highlights the gaps that currentlyexist between the needs of prisoners with alcoholproblems and the services available in prisons to meetthose needs. Their report suggests that nearly one infive prisoners have an alcohol problem, and that amongthe young offender population this rises to 30 per cent.Their reporthighlights the gapsthat currently existbetween the needsof prisoners withalcohol problemsand the servicesavailable in prisonsto meetthose needs.Women are also highlighted in their report aspresenting with a need for alcohol services; theysuggest that around 29 per cent would benefit from analcohol intervention..While there is an acknowledge need to addressalcohol related offending criminal justice agencies havetraditionally focused their attention on drug relatedcrime. In the United Kingdom we have developedNational Strategies supported by significant levels offunding to address the problems of illicit drug use —however, there remains a conspicuous absence offunding to address the social and economicconsequences of alcohol related crime.The Mental Health Screen used as part of theassessment process indicated thatalcohol dependent prisoners arelikely to present with a range ofmental health problems. Inaddition, they are likely to havehousing and throughcare needsthat if left unaddressed are likelyto impact on the offenders’s riskof reoffending on release. ManyADTP participants come intotreatment with low levels of socialsupport. Participants’ posttreatmentfeedback provides anencouraging indication that theADTP is effectively linkingparticipants to peer andprofessional support and leadingto affiliation with AA. The resultspresented in this paper supportthe notion that the use of evidence based interventionwith alcohol dependent offenders can significantlyreduce this risk.In response to the Prime Minister’s Alcohol HarmReduction Strategy the Prison Service published astrategy in 2004 to support the new emphasis onaddressing alcohol related crime. The Prison Service’sstrategy states that it will increase provision whereresources are available — however, the opportunity toincrease alcohol provision will remain severely restricteduntil a greater proportion of the available resources areallocated to the provision of alcohol services. NOMScommissioners, and the Reducing Re-offendingProgrammes Group, have recognised this challenge,and are trying to increase the availability of resources todevelop services to alcohol dependent offenders. Thisprocess is welcome, particularly as it is accompanied bythe development of accredited programmes for thistarget group of offenders in prison and in thecommunity, that have proven positive results.14 Prison Service JournalIssue 192

Prison, Education and FilmDeirdre O’Neill is the co-ordinator of Inside Film and is currently a PhD student at Ulster University.The Inside Film Project has so far run twice once inHMP Wandsworth and once in HMP RochesterYoung Offenders Institution. The aim of theproject is to act as a counter hegemonicintervention utilizing popular culture within aparticular strand of the media (film) as a vehicle todevelop a language that is analytical andadequate to understanding the socialdeterminants that affect all our lives 1 but whoseimpact and consequences vary depending uponthe social class to which we belong to. It is thepossibility of putting this understanding and thislanguage into practice that has the potential tolead to a transformation in personalconsciousness and this transformation in personalconsciousness creates the possibility of a criticalinteraction with the social world.This paper details the work of the project andconsiders the ways in which film can be used withinprison education as a means of engaging peopleserving prison sentences in ways that more traditionalsubjects are unable to do. It also presents some ideasconcerning a class specific education thatacknowledges the majority of prisoners are workingclass and therefore their experience of formal educationis one of alienation 2 from a system constructed for thebenefit of the middle classes in which the odds arestacked against them succeeding. 3The Inside Film project enables the prisoners takingpart in the course to make their own films this isachieved by running practical workshops where theylearn to use a film camera and to edit their films. Beforethese practical sessions, the first six weeks or so of thecourse explores the theoretical and historical aspects offilm and filmmaking. It is our contention that withoutthis grounding the students taking part in the projectuncritically mimic the established filmic practices theyare familiar with from watching mainstream movies andtelevision. This insistence on the theoretical andhistorical is not a sterile educational requirement but arecognition that we exist in a world where we areconstantly bombarded with media images and that inorder to make sense of these images and the purposesthey serve, we need to be able to engage critically withthem. 4 After the theoretical sessions and before filmingbegins the students take part in ideas sessions wherethey discuss (and argue about) the kind of film theywould like to make, what the subject matter will be andwhat form the film will take. These sessions have beenlively and loud as by this point the students have allbegun to develop ideas about how they want theirfilms to look. For some of the students these ideas willhave been influenced by the preceding theoreticalsessions where they were exposed to the kind offilmmaking that they might not generally have theopportunity to view. 5 It is interesting to witness in thediscussions that take place during these sessions (whichare only a few weeks into the course) a recognition thatthe mainstream dominant film product is not the onlyoption available, this consideration of other possibilitiestakes place not only at the level of form but also inrelation to representations of gender, class and race.This suggests a cognitive shift on the part of thestudents towards areas not previously explored. Thewillingness of the students to explore these other areasindicates that it is not a reluctance on the part of thestudents that has prevented an engagement withalternative forms of filmmaking but evidence of therestricted choices available in the area of culturalresources. Of course at this point the cognitive shiftrelates to the specific area of film but I would argue thisshift produces the potential for alternatives tohegemonic modes of thinking to be generalised toother areas.When a decision has been made about what kindof film they would like to make the students write thescripts, storyboard their films and cast them. Afterwhich they act in, direct, shoot and edit their films. Thepostproduction process also allows for adding music,sound effects and special effects. All through this1. O’Neill, D. & Wayne, M. (2008) Film as a Radical Pedagogic Tool in Film International vol. 5, no. 5, pp.10-16.2. For Karl Marx the concept of alienation refers to the ways in which society often feels as though it is an alien force working against theneeds of those living and working in that society. This is particularly true for the working classes but the bourgeois class is alsodistorted by the constant push for profits at the expense of all else. In education alienation results in the estrangement of the workingclass person from the processes of knowledge acquisition.3. Benson, L. (1978) Proletarians and Parties, London: Tavistock p.73.4. O’Neill & Wayne op.cit.5. To take just one example — one of the theory sessions is devoted to a film making practice known as Third Cinema — a low budget,politically committed cinema that grew out of the anti colonial struggles taking place across South America and Africa in the 1960sand 70s (see Wayne, M. (2001) Political Film: The Dialectics of Third Cinema London: Pluto Press) One of the most interesting films tohave been produced by the students is a film very heavily influenced by the filmmaking practices and strategies of Third Cinema WHOAM I? In this documentary the students make connections between personal identity, national identity and international violence in anunconventional and thought provoking way.Issue 192 Prison Service Journal15

process the students are exposed to alternatives thatdiffer from the mainstream dominant filmmakingstrategies consequently there is a need to engage withthese alternatives and to think about which ones servesbest the film they wish to make.The insistence on the theoretical component of thecourse presents us with one of the dialectical tensionsinherent in the project. We accept as valuable thepopular culture that the prisoners enjoy and recognisethat in however a distorted formthis popular culture does dealwith the very real needs, desiresand contradictions existing withincapitalism at the present momentand therefore demands to beengaged with in a serious way.But we are at the same timeoffering the students alternativemethods of engaging andprocessing that culture in order toreject the way in which thatculture positions them. It is bychallenging the dominantworldview and the normativepower of dominantrepresentations that the potentialto transform the way in whichthey view the world and byextension the way in which theyact in the world comes intobeing. This melding of theory andpractice — this praxis — createsa space between the establishedand the possible in which thosetaking part in the project candevelop (a limited) personalagency and it is the practice ofagency which the project worksto foster. It is through praxis thatwe are able to combine the waywe live our lives with the ability to reflect upon on whywe live them in the way that we do.It is this combination of what Gramsci called‘being’ and ‘thinking’ that creates the possibility forboth social and personal agency. 6 By engaging criticallywith their lives not just as individuals but as part of awider society, by reflecting on their experiences in thatsociety, by considering alternatives to their presentmode of being in the world, the students can begin toact upon the world in ways that can bring aboutchange.Most of the prisoners who have taken part in theInside Film project already have an extensive knowledgeBy engagingcritically with theirlives not just asindividuals but aspart of a widersociety, by reflectingon their experiencesin that society, byconsideringalternatives to theirpresent mode ofbeing in the world,the students canbegin to act uponthe world in waysthat can bringabout change.of film language and are familiar with filmicconventions (because they spend so much of their timewatching films). They arrive on the course with a sharedknowledge of film, of the codes and conventions thatare in place to represent prisoners, the working classes,different races, and different genders, and the ways inwhich mainstream films are edited, lit and scored (evenif these are not the terms they would use to articulatethis knowledge) Like all of us they have internalisedmany of the values and attitudesthat are presented through themedium of mainstream films, TVand other media outlets. It isthese values and attitudes thatwe attempt to analyse and todeconstruct emphasising theimportance of questioning whosevalues we are being asked toaccept when we watch an‘entertainment ‘ film, what andwhose purpose do those valuesserves, what kind of lifestyle isbeing given legitimacy and whosesocial realty is being denigrated orignored?A radical pedagogy of film isnot just a matter of the prisonersproducing films that deal withthe politics of working class lifein a more authentic way,reworking the inheritedconventions of the dominantculture although of course that isexactly what these films do (I amhere collapsing the categories ofprisoner and working classesbecauseI think it is important toacknowledge that the vastmajority of prisoners are workingclass and that the reasons theyfind themselves in prison is because of their responsesto working class life in a capitalist society). It is also aquestion of challenging the values and ideologicalpractices of a capitalist society and about creatingspaces in which to achieve this aim this means theremust be an attempt to construct a geographical spacewithin the confines of the prison, a spacedifferentiated from the usual education provision anda cognitive space that is able to consider differentperspectives. Within these spaces the prisoners cancreate their own representations of their own lives,provide evidence of their daily experiences both insideand outside of the prison and thereby challenge6. Gramsci, A. (1971) Selections From the Prison Notebooks of Antonio Gramsci, edited and translated by Quinton Hoare and GeoffreyNowell-Smith London: Lawrence and Wishart pp323- 324.16 Prison Service JournalIssue 192

assumptions of working class people, working classlife and of course prisoners.This cannot be achieved through films made aboutthe working class and prisoners that are mediated bythe life experiences and assumptions of middle classprofessionals who make films to be shown on the arthouse / competition circuit. It can only be done bycreating these spaces in which the working class personcan claim an agency that has to a greater or lesserdegree been denied them most of their lives. This is notan idealistic attempt to claim making a film aboutpersonal experiences is going to change everything, butthe pedagogic value of taking popular culture seriouslyand creating spaces for the prisoners to access theirown experiences lies in thepossibility of producing complexrepresentations with the powerto reverse homogenisingrepresentations of the workingclasses. It is also concerned withcreating cultural artefacts thatcan be owned and in the processthose taking part can movetowards being subjects ratherthan objects.Access to the means ofrepresentation is denied theworking classes in general but inparticular the section of theworking class that make up theprison population where thoseinside the prison are defined bythe crime they have committed. Their lives are narratedby others, their actions decontextulised to fit intocategories of crime and sentencing. They are not in aposition to, neither do they have the power to, directlychallenge the ways in which they are constructed bythose who have that power: filmmakers, politicians,educators, journalists, the legal system. All of thesegroups represent the working classes in ways that sharemany assumptions about working class life andworking class people and which recreate the hierarchalnorms that allow prisoners to be categorised andclassified by the middle class expert. But the way inwhich life is actually lived and experienced by theprisoners might bear little resemblance to theserepresentations.Within the mainstream media working class life ismostly represented as lacking in any cultural capital, theIt is also concernedwith creatingcultural artefactsthat can be ownedand in the processthose taking partcan move towardsbeing subjectsrather than objects.film Billy Eliot (Stephen Daldry 2000) being a significantexample —the only way for Billy to have a good life, tosucceed, to be happy is to move away from his workingclass community and become a… ballet dancer. Othermainstream films such as My Fair Lady (George Cukor1974) or Pretty Woman (Gary Marshall 1990) are alsopremised on the notion that to be successful, to bevalued is to be middle class. 7 This construction ofworking class culture as lacking, as an obstruction tofulfilment and a better life functions not only as anattack on working class individuals who must eventuallyaccept that their lives are nasty, brutish and chaoticwhichthey very well might be-and choose to take flightfrom those lives, leaving behind the people who theyhave grown up with, lived with,experienced their lives with —thisattack encompasses the workingclasses as a whole and constructsthem as a’ threat to allrespectability, a danger to othersand a burden on the nation’ 8 Thisdiscourse has becomeentrenched within the institutionsof politics, the media andeducation. 9 Of course it isimperative that the peoplesurrounding the person who hasthe means to escape alsorecognises this, so in Billy Elliot hisfather and brother are brought tosee the error of their ways (tryingto keep Billy in the community inwhich they live and which has been destroyed by thepolicies of the Thatcher government) and must sacrificeBilly and themselves for the sake of his own good whichof course means leaving behind the old industrialisednorth and making a life for himself in the modernmetropolis.As Skeggs points out this means that anyengagement with the structures that create inequalitiescan be avoided while these representations shift theblame for educational failure and crime onto the cultureof the working classes. 10 I would go further. What theserepresentations also do is to deny the possibility of acollective solution to working class deprivation andhardship —the protagonists of these films, throughhard work, good luck, or in the case of the workingclass woman, good looks ‘escape’ the working classes. 11Of course the other requirement for their escape is7. Skeggs, B. (2004) Class, Self, Culture Abingdon: Routledge p99.8. Ibid p.80.9. This has become apparent within the present discourse of the Conservative Liberal Democratic coalition government in order to justifythe public service cuts that are being implemented.10. Skeggs op.cit p.87.11. Of course what these films are incapable of doing is dealing with the complexities of moving up the social ladder — just getting abetter job/an education and the advantages those things bring in our society does not mean that it is possible to leave behind the classone originated from.Issue 192 Prison Service Journal17

complete subservience to the demands of a capitalistsystem. These uplifting stories of one life beingimproved and lived in luxury and comfort leavesunanswered the question of all those other hardworking people who are left behind to suffer theindignities, deprivations and inequalities of muchworking class life.This negation and denigration of working classculture is of course not only apparent in the symbolicrealm of representation, it also functions on a materiallevel in the lived experiences of the working class life.One of the places where it is most apparent is in theeducation system where kidsfrom backgrounds whereShakespeare and Literature arenot valued are set up to fail in asystem where the acquisition ofan understanding of thesecultural forms is considered to bethe highest of educationalachievements. Therefore theformation of working classconsciousness and thepositioning of working classchildren take place in institutionswhere their lives and experienceshave at best no value and atworst are completely rejected.Understandably for mostworking class children theirexperience of education is one ofalienation as Diane Reay puts it:The educational system israrely about positiveaffirmation for the working classes. They are afar greater risk of losing rather than findingthemselves, of both being unable to constructa successful. Learner identity and feeling thattheir working class roots and sense of selfhave no value in a context where workingclass culture and identity is constructed as ahindrance to academic achievement. 12By the time the working class person arrives in theeducation department of a prison the idea thateducation can be rewarding, interesting or worthwhilehas been thoroughly extinguished.Historically one of the ways that the working classhas often been represented is as a social problem andBy the time theworking class personarrives in theeducationdepartment of aprison the idea thateducation can berewarding,interesting orworthwhile hasbeen thoroughlyextinguished.this has become more pronounced over the last 30years: with the rolling back of the welfare state and theravages of neo liberalism talking its toll working classpoverty and deprivation have become increasinglycriminalised. While at the same time crimes committedby the middle classes are obfuscated or ignored as JoeSimms has pointed outThe constant barrage of publicity aroundbenefit fraud compared to the ongoingsilence around middle class fraud and taxevasion remains the classic example of howthe crime problem isideologically constructed bythe majority of politicians,media commentators andstate servants. 13Within this formulation ofthe working classes as socialproblem (rather than as victimsof the neo liberal pursuit ofprofits) representations of theworking class have becomeincreasingly fixed and staticleaving very little room tomanoeuvre in contrast to themiddle classes who arerepresented as mobile bothgeographically and intellectually.The working classes havebecome increasingly fixed firmlywithin a limited number ofspaces — often the sink estateor the streets, in the case ofworking class youth and of course the prison. 14 This isparticularly true of representations of the workingclasses by both fictional and documentary filmmakersand journalists, very few of whom are from theworking classes. Consequently their representations ofthe working classes cannot but fail to be inaccurate.This limited expression of working class life I wouldargue is because those representing the working classoften have no understanding and crucially noexperience of working class life. But it is the images ofworking class life and of crime produced by peoplewith no experience of that kind of life that arecirculated by the media and become the dominantdecontextulised images with which people associatethe working classes.12. Reay, D. (2009) Making Sense of White Working Class Underachievement in Sveinsson, K. (ed) Who Cares about the White WorkingClass? Runnymede Trust p.25.13. Sim, J. http://www.alternatives2prison.ik.com/p_New_Labours_Law_and_Order_Crusade.ikml(Accessed 21.06.10) in the same article he also points out that corporate fraud and VAT fraud coast the UK billions of pounds eachyear in lost revenue.14. For a wider discussion of the issue of mobility and class see Skeggs op.cit p.55-60.18 Prison Service JournalIssue 192

There are various outlets for theses images tocirculate and become fixed in the popular imagination.Among them is the reporting of crime by themainstream TV news programmes, the various genericcrime series on our TV and in realty TV programmessuch as Police, Camera, Action. And of course themainstream Hollywood film. In these visual regimes ofcrime and punishment the working classes areassociated with crime and imprisonment is seen as thesolution to the social and economic ills that arethreatening to overrun our society.These media representations of the working classcompliment other discursive constructions of theworking classes acrossmultivariate strands of publicdiscourse so for instance we canfind examples of the denigrationof working class culture and theblaming of working class peoplefor the problems that beset theirlives in the speeches ofpoliticians, the pronouncementsof educationalists and thesentencing policies of thejudiciary. The conditioningprocess of repetitivereinforcement across a range ofsites results in an acceptance ofthe working classes as morecriminally inclined while denyingthe transgressions of white-collarmiddle class crime.It is the right to selfrepresentationthat Inside Filmattempts to provide — the rightof the prisoners to represent theirown lives and not to beconsigned to a secondarycharacter in dominant narratives that situate them asthe obstacle to a better, safer society. In representingthemselves and their own experiences the studentscome face to face with the reality of their own lives.Not in the sense that they suddenly have access to howdreadful their lives are — they are already fully aware ofthis and awareness will not alter the fact of theirposition in the hierarchal structures of a class riddensociety. What I lay claim to here is the possibility of theconsideration of their lives as part of a wider totality.The pedagogical practices of Inside Film emphasises theimportance of placing dominant representations in thewider context of the economic system in which theyexist, insisting on the relationship between economicsand culture. This dialectical analysis allows for anThe prisonpopulation stands atabout 86,000 Morethan three quartersof prisoners cannotread or write to thestandard expectedof an 11-year-oldchild, half of allprisoners do nothave the skillsrequired by 96 percent of jobs.exploration of popular culture as just one aspect ofdominant political, economic and ideologicalhegemonic practices and refuses to countenance itsdetachment as ‘just entertainment’.In 2005 the basic skills agency assessmentrecorded the results of a literacy survey amongprisoners in England and Wales. They reported 60 percent of the prison population had a reading abilityequivalent to or less than a five-year-old child. Theprison population stands at about 86,000 More thanthree quarters of prisoners cannot read or write to thestandard expected of an 11-year-old child, half of allprisoners do not have the skills required by 96 per centof jobs. Only one in five people inprison are able to complete a jobapplication form. 15These figures are notdefinitive — reports of literacylevels fluctuate but it is generallyaccepted that two thirds of theprison population cannot read toa standard that enable them tounderstand what is going onaround them. These figuressuggest that the provision ofeducational courses designed todevelop literacy skills or whichentail reading and writing beyonda certain level of achievement canonly reach a very limited numberof people — the minority of theprison population that hasalready achieved acceptablelevels of literacy skills. This meansthat by definition courses centredon reading and writing mustexclude the majority of prisonerswho cannot write and these arearguably those who are the hardest to reach. Thisexclusion will only repeat a pattern that for manypeople serving sentences in prison has become thenorm.The association of writing with school lessons alsoraises another problem. I have already pointed out theexperience of school for most of the people in prisonhas been an alienating one. Enzensberger claimed that‘intimidation through the written word has remained awide spread and class specific phenomenon even inadvanced industrial countries.’ This is because mostpeople learn to write in the formalised setting of schoolin an authoritarian environment where good writing isbased upon inviolable rules that result in penalisation ifthey are broken. 1615. James, E.http://www.guardian.co.uk/society/joepublic/2009/sep/17/erwin-james-education-prisoners-rehabilitation (accessed 09.02.09)16. Enzensberger, H. (1982) Critical Essays: London: Continum p.71.Issue 192 Prison Service Journal19

