DD310
EMA
A proposal therapeutic work with women offenders: Produce a report
Write a report that evaluates the specific challenges and issues that might be faced by a
prison planning to implement a therapeutic service. Your report should be suitable for non-
academic audience.
Introduction
The governor of a local women’s prison wants to establish a therapeutic service to offer
women prisoners, many of whom are victims of sexual and domestic abuse and have been
convicted several times for various crimes.
Therapeutic approaches and their application in the work with women offenders
Cognitive Behavioural Therapy (CBT) is a talking therapy aimed to help people experiencing
a wide range of mental health difficulties (BABCP, 2012, cited in Hails, 2012, p. 162) by
challenging maladaptive thoughts and equipping them with helpful techniques to manage
difficult feelings differently (Bruce, 2017).
Core to CBT formulation is the ‘five areas model’ (Williams 2003, cited in The Open
University, 2018, wk 19 sec 2,1) which analyses how a client’s distress impacts their
thoughts, feelings, behaviour and body (see fig 1). Another key feature is the ‘cognitive
model’ intervention which helps clients to change the meanings that they give to their
thoughts and behaviours because often, this results in and fuels the maintenance cycle of
the distress they experience (see fig 2) (The Open University, 2018, wk 19 sec 2.2).
Fig 1: A ‘five areas model’ or ‘hot cross bun’ (The Open University, 2018, wk 19 sec 2,1)
, DD310
EMA
Fig 2: ‘Vicious flower’ cycles (Salkovskis, cited in OCD UK, 2017, cited in The Open
University, 2018, wk 19, sec 2.2)
In CBT, the client and therapists work collaboratively using ‘the courtroom technique’ and
‘behavioural experiments’ to implement desired changes ‘(The Open University, 2018, wk
19, sec. 3; The Open University, 2018, wk 19, sec. 3.1). The ‘courtroom technique’
challenges a client’s maladaptive thoughts by asking the client to provide evidence for and
against such beliefs with the aim of making the client aware of the facts about a situation that
proposes an alternative understanding opposed to their initial negative belief (The Open
University, 2018, wk 19, sec. 3). After this, the client can then rate and observe the changes
in their current beliefs and accompanying emotions (The Open University, 2018, wk 19, sec.
3). It is possible that the women offenders may particularly resonate with this technique
given their direct experience with real courtrooms (The Open University, 2018, wk 19, sec.
3), and perhaps a more influential intervention.
Moreover, CBT delivered in form of group programmes including Aggression Replacement
Training, Reasoning and Rehabilitation, and Relapse Prevention Therapy (Bruce, 2017, p.
209) in forensic settings have shown efficacy in reducing recidivism and improving offenders’
moral reasoning, cognitive style, behavioural inhibition and self-esteem (Landenberger and
Lipsey, 2005, cited in Bruce, 2017, p. 209). However, research suggests that some
offenders are likely to use several styles of cognitive distortions (e.g. excuses - ‘it was a
complete accident’; denial of responsibility - ‘I had no choice, they made me do it’) to reduce
guilt, accountability and disapproval from others (Sykes and Matza, 1957, cited in Bruce,
2017, p. 218), and thus might affect how some of the women offenders engage with therapy,
consequently impacting the therapeutic outcome.
In contrast, systemic therapy shares an interpersonal understanding that distress and mental
health problems are shaped and connected to the relationships, interactions and language
created within a person’s social systems (family, friends, employment etc.) and wider
contexts (e.g. community, cultural and religious context) (Vossler et al., 2017). As a result,
systemic interventions are designed to target all members of the system to facilitate change
(Vossler et al., 2017). For example, using social constructionist and narrative ideas (White
and Epson, 1990, cited in Vossler et al., 233 - the unique and personal view each individual
has of the world; Vossler et al., 2017, p. 228), unhelpful dominant discourses (language)
relating to ‘mad’ or ‘bad’ labels within the women offenders’ system can be deconstructed
through alternative (less problem-saturated) descriptions of the women's’ identity presented
by the family, which can influence recovery and opportunities for the women offenders to
change their criminal behaviour (Vossler et al., 2017, p. 233).
