Tag Archives: Offenders


Counseling in jail

By James Rose March 16, 2020

To enter my office, I first pass through a series of three heavy steel doors. The lock for each door is controlled from a remote central office. I wait to hear a buzz signaling that the door has been unlocked before proceeding through.

The first time I caught sight of a prisoner, it startled me so badly that I wondered whether I truly wanted to work here. The inmates wear smocks and pants with broad orange and white stripes. Their shoes close with Velcro because shoestrings can be used to strangle oneself. Everything here is geared toward minimizing the risk of suicide.

Four of us share a counseling office. The number of rooms where we can visit with prisoners privately is limited, and the rooms are used by others in the jail besides counselors. Seeing an inmate always depends on first winning the competition to find a room.

Inmates who are judged to be dangerous, who are on disciplinary status or who are on suicide watch are shackled with ankle chains and handcuffed. In one room, these inmates are then also chained to the wall. Nothing in my training prepared me for the shock of trying to carry on an intense, personal counseling session with a person in chains.

The individuals being held in this detention facility are most commonly referred to as prisoners, inmates or simply as males and females by the people who work here. But those of us in the counseling office refer to them as patients. We see it as our job to treat them first and foremost as human beings.

Introduction to the blocks

Inmates are screened upon booking, including for suicidality. Among the questions asked are whether this is their first arrest, whether they are detoxing, whether they have any prior suicide attempts, whether anyone in their family has died by suicide, whether they have ever been in a mental institution, and so forth. Inmates determined to be at risk for suicide are placed on suicide watch.

The jail is divided into a series of blocks, a grouping of two-person cells around a central area where the inmates can watch TV, exercise, or play poker for candy bars or cups of pudding. The blocks form a U shape surrounding an outside courtyard where the inmates sometimes go for recreation when the weather permits. There are a half-dozen volleyballs stuck on the spiraled razor wire that surrounds the upper perimeter of the courtyard. S block is for sex offenders. Participants in Project 103, the in-house addiction recovery program, are in R block. Immigration and Customs Enforcement inmates are held in K block. As the only Spanish speaker on the counseling team, it is my job to interview all of the inmates in K block. The women are housed separate from the men in blocks X, Y and Z. When they walk the hall to go to the gym or the library, the men bang the window and wave, and the women look up and wave back.

W block is for suicide watch. Inmates on suicide watch are placed in isolation cells and checked by a guard every 15 minutes. Their clothing consists of a “turtle suit,” a cardboardlike cloth that cannot be twisted into a noose. They are given finger foods only; plastic eating utensils are not allowed. Neither are books. The pages could be torn out and stuffed in the mouth to cause suffocation. The inmates can watch a television through a window in their cell door. They are allowed out of their cells for a few minutes each day to take a shower, under observation.

Counselors interview patients on suicide watch as soon as is practicable. Some of these patients have a history of schizophrenia. Some are detoxing so heavily that they act schizophrenic. Others are bipolar and in a manic or depressive state. Sometimes patients on suicide watch scream or sing loudly or beat on the wall.

They say a picture is worth a thousand words. I know the textbook definition of schizophrenia. It is a breakdown in the relation between thought, emotion and behavior leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. With all those words, my picture of schizophrenia will always be a guy on suicide watch in a green turtle suit who stuck a toothbrush up his rear end.

A dumping ground for those in need of help

Sometimes patients on suicide watch get placed in a mental hospital. Our state used to have an extensive network of mental hospitals, but most of those facilities were closed during budget cuts decades ago. Today, many people who are mentally ill who previously would have been hospitalized end up homeless. Sooner or later, many of them land in jail.

“Rogue and vagabond” is the legal euphemism for a homeless person. Jails have become a dumping ground for those who are homeless, those who have addictions and those who are mentally ill. Although we are thoroughly under-resourced to deal with all of these individuals, it is our job as mental health counselors working in a detention center to do whatever we can for them.

Our staff includes a part-time psychiatrist who can prescribe psychotropic medicines. Out of hundreds of inmates, our patients appear on the mental health radar screen for a variety of reasons. They may have a prior history of receiving mental health treatment or psychotropic medications, or they may have a prior mental health diagnosis, which we learn from the screening form. In other instances, a patient may ask to see a mental health counselor. Patients suspected of needing medication are evaluated by the counselors, and we make an initial determination of whether they should see the psychiatrist. The psychiatrist determines the official diagnosis. Patients diagnosed with schizophrenia, bipolar disorder or major depressive disorder, or who act out bizarrely, receive a treatment plan and special attention.