He argues that writing is a highly formalisedtechnique and of course for those in prison this meanssitting in one place for however many hours the classtakes. This enforced inactivity is itself not ideal for manyprisoners who have problems with concentration. Thenew media forms do not carry the weight of thesetraditions It is the new technologies of laptops andpalm held video cameras that have the potential to doaway with the ‘educational privileges and the culturalmonopoly of the bourgeois intelligentsia’ 17 to breakdown the specialised divisions of labour that existwithin a capitalist society and that are normalisedwithin most teacher student relationships-they do notbring with them the baggage of school lessons, examsand struggles to understand. Walter Benjamin claimedthat film — in its most positive form — has ‘adestructive, cathartic aspect — the liquidation of thetraditional value of the cultural heritage.’ 18 For themajority of the students taking part in the Inside Filmproject — film and film viewing is associated withpleasure and filmmaking offers a positive validation oftheir cultural pastimes-often not considered culturalbecause the working class indulges them in. They donot consider film and filmmaking to be part of theinstitutionalised and formal education apparatus. 19Of course I am not suggesting there is not a placefor the teaching of literacy skills to those serving prisonsentences what I am asking is in what way does thisserve the needs of prisonersWhat is achieved by teaching basic literacyskills to those thought to be in need of themwhen all that we are turning out is burglarswho can read and write, packing plastic bagsor cleaning out prison toilets. All these alone,do not in any sense, fit an offender to aproductive life outside of prison where crimemay continue to be seen as a more attractiveproposition. 20The Inside Film course is not just concerned withtaking the viewing pleasure of the prisoners seriouslythat would result in a celebration of popular culture forno other reason than it is popular culture.The pedagogically crucial issue at stake here is theway in which dominant representations interact withother prominent discourses in order to inviteidentification with a particular worldview whilepreventing knowledge or engagement with opposingones and with the diverse narratives essential to a moreegalitarian society. The utilisation of popular culture bythe Inside Film project fostered a critical engagementwith the dominant culture and worked against an easyassimilation into it. The films made by the students ofInside Film are not easily incorporated into mainstreamculture. Their films resist this easy identification with thedominant culture. By their very existence these filmsbring into question assumptions about criminals,education and popular culture and crucially in itsattempt to remove the divisions of labour betweenthose who are teaching and those who are learningdemystify the process of filmmaking.Inside Film strives to develop working practicesthat negate the existing practices of capitalisteducation. Film is a collective endeavour and thestudents who take part in the Inside Film project workcollaboratively, co-operating with each other over arange of jobs, from scripting, storyboarding, shooting,acting and editing. They all work on each other’s films.There is no single ‘teacher’, the distinctions betweenfilmmakers/artist/technician/ educator/ student arebroken down. Inside Film utilises the skills of a numberof practitioners: editors, scriptwriters, actors, andfilmmakers, sound technicians all of whom work incollaboration with the students. No one is paid. There isno interference in what the students wish to film(obviously that can only be true insofar as we do notproduce any material that the prison authorities mightwant to censor). The films produced are the work ofthe studentsThe approach of Inside Film is that of a reciprocalpedagogy where all those taking part contribute to thecreation of specific kind of knowledge a knowledgethat because it comes from the experience of beingworking class and a prisoner is mediated by thoseexperiences.Further information on Inside Film is available athttp://www.insidefilm.org17. ibid p.72.18. Benjamin, W. (1999) The work of Art in the age of Mechanical Reproduction in Arendt, H. (ed) Illuminations: Walter Benjamin London:Pimlico p.212.19.20. Hanson, C. http://www.againstprisonslavery.org/education_&_training.html (accessed 21.06.10).20 Prison Service JournalIssue 192

THE PERRIE LECTURES 2010Throughcare — Who Cares?Resettlement in the Real WorldIssue 192Prison Service Journal21

Perrie Lectures 2010Why Our Beliefs Matter inOffender ManagementShadd Maruna, is a Professor in the Law School at Queen’s University Belfast and the Directorof the Institute of Criminology and Criminal Justice.I am very pleased when the topic ‘Throughcare —Who Cares? Resettlement in the Real World’ wasannounced as the focus of this year’s PerrieLecture. This is a symbolic occasion taking place ata crucial, transitional moment for both NOMS andthe Government more widely. So, I think thischoice of topic sends an important message aboutthe values of the people behind the Perrie LectureSeries and in NOMS more widely. These valuesmean a lot to me and are going to be the subjectof my talk today. That is, of the ‘Throughcare —Who Cares?’ title, my remarks will focus more onthe issue of ‘Who cares?’ even though myprevious research has focused more on‘throughcare’ or reintegration. I am, as most ofyou will know, a big believer in reintegration, but,more recently I’ve become a believer in beliefsabout reintegration or what I call ‘belief inredeemability’.First, allow me a brief aside on this choice oflanguage: You will find I use the words ‘redeem’ and‘redemption’ throughout my remarks and in myresearch in general. Some people don’t like these termsbecause they think the words have religiousconnotations. None are intended. The term‘redemption’ is perfectly meaningful in a secularcontext and that is how I am employing it. Mymortgage statement that arrives every month lists atthe bottom of it a ‘Cost of Redemption’. Now, thefigure on there is not the price of my soul (that could bebought a great deal cheaper, I can assure you). The ‘costof redemption’ is the amount required to pay off mydebt to the bank. Individuals who commit crimes haveaccrued similar debts to society and my research hasfocused on how they are able to ‘make good’ on these.Like the relationship with my bank, this process is atwo-way street. The person needs to change his or herbehaviours, make efforts to atone for one’swrongdoing, but the rest of us (especially thoseworking in the criminal justice system) also play a crucialrole acting in the role of forgiver.Yes, Christian teachings have a good deal to sayabout this process, but so do other religions. This doesnot make the concept ‘religious’, though. Christianteachings also have a great deal to say about sin,punishment, and retribution (an ‘eye for an eye’ and allthat). So, by this logic, as prison and probationprofessionals, you are all in the religion businessyourselves. Redemption plays a key role in mostreligions because it is a crucial concept for a functioningsociety. One of my key arguments (and the reason I amusing this word) is that secular society would be mad toabandon the idea. If we are going to have secular sinand secular punishment, we surely also need secularways of redeeming oneself.This is why I have become interested in exploringthis notion of ‘belief in redeemability’. To helpunderstand what I mean by this concept, I’d like to askyou all your views on three statements in particular:(A) Most offenders can go on to lead productivelives with help and hard work.(B) Even the worst offenders can grow out ofcriminal behaviour.(C) Most offenders really have little hope ofchanging for the better.Along with my colleague Anna King, I asked thosequestions to around 1000 British householders in2005. 1 Here’s what they said: 86 per cent agreed withstatement A; 77 per cent agreed with statement B; and68 per cent disagreed with C. In other words, belief inredeemability appears to be alive and well amongmembers of the British public — or this sample of it atleast. 2 That said, these beliefs are hardly rock solid. Themodal response for the first two items above in oursample was ‘slightly agree’ as opposed to ‘agree’ or‘strongly agree’.What is important, however, is that our statisticalanalysis found that how strong a person’s ‘belief inredeemability’ was (i.e. how they scored on the itemsabove and the other items making up our ‘belief inredeemability’ scale) was a very strong predictor ofattitudes about a variety of criminal justice issues,1. Maruna, S. & King, A. (2009). ’Once a Criminal, Always a Criminal?: ‘Redeemability’ and the Psychology of Punitive Public Attitudes.’European Journal of Criminal Policy and Research, 15, 7-24.2. Although not a representative sample, our sample was hardly an unusually liberal one. Over half of respondents described themselvesas politically conservative, and over half said they supported resurrecting the death penalty in the United Kingdom for serious crimes.22Prison Service JournalIssue 192

especially support for punitive prison policies. The morerespondents believed in redeemability in our research,the less likely they were to want to see sentenceslengthened and harsher treatment introduced into theprison system. Redeemability beliefs probably have evenmore important implications for those of us working inthe world of prisons and probation. That is, how thepeople in this room answer those three questionsabove, may have a tangible impact on recidivism ratesin the UK.Two Views about IntelligenceI will make this case in a moment, but first let meprovide a parallel example from entirely outsidecriminology, from the field of educational psychology.Education researchers suggestthat both children and adultstend to hold one of two implicittheories of intelligence: ‘entity’theories or ‘incremental’ theoriesof intelligence 3 . Lay entitytheorists believe that intelligenceis basically fixed and unmalleable.Some people are just smarter,and although others can learnnew things or study very hard,they will never be as smart asthose born/made that way. This isa common belief in Westernsocieties, especially in the UnitedStates, where we are alldesperate to have our childrendiagnosed as ‘gifted’ before theyare even able to crawl. On the other hand, layincremental theorists believe intelligence is modifiableand believe that one can get smarter through study andexercising one’s brain. This is more common in Easterncultures, like Japan. But in all cultures, some peoplelean more toward one side or the other.Now, which one is right? In fact, there is no ‘right’or ‘wrong’ theory of intelligence. Of course, there isevidence of the stability of IQ, the genetics behind suchdifferences. We know that childhood IQ predicts a greatnumber of outcomes later in life and so forth. Yet, thereis also considerable and growing evidence for the otherside — the notion that real success has more to do withhard work and elbow grease than so-called ‘genius.’Increasingly, intelligence researchers are turning awayfrom cherished concepts of ‘genius’ and ‘giftedness’ asRedeemabilitybeliefs probablyhave even moreimportantimplications forthose of us workingin the world ofprisons andprobation.research has shown that plain, old fashioned effort(e.g., studying, tutoring) can even increase test scoresmeant to measure natural ‘aptitude’ 4 .So, if the empirical case is still undecided, whatabout a normative one? That is, if you accept both ofthese as mythological concepts in some ways (thereality is surely a little of both), which one is the ‘better’organizing concept to animate our education systems,cultural myths? This is a normative question, but again,the empirical research is useful in reaching a decision.After all, research has found that these implicit theorieshave highly predictable impacts on social behaviors. Forinstance, people who ascribe to incremental theories ofintelligence are more inclined toward and successful atchallenging intellectual tasks. They study harder(because they see a point to it) and they end up doingbetter at school and in theworkplace.Imagine you fail a mathstest. If you have been taught toaccept entity theory, you mightsee this failure as evidence thatyou are just no good at maths —you’re not a maths person. Sowhy should you study hard in thefuture? After all, you will neverbe any good at it? Hey, presto,self-fulfilling prophecy. But, in anincremental culture, a failuremeans you need to work hardernext time. In one experimentaltest of this theory, a group ofcollege freshmen were told thatit was normal that grades wouldimprove from their first to second year in University.They didn’t tell this to the control group. A year later,the experimental group did perform better than thecontrols. They didn’t get as discouraged and held on tohope that they could succeed 5 . Likewise, Asian studentswho tend to attribute success in school and in life tohard work, appear to work much harder than do NorthAmerican students, who typically attribute success totheir natural abilities, intelligence or aptitude 6 .Thus, our beliefs in our own abilities to improve donot seem to be hardwired in any way — they are stronglyshaped by the messages we receive from others —teachers, experts, peers. Literally hundreds of differentstudies have found confirmation for the idea that oneperson’s expectations for the behavior of another canactually impact the other person’s behavior.3. Dweck, C. S., & Leggett, E. L. (1988). A social-cognitive approach to motivation and personality. Psychological Review, 95(2), 256-273.4. Gladwell, M. (2002). The talent myth. The New Yorker, 22, 28-33.5. Linville, P. W. (1982). Improving the academic performance of college freshmen: Attribution therapy revisited. Journal of Personalityand Social Psychology, 42, 367-376.6. Dweck, C. S., Chiu, C., & Hong, Y. (1995). Implicit theories and their role in judgments and reactions: A word from two perspectives.Psychological Inquiry, 6(4), 267-285.Issue 192Prison Service Journal23

The most famous example of this is described inthe book Pygmalion in the Classroom 7 . Rosenthal andJacobson found that teacher expectancies of studentperformance were strongly predictive of studentperformance on standardized tests, and thatmanipulating these educator biases and beliefs couldlead to substantial improvements in student outcomes.Similar so-called ‘Pygmalion Effects’ or expectancylinkedoutcomes have been found in courtroom studies,business schools, nursing homes, and numerousdifferent workplaces 8 . Meta-analyses of studiesconducted both inside and outside the researchlaboratory suggest an average effect size or correlation(r) of over .30 in studies ofinterpersonal expectancy effects 9 .Are there dangers toinculcating children withincremental theory? Sure. It puts alot more pressure on individuals towork hard. Whereas the kid whofails a test in an entity culture cankick back with some satisfactionand say hey ‘It’s not my fault I wasborn this way,’ in an incrementalculture, there is always pressureon you to do better. And this putsa lot of pressure on kids. Ji writes:‘If a Chinese child scored 98 outof 100 on a test, the Chineseparent would likely respond, ‘Howcome you lost two points? Youneed to study harder and scorehigher next time.’’There’s another big risk here,that might be the more importantone: If you believe intelligence isdynamic, then not only can ‘stupid’ people get smarter,but smart people can presumably get ‘more stupider’ too.This is a little experiment my gifted friends and I tried outat university, by basically getting stoned and watchingbad TV all day, and I can testify to its legitimacy. For some,this dynamic nature of intelligence is an awfully scarythought to comtemplate. Still, I think this is a small priceto pay for the advantages that the research literature(again: the empirical research literature) tells us aboutbelief in incremental theory for equality, democracy,fairness. Remember, I am not necessarily arguing thatincremental theory is right (or wrong) empirically, butinstead that promoting the theory produces empiricallybetter results, normatively speaking.Two Views about CriminalityNow, why am I devoting so much attention toeducation research in a talk about throughcare?Obviously, I think a parallel dichotomy can be found inregard to criminal behaviour. Drawing on the work ofDavid Garland and others, I argue that there are twoprimary cultural scripts available in regards towrongdoing:The fact is,criminologists knowa great deal aboutearly childhood riskfactors — includinggenetic andprenatal risk factors— that substantiallyraise the possibilityof someone gettinginvolved in drugsand crime.Moral Essentialism (Entity theory, laydispositionalism, ‘Criminology of the Other’ 10 )The idea here is that criminal behaviour is dueto fixed, unalterabledispositions, traits, innercharacter. Criminalbehaviour is a symptom ofwho a person really is, deepdown, and always will be.Moral Redeemability(Incremental theory, laysituationalism, ‘Criminologyof the Self’)Here, criminal behaviour isseparated from thepermanent nature orcharacter of the person.Criminality is not ‘fixed’ in aperson, the individual canfundamentally change and‘make good’ for what theyhave done in the past.Again, remember, I’m notmaking an empirical argumentin favour of one of these two, very different models ofunderstanding criminality. Just like with intelligenceresearch, criminology has amassed considerableevidence on both sides of this coin. Indeed, one of thebest known theories of crime seeks to account forboth patterns in empirical data on crime in the lifecourse 11 . The fact is, criminologists know a great dealabout early childhood risk factors — including geneticand prenatal risk factors — that substantially raise thepossibility of someone getting involved in drugs andcrime. Further, we know there are these largely stablepersonality characteristics, like low self-control orsome of the characteristics associated with‘psychopathy’, that appear to be deeply implicated in7. Rosenthal, R. and Jacobson, L. (1992) Pygmalion in the Classroom. New York: Irvington.8. Rosenthal, R. (2002) ‘Covert communication in classrooms, clinics, courtrooms, and cubicles’, American Psychologist, 57: 839-49.9. Kierein, N.M. and Gold, M.A. (2000) ‘Pygmalion in work organizations: A meta-analysis’, Journal of Organizational Behavior, 21: 913-28.10. Garland, D. (2001). The culture of control. Chicago: University of Chicago.11. Moffitt, T.E. (1993), ‘Adolescence-Limited and Life-Course-Persistent Antisocial Behavior: A Developmental Taxonomy’, PsychologicalReview, 100, 674-701.24Prison Service JournalIssue 192

criminality and are not thought to be easily modifiedover time. At the same time, we know that there is alarge body of research evidence that people canchange lives of persistent offending. Indeed, for anyof you who have heard of my work, you will know thisis the research I have spent much of the past decadedoing: studying the process of ‘desistance fromcrime’ 12 . In fact, it is estimated that around 85 percentof those people we call ‘criminals’, even ‘careercriminals’, eventually desist from crime according tolongitudinal research 13 .My argument today is different, though. Myargument is that (like with intelligence), regardless ofthe evidence in favour of persistence or desistance incrime, we (as a society, butespecially a justice system) shouldbelieve or at least try to believe ina moral redeemability theory —not just because it is right,empirically, but because doing sois good for society. Again, this is anormative argument (anargument about what is right orwrong), but I make it based onthe empirical, research literature— not the empirical evidence forthe two theories, but ratherevidence regarding theconsequences that adherence toone theory or the other mightlikely have for society (andespecially for ‘offendermanagement’).Like with intelligence, there’sa huge body of social psychology evidence on theconsequences of stability beliefs with moral statuses thatcan support this argument. Research shows that thosewho perceive their ascribed status to be permanent (beit a label such as ‘alcoholic’, ‘mentally ill’, ‘paedophile’,etc.) are most likely to slip into hopelessness, passivity,and retreatism. They are the least likely to make effortsto change themselves for the obvious reason that theydo not think such change is possible 14 . Moreover, weDesisting from crimeis difficultand requiresconsiderable selfbelief.If a personfeels like everyone isagainst them andthat they don’t havea chance in life, well,they probably don’t.know that people’s beliefs on such issues are stronglyinfluenced by those around them.Of course, we know all about this story incriminology. We call this labelling theory and the idea iswell known — young people who are stigmatized intothinking they are no good, turn out to fulfil thisprophecy. Labelling theory fell out of favour politically inthe 1980s, but its redemption — begun by prominentcriminologists like John Braithwaite 15 and Sampson andLaub 16 — has truly come full circle with a recent, awardwinningarticle in the prestigious journal Criminology 17 .Ted Chiricos and colleagues followed the outcomes of95,919 men and women who were either adjudicatedor had an adjudication withheld in the state of Florida,and found that those who wereformally labelled weresignificantly more likely torecidivate within two years thanthose who were not. Similarfindings have repeatedlyemerged in longitudinal cohortstudies from Farrington’sCambridge Study 18 to Bernburg’srecent work with the Rochestercohort 19 to Burnett and LeBel’simportant longitudinal work onex-prisoners 20 . Desisting fromcrime is difficult and requiresconsiderable self-belief. If aperson feels like everyone isagainst them and that they don’thave a chance in life, well, theyprobably don’t.Far less attention has beengiven to the other side of this equation, but presumablyif one can internalise a moral essentialism scriptthrough a process of stigma and self-labelling, thenpresumably one can also be taught to believe in one’sown redeemability. My colleagues and I have called thisprosocial labelling process a ‘Pygmalion effect’ in therehabilitation process 21 . The idea is that if we showindividuals that we believe they can change, they maybegin to believe this themselves.12. Maruna, S. (2001). Making Good: How Ex-Convicts Reform and Rebuild Their Lives. Washington, DC: American PsychologicalAssociation Books.13. Blumstein, A., & Cohen, J. (1987). Characterizing criminal careers. Science, 237, 985-991.14. LeBel, T.P. (2008). Perceptions of and responses to stigma. Sociology Compass, 2: 409-32.15. Braithwaite, J. (1989). Crime, Shame and Reintegration. Cambridge: Cambridge University Press.16. Sampson, R. J. and Laub, J. (1997). A life-course theory of cumulative disadvantage and the stability of delinquency. In Thornberry, T.(ed) Developmental Theories of Crime And Delinquency, Transaction Press, New Brunswick.17. Chiricos, T., Barrick, K. and Bales, W. (2007) ‘The labelling of convicted felons and its consequences for recidivism’, Criminology, 45(3):547-81.18. Farrington, D.P. (1977) ‘The effects of public labelling’, British Journal of Criminology, 17: 112-25.19. Bernburg, J.G., Krohn, M.D. and Rivera, C.J. (2006) ‘Official labelling, criminal embeddedness, and subsequent delinquency: Alongitudinal test of labelling theory’, Journal of Research in Crime and Delinquency, 43(1): 67-88.20. LeBel, T.P., Burnett, R., Maruna, S. and Bushway, S. (2008) ‘The ‘chicken and egg’ of subjective and social factors in desistance fromcrime’, European Journal of Criminology, 5(2): 130-58.21. Maruna, S., LeBel, T., Mitchel, N. and Naples, M. (2004). Pygmalion in the Reintegration Process: Desistance from Crime Through theLooking Glass. Psychology, Crime and Law, 10 (3), 271-281.Issue 192Prison Service Journal25

