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Brennan, , applying these standards equally to medical and mental-health conditions [see, for example, Newman v.

Jason Matejkowski, Toni Johnson, and Margaret E. Severson

Alabama and Bowring v. In one early and widely cited prison case, the Federal Court in Ruiz v. Estelle laid out six requirements for a minimally constitutionally adequate mental-health program in the Texas prison system.

Prison Social Work

Still cited for these substantive ideas in the early 21st century, the requirements include providing initial intake screening and assessments, treatment programs, mental-health professionals in numbers and with the experience to provide necessary services, the maintenance of complete and accurate records, supervision over the administration of medication and ongoing evaluation of its allocation, and a program for identifying and interdicting in suicide crises.

Collins has since distilled these mandates down to three maxims: These maxims serve as a call to action for social-work services and interventions. At the end of the 20th century, the courts were active in numerous California prison actions that involve the care of prisoners. In Madrid , special focus was placed on persons with mental illness whose symptoms were exacerbated by solitary confinement and also on persons held in solitary confinement who developed severe mental symptoms, likely as a result of this confinement.

More recently, two important California cases highlight overcrowding as the catalyst behind serious constitutional violations involving prisoners with mental disorders Coleman v. Brown, and prisoners with serious medical conditions Plata v. In both cases, remedial orders and agreements to increase the size and capabilities of mental health and medical staff ensued, but after years of struggle to finance an enhanced health-care system that meets constitutional muster, the respective judges in Coleman and Plata separately asked for a three-judge court to review the cases and order the release of prisoners.

In fact, the three-judge court, after reviewing considerable testimony and evidence, ordered a reduction of the prison population to This decision was upheld in the U. Supreme Court in see Brown v. Why is knowledge of this legal context important for social workers? The prisoner is at the mercy of the state for his or her physical and mental well-being. She cannot seek services in the open marketplace, nor, in her quest to improve her lot, can she simply remove herself from the environment that has deleterious effects.

Although a prisoner has an established right to some modicum of health and mental-health care so as not to be left worse off than when he or she arrived at the prison gate, the average person in the community has no such constitutional right to free health and mental-health services. The EMTALA mandates that persons be assessed and, if needed, treated for emergencies in hospital emergency rooms, but there, the patient is free to leave without accepting any or all of the care recommended, the hospital is free to charge the patient its going rates for the care it provides, and all providers are free to pursue payment for services rendered.

By contrast, prisoners are not free to seek treatment elsewhere and must rely on the prison staff, including social workers, to provide a constitutionally adequate level of intervention. In the end, custody of the prisoner and the control over his or her access to care translates into a need for competent, diligent, and compassionate responses of the social worker and every other health or mental health-care provider. Social-work services have been offered in prisons for nearly a century and were advanced by the advocacy efforts of Kenneth Pray, the former dean of the University of Pennsylvania School of Social Work now the School of Social Policy and Practice.

However, the explosion in the prison population experienced since the s, along with the federal court actions described above, has created an ever-expanding need for the unique set of professional skills that social workers bring to correctional institutions. Social workers in criminal justice settings often assess new arrivals to the prison, develop treatment and support plans for inmates, provide individual therapy and psychosocial educational support groups, provide referrals to medical or mental-health services, and monitor the progress and compliance of inmates in treatment.

In many prison systems, the initial assessment of the inmate involves a battery of psychological tests and interviews with social workers and other treatment professionals to determine the presence of acute psychosis, anxiety, depression, suicide ideation and chronic conditions severe and persistent mental illness, history and current manifestations of trauma and substance abuse. The latter is no small task: Based on the assessment data, intervention and treatment plans are developed, taking into consideration the unique needs of the inmate; these may include a combination of individual counseling, involvement in a specialized treatment group, and case management services.

A growing body of research indicates that strengths-based case management is an effective response to inmates in need of skills in daily living or those who struggle with alcohol and drug addiction or with serious physical or mental-health issues Bauserman et al. Hess, Vanderplasschen, Rapp, Broekaert, and Fridell looked at the relevant body of research from 15 randomized studies of case management for persons with substance-abuse disorders and found a moderate effect size in the effectiveness of case management in linking clients with treatment and other services.

Although a smaller effect was detected, Hess and colleagues also found that case management services had a positive impact on long-term drug use and may have contributed to a reduction in criminal behavior. Social workers in prison frequently face uncommon ethical challenges and value dilemmas. Prisons are no longer associated with rehabilitation but instead focus on punishment and control Gibelman, Competent performance of the social-work activities enumerated above is complicated by the growing number of inmates who present with special needs.