Among the jail’s general populations, we expect to see issues of alcoholism or addiction in about 80% of them. My prior work in addictions recovery has served me well in this environment. I share pictures of brain scans from Dr. Daniel Amen with the patients. A normal human brain looks like a soft buttery mass. The brain of someone with alcoholism or addiction looks like Swiss cheese, with large “holes” of areas that are nonfunctioning. The brain of someone addicted to heroin looks like a sea anemone, with dangling tentacles of functioning areas and large masses between of nonfunctioning areas. Patients are often shocked when I show them the impact their substance use has had on their brain.

The point of drug use is to stop the brain from functioning properly. Most of the patients I see carry painful memories deep within them — memories so painful that they cannot hold them in conscious memory and go about living a normal life simultaneously. It isn’t hard to spot the source of their pain. I will ask about their mom, or their dad, or their childhood, and the stories typically come spilling out.

One young man told me he had once hoped to be an astronaut. I asked him why. He said that when he was younger, he asked his mom where his dad was, and she told him that his father was on the moon. In truth, his father was serving an eight-year sentence in a state prison. After years of longing for his father, the boy’s wish came true when his father finally returned home. But instead of experiencing a happy reunion, the boy’s father beat him up. Is it any wonder why this young man became addicted to drugs?

Another young man shared his story with me of addiction and repeated encounters with the law. I said, “I am going to make a wild guess that you had a rough childhood” — a line I often use to begin digging into a patient’s past.

His response surprised me. He said, “You’re the first person who ever noticed.”

Encouragement to look forward

The disciplinary block is the A block, known in jail as “the hole.” Fighting with another inmate may get you 10 days in the hole. Fighting with an officer can get you 50 in. Inmates in A block are given “23+1,” or 23 hours per day in their cell, one hour per day out into the block, one person at a time. No outside contact is allowed. There are no visits, no phone calls, no participation in the classes that are sometimes offered to the general population.

Isolation is punishment, as it is meant to be. As a mental health counselor, my concern with the guys on A block is the tendency to decompensate, to go into the deep and dangerous depression that extreme isolation can create.

One young man who had been on A block clearly showed signs of decompensation. I learned that he had been the valedictorian at his Philadelphia high school before being arrested in a 24-person drug bust. He was intelligent. Our conversations covered such diverse topics as Federal Reserve monetary policy and the use of political power in Niccolo Machiavelli’s book The Prince.

When this young man went down emotionally, I decided to find some books from the jail library that might help bring him back up. I eventually gave him two books. One was a book of jokes. The other was Man’s Search for Meaning by Viktor Frankl. In it, Frankl discusses his time as a Jewish Austrian prisoner in a Nazi concentration camp.

Frankl observed that it is not the outward circumstances of our lives that determine our destinies so much as it is the attitudes we choose to take toward those circumstances. Frankl withstood his concentration camp experience by taking the attitude of an observer of how humans survive in the most extreme circumstances.

My young patient got the point. As bad as his circumstances were, his mental and emotional state were determined by the attitude he chose to take toward his circumstances. He was excited by his new understanding, and his excitement was enough to pull him out of his depression. I had taken a gamble with him and won.

One of the hardest stories I have heard belonged to a man in his early 40s whom I first met on suicide watch. He was arrested for being rogue and vagabond, was intoxicated during his arrest, and had a history that included a suicide attempt.

The man’s story unfolded in fragments over the weeks and months that we worked together. It was like slowly gathering the pieces of a jigsaw puzzle until a full picture emerged. As an 8-year-old boy, he had been held by one of his father’s hands while his father used his other hand to pull out a pistol and unload five bullets into the boy’s mother. A cousin heard the commotion, came around a corner and shot the boy’s father. The father then turned the pistol on the cousin and shot him, still holding the hand of his son who was frozen beside him in shock. Another cousin grabbed the boy and took him to her home next door. From the living room window of that home, the boy watched as all three victims were loaded into an ambulance. Remarkably, each of them survived.

The boy was deeply scarred from witnessing the scene, however. Nightmares of what had transpired continued throughout his life, including during his time of incarceration.

The boy grew up, eventually married, and had a son. One evening, while arguing with his wife, he pulled out a pistol and would have shot her in a reenactment of his nightmares had his mother-in-law not intervened and stood between them. Unable to control himself, he took the pistol and shot into his abdomen. This was the suicide attempt noted on his record.

The man’s life was marked by episodes of violence, as was his son’s life. The son got involved with gangs and was murdered in a gang fight, having his neck sliced nearly through.