EMA
A proposal therapeutic work with women offenders: Produce a report
Write a report that evaluates the specific challenges and issues that might be faced by a
prison planning to implement a therapeutic service. Your report should be suitable for non-
academic audience.
Introduction
The governor of a local women’s prison wants to establish a therapeutic service to offer
women prisoners, many of whom are victims of sexual and domestic abuse and have been
convicted several times for various crimes.
Therapeutic approaches and their application in the work with women offenders
Cognitive Behavioural Therapy (CBT) is a talking therapy aimed to help people experiencing
a wide range of mental health difficulties (BABCP, 2012, cited in Hails, 2012, p. 162) by
challenging maladaptive thoughts and equipping them with helpful techniques to manage
difficult feelings differently (Bruce, 2017).
Core to CBT formulation is the ‘five areas model’ (Williams 2003, cited in The Open
University, 2018, wk 19 sec 2,1) which analyses how a client’s distress impacts their
thoughts, feelings, behaviour and body (see fig 1). Another key feature is the ‘cognitive
model’ intervention which helps clients to change the meanings that they give to their
thoughts and behaviours because often, this results in and fuels the maintenance cycle of
the distress they experience (see fig 2) (The Open University, 2018, wk 19 sec 2.2).
Fig 1: A ‘five areas model’ or ‘hot cross bun’ (The Open University, 2018, wk 19 sec 2,1)
, DD310
EMA
Fig 2: ‘Vicious flower’ cycles (Salkovskis, cited in OCD UK, 2017, cited in The Open
University, 2018, wk 19, sec 2.2)
In CBT, the client and therapists work collaboratively using ‘the courtroom technique’ and
‘behavioural experiments’ to implement desired changes ‘(The Open University, 2018, wk
19, sec. 3; The Open University, 2018, wk 19, sec. 3.1). The ‘courtroom technique’
challenges a client’s maladaptive thoughts by asking the client to provide evidence for and
against such beliefs with the aim of making the client aware of the facts about a situation that
proposes an alternative understanding opposed to their initial negative belief (The Open
University, 2018, wk 19, sec. 3). After this, the client can then rate and observe the changes
in their current beliefs and accompanying emotions (The Open University, 2018, wk 19, sec.
3). It is possible that the women offenders may particularly resonate with this technique
given their direct experience with real courtrooms (The Open University, 2018, wk 19, sec.
3), and perhaps a more influential intervention.
Moreover, CBT delivered in form of group programmes including Aggression Replacement
Training, Reasoning and Rehabilitation, and Relapse Prevention Therapy (Bruce, 2017, p.
209) in forensic settings have shown efficacy in reducing recidivism and improving offenders’
moral reasoning, cognitive style, behavioural inhibition and self-esteem (Landenberger and
Lipsey, 2005, cited in Bruce, 2017, p. 209). However, research suggests that some
offenders are likely to use several styles of cognitive distortions (e.g. excuses - ‘it was a
complete accident’; denial of responsibility - ‘I had no choice, they made me do it’) to reduce
guilt, accountability and disapproval from others (Sykes and Matza, 1957, cited in Bruce,
2017, p. 218), and thus might affect how some of the women offenders engage with therapy,
consequently impacting the therapeutic outcome.
In contrast, systemic therapy shares an interpersonal understanding that distress and mental
health problems are shaped and connected to the relationships, interactions and language
created within a person’s social systems (family, friends, employment etc.) and wider
contexts (e.g. community, cultural and religious context) (Vossler et al., 2017). As a result,
systemic interventions are designed to target all members of the system to facilitate change
(Vossler et al., 2017). For example, using social constructionist and narrative ideas (White
and Epson, 1990, cited in Vossler et al., 233 - the unique and personal view each individual
has of the world; Vossler et al., 2017, p. 228), unhelpful dominant discourses (language)
relating to ‘mad’ or ‘bad’ labels within the women offenders’ system can be deconstructed
through alternative (less problem-saturated) descriptions of the women's’ identity presented
by the family, which can influence recovery and opportunities for the women offenders to
change their criminal behaviour (Vossler et al., 2017, p. 233).