Of course, this is more difficult than it sounds.Many of the behaviours that we in the criminal justicesystem think of as ‘helping’ individuals actually end upstigmatizing them or reinforcing their social andpsychological deficits by treating them as passiverecipients of some expert treatment. There is adifference, therefore, between beliefs in redeemabilityand support for rehabilitation. One can support arehabilitative regime without believing inredeemability.Again, there is a useful parallel in education: bothentity theorists and incrementalists believe in the valueof education. The difference is that whereasincrementalists support schooling because theybelieve that low achievers can learn to be highachievers through education, entity theorists mostlysupport education as a sort ofsifting process, separating thewheat from the chaff,determining which studentshave the natural aptitude forleadership and which studentsare destined to lesser things.Schools are good, then, attesting individuals’ capabilities,rather than actually teachingthem things.A similar essentialistmindset can be found in somestrands of offendermanagement where the focus ison risk assessment rather thanrisk reduction. Offendermanagement becomes a processof sorting individuals into lowriskand high-risk, amenablesand non-amenables, those thatwill succeed and those whowon’t. The danger is that by assigning groups of thepopulation to the category of irredeemable, we maybe creating a self-fulfilling prophecy that none of uswants to live out when those individuals are releasedfrom custody.Conclusions. . . in a societywithout thepossibility ofredemption, the‘past dominates thepresent and thefuture [and] everyfailure results inguilt from whichthere is no exit’.forgiveness, then there is no reason for those whohave offended to ever change their ways. Instead, in asociety without the possibility of redemption, the ‘pastdominates the present and the future [and] everyfailure results in guilt from which there is no exit’ 23 .Hannah Arendt talks about this as the ‘burden ofirreversibility’ in The Human Condition:Without being forgiven, released from theconsequences of what we have done, ourcapacity to act would, as it were, beconfined to one single deed from which wecould never recover; we would remain thevictim of its consequences forever, not unlikethe sorcerer’s apprentice who lacked themagic formula to break the spell 24 .The belief in redeemabilitymay not be a magic formula, butit can help to break habituatedpatterns or mindsets thatprisoners find themselves in, andin this way it can reducerecidivism by promoting culturesor at least subcultures ofdesistance even within a prison.Yet, the power ofredeemability goes beyond this.Redemption beliefs are alsogood for society in less tangibleways. In ‘Redemption andPolitics,’ Robert Smith writes:Unlike punishment, whichmobilizes our sense ofvirtue and sets us apartfrom the transgressor,forgiveness arouses in us,and depends upon, a sense of sharedweakness. We are moved to forgive out ofour own need to be forgiven for what wehave done in the past and what we may doin the future. Forgiveness, unlikepunishment, moreover, depends upon a lifeof common values and concerns 25 .Like with incremental models of intelligence, asocietal belief in moral redeemability is necessary‘because there has to be a way to restore people togood standing so that they’ll be motivated to return tocooperation with all of the other [law-abidingmembers] in the population’ 22 . If there is no chance atRedemption brings us together as a society in away that punishment and exclusion can’t. Durkheimtaught us that punishment was not first and foremostfor the prisoner, it was for us. Whether thepunishment deterred crime or reformed prisoners wassecondary to the effects that punishing others had on22. McCullough, M. E. (2008). Beyond revenge: The evolution of the forgiveness instinct New York: Jossey-Bass, p. 106.23. Smith, R. W. (1971). Redemption and politics. Political Science Quarterly, 86(2), 205-231, p. 206.24. Arendt, H. (1958). The human condition Chicago: University of Chicago, p. 213.25. Smith, 1971, p. 219.26Prison Service JournalIssue 192

wider society. The same is true with redemption, asJohn Braithwaite has argued in his revision ofDurkheim’s thesis. Reintegration isn’t just for ‘them’, itis for ‘us’, too. A society that forgives well — and bythat I don’t mean easily, but rather carefully,purposefully, setting out reachable targets for whatindividuals need to do to redeem themselves andholding out hope that every person can —is a ‘good’society. It is also a safer society.Issue 192Prison Service Journal27

Perrie Lectures 2010The ‘Rehabilitation Revolution’Trevor Williams is Director of Offender Management for the Eastern Region.IntroductionBy way of introduction, let me first tell yousomething about the origins of the Perrie lectures.As a junior governor grade working in Long Lartinin the mid-eighties I had the great pleasure ofworking for a truly inspirational governor, MikeJenkins. Mike was old school, he knew how to runa very effective prison but he also knew theimportance of understanding the context in whichhe was trying to deliver that service. So we keen,eager apprentices, were encouraged to attenderudite seminars on matters of criminology.Returning from one such lecture on theimprovement of the lifer management system inOxford, I said to Mike, ‘surely there ought to be aplatform for those who work on the front line tohave a voice, to express ideas and issues aboutdoing the job on the shop floor?’ Mike thoughtabout this for a while and eventually said, ‘I thinkthat’s a good idea, Trevor, you should organizeone!’, and that was the origins of the PerrieLectures. Clearly the format has greatly improvedsince we created the first of those lectures and Iam truly delighted to see that its longevitysuggests that we found a basic niche in themarket, a cause that has remained constant sincethose days, with one of its core principles beingthe opportunity for different perspectives on thesame issues.Old school rehabilitationBut I digress. I joined the Prison Service in the lateSeventies and the recruitment pamphlet whichattracted me said that the purpose of imprisonmentwas two fold. The first was to keep people secure inconditions of ‘humane containment’ for the benefit ofpublic protection, with the second being that ofrehabilitation. It seems remarkable to me that so littlehas changed in the intervening 30 odd years. It isentirely true that although the label of throughcare hasdeclined in usage, the concept survives and in fact I amabsolutely confident that the notion of rehabilitation isabout to see a revival. An example of rehabilitationfrom the old days comes from my first job as a governorgrade in Feltham borstal. It was not the Feltham thatwe know today but the old Middlesex industrial schoolof the late 1830s which, until the Prison Serviceacquired it, used to have a fully rigged schooner in frontof the building which they used to train the waifs andstrays of London in seamanship skills before sendingthem to join the merchant navy. The Feltham that Ijoined was imbued throughout with the notion ofrehabilitation, as was the borstal regime. It was anindeterminate sentence; the harder you worked thequicker you got out but if you messed about youstayed.I remember spending my weekends writing ‘Page17’ reports, a simple report on each of our offendersstating what we’d learnt about them, what we’d donewith them and what work we thought remained to bedone when we discharged them into the hands of theProbation Service. We duly sent these things off and inreturn we used to get back a ‘Part C’ which was aregular, quarterly report from the Probation Officersaying how well or badly that individual was doing. Tome that seemed to be basic common sense, that isthroughcare in action. The fact that we managed itwith a couple of simple reports seems all the moreremarkable today. Feltham was also fairly unique inother respects regarding the rehabilitation agenda. Forexample, we ran a ‘drop in centre’ just off TrafalgarSquare where any ex-offender from Feltham, howeverex they were, could drop in, let us know how they weregetting on, ask for help with difficulties, and generallyshare their experiences with any recently releasedtrainees. I didn’t think that was innovative, I justthought that was plain common sense, but clearlythose kinds of services no longer exist, as far as I’maware, which says something about the way we havereorientated our thinking about our core services andour core purpose.Going further back in time, Feltham was thestarting point for the Lowdham Grange march. Felthamborstal used to put trainees through constructiontraining and in the early 1930s someone came up withthe idea of marching these men from Feltham toNottinghamshire where they could build a ‘modelborstal’. They trained up a workforce with constructionskills, marched them to Lowdham Grange, and built amodel borstal on the hill at Lowdham. Practitionerswere absolutely convinced that a regime ofrehabilitation, as lived and breathed by the trainees andthe staff was the way to do business. They were soconvinced by the premise that a couple of years later28 Prison Service JournalIssue 192

troops in Stafford prison marched to the Lincolnshirecoast to just beyond Boston to found North Sea Camp.The task of those guys was to build a huge sea wall toreclaim the salt marsh and turn it into agricultural land.In his influential pamphlet, WW Llewellin the manbehind the venture described the task as ‘reclaimingland and reclaiming lives’.Llewellin was responsible for the recruitment of awhole generation of governors who shared the sameideals and principles about rehabilitation. Men like MikeJenkins and Ian Dunbar and it was Ian, who sadly diedin May, who delivered the first Perrie Lecture in 1986.He had also coincidentally been the governor atFeltham immediately prior to my arrival. Ian will be bestremembered for his seminal workon prison regimes, A Sense ofDirection 1 . He wrote it at a pointwhen the Prison Service wasexperiencing an identity crisis,locked in the dark days ofhumane containment and‘nothing works’. His workcaptured the very essence of aneffective prison regime focusingprincipally on the three mainareas of individualism,relationships and activity; all ofwhich are necessary elements ofa successful rehabilitative prisonregime. Ian believed in the abilityof offenders to change and thecritical importance of hope tosustain them through the darkdays of lengthy imprisonment.This he thought could beachieved through positive,hopeful and empoweredrelationships between workers and offenders, which allfeature strongly in current desistance literature.End-to-end offender managementThe National Offender Management Service(NOMS) was created six years ago, with the decision toreform the system for managing offenders stemmingfrom Lord Carter’s 2003 review of correctional services 2 .This highlighted many deficiencies, particularly how thePrison and Probation Services were working in silos andthus largely detached from each other; with this havinga negative impact on offender outcomes, includingreducing reoffending. Carter found, for example, thataccess to services such as drug treatment and educationwere often dependant on whether an offender wasBoth services, as wellas a multitude ofother organisations,must work togetherseamlessly if we areto manage andrehabilitateoffenders effectively.It is about end-toendoffendermanagement.given a custodial sentence or a community sentence,rather than it being based on individual need. This siloapproach also meant that programmes andinterventions undertaken in prisons were rarely, if ever,followed up in the community once an offender wasreleased. Carter, therefore, concluded that a new, moreholistic approach was needed, with the end-to-endmanagement of offenders achieved through NOMS.Greater choice of service provider and better ‘gearing’between demand and supply were also essential.For prison and probation services to work moreclosely together to reduce reoffending and protect thepublic, clearly makes sense. Both services, as well as amultitude of other organisations, must work togetherseamlessly if we are to manageand rehabilitate offenderseffectively. It is about end-to-endoffender management. If wedon’t do that, then the excellentwork carried out by our individualfront-line staff in prisons, inprobation and by our partnerswill be wasted, resulting induplication at best and total lossof impetuous at worst. Therecannot be an effective handoverof responsibility from oneorganisation to another at theprison gate. Offendermanagement must be bothcontinuous and coherent to beconstructive. By increasingcollaboration and working in amore integrated and joined-upway we are able to manageoffenders better through theirsentence, target our effortswhere they will do the most good and tackle, withoffenders, the root causes of their offending.The journey of the NOMS we have today has notbeen simple or straightforward, with there being anumber of changes in the structure and focus of theorganisation in the last six years. In April last year webecame an Executive Agency in our own right, we havesurvived three Home Secretaries, a change ofdepartment, two Justice Secretaries and so far the newCoalition Government. The NOMS Agency is goingthrough a continuous process of structural adjustment,most recently the welcome appointment of our newChief Executive Michael Spurr and the creation of anew leadership team to take NOMS forward. Throughthese changes we remain focused on key offenderoutcomes, which are being delivered with ever1. Dunbar, I. (1985) A Sense of Direction London: HMSO.2. Carter, P. (2003) Managing Offenders, Reducing Crime: A New Approach London: Strategy Unit.Issue 192 Prison Service Journal29

decreasing resources. Our key objectives are thereforeto deliver the sentences of the courts, reducereoffending, protect the public, and do all of this in acost effective way.ThroughcareIn April last year the Agency’s responsibility fordelivering a reduction in reoffending and managingoffenders was devolved to ten regional Directors ofOffender Management across England and in Wales.Each Director is required to co-ordinate offendermanagement at a regional level for offenders incustody, or in the community, assessing demand,allocating resources across our regions andcommissioning services at a locallevel. Our role is very much thatof strategic integrator, with aresponsibility to ensure that theservices we commission matchdemand, are effective inaddressing the risks ofreoffending and achieve more forless. As contract holders weclosely monitor the performanceof the Probation Trusts and thecontracted prisons in our region,as well as having a direct line ofresponsibility for public prisons.We allocate resources across ourregions in accordance withoffenders’ needs, sentencers’demands and public protectionrequirements, with reference tovalue for money and ‘whatworks’ principles being the keydrivers of the whole system. Furthermore, we managea mixed economy of providers, with decisions on whatwork gets done and who it will be done by based onevidence and driven by best value. This joint focus onoperational delivery and partnership workingempowers staff in our region to deliver services thatmeet the essential elements of practical throughcareand have the best prospects of success.For example, John Laing Training has provided awide range of construction based vocational courses toprisoners at The Mount prison since 2004. In the lastacademic year, 2008-2009, they had achievement ratesof 90 per cent and a retention rate of 95 per cent. Theyhave linked up with internal Prison Service systems likesentence planning and the Activities Allocation, andwork in partnership with both education andresettlement providers. The courses have producedRegardless ofwhether anoffender is in prisonor on probation, weare all workingtowards the sameaim, that is to stopthem coming backand thus ending therevolving door ofreoffending.numerous success stories of prisoners who havemanaged to find employment on release, on the back ofthe training they completed whilst in prison and thus areproving to be worthwhile. For instance, one prisonerwho successfully completed the five week ResettlementCourse recently wrote to the prison saying that he hadsecured a job within three months of release. He has amanagerial role in a national research facility, managinga team of three supervisors and seven other staff.However, it is not just prisons that are opening theirdoors to new providers; the probation service has alsobeen discovering what partnerships with the private andvoluntary sector have to offer. In the past year we havetransitioned 42 Local Probation Boards into 35 ProbationTrusts. These Trusts have entered into contracts with theSecretary of State for theprovision of probation services intheir areas. The Trusts arebecoming more flexible, agile andlocally-focused with strongcommunity links allowing them touse services from the public,private and voluntary sectors toprovide the very best route to helprehabilitate offenders in the mostcost effective ways. Each Trust ismade up of Local Delivery Unitsthat work in partnership to meetlocal needs, with these unitsproviding a visible local presencein our communities and ensuringthat the diverse needs in differentparts of the country are met.The rehabilitation revolutionRegardless of whether an offender is in prison oron probation, we are all working towards the sameaim, that is to stop them coming back and thus endingthe revolving door of reoffending. Throughcare musttherefore begin at the point of sentence. As onemember of my Community Team rather succinctly putsit; ‘Criminals in, Citizens out’, that is our overridingobjective. As practitioners, we take some of the mostsocially excluded people within society, deliver thepunishments handed down by the courts, while at thesame time looking to support positive change so thatthey don’t reoffend. It is significant that, on his recentappointment as the new Lord Chancellor and Secretaryof State for Justice, Ken Clarke said, ‘We must provideprotection for the public from dangerous individualsand find ways to improve rehabilitation so to cut theworryingly high rates of recidivism.’ 3 More recently the3. Rt Hon Kenneth Clarke on announcing the new Justice Ministers’ responsibilities, 20 May 2010 available athttp://www.justice.gov.uk/news/newsrealease200510a.htm30 Prison Service JournalIssue 192

Government has made clear its aim to achieve a‘rehabilitation revolution’ in the way we deal with ouroffenders, to radically reduce reoffending and to cutcrime. To achieve this, NOMS encourages offenders toaddress the root causes of their offending and regain astake in society, most demonstrably through gainingsustained employment. In fact my alternative ‘strapline’for NOMS would be ‘making offenders pay their taxes.’The road to rehabilitation begins with individuallytailoredsentence plans which offer appropriateinterventions to help offenders move away from a lifeof crime, regardless of whether their sentence iscustodial or community based.These interventions, sometimesreferred to as the ‘resistance’approach, can range fromsupport for coming off drugs,offendingbehaviourprogrammes, the provision ofvocational training to findingsuitable accommodation. Thesepathways — accommodation,thinking and behaviour, family,drugs and alcohol, education,finance and health — are thebedrock on which NOMS hasbuilt its reducing reoffendingstrategy.Sentences over 12 monthsAlthough reoffending ratesare still unacceptably high, prisonperformance between 2000 and2008 has been impressive, withthe reduction in reoffending ofoffenders serving sentences over12 months to two years standing at 15 per cent.Furthermore, the reduction in the proportion ofoffenders serving sentences over two years that go onto re-offend currently stands at an even moreimpressive 31 per cent 4 . These significantimprovements, especially for those serving longersentences, coincide with the growth in offendingbehaviour programmes, more education and trainingopportunities for prisoners, improved detoxification,better mental health provision, the emphasis on prisonofficers treating prisoners decently and the introductionof compulsory probation supervision for thosesentenced to over 12 months. This indicative evidencethat an expansion of offending behaviour programmeshas helped reduce re-offending is consistent with theevidence base, although they do have to be packagedThese pathways,accommodation.These pathways —accommodation,thinking andbehaviour, family,drugs and alcohol,education, financeand health — arethe bedrock onwhich NOMS hasbuilt its reducingreoffending strategy.properly and fit within the broader approach toreducing reoffending, including the principles ofdesistance.An example of this approach can be seen with 40year old Richard, who is currently serving a sentence forarmed robbery in HMP Chelmsford. When he came intoprison he was an alcoholic and drug addict and his wifeand children had disowned him. He was immediatelyplaced on the Drug Services Unit which providesIntegrated Drug Treatment and successfully completedalcohol detoxification. He was initially prescribedMethadone but, with the help of his counsellors, he hasgradually managed to come offthis too. He has completed aCommunity leaders award inRugby coaching, has become an‘Insider’ and additionally qualifiedas a Health Trainer. Furthermore,he has been offered a job whenhe is eventually released and isslowly building bridges with hiswife and children.Sentences under 12 monthsDespite the promise seenabove, the reduction in theproportion of offenders servingsentences under 12 months whowent onto re-offend was only 3.9per cent 5 and this, combined withsome overall disappointingfigures in the community, is astark reminder of the challengewe all face. We know fromresearch that offending declineswith age and maturity. Offendersdo ‘desist’, although the challenge for practitioners iswhat we can do to accelerate and support this. Arecent review of the desistance literature commissionedby NOMS suggested a number of approaches, such asaccommodating and exploiting identity and diversity.We already make an attempt at this with individuallytailoredsentence plans but clearly we can go furthertowards the creation of a genuinely ‘offender centric’system. By doing this we can create, and maintain,hope and motivation, both achievable throughencouraging and respecting an offender’s owndetermination to turn his life around, and by supportingand developing individual abilities and skills (as well astackling risks and needs). Furthermore, we can build onour understanding of the role and influence ofrelationships, both between staff and offenders and4. Ministry of Justice (2010) Reoffending of adults: results from the 2008 cohort. England and Wales London: Ministry of Justice.5. Ibid.Issue 192 Prison Service Journal31

offenders and their ‘significant others’. Finally weshould support and strengthen the wider socialnetworks that are so essential to turning offenders’ livesaround.An example of where such practices are used isAustralia, where correctional officers who acted as prosocialmodels, including encouraging and rewardingpro-social statements and actions, achievedreconviction rates after four years of 49 per centcompared with 73 per cent for other officers 6 . InCanada, the Strategic Training Initiative for CommunitySupervision showed that trainedofficers who used relationshipbuilding, cognitive techniquesand a more structured approachto offender managementachieved lower reconviction ratesof 25 per cent compared withjust over 40 per cent for otherofficers 7 . Crucially, both studiesshowed that it is not about theamount of time spent withoffenders (sessions averaged lessthan half an hour) but how thattime was spent.In NOMS we are testing,through the OffenderEngagement Programme, thehypothesis that the relationshipbetween the offender and theprobation practitioner can be apowerful vehicle for changingbehaviour and reducingoffending. The aim of theprogramme is to refocus onwhat practitioners actually do ona one-to-one basis withoffenders in supporting them toturn away from crime, ratherthan placing too much emphasis on the actualprocess. This has been seen with John, a Prolific andPriority Offender in his twenties. It is worthy ofreflection at this point that in the case of Prolific andPriority Offenders, four fifths of the total costs of thesystem currently go into the process of trying,convicting and incarcerating the offender with onlyone fifth at best spent on attempting to changehis/her life. When the Offender Manager beganworking with John in November 2007 he had alreadyaccrued 18 convictions for that one year, for which hehad mostly received short prison sentences, and thusIn NOMS we aretesting, through theOffenderEngagementProgramme, thehypothesis that therelationship betweenthe offender and theprobationpractitioner can be apowerful vehicle forchanging behaviourand reducingoffending.seemed impervious to change. John was one of thefirst offenders to be referred to ‘The Bridge Project’,an intensive probation project, and alternative to shortcustodial sentences in Essex. Based miles away fromthe probation office, participation in the projectinvolved travelling into and out of London before 9o’clock in the morning, at least three times a week,and against all odds John attended, with hiscompliance and commitment being deemed excellent.Underpinned by the Offender Manager’s support andbelief, it has proved to be a turning point in John’scriminal career and despite acouple of minor setbacks he hasbeen in full time employmentsince March 2009 andsuccessfully completed hisCommunity Order, for the firsttime ever. When asked about hisOffender Manager John said:‘He listens. He tells me straight. Ican’t go too far. It feels like achore or punishment every day.But he has helped me out a lot. Isee him four times a week. He’salways in my head.’ TheOffender Manager gave John abelief in himself. This is a greatskill, a crucial element ofdesistance and a powerfulcontributor to our ‘rehabilitationrevolution’.PartnershipWhen it comes to changingan offender, however, clearly wecannot do it alone. Therecruitment pamphlet I referredto earlier, acknowledged thatthe challenge of offender rehabilitation doesn’t fallto the prison system alone, far from it. NOMS is acommissioning organisation, we identify where thedemand is and match it to supply, while ensuring thatservices are delivered both cost effectively and to ahigh standard. A whole range of organisations;statutory, private and from the voluntary sector, havea vital part to play in the rehabilitation of offenders.Offenders often find it easier to relate to those fromexternal organisations, such as charitable agencies,rather than those in a formal position of authorityand we cannot afford to ignore that. We therefore6. Trotter, C. (1996) ‘The Impact of Different Supervision Practices in Community Corrections: Causes for Optimism’, Australian and NewZealand Journal of Criminology, 29, 29-46.7. Bonta, J., Bourgon, G., Rugge, T., Scott, T-L., Yessine, A.K., Gutierrez, L. and Li, J. (2010) The Strategic Training Initiative in CommunitySupervision : Risk-Need-Responsivity in the Real World, Corrections Research: User Report, Public Safety Canada(www.publicsafety.gc.ca).32 Prison Service JournalIssue 192