When I met the man on suicide watch, he had a new girlfriend, and a second son had been born to him. He had a second chance at fatherhood. He could determine to live in the past or in the present. His newborn son needed him.

I said to him, “You can’t drive a car with your eyes firmly fixed on the rearview mirror. At some point, you have to look forward.” He later told me that comment was the turning point for him. He realized that he had to stop looking backward constantly. If he wanted his newborn son to have a chance at life, he had to look forward.

He worked hard on his issues and took the recovery program. Over our months of working together, he grew able to speak openly about the events he had suffered. Recently, he was released to a halfway house. Maybe the demons within him have finally been exorcised.

To the police, he was a drunken man on a park bench. To me, he revealed a life of trauma and tragedy that was the underlying cause for his behavior. That is our work as counselors — to help people understand the dark forces that drive them to behaviors that they know are harmful to themselves.

I have heard such stories over and over again. There was a young man who was a bully and was shuttled from one juvenile facility to another until, at age 19, he landed in an adult jail. He shared with me the story of witnessing, when he was 12, his cousin gunned down in the street and the life of fighting and violence that had followed him ever since.

I have worked with people who were pimps and people who were prostitutes, people who had molested others and people who had been molested, people caught in unhappy marriages who had assaulted their spouses, and countless people with addiction or alcoholism. With each, I have heard a similar story of unresolved grief, tragedy and trauma. Sometimes I can help them. Sometimes that is limited to helping them maintain their emotional balance while they do their time in lockup. Most seem grateful to meet someone who will at least listen to their story. Sometimes giving them a chance to vent is all that I can do.

Sowing seeds

At 5 o’clock, I pass through the three steel doors and walk out of jail. I am free to drive to my apartment and wonder about the impact I may have had. I think of the Parable of the Sower found in three of the four Gospels in the New Testament. Some of the seed from the sower lands on rocky soil or other inhospitable places. But some of the seed falls on fertile soil and takes root.

We do what we can as counselors. We try to do no harm and pray to do some good. There is a line in the Talmud that says he who saves a single life, it is as if he saved the whole world. And, so, we do what we can inside the jail, one person at a time.

In the evening, I am free to have dinner with my kids, play my guitars, sleep in a comfortable bed. I can go shopping when I want, soak in sunshine, breathe fresh air, go to yoga classes.

Tomorrow, I will pass through the three heavy steel doors again. The men and women in the orange-and-white-striped suits will still be there.



James Rose is a licensed graduate professional counselor working as a mental health counselor at the Frederick County Adult Detention Center in Frederick, Maryland. He is a graduate of the clinical counseling program at Loyola University, Baltimore. Contact him at jrose007@comcast.net.


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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

From Combat to Counseling: Veterans and the criminal justice system

By Duane France December 9, 2019

As I was preparing to retire, I was already on the path to becoming a clinical mental health counselor. I was finishing the first year of my master’s program  in clinical mental health counseling and would start my practicum and internship in about seven months. Knowing that I wanted to work with veterans as a clinician, I reached out to our local veterans treatment court to see if I could observe some of the proceedings.

I had been in court before, having served a detail as a security escort for a court martial, but that was a military court—a legal venue that operates differently than the civilian justice system. This was a real courtroom, with the judge on the bench in a robe and everything. But that’s not what caught my eye when I first walked in. The first thing I noticed was a veteran sitting to the right in an orange jumpsuit, hands and feet in shackles.

I knew him.

We had served together about seven years before this; I was the company operations non-commissioned officer (NCO) in his unit. He was particularly memorable to me, not only because we were in the same company, but because I was there at the gate the day that he came back in from outside the wire after seeing  his platoon sergeant wounded by a sniper. If there was a blinking red line from that incident in 2006 to him sitting in the county jail, I was at both ends of that line.

The time in between, for him, was filled with medical problems, homelessness, addiction, disrupted relationships and involvement in the criminal justice system. It was a shock for me to see someone I served with in that situation. But I understood; many of us do. Veterans are significantly affected by the extremely traumatic events they routinely witness.


Veterans treatment courts

If you’re not familiar with veteran treatment courts, then you’re not alone. Even though the number of courts across the country are increasing, they seem to be unknown to those who are not directly involved with them. Throughout the nation, there are over 300 of these specialty courts that serve veterans.

The first veteran courts in the country were established in 2008. They are what are known as “problem solving courts,” modeled after the drug courts that were established in the mid-1990s. Not all courts are the same, and the different models vary by location, but they all are designed to help veterans get treatment for the issues that led to their involvement with the criminal justice system.