In an industry often defined by crises, there are certain clear, demanding, and unique challenges in the prison environment that would benefit from social-work expertise. In this section, a few of those problems are highlighted, chosen because of their significant systems impact and the enormous implications they have for the health of future generations. The United States is the world leader in per-capita rate of incarceration Walmsley, , but it remains a fact in obscurity that the United States also leads the world in the per-capita number of women incarcerated.

Common to incarcerated women are their histories of child and adulthood emotional, physical, and sexual abuse, a phenomenon reported by many researchers over the past 10—20 years. Many of these women, approximately two thirds of those in prison, were sentenced for drug or property crimes and some experts suggest that these crimes are economic crimes—committed in the effort to support families or, unfortunately, to support drug addictions.

The danger, of course, is in the social worker becoming caught up in the pathologized portraits of these women. Although interventions focused on resolving the consequences of exposure to traumatic events are important for prison-based social work, an understanding of the system forces that place a woman at higher risk for traumatic injuries through the experiences of intimate partner violence, poverty, and drug possession and use is also essential.

Treatment, therefore, must also take into account the systemic change that must occur to reduce the risk of traumatic injury. Thought to be related, in part, to being removed from the stressors of partners and children and in part to having access to health and mental-health services, social workers must also be willing to help women anticipate and identify what will help them succeed upon release and be willing to accept what these women tell them.

At least one study indicates that women identify tangible assistance as the most helpful. Among other things, Severson, Postmus, and Berry indicate child care, job training, and education. There is much more to be said about women in prison, about their needs and corresponding system responses or lack thereof. In , more than 1. Research indicates that children of color are disproportionately affected by parental crime, arrest, and incarceration.

In contrast, children of imprisoned mothers are more likely to live with a grandparent or another family member other than the father or be placed in the child welfare system La Vigne et al. The Adoption and Safe Families Act was intended to prevent youth from languishing in foster care and to provide permanent homes to those who needed them; however, for incarcerated parents or parents in long-term substance abuse treatment the act has had unintended negative consequences.

A consistent finding from the research on children whose parents are involved in the criminal justice system is that, on average, this population experiences a greater total accumulation of risk factors than comparable children in the general population Dallaire, ; Johnston, Of equal or greater importance than focusing on risk factors is the identification of programs and services that support protective factors to enhance the growth and development of youth affected by parental incarceration.

Children with parents in prison need support and services, yet few programs exist that are specifically designed to meet their needs La Vigne et al. The available literature that examines existing interventions for children of incarcerated parents indicates that social workers are primarily involved in three types of services or programs: The incarcerated parent may be in a prison located hundreds of miles away from the family and inaccessible by any form of public transportation, placing severe and costly restrictions on child—parent visits.

In , the U. The intention of the program is not to replace a parent but to provide a healthy adult role model for the child, someone the child can talk to and who can provide the child with new and growth-producing experiences. Support groups discussed in the literature have been conducted by school-based social workers and social workers in community-based programs. The Girl Scouts beyond Bars program is an example of a community-based program that strives to reduce the stress of separation by supporting a healthy relationship between incarcerated mothers and their daughters.

The program facilitates support group meetings with the girls, transports the girls to the prison to visit their mothers, and provides activities for the mothers and daughters to engage in Soltes, The Father2Child Literacy Project, operating in several California prisons and modeled after the Hope House reading project in Washington, DC, seeks to promote literacy in both father and child and provides a meaningful way for parent and child to connect when frequent visits are often impossible Castro, This particular project is supported by Grace Community Church in Calipatria, California, whereas others have been started by community-based organizations or local businesses or initiated by prison staff.

In Colorado, a male or female inmate who wants to participate in the Read to the Children prison reading program sends a request to the library that is evaluated by a case manager. The case manager confirms that the inmate can have contact with the child and has not lost privileges because of behavioral problems. Once approved, the inmate is coached by a member of the library staff or a trained peer volunteer on selecting an age-appropriate book and taught the importance of reading for emphasis and using different voices for characters.

Both the book and the tape are packaged and sent to the child at no cost to the inmate or the family Walden, Most prison reading programs are prepared to work with inmates who are less than confident readers. Reading to a child is a frequent activity and a natural part of parenting for many parents; however, for many incarcerated parents participating in prison reading programs, this is the first time that the parent has ever read to his or her child Castro, ; Walden, As with the incarcerated parent, the need for strengths-based case management services is pressing for these children and their caregivers.