attach the highest importance to positive, mutuallybeneficial relationships with our partners and otherstakeholders in the interests of deliveringrehabilitation outcomes for offenders and the widerpublic.One example of this type of effective partnershipworking is the Dawn Project in Cambridgeshire. It isavailable for women throughout the county,especially female offenders and those at risk ofoffending, as an alternative to the damaging shorttermcustodial option. The project offers information,support and an opportunity to change, for example,helping women to find suitable accommodation,access education and training programmes, managetheir feelings, be better parentsand importantly break theintergenerational cycle ofoffending. Yasmin, for instance,was a professional woman froma traditional Muslimbackground, with a law degree.At the age of 23 she began arelationship with a man whohad a well established heroinand crack cocaine habit. Sixmonths later she started takingdrugs, was in and out of jobssupporting their habits and hadlost all of her friends. By the ageof 28 she had been convicted oftheft, shoplifting, handlingstolen goods and fraud.Previous attempts to come offthe drugs had beenunsuccessful, it was a convictionfor handling stolen goods and aDrugRehabilitationRequirement that got her the help she needed.Turning Point gave her one-to-one counsellingsessions which forced her to look at her life andchallenge her behaviours and as a result she beat herdrug habit. Disappointingly however, following thecommunity sentence, Yasmin was caught andconvicted for stealing from her employers to feed herpartner’s drug habit. She was sentenced to attend theWomen’s Programme, along with 80 hourscommunity service and 18 months supervision. TheWomen’s Programme gave her some structure andhelped her to deal with her emotional andpsychological issues through group work and peersupport. She learnt to identify triggers, risk takingbehaviours and coping strategies and now feels thatshe can move on; having higher self-esteem andbetter life skills. Without this Programme she wouldprobably have still been on drugs and likely, by now,to have been imprisoned.. . . the scale of thischallenge is quitedazzling and anynotion that we cansimply revert tosome of the familiarideas about whatwe used to feelcomfortable withand what used towork in the past arebest forgotten.ResourcesFinally, I want to briefly focus on the challengesand opportunities that lie ahead, looking at resourcesfirst. The Coalition Government was elected on apromise to accelerate the savings programme by £6billion this year. This sounds like a lot of money but is acomplete drop in the ocean with regard to theincreasing scale of the national debt. As part of the £6billion savings plan, we have seen a completerecruitment freeze in the Civil Service, so if this is theeffect of a £6 billion saving what will it take to recoupthe outstanding £150 billion. The best objectiveassessment of the state of the finances for the Ministryof Justice, suggests that by 2014we will be £2 billion adrift on ourspending plans. Those spendingplans are based on every singleefficiency prisons and probationhave thought they might makeover that period. The Agencyaccounts for approximately 50per cent of the Ministry of Justicespend. If we took £1 billion outof the prison side of the businessalone we would have to managethe system with 25,000 feweroffenders in it. If you look at itfrom the probation perspective,we spend just over £900,000 onthe probation budget so a £1billion saving would mean therewould be no Probation Serviceleft at all. So the scale of thischallenge is quite dazzling andany notion that we can simplyrevert to some of the familiarideas about what we used to feel comfortable with andwhat used to work in the past are best forgotten.So what can we do about this? There are a fewideas; they are not that well worked out but they maybe the difference between whether we sink or swim.For example, we need to triage before carrying out fullassessments on offenders. The notion that we have tohave a complete, full diagnostic assessment on everyoffender in the system before we decide what to dowith them is a nonsense because what often happens iswe spend all the cash on the diagnosis and then havenothing left for interventions. We therefore need tochange our priorities in respect of offendercircumstances as they change, reduce the number ofpriorities in the sentence plan and drive those sentenceplans to a conclusion. Furthermore, we need to manageour resources better by avoiding the notion of death bya thousand cuts and take this opportunity for afundamental service redesign. We must pay attentionIssue 192 Prison Service Journal33

to our strengths, outsource the rest and lever inadditional funding from other agencies. Of course inthis day and age and in these circumstances workingacross boundaries becomes ever more challenging. Ithas been challenging between prisons and probationand so we need to work out how to agree commonoutcomes, and how to avoid unintendedconsequences. We need to share data, we need to doassessments once and get them right, and we need tonot mind who takes the credit for it all. Furthermore, ina world of shrinking budgets, with less flexible cash,innovation becomes even more important.Public ProtectionNext we have to make sure that we can shift thebalance point between public protection and reducingrecidivism. We have to influence and persuade a changein public perception and bolsterpolitical will to redress thebalance. We need to be open andrecognise when our efforts fail,and we need to encourage, notpunish, staff who take appropriaterisks. We should be moremeasured over recalls because wecurrently have 12,000 of them incustody, the vast majority ofwhom are there for reasons ofbreach of licence rather than for further offending. Alongwith all of this we need to build better publicunderstanding and confidence, because we cannot dothis in isolation or below the radar. We should promoteour successes, be honest about those failures, but believein the value of the work we do. Borrowing from theexperience of the police, I think the notion of ‘policingwith consent’ is a significant development in the lastcouple of decades, and I wonder whether there is anopportunity to have a deal with the public where wepunish and rehabilitate with consent. We need to delivercrucially legislative changes and provide appropriateguidelines that reduce the harmful use of imprisonmentand limit the size of the judicial system.ConclusionOf course there are challenges ahead but the taskis, in my judgement, still doable. Sometimes I think wePrisons havebecome infinitelymore secure andmore decent.spend too much of our time exaggerating the scale,complexity and difficulties of the job rather than justgetting on with it. Remember, we have fewer totalnumbers of offenders on the books of NOMS thanthere are members of the National Trust; more peoplewill watch the World Cup final in the CalabashStadium than we have total number of prisoners inour overcrowded prison system; and, most ShireProbation Trusts have fewer offenders on communityorders than there are children in a typical urbancomprehensive school. So this scale is manageable.Furthermore, there are very few offenders whose pathto criminality we cannot trace, or whose risks andneeds we cannot identify. We know whatinterventions work, we know when to deliver themand generally in what dosage and so we know whatto do and how to do it. A recent study of the topperforming leadership teams in prisons, by theInstitute of Criminology inCambridge, identified that themost important characteristicswere optimism and resilience 8 .With these attributes and ourknow how, we can make a bigdifference to reoffending. Thestrapline of the recentlylaunched ex-offenderorganisation ‘User Voice’, ‘Onlyoffenders can stop reoffending’is profoundly true, but we need to be there to helpand maintain belief in their ability to change.We have come through a decade with a heavyand appropriate emphasis on public protection.Prisons have become infinitely more secure and moredecent. Probation has focused on compliance,enforcement and the creation of comprehensive riskassessments. These objectives remain relevant toNOMS today and are necessary to maintain publicconfidence and secure investment but whilst they arenecessary they are no longer sufficient. The nextdecade will therefore be dominated by two realities: areduction of spend on all our public services and theurgent reform of our thinking, attitudes and deliveryof a justice system that has at its core the requirementto transform offenders’ lives and deliver the‘rehabilitation revolution’.This article is an edited version of the Perrie Lecture8. Gadd, V. (2010, in progress). ‘A Typology of Prison Senior Management Style and Effectiveness’.34 Prison Service JournalIssue 192

Perrie Lectures 2010Managing offenders throughProbation ServicesBeverley Thompson is the Acting Chief Executive of Northamptonshire Probation Trust.This is the second time I have had the opportunityto give one of the Perrie lectures, the first when Iwas at Nacro about women in prison where I washighlighting the need to offer appropriately tailoredsupport and activities to assist with successfulresettlement. This lecture 12 years on has similarthemes. The importance of timely support andjoined up services for offenders and their familiescannot be over stated. My work at Nacro and nowin Probation supports this proposition.I started my career as a Probation Officer in Londonin the 1980’s the mantra then was advise, assist andbefriend. ‘Aftercare’ was part of the lexicon of Probationlanguage and it was permissible and even cool to careabout offenders. There was even voluntary throughcare/aftercare in those days. Today the language haschanged. But has the practice?I want to illustrate this with a story. I remember manya long journey to some distant prison to meet with anoffender to plan for their release — this was a legitimateactivity fully endorsed by the Service, (there was still theessential car user allowance). I would advise the offenderthat the three bedroom flat with deep pile carpet (I did sayit was the 80s) they were expecting was not likely to bepossible. I would then assist the offender to complete theapplication form, for the hostel they were more likely toget, followed by the relevant housing department formwhich was often a mere formality — as they were nevergoing to get a council property quickly particularly inSouth London. I would befriend with a packet of Bensonand Hedges, hastily bought from the local garage to helpthis process of through care/rehabilitation/resettlement/aftercare take place smoothly. Whicheverword you choose — depending on the era you relate to.As I look back and consider, is what I have describedis such crude terms really any different to what offendersexperience today? We have changed the language butare the outcomes any different? Has the Probation role inthe process been diluted through the 70+ indicators weare measured against? Is multi-agency working reallyworth the effort? Is it making a difference?I want to start by considering what we think we aretalking about when we talk about Resettlement,Rehabilitation, through care or even end to end offendermanagement. None of the offenders I have ever workedwith or spoken to has ever used this language other thanas a means of communicating with us, the ‘professionals’.They generally say something like ‘I need some help withhousing or finding a job when I return home, Miss’. Wehowever have taught them a language of our profession.They have learnt the language we use to describewhat we argue we do to them, and I do mean do to themas often we do not work ‘with’ despite what we claim.I want to question when were these offenders ever‘settled into the communities we expect them to returnto?’ The majority of offenders have led chaotic lives priorto imprisonment, a third of prisoners have no permanentaccommodation prior to imprisonment; two-thirds areunemployed prior to imprisonment; 40 per cent ofprisoners lose contact with families.Our contact with the offender is I suggest based onan implied assumption that we will settle them intocommunities through our intervention. This is what thelanguage offenders have learnt from us; leads them tobelieve. They will ‘settle’, meaning put in order; or arrangein a desired state or condition. I would suggest that nowis the time to re-think our language — we may be able toassist and guide in securing accommodation oremployment, but this is not the whole picture, as leftwithout meaningful support/contact or family supportoffenders can feel isolated leaving them vulnerable toreturn to previous routines or associates they are tryinghard to move away from. Is there now a case for us to beclearer and more honest and transparent about — whatwe regard as a successful ‘resettlement’ outcome?Has the Probation role in the processbeen diluted?When I was preparing for this I asked my Treasurer totell me what proportion of our budget was dedicated toresettlement activities? We didn’t have a figure as we don’tdifferentiate activities in that way any longer; it is nowsubsumed into general offender management (OM)activities. This confirmed for me one of the greatfrustrations I have currently with Probation activities. Weare required to spend so much of our activities deliveringoutputs against standards that it appears we haveforgotten those who should be at the heart of what we do:the offender. How do we know if what we do really makesa difference to the offender? The recent research ondesistance theory would appear to cast doubt on thecentrality of the Probation role in the process. In fact thematerials on desistance leads me to believe that if theIssue 192Prison Service Journal35

investment we have made in accredited programmes overthe years were a commercial product we might questionthe value of the return on our investment. I oftenconsidered what was so special about the one to onemeetings I would have with offenders, did it really make adifference to them? Or was it just that they had grown up?Become a parent? Or left a dysfunctional relationship?Today’s OM does at least have the language ofpunishment enshrined through their work and well as thecontrol aspect. I would argue that we still remain short onthe helping aspect of our work. We are still too processorientatedand we need to have more qualitativeoutcomes. What do offenders think about the service theyreceive from Probation. Prisons at least have the MQPL(Measuring the Quality of Prison Life) survey to give theman indication and the British Crime Survey gives someindication to criminal justice agencies, but Probation isalmost invisible in this arena. Yet weare measured on our contributionto reducing re-offending.I would suggest thatProbation is spending too muchtime counting completions,measuring outputs and managingrisk processes — this I believe hascaused an imbalance in our work.The offender is almost seen assecondary and wouldn’t it be niceif the offender turned up forappointments on the right day atthe right time, didn’t have anyissues going on in their lives whichthey chose to divulge toward theend of their thirty minute session. This must be the OM’sworst nightmare as their already filled diary is thrown intochaos. I am acutely aware that the time constraints thatOM’s operate under now must impact on the quality oftime they are realistically able to offer to offenders. Letme be clear I am in no way criticising the work of OM’s asI am immensely proud of the work that my staff do inoften difficult and challenging situations, as I am sure aremy other Chief Executive colleagues across the country oftheir staff, but I am concerned by the restrictions thatdrive the performance mechanisms may be having anadverse impact on the quality of outcome.Just recently in Northamptonshire we carried out ashort exercise seeking the views of women offenders onhow to improve attendance and thereby avoid breachaction; the comments were revealing and in parts a starkreminder of how far we have potentially gone inforgetting basic issues. Some comments:A survival guide written by women whoexperienced probationLeaflets about what will happen on your firstappointment would help (given out at court)A more ‘women friendly’ reception area wheremen do not ‘come on’ to youReception is too smallAlcohol users in reception put you off coming inIt is scary being the only woman in reception. Itgets better but the first few times are scary.Providing childcareI would argue that westill remain short onthe helping aspect ofour work. We are stilltoo processorientatedand weneed to have morequalitative outcomes.Fear of coming in the first few appointments, feelas though everybody is looking at youA clock in reception would be goodResettlement or whatever word we choose begins atthe start of the order not the end — Nacro and otherorganisations have long reminded us of this but it appearsin our continual reorganisations we might have forgotten— some of the more fundamentalprinciples that used to embraceour work. I recognise theimpressive work that has beenundertaken in this area by manyProbation Trusts but my view isthat the experience of offendersstill demonstrates patchy provision.I still find it astonishing that yearsafter the Woolf report which setthe new agenda around decencyin prison and the need for properresettlement activity which shouldstart in prison we have still not beable to maintain a consistent andthorough approach to the issues.Multi agencyResettlement activities of any kind in my view isimpossible without meaningful contributions from thevoluntary sector. A recent piece of information from theOffice of Criminal Justice states that 50 per cent of theresources required to assist in the resettlement ofoffenders lies outside of the criminal justice system (CJS).Therefore it is a no brainer to assume that we canundertake this responsibility in isolation. We know andrecognise that many of the cost of re-offending is noteasily quantifiable but can and does have devastating andlong term implications.An ex-prisoner’s path back to prison is likely to costthe CJS an average of £65k. Prolific offenders cost evenmore. The average cost of a prison sentence imposed atcrown court is roughly £30,500 made up of legal costs.The actual cost of keeping a prisoner in prison varysignificantly, but on average £37,500k per year.A case study from Northamptonshire illustrates:Gerry (not his real name) sentenced to 16 monthscustody in September 2009 for Burglary. Is selected as a36 Prison Service JournalIssue 192

Prolific and other Priority Offender due to his previous andcurrent offending. Has entrenched offending behaviourlargely related to general acquisitive crimes. Is a class Adrug user. No employment history. Numerous previoussentences including both custodial and communitysentences. All previous sentences have been under twelvemonths therefore not on the probation radar. He is alsoextremely unlikely to have benefited from anyprogrammes in custody due to his sentence length. Sixweeks after his sentence a sentence planning board isinitiated by Northamptonshire. A number of individualsare invited including our PPO police officers, drug workersetc. Objectives are agreed and Gerry is given a copy of hissentence plan. Referrals are made to courses within theprison to address his thinking skills, drug and alcohol use,accommodation and employment, training andeducation. Gerry was prescribed drug treatment in prisonand prior to release arrangements were made for him toattend the local drug and alcohol service as well asservices to support him withrelapse prevention. Additionallicence conditions were addedprior to release to address drugand alcohol use, PPO work andclass A drug testing.Gerry was released in March2010. He has attended allappointments (55 in total), passedtwice weekly drug tests and isattending appointments with allpartner agencies to enhance hisemployment prospects through training and education.He remains on licence.This case study is probably replicated countless timesacross the country, but I believe it is illustrative of thepivotal role that voluntary organisations and otherpartners play in our work with offenders.As we move to an era of scarce public resources,where we are faced with looking at potentially deliveringonly our core business, the necessity to work withpartners is even more imperative to ensure that resourcesare used to best effect to achieve outcomes thatcontribute to our overall business of protecting the publicthrough the safe supervision of offenders in thecommunity.Barriers to Effective ResettlementWe all know the range of factors which contribute toeffective resettlement and these have again beenrehearsed through the lectures. A place to live,employment, family ties or at least good supportmechanisms and help with health or substance misuseissues. We have known these factors for a long time andI have never heard anyone disagree with what needs to. . . we sometimesforget that we arenot resettling justthe offender but alsothe family.be done. However there is not a one size fits allresettlement provision and the needs of women, men,Black and minority ethnic, faith groups, age etc all need tobe considered in every case. We need to recognise thatresponses from some communities to the resettlement ofcertain groups are different and can fundamentally affectsuccessful resettlement for example the stigma associatedwith imprisonment if a woman with children is sent toprison, those from some faith groups. An event at HMPThe Mount recently around community links and effectiveresettlement, a prisoner said, ‘it is difficult to pick up insociety after release especially if you are pious and have along beard — that will get you insults not a job’ added tothe fear and suspicions as to why such an individual mighthave gone to prison is only likely to further alienate theindividual from his immediate community or the widercommunity. So our ability to effectively meet the differingneeds is questionable if we choose to work in isolation. Idon’t believe anyone involved in the CJS process wouldargue against multi-agencyworking however my experience isthe practice often doesn’t live upto the intention. Multi—agencywork can be time consuming anddifficult but it is effective in itschallenge to agencies to definewhat they do and the resourcesapplied it.The impact of resettlement onfamilies is often underestimatedand we sometimes forget that weare not resettling just the offender but also the family.Those groups in the community that work with familiesconsistently remind they too serve the sentence and facethe alienation from communities and suffer the stigma ofhaving a loved one in prison. How can we address thiswithin the safeguarding children responsibilities we face?We cannot forget the Rehabilitation of Offenders Actand its impact on successful resettlement. However, weneed to look closer to home about our own approach toemploying ex-offenders. Why do we believe that anyemployer will want to employ ex-offenders if we equallyare not prepared to, or our organisations have suchrestrictive policies that it would be impossible even forNelson Mandela to gain employment? We need toexamine our own policies and practices in this area.We must maintain offenders being at the centre ofwhat we do — that may be unfashionable as publicopinion appears to have become more regressive over theyears, but our contribution in preventing further victimsand reducing crime must be to work more effectively withoffenders.Through care — who cares? I believe we all do —but we just don’t remember for long enough.Issue 192 Prison Service Journal37

Perrie Lectures 2010Interview: Stephen ShawStephen Shaw was the Prisons and Probation Ombudsman for England and Wales from 1999 to 2010.He is interviewed by Martin Kettle who works for HM Inspectorate of Prisons.Stephen Shaw CBE is the recipient of the Perrieaward 2010. He was appointed PrisonsOmbudsman in October 1999. His role wasextended in September 2001 to take incomplaints against the National ProbationService (NPS) from those under supervision in thecommunity and the post was renamed as thePrisons and Probation Ombudsman for Englandand Wales. . His remit was further extended totake in complaints from those in immigrationdetention in October 2006.Initially established in order to provide someindependent oversight of complaints, during his timein office, the work and responsibilities of the officehave expanded significantly. Most notably, from April2004, the Ombudsman’s office has been responsiblefor the investigation of all deaths in prisons andimmigration removal centres, as well as the deaths ofresidents of NPS hostels (approved premises).As Ombudsman, he conducted a range ofinvestigations in a personal capacity, including theinquiry into a riot an immigration centre, aninvestigation into the death of Harold Shipman, andthe first public inquiry to be held into a near death inprison. He also served as one of two independentmembers of the Parole Board’s review committee thatconsiders the cases of released prisoners who havecommitted serious further offences.Prior to becoming Prisons Ombudsman, he wasdirector of the Prison Reform Trust (PRT) charity for18 years.In April 2010 he left his post and took up a newrole as the first Chief Executive of the Office of theHealthcare Adjudicator. This office has beenestablished in order to create a clear separationbetween the power to investigate and the power toadjudicate concerns about health professionals.He has written widely on both criminal justice andeconomic issues. His latest publication is entitled FiftyYear Stretch: Prisons and Imprisonment 1980 — 2030and was published in 2010 by Waterside Press.MK: Many congratulations on receiving thePerrie Award 2010, in recognition of your manyyears of work to improve the criminal justicesystem.SS: I was very pleased when I found that not onlywas I the recipient of the Perrie Award, but also thatas a concomitant of this I had this opportunity tospeak to the readers of PSJ. I remarked when I wasgiven the Award that it is the sort of award that isgiven to people at the end of their careers. I comparedit with what happened at the Emmys, the musicindustry awards, this year. They had given one toAndre Previn, aged 81, one to Leonard Cohen, aged75, and one to Bobby Darin, who would have been amere 74 but for the unfortunate fact that he died inthe 1970s. So to receive the Perrie award wasbittersweet, and I reject the implication that my bestdays may be behind me. Still, I was delighted.MK: The Award is mainly in recognition ofyour years as the Prisons and ProbationOmbudsman. Before that you were wit thePrison Reform Trust for 18 years.SS: Yes, two jobs in 30 years. I was described onsome left-wing website as a careerist, and I thoughttwo jobs in 30 years was an interesting definition ofcareerism.MK: Which was the better of those two jobs?SS: Each in its time, really. I don’t envy peoplerunning pressure groups and interest groups thesedays; I think it’s a much trickier business. When Istarted all those years ago at the PRT, newspaperswere literally based in Fleet Street, and they wouldtake a huge amount of pressure group material. Youcould (and I did) run or drive up and down Fleet Streetwith a photocopied press notice and hand it in at thedesk with a reasonable chance that the next day itwould get in. I remember one incident where it wasthe first time that the government of that timeproposed intermittent custody — we used to call themawayday prisons. We thought it was a daft idea. Iwrote a press notice saying so, for PRT and also for aseparate campaigning body. As I was driving home,just after midnight, on the BBC radio in my old Datsuncame on saying that the government is proposingintermittent custody, and already the idea has beencriticised by two organisations, PRT and this other one— and that was just me at a typewriter. It was mucheasier then. Now the serious newspapers wantexclusives, they are happy to report crime but less soserious discussion about crime and how to deal with itbecause other matters, often consumer-based, havetaken the space. If you do an analysis of what goes38Prison Service JournalIssue 192