The problem-solving court model is one that addresses a particular issue with similar defendants using an interdisciplinary team of professionals to address the needs of the participants. Drug court, for example, provides substance use recovery treatment while addressing other risk factors that could lead to continued involvement in the criminal justice system. Some jurisdictions have other kinds of problem solving models such as DUI/DWI or domestic violence courts.

Veterans who become involved in the justice system frequently struggle with the difficulties that these other courts address. However, they are often experiencing many of these issues at the same time—creating the need for, in essence  substance recovery courts, DUI courts, mental health courts and domestic violence courts all rolled into one. Veterans treatment courts are designed to address these and other population specific needs with a multidisciplinary team that in addition to traditional court personnel such as a judge, the prosecution and defense, includes treatment providers, law enforcement, Department of Veterans Affairs representatives and a team of volunteer veteran mentors.

Some might argue that the regular criminal justice system has been handling veterans’ cases for years — why create special courts now? In the past, the elements that drove veterans to commit crimes were usually not unique to the military population. But multiple extended campaigns like those in Afghanistan and Iraq have created a large population of military members with extended conflict experience. As a result, there are situational and systematic influences on many current  veterans’ thoughts and emotions that lead to poor choices and reckless, dangerous behavior. I’m not saying that all who are incarcerated are innocent and misunderstood victims– there are veterans who commit heinous and horrendous crimes. The majority of veterans who are currently in the criminal justice system, however, aren’t hardened criminals.

In addition, veterans are usually not repeat offenders with a history of criminal behavior. That is the challenge when working with justice-involved veterans – determining the underlying motivation and reasons behind the dysfunctional and antisocial behavior. Treating the emotional and behavioral problems that lead to criminal behavior is one of the keys to helping veterans get—and stay—out of the criminal justice system. As a society, we need to have veterans return from combat and reintegrate, to get back into the workforce, engage in the public process, go to school, and become scientists and scholars.

The challenge, however, is that there is a period of adjustment for many veterans, and the difficulties it poses are different for everyone. For some, a lack of a sense of purpose and meaning in their lives leads to a period of wandering and aimlessness, and their behavior never rises to the level of criminality. It is a very thin line, however, that separates behavior that is reckless from behavior that violates the law, and many times veterans cross that line.

The majority of veterans leave the service strong and resilient. Many, however, do not, and that is a fact. Remembering that there are veterans who face, and fail to deal with, significant challenges is just as necessary as encouraging those who meet those challenges.

For more information on the effectiveness of veteran courts, a number of published studies such as this one has shown that graduates from these programs have a lower recidivism rate than others in the criminal justice system.




Duane France, LPC

Duane France is a retired U.S. Army noncommissioned officer and combat veteran who practices as a licensed professional counselor in Colorado Springs, Colorado. He is the director of veteran service for the Family Care Center, a private outpatient mental health clinic specializing in service members, veterans and their families. He is also the executive director of the Colorado Veterans Health and Wellness Agency, a 501(c)3 nonprofit that is professionally affiliated with the Family Care Center. In addition to his clinical work, he writes and speaks about veteran mental health on his blog and podcast at veteranmentalhealth.com. Contact him at duane@veteranmentalhealth.com.



Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: Invisible people, Part 2: The incarcerated

By Gregory K. Moffatt May 6, 2019

In the 1980s, the head of the department of corrections in my home state removed the exercise equipment from the state prisons. “They aren’t here on holiday,” he proclaimed in his no-nonsense tone.

I remember feeling a sense satisfaction at those words. “Yeah!” I thought to myself. “They deserve to be miserable. It’s prison, not a health club.”

In the years since, I’ve been inside prisons many times in the course of my work, and I now realize how thoughtless I was. Beyond my work, I have visited prison most often to see a friend. His incarceration was an experience that taught me the most about this invisible population.

Any politician running on a platform of prison reform would risk the accusation of being soft on crime. Although chain gangs and hard labor camps are, thankfully, part of history, for the most part, people don’t really care about what happens to prisoners. Like Native Americans (see the first article in my three-part series on “invisible people”), prisoners are often simply ignored.

In my experience as an investigator, a friend and a counselor of prisoners, most prisoners want to mind their own business, serve their time and get on with their lives following release. Many of these individuals are good men and women who readily admit their mistakes and are trying to put their lives back together.

I once wrote a similar thought in a newspaper column and received angry responses from readers. “My mother was killed. … Prisoners should be punished.” You get the idea.

