‘Through the Gate’

Forensic Therapies has participated in the London Resettlement Strategy and, in particular, has been involved with the HMP Holloway Resettlement Pilot. Inter-agency discussions during this process have highlighted the complex needs of women prisoners in relation to leaving custodial settings, the experience of release and the ongoing experience of being integrated back into the community. Additionally, our own clinical work with offenders returning to prison, often many times, affords us the opportunity to identify gaps in provision at grass roots level, in particular, the need for continuing prison-based therapeutic interventions ‘Through the Gate’ and into the community.

"The only answer is counselling, the only release is counselling, the only healing is counselling."

Client describing what she feels about counselling following a life time of painful experiences

On release from prison our clients are often excluded from access to psychological support for the following reasons:

  • Prisoners are marginalised in society and therefore social exclusion is a defining feature of their experience. One of the consequences of this is that those with low to medium level mental disorders such as anxiety and depression fail to be recognised or treated. If these issues are recognised during a custodial sentence then continuation of care on release is often absent. The post release period is then extremely dangerous in terms of worsening mental ill health and increased risk to re-offending (50% re-offend within two years).
  • Primary-care-based counselling provision is oversubscribed, resulting in long waiting times before any service can be accessed. Once accessed, provision is also likely to be only short-term and therefore woefully inadequate given that many prisoners leave custody with considerable levels of unresolved trauma and complex inter-personal problems. Short-term intervention cannot address the depth and complexity of such presenting issues. Further prohibition from therapeutic intervention is exacerbated by the fact that 50% of newly released prisoners are not registered with a GP.
“This should not be something you have to search for, beg for.”
  • Access to private practitioners offering counselling and psychotherapy is rarely a feasible option due to cost and offence-related risk issues.
  • Voluntary sector agencies providing counselling and psychotherapy often lack experience of working with offenders and are therefore unable to recognise and address issues relating to offending dynamics, risk management and triggers to re-offending. Generic therapeutic services within the voluntary sector do not necessarily have links to other agencies within the criminal justice system and some may even subscribe to professional codes of ethics preventing the sharing of information, which is crucial in the management of risk.
  • Community-based forensic mental health services are often limited to providing short-term and crisis intervention.

In recognition of these difficulties, Forensic Therapies has developed its services to enable prisoners to access community-based counselling from the point of release and for a maximum of 45 weekly sessions as appropriate. The intervention is provided by Forensic Therapies’ honorary counsellors and psychotherapists.

“I slowly became stronger, slowly began to heal. I was able to help myself and deal with problems and face them without falling to pieces.”

In the context of this service, Forensic Therapies practitioners work to prevent re-offending and contribute to the protection of the public. To facilitate this, the referral process includes a comprehensive risk assessment. Practitioners then work with the client to reduce the risk of re-offending by identifying triggers and assisting them in developing strategies to prevent their repetition, to increase self esteem and to recognise that the impact of offending behaviours on self and others is also an important part of this process. Practitioners liaise with others in the client's support network and will instigate other interventions if there is cause for concern. Pathways into other mental health services can be established in order to manage any deterioration in mental health functioning and a related crisis effectively.

Ten prisoners have benefited from the initial development of this service and we look forward to increasing this provision over the next year.

Case study

Appreciation from a released prisoner who is now using our ‘Through the Gate’ service

Firstly, I would like to say what an amazing counsellor my counsellor is and what strength she has given me.

My first sessions with my counsellor following release were at HMP Holloway’s Visitors Centre and were not as comfortable as I thought they may be and I was not sure if this was because of myself having just been released or if it was the actual location.

Now many weeks on, for me personally, I can recognise a huge difference in my self esteem. How I deal with situations and with the effect of the bereavements I’ve experienced. Every session something I did not expect gets brought up and I then look at them in different ways. I’ve been able to look at issues more deeply and clearly and this has been of great use to me. It has helped me to move on and deal with current issues more productively than I would have done in the past.

I feel a genuine empathy in my sessions and this has helped me to open up and look particularly at losses that I feel have affected me negatively for years. I now know how important this work is and how it has been helping me to get to where I now am.

I am grateful for my counsellor for helping me to find ‘me’.