into the broadsheets it’s utterly different from whatobtained 30 years ago.You had that period, around the Strangeways riotand the Woolf Report, and although Harry Woolf verymuch came to his own judgments, in a sense theinfluence of Prison Reform Trust, NACRO and theHoward League was at its apogee. That was atremendously exciting period. In the late 70s theprison system was not much to write home about,there were huge opportunities both to say things andto change and shape — there was a lot to change.MK: So was being the Ombudsman a bit lessexciting?SS: Not at all. When I joined the Ombudsman’soffice I enjoyed that too. I used to say to people thatI found the move seamless, fortwo reasons — first, in runningPRT I had always wanted toengage with those prison staff,governors and officials whoactually wanted to change themould, so although outside thetent I wanted to and could workwith people inside the tent.Secondly, though I liked all thepress and policy stuff, I supposein my juvenile way I liked havinga profile and being able tochange things. The thing thatpleased me most was being ableto make small changes forindividuals; I remember going toSaughton prison in Edinburgh,and finding this very grubby young man, a sexoffender. He’d urinated on himself and was in thishorrible old cell, and he just needed a radio; in thosedays you could get a radio off the chaplain, but hehadn’t liked to ask, or he’d asked a member of staffand they hadn’t told the chaplain, or the chaplaincouldn’t be bothered to do it, and before I leftSaughton that day I’d got the fellow a radio. Itdoesn’t change what he’s done, it doesn’t change hislife chances, it didn’t change the prison very much,but was the world a marginally better place?Absolutely. And lots of what I did as Ombudsman,particularly on the complaints side, was making theworld a marginally better place. If something hadgone wrong for a prisoner, we could help to put itright, or if the chap deserved to have somethingexplained to him, he got an explanation. If somethinghad gone wrong and the governor really should haveapologised for it, that was done. And thataccumulation of small improvements, I alwaysthought, was part and parcel of the decency agenda.So that was enormously worthwhile. And I had somegreat colleagues.I always felt thatbeing treatedproperly, beingconfident that ifyou had a problemit would be putright, was all partof pro-socialmodelling.MK: What is the best or worst state of affairsthat you have come across in a prison?SS: To talk about the ‘best’ prison is difficult.Prisons are an unfortunate social necessity: they havecruelties about them which are necessary — the veryfact of separating people from their family is anecessary cruelty; the lack of autonomy over your ownlife is a necessary cruelty. I support strip-searching,because I think that that is a necessary cruelty ofprison. A degree of control or censorship over yourmeans of communication is a necessary cruelty — soto talk about ‘good’ in that context is tricky. It’s notthat I think these things are wrong In themselves — Ithink they are ineluctable — but that’s why prisonsshould be subject to a degree of monitoring.MK: Much of theOmbudsman work was aboutcomplaints. Many people, notperhaps among readers ofthe PSJ, informed by certainparts of the media, wouldthink that prisoners’complaints are taken tooseriously and that prisonersare treated too well.SS: I never saw it like that.Most offenders have very littleconfidence in authority, they arealienated from society. I alwaysfelt that being treated properly,being confident that if you had aproblem it would be put right,was all part of pro-socialmodelling. Prisoners have often been failed by theirdad, if he was ever around, they’ve been failed by theschool (as they would see it), they’ve been failed byworkmates, by the police and courts and Probation,they’ve been failed by the housing authorities, and sothey have very little confidence that authority will actother than in a way that disadvantages them. If yourun a prison in a way that confirms that — ‘Here youget nothing’ … there was a great phrase in one of thecomplaints I read, from the wing conduct report in anadjudication: ‘To be fair’ (which I thought wasbrilliant), ‘X causes no trouble on the wing — he asksnothing and gets nothing’. All of that, I think, justconfirms a criminal identity, that authority is out to getyou, it will do you down, the only people you can trustare your mates who share your view of the world. SoI always felt that what we were doing on thecomplaints side, as far as the prisoner was concerned,was yes, putting right things that ought to be putright, but also saying ‘Yes, if you play by the rules,other people can play by the rules, and authority isnot unjust and uncontrollable; on the contrary,authority is legitimate, prisons are legitimate, but youIssue 192Prison Service Journal39

also have expectations about how you should betreated, which are legitimate’.So I was always very proud of that. I also felt thatwhat the office does in respect of prisons complaints,like all complaints agencies and all Ombudsmen, isabout helping the service whom you oversee, toimprove the quality of what it does. I have used thismetaphor before: if you think of the most successfulcommercial organisations, say Tesco, what is the firstthing you see when you walk in? It’s the customerservice desk, which is really the complaints desk,where you take back the fruit that was off when yougot home, or you’ve been over-charged on Till 13, oryou were supposed to get 2 for the price of 1 but youhaven’t. Why’s that the first thing you see? Becausethey are saying to you as a customer, you areimportant to us, you are entitledto be treated properly, but alsobecause they want to knowwhen those things are going on.If people are always being overcharged on Till 13, thensomething’s going wrong on Till13, and we want to change that.If you’re bringing back thebananas that have gone off bythe time you get home, wedon’t want to stock them fromthis supplier any more; and sothey’re using the complaint as away of improving servicedelivery.I remember a friend of minewho became a governor of whatwas then a rather notoriousyoung offenders’ institution (it’snow a rather better one and Iwon’t name it), saying to me that one of the indices ofhis success was that he was getting more complaints.And the reason for that is that the young men in theYOI, firstly they weren’t terrified of complaining,because they weren’t fearful of recrimination, andsecondly they had an expectation that if theycomplained something might actually be done aboutit. There is a perverse aspect to complaints, that ifyou’ve got a really bad institution, you don’t get anycomplaints, because nobody expects anything to beput right. If you have an excellent institution, youprobably get quite a few complaints, because peopleare confident that something will be done to putmatters right. So I think those things are worthrepeating.MK: Then deaths in custody became a majorpart of your remit.SS: It was incredibly worthwhile when in 2004we took on the death in custody remit. The ability toThere is a perverseaspect tocomplaints, that ifyou’ve got a reallybad institution, youdon’t get anycomplaints,because nobodyexpects anything tobe put right.tell people’s story, the opportunity to engage with thebereaved, the ability to change things hugely for thebetter for prison staff — in 2004 you got hardly anysupport, if someone died in prison it was all verymacho, you went back to work the next day and noone seemed to care very much. Family liaison wastransformed in the prison service, largely I think as aconsequence of the Ombudsman’s office’s work. Andof course, whether it’s directly related or coincidental,the very substantial reduction in the rate and overallnumber of self-inflicted deaths in prison. That is workof huge public value, of which I am very proud.Running round Fleet Street is trivial — what is moreephemeral than a press notice? — compared tohelping to drive down avoidable deathsMK : Did those changes come about throughthe fear of consequences, ofinvestigations if peopledidn’t open the ACCT and soon, or do you think your rolewas positive?SS: I think this has beenunacknowledged by politicians— the extent to which theprison service acknowledgedthe value of independentinvestigation (and it benefitednot least because it involvesindependent validation of whatthings are done well). But it isalso a way of drivingimprovements in performance. Ihad huge encouragement fromthe service in carrying out thisdeath in custody work. Whenwe first started of course therewas some unease — that’s onlynatural. But over the six years when I was personallyresponsible for about 1000 investigations, there washuge support first from Martin Narey and then fromPhil Wheatley — and from everybody lower down thefood chain. In some sense it goes back to my personalapproach as a pressure group activist, which was thatI always preferred to work with the grain rather thanagainst it. And I was very fortunate that theleadership of the service wanted to go in the samedirection that I did. I don’t think it’s telling tales out ofschool, that Phil Wheatley, just before his retirement,when he was responsible for NOMS and with all themeetings with MoJ that he had to spend a lot of histime doing, would personally read some of our deathin custody reports. Now that tells you a huge amountabout him as an individual, it tells you about thesignificance that he attached to what we were doing,and it tells you a lot about the impact of the work forwhich I was responsible.40 Prison Service JournalIssue 192

MK: Do you think that the reduction indeaths in custody can continue? A highproportion of them take place on remand.SS: They always have done. Funnily enough, ifyou go and look at the 1922 book English PrisonsToday by Stephen Hobhouse and Fenner Brockway,they have a section dealing with suicide; and there itis, it’s in the first few weeks in custody, it’s more likelywhen you’re on remand, the old lags tend not to do it— and broadly, that picture remains the same today.Well, what do we know about reduction in suicides?We know that a lot of it has been driven by improvedpractice — I think ACCT is a world-class system thatsaves lives daily — but ACCT is expensive if you do itproperly, if you really do it in a multi-disciplinary way— that’s a lot of staff and a lotof staff time. So there is pressurethere, on some of the processes.We also know that suicide andself harm are correlated withprisoners’ sense of their ownsafety; and with whether theythink they are in a good prisonthat cares for them. Individualcare and a sense of safety maybe undermined if the populationremains at about its current levelbut the funding reductions thatare projected begin to takeeffect.MK: Do you have yourtwo penny-worth to put in tothe debate about shortsentences, and where thegovernment should be goingwith that?SS: Well, it is encouraging that you have aSecretary of State who is very publicly making the casethat prison is not an effective way of reforming themany mainstream offenders, and the statistics on thisare now very powerful: that there is a reformativeeffect, but with very short sentences prison doesmarginally make people worse than you might haveanticipated — reconvictions are slightly higher thanmight otherwise be the case. There may still be a casefor short-term imprisonment if people continue tobreach non-custodial sentences, so that you’re beingpunished not for the seriousness of what you’re doingbut for its persistence — and a break in a criminalcareer may still provide some relief. I did a lot of workat Styal prison — and the vast majority of women inthe remand wing at Styal are women who areaddicted to heroin, whose lives are very bleak; manyof them have been subject to physical and sexualabuse from men, their offending is mostly petty, butvery persistent, to fund a drug habit — because anyWe also know thatsuicide and selfharm are correlatedwith prisoners’sense of their ownsafety; and withwhether they thinkthey are in a goodprison that caresfor them.money goes on drugs, you steal food from a localsupermarket. We sitting here would describe that aspetty thieving. But if you’re the person running thatcorner shop, or the little petrol station, and it’s thesame woman coming in most days stealing from you,then it’s suddenly not petty, and interrupting thatcriminal career is really rather important.So imprisonment gives some public protection. Iwanted to be careful about what I said there becausea lot depends on how bold the Secretary of State is interms of reforms to sentencing structure — youcannot reduce the prison population by very muchunless you reform the sentencing structure. If you lookat the make-up of the prison system now, there aren’tmany petty persistent offenders in the male system;over half the people there areserving longish sentences fordrugs or for sexual crimes orviolence. It’s a hard nut to crackto say that we want shortersentences for those people. Andit’s a hard nut to say that weknow short sentences are no usein terms of reducingreconvictions, but what’s fed thepopulation with short —sentence people is that theykeep doing it time and timeagain — so what policy are yougoing to have on breach? Theenforcement of communitypenalties has become muchmore robust in recent years. It’svery hard to say it shouldn’t berobust — of course one wants tobe forgiving, understanding,tolerant (tolerance is a good thing, I’d like to see it nolonger a dirty word) — but if you actually want toreduce the prison population you have to make somevery hard choices about sentencing, and that’s a realtest. If you don’t do that, then I’m fearful that theconsequence of current policy is that there will befewer resources, but the prison population — it maynot rise as the worst projections showed, but actuallyforcing it down from the current 84 or 85000 is goingto be incredibly hard. There’s a sort of ratchet effect insentencing, and I hope that officials and politicians areclear just what challenging decisions they will have tomake. Saying that nobody goes to prison for less than3 months or even 6 months (which would presumablyset the Magistrates’ Association’s alarm bells ringing)doesn’t really do enough to force down thepopulation.MK: You have recently published you ownmanifesto in the form of your book Fifty YearStretch. What for you are the key principles?Issue 192 Prison Service Journal41

SS: That book is in some ways an optimisticaccount of how much has changed for the better inprisons, in terms of how they run, the culture, thevalues of staff, and what they can now deliver inturning lives around. In the book I talk about this asan intensely moral outcome — fewer victims, fewerlives wasted. To talk about reducing the reconvictionrate sounds terribly bureaucratic, but turning livesaround, meaning fewer victims of crime in the future,that’s intensely moral. So in many ways the prisonservice (and I use them term advisedly) is a hugesuccess story in public administration in the last 30years, almost entirely unacknowledged by the media,the public and politicians, and perhaps not alwaysacknowledged by prison staffthemselves — there is still along-standing tradition,particularly among officers, ofthinking everything’s for theworse, and it’s always been bad.I’ve used this metaphor before,but it reminds me of that songthe Millwall football supportersused to sing, ‘Everyone hates us,we don’t care’ — there’s someof that mood which is there,perhaps not just amonguniformed staff either. So partof the purpose of the book is totry to celebrate that success. Butit is less optimistic in terms ofthe reach of the prison system.My 30 years has covered aperiod when the prisonpopulation has more thandoubled. And one of thequestions that I pose in the book is whether there issome realistic likelihood of reverting to the situationthat obtained 30 years ago. 30 years ago there wasan active abolitionist movement in the universitiesand more generally — well, abolition has lost any sortof currency at the moment. Is the thought ofreducing the prison population to its 1980 levelequally unlikely? The book suggests that that is thecase. It was written before Kenneth Clarke becameSecretary of State, and before it became clear thatlaw and order was not immune from the sorts offinancial cutbacks that the government is currentlyplanning. Kenneth Clarke has had the support ofDavid Cameron in this so far, and it was often saidthat the Treasury was the best prison reformer,because it is always sceptical about law and orderspending, in terms of improving real public safety.The book perhaps underestimated the extent towhich the Treasury will prove to be the best prisonreformer of all.To talk aboutreducing thereconviction ratesounds terriblybureaucratic, butturning livesaround, meaningfewer victims ofcrime in the future,that’s intenselymoral.MK: Speaking of value for money, somepeople trace a change in the management stylein NOMS, and think that the emphasis onperformance and targets has undermined areflective and moral approach to managingprisons. Do you share that concern?SS: My friend Alison Liebling has conductedresearch on this very issue at Cambridge, and she hasfound that sadly there is some truth in this, that manymore of those in senior positions in prisons are verytask-oriented — they are managerialist — and thereisn’t the moral dimension to their work that perhapsthere was in the past. I think there has been thatchange, and I do of course very much regret that. Inthe old days, of course, peoplewould talk about ‘the numbers’,rather than prisoners, or about‘feeding’; even in DavidRamsbotham’s day, you’ll findInspectorate reports referring to‘feeding’. This is appalling — andyou say ‘Oh, we wouldn’t dothat sort of thing now’; but ifyou are involved, almost daily, intransferring prisoners againsttheir best interests, almost willynilly around the prison system,because you’ve got to find theavailable spaces, that isdehumanising as an act, and Ithink it is very much to beregretted that the more reflectiveapproach encouraged by the PSJ,and by the Perrie Lectures, is nolonger part of the mainstream.Of course it is important that theprison service, and prison governors, make best use ofthe taxpayers’ money. I sometimes point out that mymother is alive, she’s 90, she still pays a bit of tax onher pension, and there is no case for that money beingused wastefully; so I am in favour of that money beingspent well, I am in favour of an evidence-basedapproach to policy making, so that governors can’t justsay ‘I’ve got a whim, I want to do X whether there’s anevidence that X does any good or not’. But I amequally concerned that if people come into the PrisonService and say ‘Well, I’m in the Prison Service, but Icould equally well have joined ICI or some other walkof life’, without acknowledging what distinguishes allprisons — but especially those in England and Wales —namely the human element, that they run best onrelationships, that softer skills matter hugely both tostaff and to prisoners,. The new government hassuggested in relation to Health that it has becomeperhaps too target-driven, and that we should bemuch more interested in real outcomes for people42 Prison Service JournalIssue 192

ather than artificial targets. Some of this is politicalrhetoric, but some of it does suggest a change ofdirection.MK: So you have become chief executive ofthe Office of the Health Professions Adjudicator,just at the time when the health service is havingits biggest reorganisation for however manydecades …SS: Yes — just to explain what the OHPA is — I’lllet you into a secret, there ain’t no such thing as aHealth Profession Adjudicator, so it’s a daft title. TheOffice was set up under the Health and Social CareAct of 2008, and it is intended to take over initiallyfrom the GMC the responsibility for Adjudications inwhat are called ‘fitness to practise’ cases. In effect,OHPA will be running the tribunals which determinewhether doctors, and in the future other healthprofessionals, should be allowed to continue on theregister, or whether they should only practise subjectto particular conditions. There is a link back to myprevious career, in that OHPA can trace its history backto a judge, Dame Janet Smith, who conducted a seriesof enquiries following Harold Shipman’s murder ofhundreds of his patients. She proposed that, forreasons of public confidence and because in principlethe same body should not be responsible forinvestigating such cases and adjudicating on them,there should be a separate organisation. So this has acertain resonance for me, because I personallyinvestigated the suicide of Harold Shipman, the firstindependent investigation of a suicide in a male prisonin this country. There is a pleasing symmetry for meabout how I have ended up here. Healthcareregulation, like prison inspection, and law and ordergenerally, are public goods; they have to be paid for— these are political choices, and some things will goincluding some things which we think are importantThe job of the Office of the Health ProfessionsAdjudicator is about balancing the rights of the doctorwho is accused of malpractice against the right of thepublic to protection from doctors who are not fit topractise — and that’s familiar territory, is it not? So inthat sense I found the transition from prisons tohealthcare seamless.MK: We wish you well for this new task, andthank you again for your real contribution to thehuman rights issues which lie at the heart of thecriminal justice system.Issue 192 Prison Service Journal43

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Report on the first cohort of prisoners thatcompleted treatment in the Fens Unit,Dangerous and Severe Personality DisorderUnit at HMP WhitemoorJacqui Saradjian, Naomi Murphy and Helen Casey are all based on the Fens Unit at HMP Whitemoor.IntroductionTowards the end of the 1990s, there was arecognition that there was a particular group ofmen for whom no services were available, in prisonor the NHS, that would enable them to reduce therisk that they posed. These men were those with adiagnosis of severe personality disorder whoseoffending was linked to their personalitypsychopathology. These men were particularlylikely to commit interpersonal offences, includingserious sexual and physical violence, manslaughterand murder. The 1999 government manifesto,attempted to address this need and consequently,four high secure units were set up; two in hospitals,Rampton and Broadmoor, and two in prisons,Whitemoor and Frankland, to assess and treat menwith severe personality disorder who were deemedto be at being at a high risk of reoffending in aform that would caused significant harm, bothphysical and psychological to another person. Theaims of these units were to — ensure high quality detailed risk assessment toprotect the public from some of the mostdangerous people in society provide high quality services for the individualsthemselves to improve their health outcomes reduce the risk that they pose and enable them towork towards successful integration into thecommunity or to be able to be detained at thelowest level of security without harm to others.These units became known as the Dangerous andSevere Personality Disorder or DSPD units. Whilst theassessment and criteria for admission to the units werecentrally set, as the evidence base of best practice withthis client group was minimal, each unit developeddifferent treatment programmes under the scrutiny of anexpert advisory panel. Consequently, the make-up of thestaff teams differed depending on the treatment beingdelivered, and consequently the costs of running theunits the run; each hospital place costing approximately3 times the cost of a prison place. Interestingly however,research undertaken as to the characteristics of the menin these establishments indicates that the men in theprison units tend to have committed more seriousoffences, and that those at The Fens Unit, HMPWhitemoor tend to have higher levels of personalitypsychopathology and also greater levels of mental healthproblems than those men in the hospital units (Burns etal, 2010) 1The unit at HMP Whitemoor has now completedtreatment for its first cohort of prisoners. It is too soon tolook at the key outcome data, namely reoffending rates,but there is an overall trend that shows a reduction of riskbased on specific risk measures. This is a descriptivearticle and sets out to describe the unit at HMPWhitemoor and the treatment it offers, and then to usethis first cohort of men as an exemplar of how theyresponded to the service they were offered.The UnitThe Fens Unit at HMP Whitemoor is not a purposebuilt unit but is an adapted prison wing. It has no specialfacilities; cells on the top landing have been convertedinto individual treatment rooms and offices; associationrooms become group rooms during the working day andall other facilities are shared with the rest of the prison.The unit has the capacity for 65 prisoners in assessmentand treatment, equally distributed across three spurs and5 prisoners in progression places. There is also a smallcrisis suite of 3 safer custody cells and a gated cell. Thecrisis suite is used when prisoners are in a state of crisis(as often occurs in effective therapy) so that they canaccess additional support in a smaller unit.The PrisonersThe men who are most likely to meet criteria forthese services are almost always ‘a managementproblem’. Most of the men who have come through theservice have been violent in prison, many have spentyears in and out of segregation and some have come outof the Close Supervision Centres (CSCs). They have beenresponsible for numerous assaults on staff and other1. Burns, T., Yiend, J et al (2010) IDEA Resaerch undertaken in the High Secure DSPD Sites for the Ministry of Justice.Issue 192 Prison Service Journal45

prisoners and regular damage to property by smashingand/or burning out cells. They have caused significantoperational management issues for Governors andaffecting adversely, the regime/quality of life for themajority of prisoners. Some become psychotic anddelusional when they are under extreme stress. All suffersignificant emotional distress that the have previouslymanaged by offending and/or developing drug andalcohol addictions by attempting to self-medicate thesymptoms associated with their personality disorder.Some have long histories of self-mutilation and suicideattempts. A strategy that such prisoners use, is to be inand out of gated-cells and healthcare; regularly takingoverdoses, use ligatures or deep self-lacerations.Prisoners with severe personality disorder are also proneto conditioning staff and several have developedinappropriate relationships with officers, teachers, nursesand/or psychologists.Offending BehavioursThe men who reach criteria for the service mostoften begin offending at a young age. They tend tocommit a diverse range of offences which increase inseriousness. Their index offences are predominantlymurder, manslaughter, extreme violent assaults, rapeand/or sexual assault but most have committed morethan one such offence. Chart 1 indicates the indexoffences for the first cohort that completed thetreatment programme.12108CHART 1Index OffencesAssessmentOn The Fens Unit assessment is carried out by takingin groups of 6 to 8 men onto the unit. Assessmentconsists of undertaking a review of all collateraldocuments available on each prisoner, individualinterviews with prisoners conducted by psychologists anda psychiatrist and daily officer-led group-work. Thepurpose of the group work is to closely observe andrecord the prisoners interpersonal behaviour and for theprisoners to learn to work in a group and to establishgroup identity. The process takes 16 to 20 weeks. Tomeet criteria the prisoner must: — be a high risk of reoffending (measured by RiskMatrix 2000, Static 99, VRS, HCR-20, and SARN) have a severe personality disorder (measured byIPDE and PCL-R) have a link between his personality pathology andthe offences he commits (assessed by thecombination of detailed offence analysis and clinicaldevelopmental history).Those who reach criteria carry on working togetheras a group throughout treatment. Those that do notreach criteria or who refuse a treatment place arereturned to the referring prison with a detailedassessment report. The following charts 3-5 indicate themajor findings for the first cohort of prisoners whocompleted treatment.These statistics indicate that these are a particularlydifficult group of men. They present at a high risk ofreoffending yet their personality psychopathologywould exclude them from standard prison programmes.They are therefore exactly the group that the servicewas set up to treat.Treatment Programme642086420Murder Manslaughter Sexual Violence Other Violence FalseImprisonmentCHART 2Prisoners’ Scores on PsychopathyChecklist (PCL-R Scores)>30 27-29 24-26 21-24Score on Psychopathy Check ListWhilst traditional accredited prison treatmentcourses work well for many offenders to help reducetheir offending behaviours, men who reach criteria fortreatment within the Dangerous and Severe PersonalityDisorder Units have either been excluded from thoseaccredited prison programmes by virtue of theirpersonality psychopathology (PCL-R Score exceeding28) or have completed standard offending behaviourprogrammes and yet are perceived to continue to posea high risk of re-offending. The treatment programmedevised was rigorously scrutinised and agreed by anInternational Group of Experts in this field and thus hasbeen subjected to similar analysis to accredited prisonprogrammes.As offending behaviour and level of risk isconnected to personality pathology, unless thatpersonality pathology is addressed, at times of stress46 Prison Service JournalIssue 192