I am not denying that there are some very bad people in prison. In fact, whenever I leave a prison, I’m glad that those iron doors lock behind me. Certain people need to be there, and they need to be there for a very long time. But just as there are many people in the general population who should be in prison — they just haven’t been caught yet — there are many individuals in prison who are very good people. Many of the men I’ve counseled could have been let out the front doors at any point and the community wouldn’t have been in any greater jeopardy whatsoever. People make mistakes, and sometimes those mistakes land people in the judicial system.

It is hard to describe the public humiliation of being arrested, tried, and sent to prison. And that humiliation is shared by family members. If someone asks where your father/son/brother is and you say “prison,” there will almost certainly be an awkward silence.

Once in the system, no matter how humane, prisoners are treated more like animals than like people. They are told what to wear, where to stand, when to eat and when to sleep. They are locked in crowded cages, and events they look forward to all week — visitation, a welding class, an appointment with the prison counselor — are often snatched away from them without notice because of the behavior of others. It can be total lockdown because of one guy doing something stupid.

Prisoners can be transferred without warning. Loved ones might travel four or five hours to see them only to discover that they have been moved, and it may take days or weeks to find out where they are. In such cases, the fragile lives that inmates have built in their prison world are erased, and they have to start over.

They are numbers in a system, not names. And they are identified by their crimes by probation officers, future potential employers and others. I would hate to be identified by my mistakes rather than by my character.

One inmate told me just after sentencing, “I know that no matter how many good things I’ve done in life, I’ll only be remembered for this one thing.” I couldn’t tell him he was wrong.

People entering the system can’t trust their fellow inmates — not because they are necessarily unworthy of trust, but because these new inmates just don’t know who they can trust. It is literally every man for himself. Sadly, neither can they trust the police, their lawyers or judges. I’m not suggesting at all that these people are unethical. I’m only stating the fact that at the end of the day, none of them see the accused as their friend. They see the person in relation to the charge and the process. If you don’t believe me, you’ve never been exposed to the system.

The consequences of the near-sighted policy of the former director of prisons in my home state were easily foreseen. Instead of occupying their time with exercise, inmates had little to do. Consequently, they filled their time with disruptive behaviors. The equipment was eventually returned — as it should have been.

If you want to experience real cultural diversity as a counselor, volunteer to work with prisoners in the system. It will open your eyes to what you (like me in my earlier days) have probably been unable to see.




For a more detailed perspective of the prison system, see the book I co-authored with W.A. Murphy, Handcuffed: A Friendship of Endurance.




Gregory K. Moffatt is a veteran counselor of more than 30 years. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Containment in restraints

By Erika Berger March 4, 2019

“The degree of civilization in a society can be judged by entering its prisons.” ― Fyodor Dostoevsky




A group of young black men sit and interact before our weekly art therapy group. Some laugh and share stories of their children and loved ones. Others put their heads down and are silent. They discuss and debate song lyrics and current events.

One young man, freshly 18 years of age, bursts into laughter so deep, his eyes begin to tear up. He cannot wipe his eyes though because his wrists are handcuffed together. Those handcuffs are shackled to a small metal desk, which is chained to the floor. His feet are also chained together and shackled to the floor. This is the state of juvenile justice in the United States.

When I first began working in custody as a graduate student of art therapy, I ignorantly thought that juvenile detention centers were different than the adult prisons and jails that I frequented. I was wrong. Juvenile detention centers incarcerate adolescents ages 13-17 and house “adult inmates” until they are 21. Juvenile detention centers are no different than adult prisons in their daily operation, physical structure or philosophy of detention.

From my perspective, a more accurate name for such centers would be “child prisons.” More than 60,000 youths are incarcerated in these prisons on any given day. The majority of these young people are black. This does not include the numbers of children incarcerated at adult prisons. Many children are tried and sentenced as adults. Episode 8 of the new season of NPR’s Serial podcast takes an in-depth look at one such child prison in Cleveland.


Harsh juxtapositions

To think about therapeutic containment or the creation of a safe holding environment in the context of prison feels paradoxical at best. These young people are not safe in this environment, either physically or psychologically. Histories of trauma, coupled with the toxic stress and bigotry inherent to the prison system, often lead clients to feel utterly psychologically uncontained while completely physically restrained.

This kind of harsh juxtaposition defines the clinical environment I work in. Weekly group art therapy is the only therapeutic support that my clients receive. Art therapy is one of four hours out of the week in which these clients are let out of their cells. Simply being in the presence of a group can be overwhelming to them. To open up too much emotional expression in therapy can be dangerous because these kids are left to cope by themselves.