In summary, the information provided here can serve as a guide for social workers who may come in contact with children of prisoners through the incarcerated parent, the school system, community-based organizations, or church programs. In an international review, Fazel and Danesh reported a prevalence rate of 3.

Compared with the general American population of similar age Kessler et al. As noted earlier, social workers in corrections play an important role in identifying the presence of mental-health treatment needs among inmates. Assessments, conducted at the intake or orientation to incarceration, are used to identify inmates who have mental illnesses that might contribute to adjustment and behavior problems and require treatment Morgan, As such, social workers may administer a range of assessment tools that aid in the identification of psychiatric and substance-use disorders, risk for suicide, and educational and vocational needs among inmates.

On the other hand, feigning illness that is, malingering may be used by inmates to be admitted to therapeutic units within the prison that are perceived as more comfortable than general population areas Hills et al. In addition, inmates with mental-health problems may lack the verbal skills to respond to assessment questions or to convey to the interviewer their experiences or psychiatric symptoms Hills et al.

Inmates with mental illnesses report more complex histories than do inmates without mental illness. Prisons are not well equipped to respond to the myriad needs of persons with mental-health problems. Although self-harm attempts by inmates may indicate a psychiatric crisis, they tend to be interpreted as behavioral problems and treated as institutional infractions Human Rights Watch, The interdisciplinary nature of social work and its value of advocacy can benefit inmates in this and like situations Severson, Prison social workers must understand that they are part of a team of professionals that includes correctional officers and wardens, all of whom value the safety of the inmates, the institution, and its staff.

These responses can include recommendations for placement of the inmate in a crisis stabilization unit or for the employment of a regimen of psychotropic medications or other treatment or programming. Basic therapeutic services for inmates with mental illness focus on the stabilization of offenders so that they can function safely within the prison Morgan, In this endeavor, prison social workers may be called upon to provide individual and group psychotherapy services to inmates with mental-health problems.

According to Morgan, individual psychotherapy is less common than group therapy, tends to be employed with more psychiatrically disturbed inmates, and focuses on symptom reduction and adaptation to the prison environment. Group psychotherapy services are more problem focused and can include topics on anger and stress management and problem solving Morgan, p.

Social workers are trained in various techniques that have been shown to be effective with mentally ill offenders in these contexts, including empathic listening, nonconfrontational communication, and the modeling of prosocial behaviors Hills et al. Prisons offer varying amounts of treatment-oriented services like life skills training, vocational rehabilitation, and educational programming; however, prison programming is often not provided in a way that is responsive to the unique needs of mentally ill offenders.

Inmates with mental illnesses may have difficulty paying attention to or concentrating on particular tasks, remembering and recalling information, or relating and communicating to other people. Although taking into consideration these special needs may improve program outcomes, responsivity to the special needs of mentally ill inmates is rarely taken into account in correctional programming Van Voorhis, As a result, these institutional programs have low rates of initiation and retention of inmates and are not highly effective at providing inmates with the skills and tools necessary to improve their adjustment to prison or their chances of successful community reintegration.

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Prison social workers possess a unique set of skills that can be used to increase the ability of prisons to enroll and retain inmates in effective institutional programs for example, motivational interviewing and the stages-of-change model. Trained in evidence-based practices, social workers should be involved in identifying programming that has rigorous empirical support for alleviating a specific type of problem common in the inmate population.

Once identified, the social worker can advocate for the implementation of these programs. Subsequent to their implementation, social workers can advocate for institutional procedures that will facilitate access to programming among those with psychiatric disorders. This may mean helping prison staff rethink classification and program entry criteria or modifying the criteria to make room for persons with mental illnesses.

Such efforts may smooth the way of recovery and educational attainment conducive to the successful community reentry of inmates with mental illness. Parole services can also assist in this transitioning process. However, parole agencies are often ill prepared to address the treatment and support needs of their service populations. However, people with mental illness who are under parole supervision tend to experience both criminal and noncriminal that is, technical violations of the conditions of their parole recidivism at higher rates than parolees without mental-health problems Baillargeon et al.

Social Workers are Worth Millions

Together these findings indicate that, for those offenders with mental-health problems, parole supervision can aid in their community adjustment, but to do so, parole officials must know and use effective methods to respond to the needs of those under their supervision. Social workers summarize the information gleaned from these instruments and offer recommendations for release and case planning to the parole board. Incorporating social-work approaches into parole supervision can improve responses to problematic behaviors of parolees with mental illness.