CHART 3The Range of Personality Disorders Diagnosed in the Prisoner Group1614121086DefiniteProbable420Schizoid Schizotyal Paranoid Antisocial Borderline Histrionic Narcissistic Avoidant Dependant ObsessiveCHART 4Risk Measures on Risk Matrix 200010864Sexual RiskViolent RiskCombined Risk20Low Medium High Very HighCHART 5Initial VRS Scores of the Prisoners in this Group8642050-55 56-60 61-65 66-70Issue 192 Prison Service Journal47

such men will resort to previous behaviours. Thereforefor risk reduction that is generalisable acrossenvironments, personality psychopathology must betreated and not just managed. Personality disorder is aconstellation of coping strategies that a persondevelops as a response to developmental experience.There are manifest dysfunctions of thinking, feeling,behaviour and interpersonal relationships. As theoffending is linked to those areas of dysfunction, theprogramme aims to address the developmentalexperiences that generate those areas of dysfunction.Thus throughout the programme on The Fens Unit,those aspects of the personality that lead to offendingfor each individual are assessed and the remedialtherapeutic experiences directly address the aetiologicalpersonality characteristics that have resulted in theoffending behaviours.Consequently work on eachprisoner’s offending behaviours isindividually formulated toinclude a developmentalpsychopathology with detailedassessment of factors that willincrease and those that willdecrease risk. There is anindividual assessment of themotivations to offend, atcognitive and affective levels,defining, directly observing,challenging and recordingparallel offending behaviours.Those factors that increase riskfor that individual becometreatment targets and the interventions are intrinsic toevery aspect of the programme. Each of these factorshas been identified for each prisoner and these areasare worked on in both formal interventions (describedbelow) and on a daily basis by officers on the landingsand workshops who observe and address hisbehaviours. These daily observations are communicatedat debriefing so there is constant monitoring of hisbehaviours, beliefs and emotional regulation. Theoffences that the men on the unit have committed aredirectly interpersonal offences — therefore thetreatment model is cognitive interpersonal. Thistheoretical model is based on a holistic model of humanfunctioning where it is believed that the personalitycharacteristics a person develops are a result of theinteraction between genetic predisposition andexperience.The aim is to develop boundaried relationshipswith prisoners through which they can experiencereparative interventions that will affect all aspects oftheir functioning. This requires that the prisonersexperience change at the level of affect; this means atan emotional level, not merely on a cognitive andPersonality disorderis a constellation ofcoping strategiesthat a persondevelops as aresponse todevelopmentalexperience.behavioural level. The programme involves thefollowing components —Individual Therapy (IndT) — This startsimmediately the prisoner enters treatment and focuseson the development of an attachment relationship inwhich the aetiological factors of the personalitydisorder can be explored and addressed, workingtherapeutically at the level of affect. This allows theprisoner to experience empathy at the level of affectiveattunement (feeling with the person) rather than solelyat the level of verbal cognitions. During the individualtherapy every aspect of the person’s life past, presentand future are addressed. Importantly, all areas relatedto offending are thoroughly explored in depth and at anemotional, as well as cognitive level. To work at theemotional level is vital if real sustaining change is to bebrought about.Personality DisorderAwareness Group Weeklysessions for 25 weeks, facilitatedby therapists and prison officers.This is mainly a psycho-educationgroup to help prisonersunderstand their disorders.Cognitive InterpersonalGroup Therapy (CIGT) This is anunstructured psychotherapygroup which focuses on theinterpersonal relationshipsbetween all involved in thegroups including the facilitators,making explicit the connectionbetween the behaviours,cognitions and emotions within those relationships andconnection between relationships and offending. Thisgroup also aims to develop a sense of connectionbetween group members, for prisoners to be able tochallenge each other and to allow self to be challengedregarding their distorted beliefs about themselves andothers and to find ways to resolve conflict with others ina healthy manner. This group also focuses on theprisoner’s ability to take emotional responsibility for hismaladaptive behaviours in both the past and in thepresent by understanding the process of paralleloffending and make positive changes to reduce suchstrategies.Schema Focused Therapy Group (SFTG)Schemas are underlying beliefs developed throughexperience which have a powerful (mostly unconscious)influence on behaviour. Groups educate prisonersabout distorted schemas which are connected tooffending and how these schemas are maintained.Groups will shift from education and awareness-raisingto more active challenging of distorted beliefs andmethods of behaving in order to maintain these beliefs.Thus this group aims to enable the prisoner to be able48 Prison Service JournalIssue 192

to identify his own patterns of behaving, thinking andfeeling (schemas), which contribute to and maintaintheir maladaptive behaviours; to challenge maladaptiveschemas that result in distress and difficulties in life andto change schema-driven behaviours, particularly thoseassociated with offending.Affect Regulation Therapy Group (ARTG) Thisstarts as educative, raising the prisoners’ awareness oftheir affective states and enabling them to beaccurately able to identify the emotions they areexperiencing, then shifts towards providing further skillsfor appropriate regulation of affective states. Prisonersare encouraged to challenge their over-reliance uponone affective state and avoidance of other emotions.Emphasis will be placed as muchon those that use repression anddissociative strategies to dealwith emotional arousal as onthose who appear to haveexplicitly high levels of emotionalarousal. Thus this group aims tofacilitate the prisoner to regulateemotion, to recognise when he isdiverting one emotion intoanother and the role ofemotional dysregulation inoffending. It also aims to helpprisoners manage affectadaptively, experience anddemonstrate empathy at the levelof affect. Importantly it facilitatesthe prisoner to manage affectmore adaptively rather thanconvert all vulnerable emotion toanger and engage in offencerelatedfantasy and behaviours. After the group work,there are 10 sessions of individualised skills training andpractice sessions to consolidate the group work.Offending Behaviour Therapy Groups (OBFT)This group deals with all forms of offending, violentand sexual, as they are so often inextricably linked.This groups aims to summarise for the prisoners thework that has been done to date on the man’soffending behaviour in individual sessions and in othergroups and explores offending patterns. The aims ofthis group are primarily to enable the prisoners todiscuss their understanding of their offending patternsand process, the most likely routes to reoffend andother possible routes to reoffend in a group setting.Group work, in particular, helps them deal with theshame and guilt associated with their offending. Italso enables them to become more aware of theirown and each others’ patterns of parallel offendingbehaviours, emotional and physical risk factors relatedto offending and to challenge any remaining distortedoffence-related cognitions and beliefs. The groupImportantly itfacilitates theprisoner to manageaffect moreadaptively ratherthan convert allvulnerable emotionto anger andengage in offencerelatedfantasy andbehaviours.considers individualised triggers to offending, needsmet by offending, and how the person learnt thatoffending could meet those needs. It also addressesthe role of violent and sexual fantasy in offending, andgoes on to produce an individualised offendingformulation and do relapse prevention work.Emphasis is placed on finding non-offending ways ofmeeting needs that the person finds desirable,acceptable and obtainable, and to develop copingmechanisms that work fast and effectively.Consequently prisoners are able to identify and testdetailed relapse prevention plans in practice.Addictive Behaviour Therapy Groups (ABTG)Almost all of the prisoners on the unit have useddysfunctional strategies tomanage affect that have becomeaddictive. Addictive behavioursare seen as a solution to aproblem when the real solutionwas unavailable. This group workaddresses all forms of addictivebehaviours, not only substanceabuse and how they become theperceived need to mask the realneed. These behaviours may havehad a direct effect on theirphysiological system such aspsychotropic substances (e.g.prescribed or illicit drugs),alcohol, nicotine or an indirecteffect by behaviours such asviolence, self harm, sexualbehaviours, gambling, eating (inexcess or starving), and theft.Prisoners will be enabled torecognise the role these addicted behaviours haveplayed and find alternative and more personally andsocially adaptive strategies. Individualised RelapsePrevention work is also carried out.Healthy Sexual Relationships Therapy Group(HSRTG) The Healthy Sexual Relationships Programmeis used with all prisoners and is an adapted version ofthe OBP course, omitting those areas that have alreadybeen covered in depth in the rest of the programme.This group concentrates on the sexual beliefs andattitudes held, and how they impact on behaviour. Thebeneficial role of appropriate sexual fantasy andcomponents of a healthy sexual relationship are alsothe focus of intense work. The programme aims todevelop more healthy sexuality, managing patterns ofsexual arousal, increasing healthy sexual interest andfocusing on relapse prevention.Overall Individual relapse prevention plans will bedevised with each prisoner based on their individualclinical formulation related to the connection betweenthose factors known for each individual that willIssue 192 Prison Service Journal49

increase and decrease the likelihood of offendingbehaviour.Therapeutic Milieu Treatment within the unitaims at creating the quality of interpersonalrelationships and remedial experiences that are believednecessary for people to attain the capacity to developsocially adaptive cognitive, emotional and behaviouralresponses. The aim is for all staff to develop appropriaterelationships with prisoners through which they canexperience reparative interventions that will change allaspects of their functioning. All staff engage withprisoners in this way and Schema-Focused TreatmentPlans are in situ for all prisoners in order to guide allstaff in their interactions with prisoners. Thus,interactions with staff upon the landing are consideredas necessary for change as the more formalpsychological interventions and prisoners are able toaccess a high level of support via access to operationalstaff. Attention is also given to the prisoner’semployment to ensure that their job is not maintainingtheir psychopathology. For instance, obsessivecompulsive prisoners are not provided withemployment as cleaners since this prevents them fromacquiring new ways to manage the emotions that theyavoid by cleaning.OutcomesAttendance at Therapy SessionsPeople with a diagnosis of personality disorder arenotoriously difficult to engage in therapy, particularly in anemotionally meaningful way. This is one of thecharacteristics that gave them the oft quoted label thatthey were ‘untreatable’. The prisoners who completedtreatment however were highly engaged in therapy andtheir attendance far exceeded what would be predictedfor this complex and damaged client group (Chart 6).Indeed many men had an attendance rate of over 95 percent in all interventions. These are not accreditedprogrammes, and there is an expectation but nocompulsion to attend the sessions. As is characteristic ofthis client group, some of the men withdrew for periods ofvarying length and then re-engaged. Such ruptures intherapy are predictable for this client group, and for mostmen necessary to establish genuine change. Part of thehigh attendance rate is attributable to the slow build-up ofthe therapeutic interventions. Experience indicates thattherapeutic engagement is facilitated by the establishmentof an appropriate individual therapeutic relationship andthe gradual introduction of therapeutic interventions to amaximum of five formal therapy sessions.Overview of Fens Unit Cognitive Interpersonal Treatment Programme0 - 6 6 - 12 12 - 18 18 - 24 24 - 30 30 - 36 36 - 42 42 - 48 48 - 54 54 - 60Months months months months months months months months months monthsINDIVIDUALTHERAPYINDIVIDUAL THERAPY(focuses on the developmental roots of the personality disorder)PDAwareness(0 - 3months)HumanRelationships(4 — 6months)GROUPWORKCOGNITIVE INTERPERSONAL GROUP THERAPY(addresses dysfunctional relationships)SCHEMA FOCUSED THERAPY GROUP(addresses thinking errors)AFFECT REGULATION GROUP(addresses emotionaldysregulation)OFFENCE FOCUSED THERAPY(summarises workon offending)ADDICTIVEBEHAVIOURS GROUPHEALTHY SEXUALRELATIONSHIPS50 Prison Service JournalIssue 192

CHART 6Average percentage attendance of prisoners at each of theformal Therapy Interventions100959085807570IndT CIGT SFTG ARTG OFTG ABTG HSRTGChange in BehaviourAlmost the men on the unit had problematicbehaviours in prison prior to coming into treatment.The interpersonal difficulties that these men had inthe outside world become more intensified within aprison environment. This can lead the men to at bestbecome belligerent and refuse orders and at worst beverbally and physically aggressive. Several of the menhad also previously taken hostages. The first cohort ofmen was a particularly difficult group, as they weresent as the unit opened. Almost all had been inrepeated or constant segregation for several yearsbefore coming onto the unit.Whilst being on the unit the interpersonalbehaviours of these men improved over time asrelationships developed and thus dynamic securityincreased. Also the approach to these men was verydifferent in that explicit communication was usedwith them by all staff with whom they had contact. 2The number of incidents per year that this group ofprisoners was responsible for perpetrating reduceddramatically. It has been argued that this dramaticreduction in number of adjudications can in part beaccounted for by a greater level of tolerance to verbalabuse. This is accepted; however, in many ways thegreater number of staff can lead to more incidents asofficers are constantly observing prisoners and willpick up on and challenge minor incidents that maynot be seen on other wings. On the unit, all refusalsto follow a direct order, serious verbal aggression andall physical acts of aggression, against others oragainst property are subject to adjudication.The figures available prior to coming onto theunit are almost certainly an underestimation due tounavailability of all records, whereas whilst on theunit every incident has been recorded. Nevertheless,even counting those incidents that were previouslyrecorded, it can be seen that that is a highlysignificant reduction in such incidents per year aftertransferring to the unit. Prior to coming on the unitthese prisoners were jointly responsible for anaverage of 18.4 aggressive incidents per year(considerable underestimation due to missing data).After coming onto the unit the same prisoners werejointly responsible for an average of 2.4 aggressiveincidents per year. This was calculated by summingthe average number of incidents per year across all 18prisoners both prior to and after coming onto theunit. This, of course, represents a significantreduction in both the costs of suffering, to officers,other prisoners and the prisoners themselves and alsoa large financial saving in terms of cost of staff timeof sick replacing property and compensation.2. Murphy N., & McVey, D (2010) Fundamental Treatment Strategies for Optimising Interventions With People with Personality Disorder inTreating Severe Personality Edited by Naomi Murphy & Des McVey. Routledge: London.Issue 192 Prison Service Journal51

CHART 7Comparison of the average number of aggressive incidents per yearprior to coming onto the unit with their time on the unit2018.415Average number ofincidents per year1052.40Prior to the Fens UnitWhilst on the Fens UnitReduction in Risk as Measured by Formal RiskMeasurement ToolsEffective risk assessment and risk management arecrucial to public protection and to the reduction ofharm to potential victims. It is also crucial for an servicesuch as the DSPD service that is accountable to thepublic, and exposed to legal liability and media scrutiny.The Violence Risk Scale 3 (Wong, S.C and Gorden,A.,1996) was designed to assess the risk of violentrecidivism for incarcerated offenders. It consists of 6static historical factors and 20 dynamic factors. Thedynamic factors can be used to measure changes in risklevel as a result of treatment. Dolan and Fulham (2007) 4researched the predictive validity of this tool. The resultsindicated that those with the lower scores on dynamicfactors were less likely to reoffend in the 12 monthspost-treatment. The findings for the 17 of the 18 menwho were assessed post treatment how that there wasa significant change in the scores(Chart 8).The Historical-Clinical-Risk Management-20 (HCR-20) 5 (Webster, Douglas, Eaves, and Hart, 1997), is aCHART 8Changes in VRS scores after Treatment(Lower scores showing Improvement)9876543210Pre-treatmentPost-treatment45-50 50-55 56-60 61-65 66-703. Wong, S.C & Gorden, A.,(1998-2003) Violence Risk Scale. Available from authors. Dept of Psychology. University of Saskatchewan,Canada. S7N 5A5 or at http://www.psynergy.ca4. Dolan, M. & Fullam, R. (2007). The validity of the Violence Risk Scale second edition (VRS-2) in a British forensic inpatient sample. TheJournal of Forensic Psychiatry and Psychology, 18, 381-393.5. Webster, C.D., Douglas, K.S. Eaves,D., & Hart, S.D (1997), HCR-20 Assessing Risk for Violence. Burnaby BC. Canada : Simon Fraser University.52 Prison Service JournalIssue 192

CHART 9Changes in HCR-20 Scores after Treatment(Lower scores showing Improvement)65Number ofPrisoners4321First HCR-20Last HCR-20017-19 20-22 23-25 26-28 27-29 32-34 >35Scoresviolence risk assessment scheme intended for use inforensic psychiatric, civil psychiatric, and prisoninstitutional and community settings. Its purpose is tostructure clinical decisions about the likelihood ofviolent behaviour. The HCR-20 provides significantlyimproved valid predictions over previous testingmethods. The HCR-20 is an example of a StructuredProfessional Judgment (SPJ) risk assessment instrument.Clinicians gathers qualitative information about theperson being assessed, guided by the HCR-20, and theresults are used to make treatment decisions. Whilst thehistorical factors cannot change, the clinical and riskfactors can change; the lower the score the lower therisk of violence. In a prospective study of 41 long-termsentenced offenders in two high-security prisons,Belfrage et al (2000) 6 found that the historical scale wasof little use for high-risk men, but that there was a highpredictive value for the clinical and risk managementscales. These two scales can provide more sensitivediscrimination for high-risk groups. Chart 9 indicatesthe change in HCR-20 scores over the period oftreatment on the unit of the 17 men that were able tobe assessed post treatment. All bar two men showedreduction in the clinical and risk scales on the HCR-20over the period of treatment.ProgressionAll men in the first cohort came to the unit fromdispersal prison or segregation. Of the 18 prisoners, 9were Cat A prisoners. Of those 9 men, 5 have beendecategorised, and another man had received localrecommendation for decategorisation and is awaitingthe decision of the Central Team. One man has goneto hospital for further treatment, one is waiting for aspecialist hospital place, and two will remain in thedispersal system. Six men have been moved to Cat Bestablishments and a further 5 are awaiting places atCat B prisoners. Two men are currently on medicalhold for physical health problems but they will beleaving the dispersal system. One man, who hadpreviously spent most of his sentence in segregationand who, just prior to coming onto the unit, could notbe unlocked without a Senior Officer and 6 officers,was discharged into the community at the end of hissentence where he has lived safely for more than 18months.Financial Saving By Treating These PrisonersMuch as been talked about the cost of a place ona DSPD unit. Prison DSPD places are far less costly thanhospital DSPD places but are also less costly thanplacing men regularly in segregation or in CloseSupervision Centres (CSCs) to which many of the menin this first cohort were destined had they not beenplaced on the unit. If these prisoners had not receivedtreatment the ongoing cost to the public would almostcertainly have included costs of replacing broken orburnt property, cost of staff time due to recovery frominjury and related stress, and cost of regularly movingthese prisoners as most prisons did not hold them forlong periods. Two of the group of 18 were on ‘laydown’.Although not a current prison practice, thesetwo Cat A men, prior to coming onto the unit, were6. Belfrage, H., Fransson, G., & Strand, S. (2000). Prediction of violence using the HCR-20: A prospective study in two maximum securitycorrectional institutions. The Journal of Forensic Psychiatry, 11, 167– 175.Issue 192 Prison Service Journal53

moved every month as they were too violent for anyprison to manage for a long period of time. This isextremely costly as any movement of a Cat A prisonerinvolves the use of a specialist van and a minimum of adriver and a relief and a Senior Officer and two otherofficers as escort. In some cases, it also requires policeescorts. Whilst on the unit, all the men in this cohort ofprisoners remained for the full period of theirtreatment. This in itself represents a considerable savingin the cost of moving such prisoners. Thus the estimatesshown below are a considerable underestimate of thesavings made by to the public finance by treating thesemen on the unit and by reducing their risk so that aftertreatment they can be held in lower levels of security.Approximate average Approximate average Approximate averagecost per place prior per place during per place afterto treatement treatment treatment£97,000 approx £92,000 approx £44,000 approxSummaryThis paper describes the first cohort of 18 menhave completed the treatment programme at TheFens Unit HMP Whitemoor and the outcome of thattherapy. These men that were previously considered‘untreatable’ and who regularly dropped out or gaveonly surface compliance to interventions had anextraordinarily high attendance in both individualtherapy and groups. There was considerable change inthe way that these men related to all staff on the unitand a highly significant reduction in the number ofaggressive incidents they perpetrated in custody.There was also a significant reduction in the dynamicfactors of formal risk assessment tools. Researchindicates that such a reduction is predictive of areduction in likelihood of reoffending. Some menhave changed sufficiently to be able to safely move onto prisons at lower levels of security; one man hasbeen living successfully in the community for morethan 18 months and others are now able to bedetained more safely in the dispersal system andengage in programmes from which they werepreviously excluded.Importantly, the quality of these men’s lives havebeen greatly improved — bringing to mind WinstonChurchill’s quote of exactly 100 years ago in 1910 whenhe said that the civilisation of a society can be judged bythe way it treats its prisoners. The treatment on TheFens Unit has brought to many of these extremelytroubled and troubling men, a far better quality of lifein that it has treated their psychological distress, whichpreviously they managed by self-medicating with drugsor equally addictive behaviours such as sexual abuseand violence. Although much has been written aboutthe financial cost of such a service, for those on TheFens Unit, despite the apparent high cost, the unitconstitutes a considerable saving when measuredagainst the cost to the public of keeping such prisonersin custody prior to being on the unit. Treatment alsoleads to a considerable financial saving in the cost ofkeeping these prisoners in custody after being on theunit and in the potential for safer rehabilitation andeventual discharge from custody.54 Prison Service JournalIssue 192