How then does a clinician establish boundaries and a contained, safe therapeutic environment in a context defined by walls, chains and fences? Walk beside and begin with the art.

Walking beside clients in their therapeutic journey is to embody empathy. It is to see the clients as unique individuals while understanding the cultural and sociopolitical forces (racism, toxic masculinity and other forms of oppression) at work around them. It is to continually investigate my place in that oppression. It is to know and accept that my mere presence and vast privilege as a white, upper-class, free individual may be painful for clients. It is to be open to dialogue about our identities and to hold anger. It is to express my anger at the systems of oppression that shackle young people.

Empathic embodiment is indeed visceral. I strive to walk beside these clients with my heart and, as clinical and liberation psychologist Taiwo Afuape writes, to have my heart broken. I work toward deep therapeutic attunement that allows me to experience the unbearable feelings of clients while remaining grounded. These feelings are simultaneously bearable and unbearable. I stand in the eye of the storm. This position allows me to support clients in the processes of identification, digestion and integration of feelings and experiences.


Art making as resilience

We always begin with art making in sessions. The materials automatically become physical containers for emotions. The concrete nature of the art materials stands in opposition to the rampant, formless boredom of prison. Art therapy interventions have a beginning and an end that is client directed, while time in prison is endless.

Clients often verbalize their creativity and creations as acts of resilience and resistance: “I felt free when making this”; “I forgot I was in prison”; “They can’t take these ideas from me.”

Early on in group therapy, I often implement the “I am” format of sharing about artwork. Clients speak from the perspective of their pieces and work to use literal descriptions of the artwork that begin with “I am”: “I am colorful. I am dark and light. I am chaotic. I am beautiful. I am bound. I am peaceful. I am bright. I am vibrant.”

The continual process of naming and deepening who you are in prison is indeed an act of peaceful resistance. To claim presence is to erode the stereotyped, bigoted treatment by the system.

A drawing Erika Berger made to help her process her work with prisoners.

I know our therapy is progressing when the art making begins to be inspired by the clients’ personal passions. It can take weeks or months of rapport building for clients to share their dreams and goals in therapy. Leading up to these passion projects are long hours of walking with clients through self-doubt, self-hatred, anger, depression, anxiety, fear and shame. Creative writing in the form of poetry, short stories and rap is common during these stages. It is a medium and coping mechanism with which clients are familiar and comfortable.

Passion projects begin to subtlety shift the orientation of time from the present moment to the future, indicating growing resilience and hope. Clients are often more self-directed with these projects. As self-regulation increases, the use of materials generally shifts from two-dimensional to three-dimensional, reflecting a literal inner growth or expansion. Drawings, paintings and writings transform to creations such as folded paper boxes, sculpted figures and dynamic collages. In this place of creativity and visibility, we can approach pain with enhanced flexibility and perspective.


In summary, fostering therapeutic containment in the prison setting is about holding steadfast to attunement and empathy. It requires looking our broken justice system in the eye and allowing our hearts to be broken. Remain grounded in this brokenness and always stay connected to each individual client’s uniqueness, creativity and inner light.





Erika Berger is a recent graduate of Pratt Institute’s master’s degree program in art therapy. For the past two years, she has worked to create and implement clinical art therapy programming in western North Carolina prisons. Prior to becoming an art therapist, she was a bilingual special education teacher in New York City public schools. Contact her at Erika.wallace.berger@gmail.com.




Related reading, from Counseling Today: “Seeing people, not prisoners

Seeing people, not prisoners





Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The fragility of freedom

By Carl Sheperis and Franzi Walsh October 4, 2017

With more than 2.2 million Americans behind bars, there are more citizens incarcerated in the United States than in any other country in the world, according to the U.S. Bureau of Justice Statistics. The United States can also lay claim to the highest rate of recidivism. According to a Department of Justice study, a staggering 76.6 percent of released inmates are rearrested within five years. A lack of basic literacy skills and job training is part of the issue, but it is equally important that we begin to understand how imprisonment behaviorally and psychologically conditions individuals to perpetuate the cycle. It is a problem that is forcing lawmakers, think tanks and the public at large to rethink our nation’s current approach to incarceration and rehabilitation.

As educators in the social sciences and criminal justice, we recognize that education and vocational job training are crucial first steps to addressing rates of recidivism. A study by Rand Corporation, a nonprofit research organization, found that inmates who participated in correctional education programs were 43 percent less likely to return to prison than were those who did not participate. Furthermore, those same individuals were 28 percent more likely to find employment upon release. These findings clearly suggest that those who are more prepared to tackle the challenges associated with the world post-prison are less likely to resort to criminal actions to achieve basic means.