Therapeutic responses built on a strong working alliance and positive regard, rather than strategies aimed at control and deterrence, are associated with greater participation in treatment and rehabilitation programs and improved client outcomes Norcross, ; Rogers, Extending these social-work values to the parole setting may reduce risks for reincarceration and increase treatment access and adherence for individuals with psychiatric disorders and ultimately improve both public health and safety. Any discussion of prison social work would be incomplete without some reference to the rehabilitation efforts made by connecting the services delivered inside the prison to services made available to the offender in the community at the time of release.

Indeed, the reintegration process must start the moment the offender enters the prison. From the point of assessment onward, when risks for criminal behavior and needs for specific and tailored interventions are identified, the prison social worker must think about what will be needed on the other end of the sentence, at that critical point when it is literally show time for the offender. Have the services offered in prison benefited the offender in such a way as to ease his or her reentry into the community? Have they empowered the offender to recognize his or her choices and make healthy decisions?

When Gresham Sykes penned his famous book The Society of Captives , he described a world—a society—quite separate in organization and rule from the reality in which most lived. In the 21st century, although it can be argued that an imprisoned life is still significantly different from a free life, the importance of having collaborative, working relationships with service providers, employers, landlords, and educators in the community to which the offender will return cannot be underestimated in the rehabilitation process. Much remains to be shown effective in reentry designs and efforts, and work continues to find the right mix of human and programmatic responses that will yield fewer returns to prison for any reason.

Despite a history of ambivalence toward corrections, social workers are now firmly entrenched in prisons. The social-work profession has answered this call through its involvement in inmate care from the moment the individual arrives at the correctional institution until he or she is released and oftentimes beyond the prison walls into community supervision settings.

In summary, social work in prisons must increasingly accommodate the growing numbers of women in prisons, the high proportions of inmates with mental-health problems, and the children of prisoners on whom the impact of incarceration weighs for decades. Social-work interventions assist with resolving the consequences of exposure to traumatic events that is all too common among female inmates. Four studies reported on services that were delivered in different settings: However, it was largely unclear the extent to which implementers were trained in using the technologies.

One of the key benefits across studies was improved accessibility and support that would otherwise not have been received. Other key barriers included the need to have access to the technology and some difficulty around client use of the technology. Interestingly, our systematic review yielded only six empirical articles reporting on five technology-based interventions in social work direct practice. The infiltration of technology into the broad mental health arena has progressed at a fairly deliberate pace Mohr et al. Furthermore, given that our literature search yielded only one published study since that met the current criteria, there seems to be little indication that efforts in this area are developing more rapidly in recent years.

Compared to the medical field, the relevance of new technological innovations to social work practice may be less obvious, perhaps suppressing increased interest in this area. This may serve to catalyze increased attention to technology-based mental health interventions within the field of social work practice. In any case, the current results call for more empirical research into the ethical, interpersonal, and mental health implications of integrating technology-based methods into social work interventions.

Despite only five studies being identified, the content and target population of the technology-based interventions spanned widely, including manualized computer-based cognitive behavioral therapy to treat childhood anxiety, online self-help groups to manage recovery in sex offending adults, and videophone hospice care support for senior caregivers. As evidenced in this review, technology can extend the reach of care for social workers trained in a particular intervention, and may help social workers provide evidence-based care with higher fidelity.

Further research is needed to better understand circumstances in which technology can be used to substitute traditional provider-based care or more appropriately as a supplement to or extension of face-to-face therapy. The largely positive reports on anxiety and well-being outcomes are encouraging, but should not be perceived as conclusive, particularly for the range of mental health outcomes. Corroborating findings from this review, the efficacy of computer-assisted interventions on anxiety symptoms has been documented in a previous meta-analysis outside the field of social work Cuijpers et al.

This review should motivate social work researchers to test the effectiveness of technology-based interventions on a broader array of mental and behavioral health outcomes. Furthermore, although more than half of the included studies reported on the acceptance and feasibility of the intervention, the measurement of other implementation outcomes are important and largely unknown with regard to technology-based therapies.

Future research in this area would benefit from examining the fidelity of intervention delivery, the appropriateness of technology-enhanced care for certain populations and settings, the cost-effectiveness relative to face-to-face therapy, and long-term sustainability of technology-based interventions with varying levels of therapist involvement. Due to the highly disparate settings, populations, mental health conditions, interventions, and technologies reported on in this review, it is premature to draw conclusions about the effectiveness of technology-based interventions in social work practice.

However, the wide range of benefits reported across studies exemplify the potentially dynamic role that technology can play as the primary mode of delivery or as a feature supporting a larger intervention. Partnered development of these therapeutic tools that includes all stakeholders e. Interestingly, however, there were no reports of therapist or client trepidation or negative reactions resulting from a reduced level of therapist contact inherent in the technology-enhanced interventions.