Prison staff occupational health and safetyand its relationship with inmate health:A reviewProfessor Michael W. Ross is based in the School of Public Health, University of Texas 1 .Introduction:Sharing Health Risks in PrisonPeople sharing an environment, even those withdifferent patterns of social structure andmovement, will also share many of the same healthand environmental risks. In a prison or jail context,therefore, there may be significant overlap in risks— and health protective factors — betweenprisoners and prison staff. In a close and closedcommunity, infectious diseases will spread withlittle distinction between the inmates and thecustodial staff. Further, where the environment isstressful, that stress will be manifested in both theinmates and the staff, and where it is unsafe, thelack of safety will extend to staff-prisoner as well asprisoner-prisoner interactions. In addition,environmental hazards will impact on both staffand inmates, whether through cold, heat, noise,poor ventilation, or environmental toxins such asasbestos or lead. Inmates and staff breathe thesame air, walk in the same buildings, touch thesame objects, and often suffer the same stresses ofthe psychological and physical environment.Sometimes they will eat food prepared in the samekitchens by the same staff or inmates. From aphysical and psychological health perspective, if aprison is an unhealthy environment for inmates, itwill also be unhealthy for staff. Thus, it makes nosense to consider the health needs of prisonerswithout realizing that in many instances, they areclosely connected with occupational health andsafety issues of prison staff, and vice-versa.Prison Staff as a Neglected Sector ofOccupational HealthIf prisoners can be considered a relativelyforgotten sector of the community, prison staff mightalso be considered a relatively neglected sector of theworkforce. The literature on the health andpsychosocial stressors of correctional staff is sparse,and staff in correctional institutions are oftenconsidered in conjunction with other peace officerssuch as police, although their duties and risks may varyconsiderably 2 . Part of this confusion may lie in the factthat in some occupational databases, no distinction ismade between police and correctional officers andthus occupational and lifestyle hazards in the twogroups cannot be separated. Further, as Jetté andSidney 3 observed, sometimes there is a traditionallyadversarial relationship between management andunions where there is a suspicion of any form oftesting of union members or their involvement inhealth-related or health-enhancement programs, and awariness that information collected might not be in thebest interests of their members. On the other hand,more recently other researchers have conducted largestudies in correctional systems with a high degree ofsupport and produced important findings that benefitboth management and staff 4 , 5 . All of these studieswere carried out in North America, although theyprobably generalize to other Western correctionalsettings.Long-term effects of Correctional System WorkOften, health issues of staff in the correctionalsystem focus on short-term risks to health such as traumaor infectious diseases. The long-term effects of working ina correctional setting should also be considered: however,such studies rely on following up large samples ofcorrectional staff over relatively long time periods, orlooking at measures or markers of morbidity incorrectional staff. Thus, they can be difficult andexpensive, or depend on the availability of large state ornational occupational data sets which distinguishcorrectional officers. When comparing mortality and1 . I thank Dr Amy Jo Harzke for her helpful comments on an earlier version of this paper.2. Hessl SM (2001). Police and corrections. Occupational Medicine 16(1):39-49.3. Jetté M, Sidney K (1991). The benefits and challenges of a fitness and lifestyle enhancement program for correctional officers. CanadianJournal of Public Health 82: 46-51.4. Armstrong GS, Griffin ML (2004). Does the job matter? Comparing correlates of stress among treatment and correctional staff in prisons.Journal of Criminal Justice 32:577-592.5. Alarid LF (2009). Risk factors for potential occupational exposure to HIV: A study of correctional officers. Journal of Criminal Justice37:114-122.Issue 192 Prison Service Journal55

morbidity by occupational category, Hessl 6 notes that lawenforcement personnel in the U.S. (police and correctionsofficers) have among the top ten proportional mortality(death) rates from ischemic heart disease (narrowing ofthe coronary arteries and decreased blood supply to theheart), with black officers having a significantly higherrates than white officers. Hessl 5 lists a number of healthrisks for correctional staff in the prison environment:Tuberculosis, blood-borne pathogens (hepatitis B and C,HIV) in injecting (or tattoo) equipment, lead and asbestosin old facilities, chemicals and solvents in prison industries,noise, heat and cold; the effect of shift work, includingdisordered sleep; trauma from violence; heightened riskof homicide or suicide; and particularly, stress, which canlead to gastrointestinal complaints, an increased risk ofheart disease, and alcohol abuse and subsequent cirrhosisof the liver.Impact of StressStress may be at the heart ofthe health issues confronting staffin prisons and other correctionalinstitutions. Because the health ofprison staff and inmates isintertwined, stressed prison staffmay produce stressed prisoners,and stressed prisoners producestressed prison staff. Therelationship can develop into avicious cycle. It is thus in theinterests of the health and safetyof all concerned that theinterdependence of prisoners andstaff in prison health — infectiousdisease, violence, environmentalhazards, and stress — are seen to interact in a relativelyclosed system. I use the term ‘relatively’ closed, becausenot only do prisoners get released, but prison staff returnto the community at the end of their shifts, where theeffects of disease and stress are transmitted to theirfamilies, with both immediate and long-termconsequences.Staff Stress and Prisoner Stress InteractThere are mutually dependent relationships betweenstaff stress and prisoner stress because both are caused byenvironmental conditions in the prison. Nurse, Woodcockand Ormsby 7 conducted focus groups of staff andprisoners separately at a medium-security prison inEngland and found that the key aspects of the prisonBecause the healthof prison staff andinmates isintertwined, stressedprison staff mayproduce stressedprisoners, andstressed prisonersproduce stressedprison staff.environment that affected prisoners’ mental health wereisolation and lack of mental stimulation, which in turnencouraged drug misuse as a means of escape and torelieve mental tedium. All the prisoner focus groupsemphasized the interactive nature of negative staffprisonerrelationships, where if an officer treated prisonersbadly, prisoners would make that officer’s life difficult,thus causing more stress for the officers. They also notedhow fewer staff increased the amount of time prisonersspent in cells, which made prisoners more difficult to dealwith, thus increasing stress levels of both staff andprisoners. Staff focus groups noted, in addition to thestress caused by increasing numbers of prisoners and itsresultant increase in tensions between staff and inmates,problems arising from management style — lack ofcommunication, insufficient information, and lack ofcontinuity of care with prisoners.Uniformed staff considered thatstress was the most importantissue affecting their health. Prisonhealth care staff were alsoconcerned about how other staffmembers would ‘offload theirstress on them’ (p482), as well assafety concerns about having tointerview prisoners on their own inpotentially unsafe situations. Theincreasing numbers of prisonerscontributed to staff stress becauseit decreased the possibility ofpositive interactions with prisonersand the chance of identifyingprisoners’ problems. One staffmember observed that ‘Only acouple of years ago there wasenough time for staff to talk oneon one with prisoners… you could identify prisoners whowere having problems’ (p482). Such commentsunderscore the often interactive nature of relationshipsbetween staff and prisoners and their strong potential forcontribution to stress in both groups.Nurse et al.’s 6 study found that stress differedbetween health care workers in prisons and uniformedofficers. In an insightful study of nurses in English prisons,Walsh 8 notes the cognitive dissonance often felt by nursesas a ‘care-custody conflict’ created by the clash of thephilosophies of caring and custody. This clash, arguesWalsh, arises largely because the prison setting has itsprimary focus on secure custody, while healthcare is oftenseen as secondary. In her study nurses working in prisonsconsidered their work to be ‘emotional labour’, due tothe continuous negotiation of the web of demanding6. Hessl SM (2001). See n.2.7. Nurse J, Woodcock P, Ormsby J (2003). Influence of environmental factors on mental health within prisons: focus group study. BritishMedical Journal 327:480-483.8. Walsh E (2009). The emotional labor of nurses working in Her Majesty’s Prison Service. Journal of Forensic Nursing 5:143-152.56 Prison Service JournalIssue 192

elationships that exist in prison healthcare settings. Suchdemands include ensuring that the prisoner feelsconfident in the nurse’s ability or the prison officer feelingthat the nurse understands the officer’s perspective, or theprison’s routine restricting the nurse’s ability to provideparticular or appropriate care. In Walsh’s study, nurses alsonoted stresses inherent in managing aggression andmanipulation, coping with prisoners whose offenses theyfound difficult to deal with emotionally, workingalongside colleagues whose practice was felt to besubstandard, and managing relationships with prisonofficer colleagues. Some described using detachment as away of avoiding sympathy, empathy and care forprisoners. These data suggest that conflicting professionalideologies, sometimes combined with a relative lack ofpower in the prison structure, maytake a higher toll in job-relatedstress on health care personnel inprisons.A second stress-producingaspect of the job for correctionsofficers is the need to deal withviolent and disruptive inmates 9 .Parker designed and evaluated atraining course for correctionalofficers in a ‘supermax’ facility(designed for violent or disruptiveinmates). The course was designedon the premise that correctionalstaff had received only minimalprior training for managing suchinmates, and for understandingmental health issues. The 10-hourcourse was designed and taughtby the National Alliance on MentalIllness especially for correctionalstaff and focused on the specificconditions that correctionalofficers faced. Compared with the nine months beforethe course, incidents of assault by bodily waste (the socalled‘prison officer cocktail’) on officers by inmates inthe unit after the course declined significantly to zero, andall incidents involving officers also significantly declined.Parker 8 suggests that this was as a result of trainingcorrectional officers to better understand and deal withmentally ill offenders, including talking with offenders ina therapeutic manner, and working as an integral part ofthe mental health diagnosis and treatment process. Thisnot only reduced violence against officers throughproviding officers with a better understanding of how toThe prison’s physicaland organizationalenvironment itselfmay account for aconsiderable amountof stress and poorhealth in workers inthe system — bothcorrectional officersand correctionalhealth andtreatment personnel.deal with the mentally disturbed, but also reduced thestress of working with difficult and potentially violentoffenders. Thus, some workplace stressors are open toreduction through appropriate training and interventionprograms. Further, Parker’s data also confirm the closeinteractions between the adequacy of officers’ trainingand prisoners’ behaviour in stressful situations.Organizational environment and StressThe prison’s physical and organizational environmentitself may account for a considerable amount of stress andpoor health in workers in the system — both correctionalofficers and correctional health and treatment personnel.In a landmark study of predictors of stress in bothcorrectional officers and treatmentpersonnel in the Arizona prisonsystem, Armstrong and Griffin 10found that correctional officersand prison treatment staff scoredsimilarly on measures of stress andon stress-related health problems(including headaches, fatigue, andstomach trouble). High workplacestress (disturbance of physiological,psychological or social functioningin response to a condition in thework environment which poses athreat to well-being or safety) isexperienced by large numbers ofcorrectional staff (39 per centaccording to Lindquist andWhitehead 11 in their 1986 study)and may be associated with acombination of factors such as thecorrectional environment itself andlow pay and lack of benefits. Oneof the results of these highstressors is high staff turnover rates, itself contributing tounderstaffing and lower levels of training. The interactionof stress, staffing levels and training levels can lead to avicious cycle of understaffing, stress, high turnover andlower levels of training and experience.One of the organizational factors that Armstrongand Griffin 12 suggest lead to stress is the shift in the UStoward viewing correctional institutions as primarilypunitive rather than rehabilitative. Shifts in institutionalpurpose can lead to a lack of clarity about role, jobobjectives, and responsibilities, lack of support fromsuperiors, and lack of consistency in instructions and9. Parker GF (2009). Impact of a mental health training course for correctional officers on a special housing unit. Psychiatric Services60:640-645.10. Armstrong GS, Griffin ML (2004). See n.4.11. Lindquist CA, Whitehead JT (1986). Burnout, job stress and job satisfaction among southern correctional officers: Perception and causalfactors. Journal of Offender Counseling, Services and Rehabilitation 10(4):5-26.12. Armstrong GS, Griffin ML (2004). See n.4.Issue 192 Prison Service Journal57

supervision. Lack of role clarity, where roles are perceiveddifferently by the staff and by management, may result instaff stress.Physical environmentPhysical environment also constitutes a health andsafety risk, with prison officers ranking second only topolice officers in the number of workplace non-fatalviolent incidents. Prison officers frequently perceive aconstant threat of danger from those they supervise, withthe suggestion that the threats are higher in maximumsecurityinstitutions. This is consistent with reports ofhigher rates of illness in prison officers in maximumsecurityprisons compared with minimum security ones 13 .However, the risk of physical danger is significantly higherfor prison officers than fortreatment staff, and so the findingof Armstrong and Griffin 14 thatthere were no differencesbetween the two groups in jobstress and stress-related healthconditions raises questions aboutthe specific weighting ofenvironmental stress on stress andhealth outcomes. They found thatthe strongest predictors of jobstress for custodial staff were roleproblems (conflict over differingand ambiguous job demands),while lack of intrinsic rewards, lackof co-worker support, lack oforganizational support, andenvironmental safety were othersignificant contributors. Fortreatment staff, the findings weresimilar. For stress-related health problems, role problemswere again strong predictors of physical symptoms, alongwith lack of organizational support. Interestingly, fortreatment personnel, and to a lesser extent prison officers,a second strong predictor of health problems was lack ofintrinsic rewards on the job, while environmental safetyalso acted as a predictor of health problems for prisonofficers. As might be anticipated, demographic variablessuch as being female, being younger and shorter durationof employment in the prison system were also associatedwith increases in stress and health problems. These data,which have the additional strength of being based on alarge sample of the total state correctional facility staff,confirm the anticipated linkages of stress and stressrelatedhealth problems, but point to management issuessuch as job role problems and lack of organizationalPhysicalenvironment alsoconstitutes a healthand safety risk, withprison officersranking second onlyto police officers inthe number ofworkplace non-fatalviolent incidents.support (and the presence or absence of intrinsic rewardsin the job) as being of equal or greater import thanenvironmental safety in predicting stress and stress-relatedhealth problems. The clear implication of these findings isthat management issues may be of equal or greatersignificance than anticipated prisoner violence in theproduction of stress-related illness such as headaches,fatigue and stomach upsets. Armstrong and Griffinconclude that apart from perceptions of personal safety,sources of stress (as well as protective factors againststress) were similar in both custodial and treatment staffgroups, with environmental factors having the strongestimpacts.Predictors of Workplace Stress and Poor HealthA study by Ogi ska-Bulik 15among uniformed personnel,including a large sample of prisonofficers, in Poland suggests that thepredictors of workplace stress havecommonalities in prison officersacross western cultures. Ogi ska-Bulik used measures of stressrelatedillnesses (somaticcomplaints, anxiety and insomnia,social functioning disorders, andsymptoms of depression). Thelowest level of stress, the highestdegree of a sense of socialcoherence, and the highest degreeof social support (along with thebest health status) was found inprison officers, in comparison withthe other uniformed servicemen(i.e. police, firefighters, securityguards, city guards). Ogi ska-Bulik also found, as didresearch in North America, that the best predictors ofhealth status were stress at work, and amount of socialsupport. Thus, high workplace stress is associated withpoorer health, and good social supports help to bothreduce stress at work and be associated with betterhealth. As in most other research on workplace stress,actual levels may depend on particular prisonorganizational and physical environments: thus, the levelof stress compared with other uniformed professions mayvary between and within countries.Blood-born DiseaseTaking an apparently very different health-relatedissue in prison staff, the risk of contracting blood-born13. Lindquist CA, Whitehead JT (1986) see n.11.14. Armstrong GS, Griffin ML (2004). See n.4.15. Ogisnka-Bulik N (2005). The role of personal and social resources in preventing adverse health outcomes in employees of uniformedprofessions. International Journal of Occupational Medicine and Environmental Health 18:233-240.58 Prison Service JournalIssue 192

infectious diseases such as HIV, the findings aresurprisingly similar in locating the problem in contextualfactors which in turn influence individual risks. Alarid 16carried out a study of nearly 200 correctional officers in aUS Midwestern state and found that it was institutionalvariables rather than individual behaviour that predictedexposure to HIV. It is important to note that HIV hereserves as an exemplar infectious disease, since it istransmitted through blood and other body fluids, as arehepatitis B and C, both of which are very prevalent inprison populations, both an order of magnitude moreinfectious than HIV, and both may have severe orpotentially fatal consequences. Alarid notes that prisonstaff are likely to be first responders to physicalaltercations, accidents, medical emergencies, andunpredictable and often hostile situations where sharpobjects and body fluids may present risks. In addition,prison staff may frequently come into contact withneedles discarded by inmates who don’t have access toneedle exchange or drug treatment, or from prisontattooing practices. Alarid notes that a number ofinstitutional variables are likely to increase risk, includinghigher prisoner security level units, afternoon and eveningshifts when there is more misconduct on the part ofprisoners, and length of time employed in the correctionalsystem.Alarid’s data confirm that institutional and contextualvariables (perhaps through their influence on individualrisk) are among the best predictors of occupationalexposure to blood-borne pathogens such as HIV. Thecustody level of inmates (a measure of the level ofviolence), length of employment (a measure of thecumulative level of exposure to risk situations), and rank(which reflects the risk of being called to medicalemergencies and altercations) all predicted level ofexposure to blood-born pathogens. Interestingly, in termsof the prisoner variables that impacted on the risk ofexposure for custodial staff, the sex of prisoners was nota significant risk, but prisoner behaviour (injecting druguse, tattooing, security level, and (for males) inmateinmatesex) all presented the greatest risk of HIV infectionand thus the greatest potential threat to prison staff.What is important to note in both Armstrong andGriffin’s 17 and Alarid’s work is that institutional andorganizational variables may be strongly associated withhealth status or risks in correctional settings. The risks ofcontracting infections such as HIV and hepatitis B and Care obviously dependent on the prevalence of theseconditions in the inmate population, but also oncontextual and institutional factors: the institutional-levelprobability of exposure events, such as needle sticks orother forms of exposure to inmate blood and other bodyfluids, and the individual-level probability of directexposure, given the individual’s role in the institution. Thehealth of prison staff, therefore, needs to be understoodnot only in terms of the immediate risk situation, but alsoin terms of the organizational and institutional factorsthat focus that risk, and may also create some of thestressors that are associated with longer-term chronicdisease in correctional staff.Inmate and Prison Staff Health InteractionsTaken together, these data suggest that there are anumber of significant relationships between the health ofinmates and of prison staff, and that prison environmentaland organizational issues may also play an important rolein the health of custodial staff, particularly over the longterm.Interestingly, the pattern also holds with blood-borninfectious diseases, suggesting that the concept of riskenvironments, as much as risk sources and behaviours,needs to be considered. In particular, the long-term healthconsequences of working in a custodial environment (andthe role of stress and environment) need to be betterstudied. However, any distinction between inmate healthand custodial staff health, either short-term or long-term,is likely to be arbitrary. For a number of important healthissues in custodial environments, there is little distinctionbetween inmate and free, and the concept of a healthyprison needs to embrace both inmate and staff health asintegral to one another.16. Alarid LF (2009). Risk factors for potential occupational exposure to HIV: A study of correctional officers. Journal of Criminal Justice37:114-122.17. Armstrong GS, Griffin ML (2004). See n.4.Issue 192 Prison Service Journal59