However, when we talk about recidivism, there are issues and solutions that lie far beneath the surface, often entrenched deep within the psyche of former inmates. Simply put, we cannot overlook the psychological and sociological effects of imprisonment, including the barriers to achievement that they cause. From a mental health perspective, it is important to recognize that individuals who are transitioning from incarceration require support to be successful once they leave the prison system.

Many individuals involved in the criminal justice system have multiple mental health and substance abuse issues. In fact, the National Comorbidity Survey Replication demonstrated that strong relationships exist among mental health, substance abuse and history of incarceration. Based on research conducted by Jason Schnittker, Michael Massoglia and Christopher Uggen in 2012, the majority of common disorders documented among former inmates could be traced back to childhood, before involvement in the criminal justice system. Their research showed that mood disorders, substance abuse and impulse control disorders had strong relationships with various patterns of involvement in the justice system.

In 2014, research by Amy Blank Wilson, Jeffrey Draine, Stacey Barrenger, Trevor Hadley and Arthur Evans found that those individuals with comorbid mental health disorders had a 40 percent higher rate of recidivism in comparison with other offenders. In their study, more than 50 percent of the sample had at least one documented readmission to incarceration within three years. Clearly, problems with mental health act as a barrier to successful transition to the community for ex-offenders, and there is a need to develop more comprehensive support services for these individuals.

Incarceration also leaves little room for asserting personal responsibility, with basic functions such as eating, bathing, exercising and socializing largely outside of inmates’ control. Rigid programming has such a strong psychological effect on inmates that, once they are released, individual freedom often feels foreign or overwhelming. When combined with the additional stress of managing symptoms of mental health, the transition process becomes even more problematic.

Schnittker, Massoglia and Uggen demonstrated that there is a significantly higher relationship between mood disorders and subsequent disability after incarceration than what exists among the general U.S. population. This means that when offenders with mental health issues are released from the criminal justice system and left to create their own paths, it is likely that they will have extreme difficulty making successful transitions.

Counselors and support personnel can help break the cycle

Because mental health has been shown to have prominent comorbidity with incarceration, and because recidivism can be predicted for those with mental health issues, counselors who take an active role in addressing the needs of these individuals as they transition back to the community have the opportunity to make a significant impact. That impact extends beyond the ex-offender to the individual’s family, community and generations to come.

To create real change in the criminal justice system, all offenders — regardless of their history of mental health or substance use issues — need additional support to break a cycle that perpetuates their involvement. Offenders are considered a vulnerable population and should receive support in a manner that is commensurate with other vulnerable populations. Successfully addressing the complex needs of offenders requires a wraparound approach that is multidisciplinary and multifaceted, and counseling is an important element in the spectrum of needed services. Professional counselors experienced in addressing the unique needs of individuals who have been incarcerated can help to break down psychological barriers to achievement through the use of cognitive restructuring, motivational interviewing and other evidence-based approaches. Specifically, counselors can help relieve the stagnation in which many prisoners find themselves trapped. This can be done in part by offering education about appropriate decision-making and general life skills.

Counseling is certainly an important facet of reintegration, but we believe that an array of social and human services support personnel must be in place to help make this process successful. Probation and parole officers monitor the transition process, but there should also be individuals who can provide support for the social, emotional, medical, educational, occupational and recreational needs of those transitioning from incarceration back into the greater community. This multidisciplinary group of professionals must work together to create change for the individual and for the overall system. They must provide effective treatment and serve to advocate for change.

Advocacy and change can begin with small steps. Through past experiences, we have found that labeling someone a criminal can become too easily generalized. We often think of a prisoner as a lawbreaker first, rather than as an individual who has broken a law. The key difference is the articulation of the individual, which encompasses an entire life that led to the moment a crime was committed — and, similarly, extends to the quality and achievement of life upon release. As a society, we have moved toward person-first language for special populations. It is now time to include offenders in the category of special populations and to drive change through the ways in which we talk about offenders.

Addressing the shortage of mental health professionals

Although the need is strong for counseling and human service support for ex-offenders, the fact is that a shortage exists of personnel available to provide these services. According to the U.S. Health Resources and Services Administration, there are nearly 4,500 shortage areas for mental health services throughout the United States, and there is no identified time frame for these shortage designations to be removed.