This review is not without limitations. The literature search only included published articles retrieved through online databases and, as a result, excluded grey literature. While this approach introduces publication bias, a primary goal of this study was to examine the extent to which the use of technology-based interventions has been reported on through published articles.

While this method was deemed appropriate for this study, future reviews may seek to consult unpublished papers, theses and dissertations, conference meeting abstracts, online sources, and study authors through personal contact in order to include a wider array of efforts to integrate technology in social work practice. Further, our review spans approximately 10 years, a period we considered to represent contemporary conceptualizations and applications of technology.

While the most recent applications of technology were the focus of the current study, we recognize that this strategy omits years, even decades, of integrating technological approaches into social work practice. In addition, it is possible that some of the articles reviewed did include social workers in the delivery of the intervention, but failed to explicitly report their involvement. Finally, this review only includes studies published in the United States, thereby excluding efforts in Canada, the United Kingdom, and other countries that have explored the use of technology to facilitate social work practice.

Because there are many contextual factors that differentially influence the provision of mental health services delivered by social workers around the world, we felt it important to first focus on interventions delivered in the United States. Future studies should consider examining and comparing technology-based interventions across countries.

Developments in Social Work with Offenders

Despite a historically cautious approach toward the integration of technology into direct social work practice, studies are beginning to report on the implementation of innovative technologies to address the mental health needs for a wide variety of populations, settings, and presenting symptoms. This systematic review of published articles summarizes the current state of technology-based interventions within social work practice and evaluates the reported findings with regard to design, sample, intervention characteristics, mental health outcomes, and the use of technology.

Although several barriers to effective technology use were noted across studies, a variety of benefits were reported, and initial evidence suggests that the use of technology-based interventions may be associated with improved mental health outcomes. Further attention from social work researchers and practitioners into the appropriateness, effectiveness, and strategic implementation of technology-based mental health interventions is warranted. The authors report no conflicts of interest.

Innovative Approaches in Community and Institutional Rehabilitation of Offenders

National Center for Biotechnology Information , U. Soc Work Health Care. Author manuscript; available in PMC Oct 1. See other articles in PMC that cite the published article. Abstract Despite concerns around the use of technology-based interventions, they are increasingly being employed by social workers as a direct practice methodology to address the mental health needs of vulnerable clients. Method Inclusion Criteria To be included in this review, studies: Search Process To identify the most appropriate articles relevant to social work and mental health interventions, the following academic databases were searched through EBSCO: Three search strings were utilized: Open in a separate window.

Data Extraction and Coding Procedures Two reviewers independently screened all of the full articles for inclusion. Table 1 Design, Sample, and Setting Characteristics. Intervention Characteristics and Mental Health Outcomes As indicated in Table 2 , two of the interventions were delivered online to a group. Higher use of self-help group was significantly associated with outcome benefits. Parker-Oliver et al, Telehospice Care No Recruit caregivers, train caregivers in technology use, and administer assessment instruments during ongoing work with caregivers Graduate research assistant and hospice nurse Yes, but does not state how much training was provided Adults and provider Hospice patient's home Unknown Anxiety and quality of life Acceptability and feasibility Caregivers were generally satisfied with intervention.

There were no outcomes differences. Table 3 Use of Technology. Citations Types of Technology Use Primary component of practice being delivered or facilitated by technology Were implementers trained in using technology Primary benefits using technology Barriers using technology General conclusions about technology Crawford et al. Because the group was conducted through posts and not live interaction , participants could not receive immediate crisis support.

Difficulty for staff regarding time requirements, comfort with using the technology, and comfort with the research process. Limitations This review is not without limitations. Conclusion Despite a historically cautious approach toward the integration of technology into direct social work practice, studies are beginning to report on the implementation of innovative technologies to address the mental health needs for a wide variety of populations, settings, and presenting symptoms.

Footnotes Declaration of Interests: Contributor Information Alex T. Current and future trends in Internet-supported mental health interventions.

Giving up and giving back: desistance, generativity and social work with offenders

While much of the restorative justice discourse emerged from and flourished in the West, it has also gained significant ground in Asia in recent years, especially in relation to juvenile offenders. Criminal justice systems in Singapore and Thailand, for example, have formally recognized restorative principles, while others such as Hong Kong and South Korea have experimented with programs in various forms.

In this special issue, we aim to highlight the recent developments in offender rehabilitative practices in the Asia Pacific region.