ReviewsBook ReviewThe Dynamics of Desistance:Charting Pathways throughchangeBy Deidre HealyPublisher: Willan Publishing (2010)ISBN: 978-1-84392-783-9(hardback)Price: £40.00 (hardback)The Dynamics of Desistance ispart of a series of publications beingled by Sheffield University’s StephenFarrall, examining issues connectedwith desistance and rehabilitation.The source material for the book isbased on a Phd study of 73 maleprobationers in Dublin, making thebook very much a genuine piece ofresearch rather than a referencebook. Potential readers may be putoff by the fact that this is, in effect,an international study, by a relativelyunknown academic but this wouldnot do the study or the authorjustice. This is a very well writtenpiece both in terms of its eruditereview of surrounding literature andthe learning and discussion thatHealy draws from her work. If youwant to find out about desistancetheory read the opening chapters; ifyou want to expand your knowledgein this rapidly developing area ofwork read the whole book.Desistance theory is nowstarting to emerge as a new methodof inquiry into the discovery ofreasons why offenders cease tocommit crime, and brings a newdimension to the current emphasison what has become the ‘whatworks paradigm’. The book usesphenomenological accounts of thepsychosocial processes involved indesistance from crime. The studygroup is tracked over a four yearperiod and research methods use indepth interviews with participantsand those working with them. Thisapproach compliments some of theearly work in this area by authorssuch as Shadd Maruna and FergusMcNeill.Healy uses a combination ofquantitative and qualitative methodsto explore and describe theattitudes, motivations andbehaviours of participants to trackthe transition to crime free life.Desistance theory breaks awayfrom the more traditional (and oftenblack and white) description ofchange that characterises the ‘whatworks’ approach, adding greaterdepth to our understanding ofemotional experiences andmotivation for change. Thisapproach allows us to put intocontext some of the ambiguitiesassociated with study in this area,including the transient or eventurbulent nature of giving up crime.I particularly enjoyed the sharpinsight that Healy has, the way thatshe attempts to reconcile competingapproaches and track the history andoften complex issues that arise indesistance theory. The book beginswith a very constructive and wellwritten overview of the currentliterature which is skilfully set incontext and sets the scene for somevery detailed enquiry into individualclient experiences. This narrativeapproach to studying behaviour andoutcomes, very much championedby Maruna in his now seminal pieceset in Liverpool, is to some extentchallenging what has become Anover simplified approach to servicedelivery for resettlement andrehabilitation of offenders builtaround what is commonly describedas the 7 pathways. Conventionalwisdom suggests that offenders willnot give up crime, or at least bevulnerable to re-offending, whilstthere are ‘unmet needs’ within oneor more of the pathways, not leastin terms of attitudes to crime.Desistance theory starts to broadenout this thinking by examining thereal experiences of offenders as theygive up crime, and often concludingthat Desisters will find their ownpath to crime free lives. This is not tosay that the core social issues such asaccess to secure housing, a source oflegitimate income and familysupport are not important, it is theway that these issues affect the livesof offenders is important, it is thisnarrative that desistance theoristsseek to draw out.Healy, in common with McNeiland champions of this newapproach suggest that we need tospend more time looking at socialengagement and develop greaterunderstanding of the concept of‘human capital’ and how it isexercised. New concepts emerge likethe extent to which ‘self belief’ and‘acceptance’ play a major part inreform. This approach helps to givealternative explanations of whysome approaches which do appearto deliver results may do so forentirely different reasons:Ian, who got out of prison earlyon review [early release], describedhis experience when he had to talkabout his offence in a group basedcognitive-behavioural programmefor the first time. For him, it was notjust a matter of dealing with hisfeelings about the offence, but alsothe acceptance he received fromboth staff and fellow participantsafter revealing his crime. (p. 141)Desistance theory placessignificant emphasis on ‘personalconnection’ and relationships,offenders become ‘ex-offenders’when they label themselvesdifferently. In this way Healy is ableto draw out how identity is oftenmore important than other factorswhich lead to being able to livecrime free.Because the study group areprobationers, she also provides anaccount of the relationship andissues that arise in relation tosupervision. She gives factors that60 Prison Service JournalIssue 192

indicate success and failure in thisrelationship; including those thatremained crime free because of theirfear of custody and those that saidthey returned to crime because ofthe failure of the system to providethe help they needed when theyneeded it.One interesting outcome to theresearch was an unusually longfollow up on re-offending usingcriminal office records. This followup produced surprising results. Only9.6 per cent of the study groupreceived their first new convictionwithin the first year, however thisrose to about one third by year twoand continued to rise to 65.8 percent by the end of 4 years. Thischallenges the conventialassumptions around both rates of reoffendingand desistance. In thissample group it took an average oftwo years to first conviction (forthose that offended) or three yearsof being crime free for the group asa whole. Other studies have shownthat the highest rates of recidivismoccur immediately (i.e. within thefirst 6 months following probationorders). Healy speculates that thismay be as a result of a suddenchange in the economic climate inIreland, although this may equallyraise issues about a relativelyuncharted area of relapse andtemporary desistance. However theauthor then went on to examine thenature of the re-offending to findthat this was composed of relativelyminor offences compared with theindex offence, suggesting that a shifthad in fact taken place that washidden by the fact that reconvictionrates account for all crime and makeno distinction for seriousness.Desistance theory uses this typeof information to add greater depthto the understanding, separatingprimary desistance who are on thepath to true desistance, fromsecondary desisters who we’reexperiencing a lull in offending.Another area which wasstriking was the finding that therewas no significant relationshipbetween criminal cognitions andoffending behaviour, also picked upby other authors and thuschallenging our obsession withtackling criminal thinking throughcognitive based programmes. Againshe found that it was not thatcriminal thinking was not importantbut the style of thinking. Desistersare more likely to externalise blameand not take responsibility as thisenables them to maintain a positiveself image, whereas persisters weremore likely to blame external factorsand personal circumstancesincluding the victim for their crimeand lack of availability of personalresources.Overall the book was wellwritten, accessible and shouldcertainly be of interest topractitioners and students alike.Steve Hall is a prison managercurrently working for SERCO.Book ReviewRelease from Prison. Europeanpolicy and practiceEdited by Nicola Padfield, Dirk vanZyl Smith and Frieder Dunkel.Publisher: Willan Publishing (2010)ISBN: 978-1-84392-741-9(hardback)Price: £55.00 (hardback)Parole and the opportunity tobe released from prison is animportant aspect for the vastmajority of prisoners incarceratedthroughout Europe; with differentcountries having different legalsystems and thus rules. Despite thisvariation there has been littlecomparative research published onthe rules of release across Europe.‘Release from Prison. Europeanpolicy and practice’ is therefore amuch needed encyclopaedia on therules of release of sentencedprisoners across 13 different EUCountries. The rationale for thebook is therefore to fill this gap inthe literature and in addition to lookat other surrounding key themesand issues.To put the anthology incontext, the book opens with anintroductory chapter which setsout layout and contents; but moreimportantly is chapter two, whichexplains the European dimensionto the release of sentencedprisoners. Looking at institutionssuch as the Council of Europe andthe Committee for the Preventionof Torture, in addition tojudgments of the European Courtof Human Rights and Council ofEurope Conventions 1 , chapter twoexplains why we now need to lookat parole from a Europeanperspective. Not only do allprisoners under the EuropeanConvention on Human Rights(Article 5.1) have the right to bereleased at the appropriate time,there is also the more complicatedsituation where a prisoner in oneEuropean Country is required orrequests to serve his sentence inanother European Country.Bearing in mind, the hugevariance between some countries,when such circumstances arise,under which rules of releaseshould the prisoner be subject?Brussels has issued a number ofFramework Directives to try andaddress such issues, with some ofthese affecting parole and release.Of greatest importance is CouncilFramework Decision of November2008, which looks at: ‘mutualrecognition to judgments incriminal matters imposingcustodial sentences or measuresinvolving deprivation of liberty forthe purpose of their enforcementin the European Union’. In1. These include the European Convention on the Supervision of Conditionally Sentenced or Conditionally Released Offenders; theEuropean Convention on the International Validity of Criminal Judgments; and, the Convention on the Transfer of Sentenced Persons.Issue 192 Prison Service Journal61

essence, parole and release can nolonger be assessed in just a UKcontext.The following 13 chapterstherefore provide an invaluablesurvey of the situation regardingthe rules of release for a number ofEuropean countries. The countriesincluded in this analysis are: Austria,Belgium, England and Wales,Finland, France, Germany, Greece,Ireland, Italy, The Netherlands,Scotland, Slovenia and Spain. Eachchapter therefore provides asummary of the current law,historical influences and anevaluation of existing research andstatistical data; all written byleading academics andcommentators.Finally, in part three, is aconcluding chapter which not onlytries to bring everything togetherbut also, additionally, includesinformation from other countriesnot listed above. In easy to readtabular form, early release fromdeterminate sentences ofimprisonment is catalogued andcompared; with additions includingCroatia, Czech Republic, Denmark,Estonia, Hungary, Lithuania, Poland,Romania, Russia, Sweden andSwitzerland. This brings the totalanalysis to 24 European Countries.The final chapter also considers theextent to which a ‘coherent and fairpolicy on release from prison isdeveloping within the EU’ andanalyses the challenges to thisendeavour.Release from Prison. Europeanpolicy and practice is therefore amuch needed and importantaddition to the literature on paroleand release. Not only does it havean impressive array of contributorsit is on its own in respect of thebreadth and depth of subjectmatter it offers. If you are interestedin comparative research in this area,this is a definite ‘must have’.Dr. Karen Harrison is a Lecturer inLaw at the University of Hull.Book ReviewManaging High-Risk SexOffenders in the CommunityEdited by Karen HarrisonPublisher: Willan PublishingISBN: 978-1-84392-526-2(paperback) 978-1-84392-525-5(hardback)Price: £26.00 (paperback) £62.00(hardback)For somebody who hasworked with sex offenders for over15 years, this book brought hometo me the considerabledevelopments we haveexperienced within that period interms of our working practiceswith this group of offenders. Withan aim to identify methods forpreventing further sexualvictimisation, the editor KarenHudson who lectures in Law at HullUniversity has managed toassemble a wide range of writingsfrom experts within their fields thatboth chart this development andreview most if not all of themeasures that are now available totreat and manage sex offenders inthe community, particularly thosethat present a high level of risk.The cover note describes thisbook as essential reading for policymakers, professionals working inthe field of sexual abuse andinterested academics. However forthe wider audience it struck mehow valuable some of themessages were in terms of theirpotential for providing aninformed view of what works inthe management of sex offendersand a possible antidote to themoral panic that the popular pressseems to be able to generatearound this subject, a theme whichits contributors regularly commentupon throughout this book.Assembled within five distinctsections the reader is firstintroduced to a discussion on‘paedophilia’ and the differencesin the definition of the term,before moving onto consider froma NOMS perspective, under theguidance of Ruth Mann and MarkFarmer the policy issues facingthose within offendermanagement who deal with thisgroup of offenders.Risk Management measuresand their effectiveness, suchas MAPPA proceduresand Registration/Notificationrequirements are reviewed in thesecond section, before section threeintroduces the reader to the mainprovisions for treatment and riskreduction, including treatmentprogrammes, pharmacotherapy(drug and medical basedinterventions) and finally restorativejustice initiatives such as Circles ofSupport and Accountability.The fourth section of the bookreminds us that sex offenders arenot a homogenous group andprovides some detailed writings inspecific areas. The opening chapterby Franca Cortini focuses onfemale sex offenders and the needfor a better understanding of theirrisk assessment, management andtreatment needs. Sexually abusivebehaviour by youths mentallydisordered and intellectuallydisabled individuals are also putunder the spotlight in subsequentchapters with interesting practiceperspective being provided fromplaces such as the Netherlands andUSA to name just a few.The concluding sectionreviews the emergence of on-lineoffending by examining patterns,prevention and protection, beforeKeiran McCartan then leads thereader through a discussion on themedia and the way it has shapedattitudes opinion and ultimatelyGovernment strategy. Finally andmost appropriately the last chapteraddresses the premise that therights of the individual sexoffender we work with must bebalanced against the need forcommunity protection.Managing High Risk SexOffenders in the Community isboth informing and balanced in itspresentation of the methods we62 Prison Service JournalIssue 192

deploy with sex offenders, and willbecome part of my recommendedreading list for those consideringentering this field of work.Phil Jarvis is Sex OffenderProgramme Manager forHertfordshire, Bedfordshire,Cambridgeshire and PeterboroughProbation Trusts.Book ReviewSex offenders and preventativedetention: Politics, policy andpracticeBy Bernadette McSherry andPatrick KeyzerPublisher: Federation press (2009)ISBN: 978-1-8628-7763-4(paperback)Price: £24.99 (paperback)This concise book compareslaws enacted in Australia, the UnitedStates of America and in Scotland tomanage high risk sex offenders. Thebook is authored by two AustralianLaw professors who specialise insocial and public policy. Despite itsshort length, this book manages topack a significant punch.The book opens by illustratinghow signal cases in each of the threecountries led to calls for theintroduction of new measures tomanage the risk presented by serioussex offenders. In the American andAustralian cases, the legislationallowed for indefinite detention to beordered post-sentence whilst inScotland the new orders were forlifelong supervision in the communityfollowing release and this wasimposed at the time of the originalsentence.The second chapter discussesthe practice of risk assessment. Thediscussion shows how a range offactors and different approaches canbe used in order to assess thelikelihood of an individualcommitting a serious offence in thefuture, however this also exposes thelimitations of the techniques whichare far from infallible. The authorstake this discussion further: theyexplore the ethical choices faced byprofessionals carrying out riskassessments in these circumstances;and how such decisions areessentially political rather than clinicalas they enact coercive state directedaction against identified groups.The third and fourth chaptersprovide a detailed examination of,respectively, the policy and practicalissues raised by the three differentschemes. This includes the humanrights risks posed by the differentapproaches, their effectiveness andtheir organisational efficiency. Thebook draws together these threadsand concludes that the Scottishpolicy provides the more positiveapproach. The authors argue thatthis is better in human rights termsbecause it takes place at the time ofsentencing and involves appropriateprofessional input. They alsoconclude that it is better organisedand has a more therapeuticapproach, attempting to reintegrateand support those who present a riskto live safely in the community aftertheir sentence.Discussing the management ofsex offenders is always intenselyemotive and for many, this provides abenchmark for the kind of criminaljustice system that should exist in acountry. As the authors of this bookpoint out, what might start as an‘exceptional’ measure quicklybecomes the norm and sets the tonefor the system as a whole. Given thechallenges of discussing themanagement of high risk sexoffenders, this book makes animportant contribution by conciselyand rationally evaluating differentinternational approaches to thisproblem.Jamie Bennett is Governor of HMPMorton Hall.Book ReviewAnti-social behaviour orders: Aculture of control?By Jane DonoghuePublisher: Palgrave Macmillan (2010)ISBN: 978-0-230-59444-9 (hardback)Price: £50.00 (hardback)Anti-social behaviour orderswere one of the flagship New Labourpolicies, providing a means throughwhich courts could issue ordersrequiring individuals to desist fromanti-social, but not necessarily criminalbehaviour. Although there has beennegative media coverage of someextreme examples of how the ordershave been used and the academiccommunity has been generallyhostile, the orders have met withpopular public approval. In this bookJane Donoghue, a lecturer in law atthe University of Reading reports thefindings of a study based on surveysand interviews with local authorityofficials and judges involved in antisocialbehaviour cases. Her essentialcase is that she sets herself apart fromthe majority of the academiccommunity and presents a positiveargument in support of the use ofASBOs.The book starts from the premisethat most academic criticism hasdescribed ASBOs as part of whatDavid Garland has described as a‘culture of control’ 1 , in other wordspunitive strategies, dominationstrategies and techniques ofsurveillance have been increasinglyused to replace more liberal welfareapproaches to crime and deviancethat sought to address the underlyingsocial problems. Donoghuechallenges this perception and arguesthat those at the margins of societyare not only those most likely toreceive ASBOs but are also those mostlikely to suffer the effects of anti-socialbehaviour. She therefore makes thecase that this is an approach that canbenefit the marginalised and sociallyexcluded and can form part of astrategy to address the underlying1. Garland, D. (2001) The culture of control: Crime and social order in contemporary society Oxford: Oxford University Press.Issue 192 Prison Service Journal63

social problems. She argues that thecriticisms of ASBOs are individuallyfocussed and do not take account ofthe wider benefits, including those forthe victims of anti-social behaviour.She also ties this view in to recentdiscussions which have sought to linkrights with responsibilities and moveaway from individual rights towards amore collective perspective.This work is perhaps best viewedas an important corrective to thedominant academic debate on ASBOsand an intellectual justification of theNew Labour policy. Given themethodology, focussing on thepowerful figures involved inmanaging the policy, it is perhaps notsurprising that such complimentaryconclusions have been drawn. It doesraise the question of whether a studybased in communities where ASBOsare used may have led to morenuanced and challenging conclusions.There are also several importantareas that are left unexplored in thisstudy. For example, the✄appropriateness of the use of ASBOscould be further questioned. There isa concern, revealed in the media andacademic coverage, about how theintroduction of this measure has ledto the labelling of the behaviour ofcertain groups such as young peopleand a reduction in tolerance.Although in this book the judges andmagistrates interviewed suggestedthat their role is to act as a bufferagainst this the reality exposed is thatthey seem to exercise a light touchwith 97 per cent of applications forASBOs being upheld. In addition, theuse of criminal justice measures todeal with the social problems ofmarginalised and excludedcommunities has been widelycriticised. In part because this divertsresources away from dealing withthose issues and in such straightenedfinancial times this does raisequestions about what is the best useof resources. Would it, for example,be better to use the money spent onASBOs, or at least a proportion of it,improving services such as education,health and youth facilities in thosecommunities? This is the centralargument of those who supportJustice Reinvestment strategies 2 . Thereis also a concern about how the highprofile use of such measures creates awider perception about poorercommunities. It deflects attentionfrom concern over issues such asinequality and poverty, but insteadcreates an image of a feral populationundeserving of welfare support, andso undermines and reduces supportfor attempts to address the underlyingcauses of social exclusion 3 .Overall, this book is of value inproviding a corrective and anintellectual articulation of the officialcase for ASBOs however the gaps inthe coverage mean that it cannot beconsidered a definitive examination ofanti-social behaviour policy.Jamie Bennett is Governor of HMPMorton Hall.PUBLICATIONSBookson SpecialOffer!The Prison Governor: Theory and Practice by Shane Bryans and David WilsonDescribes in one closely argued book, the history of imprisonment, the management ofprison staff, the understanding of prisoners, the developing role of the Governor andsome well governed prisons.Order Form (Please photocopy this page) Copies TotalThe Prison Governor£4 for prison staff .....................£5 for non Prison Service staffInclude £3.00 p+p per book Cheque Value ....................Enclose a cheque made out to ‘HM Prison Service’ and send to:Prison Service Journal, c/o Print Shop Manager, HMP Leyhill, Wotton-under-Edge,Gloucestershire, GL12 8BT. Tel: 01454 264007Name........................................................................ Address ........................................................................................................................................................................................................................................................................................................ Signature ..........................................................2. Allen, R. and Stern, V. (eds) (2007) Justice reinvestment – A new approach to crime and justice London: International Centre for Prison Studies.3. Bennett, J. (2008) The social costs of denagerousness: Prisons and the dangerous classes London: Centre for crime and justice studies.64 Prison Service JournalIssue 192

Purpose and editorial arrangementsThe Prison Service Journal is a peer reviewed journal published by HM Prison Service of England and Wales.Its purpose is to promote discussion on issues related to the work of the Prison Service, the wider criminal justicesystem and associated fields. It aims to present reliable information and a range of views about these issues.The editor is responsible for the style and content of each edition, and for managing production and theJournal’s budget. The editor is supported by an editorial board — a body of volunteers all of whom have workedfor the Prison Service in various capacities. The editorial board considers all articles submitted and decides the outlineand composition of each edition, although the editor retains an over-riding discretion in deciding which articlesare published and their precise length and language.From May 2005 selected articles from each edition are available in the Resource Centre of the HMPrison Service website. This is available at www.hmprisonservice.gov.ukCirculation of editions and submission of articlesSix editions of the Journal, printed at HMP Leyhill, are published each year with a circulation of approximately6,500 per edition. The editor welcomes articles which should be up to c.4,000 words and submitted by email topsjournal@hotmail.com or as hard copy and on disk to Prison Service Journal, c/o Print Shop Manager, HMPLeyhill, Wotton-under-Edge, Gloucestershire, GL12 8HL. All other correspondence may also be sent to the Editorat this address or to psjournal@hotmail.com.Footnotes are preferred to endnotes, which must be kept to a minimum. All articles are subject to peerreview and may be altered in accordance with house style. No payments are made for articles.SubscriptionsThe Journal is distributed to every Prison Service establishment in England and Wales. Individual members ofstaff need not subscribe and can obtain free copies from their establishment. Subscriptions are invited from otherindividuals and bodies outside the Prison Service at the following rates, which include postage:United Kingdomsingle copy £5.00one year’s subscription £25.00 (organisations or individuals in their professional capacity)£18.00 (private individuals)Overseassingle copy £7.00one year’s subscription £35.00 (organisations or individuals in their professional capacity)£25.00 (private individuals)Orders for subscriptions (and back copies which are charged at the single copy rate) should be sent with acheque made payable to ‘HM Prison Service’ to Prison Service Journal, c/o Print Shop Manager, HMP Leyhill,Wotton-under-Edge, Gloucestershire, GL12 8BT.Issue 192Prison Service Journal

PRISON SERVICEJOURNALThis edition includes:Drug mules in the international cocaine trade:diversity and relative deprivationDr. Jennifer FleetwoodPerrie Lectures 2010Why Our Beliefs Matter in Offender ManagementProfessor Shadd MarunaThe ‘Rehabilitation Revolution’Trevor WilliamsManaging offenders through Probation ServicesBeverley ThompsonInterview: Stephen ShawMartin Kettle