The shortage of trained professionals is daunting, and it becomes even more problematic when examining the need for specialized providers such as those who have experience addressing the needs of offenders. As educators, we believe one of the crucial elements of our role is to prepare students to meet the needs of our communities. We also believe that we must educate students to consider perspectives that challenge stigmas and help promote positive change.

Because there is such a shortage of counselors who specialize in working with offenders, the process of filling this gap must begin in the educational realm. Addressing the workforce gap can also be done through the development of bachelor’s-level programs in psychology, social work and human services that have specific tracks dedicated to the support of the offender population. In addition to helping meet a population need, programs of this nature would serve as natural bridges for undergraduates to pursue graduate degrees in counseling or similar helping professions.

Counselor educators can change the conversation

One way to change the conversation is through formal education. Standard F.7.c. of the ACA Code of Ethics requires counselor educators to take an active role in educating students about diversity. Because offenders are considered a vulnerable population, it is important for counselor educators to include this population as part of the knowledge base for counselors-in-training. Counselor educators can also make concerted efforts to develop field placement relationships with the criminal justice system and community agencies that serve offenders.

Changes to the way that we serve the offender population ultimately will be driven by the strength of voices among practicing counselors and other helping professionals. As stated in Standard A.7.a. of the ACA Code of Ethics, “When appropriate, counselors advocate at individual, group, institutional and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients.” It is an ethical imperative for counselors who work with offenders to engage in individualized efforts to advocate for the elements needed to help their clients make successful transitions. Each individual effort is important and creates momentum toward greater social change.

Although we take small individualized steps toward a new process, we also must keep our eyes on greater systemic change. Rehabilitation is a matter of systems, encompassing the criminal justice system, the parole system, the mental health system, the human services support system, the employment sector and the broader community. Those experiences directly following imprisonment often have the greatest impact on an individual’s success in transitioning back into the community. We can begin tackling this issue seriously if we combine training and education with a renewed focus on the psychology of both imprisonment and freedom, working as one to promote transformation even for those individuals for whom we might have thought it impossible.

Summary recommendations

Social change is a process that unfolds over time, but it begins with recognition of a disparity. This leads to grassroots efforts to develop a movement that will create sustainable change. At the University of Phoenix, we have taken a step toward addressing these issues by creating a bachelor’s degree in correctional program support services to train individuals to help offenders be successful during and after transitioning back into the community. We have also worked to collaborate across our colleges of social sciences and criminal justice to develop multiple projects that address the broad needs of offenders. These small efforts are just one step in creating broader change. We invite readers to join the effort and to develop their own small steps.

Here are some suggestions for beginning the advocacy and change process:

  • Become an informed counselor by exploring the research on mental health, substance abuse and incarceration.
  • Examine the organizations in your community that serve the offender population, and develop a relationship with providers in that network.
  • Look for opportunities to advocate for system change at the local, state and national levels. Contact your state counseling association or the American Counseling Association to determine any ongoing initiatives that you can support.
  • Obtain additional training in evidence-based practices that have been effective with the offender population.
  • Counselor education programs can consider developing specialty courses or specialized field experiences related to the offender population.
  • Counselor educators can develop cross-disciplinary relationships that help to promote greater understanding of the needs of offenders transitioning back into the community.
  • Counselors can develop relationships with legislators and local officials.
  • Join organizations such as the International Association of Addictions and Offender Counselors, a division of ACA.
  •  Join a professional network of colleagues who have an interest in serving the offender population.
  • Look for opportunities to educate and encourage the conversation about system change in your home community. Raising awareness is one key to successful change.


The research and literature have clearly demonstrated that:

  • Offenders are a vulnerable population
  • Many offenders have mental health and substance abuse disorders
  • Those offenders with comorbid mental health issues have a 40 percent higher rate of recidivism than other offenders
  • Offenders — regardless of mental health history — face incredible barriers in their transition back into society

Our hope is that as a result of reading this article, more counselors will feel empowered to address these issues and advocate on behalf of this vulnerable population. We encourage counselors to take a stand to address the existing barriers that block offenders from successful reentry into our communities, and we look forward to using our collective knowledge and training to impact future generations.




Carl Sheperis is the social services program dean for the College of Humanities and Sciences at University of Phoenix. Contact him at Carl.Sheperis@phoenix.edu.

Franzi Walsh is the criminal justice and public administration program dean for the College of Humanities and Sciences at University of Phoenix. Contact her at Franzi.Walsh@phoenix.edu.

Letters to the editor: ct@counseling.org




Related reading, from the Counseling Today archives: “Seeing people, not prisoners” https://wp.me/p2BxKN-4tq





Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.