Transference when seeing clients in prison

 

I have previously discussed the issues surrounding transference and indeed pre transference where I wondered how the circumstances and location of the therapy session affected the minds of both the counsellor and the client. This week I attended a ward round in a health-care setting in a prison as part of psychiatric placement.

The unit serves the prison community which is comprised of adult men, with no upper age limit and accepts patients who have mental health problems. It incorporates those suffering from acute psychotic episodes and/or other mental health illnesses, patients with a personality disorder and some patients with a learning disability. Occasionally a patient with a mental health problem and a substance misuse problem may be admitted. It excludes those patients who primarily have a substance misuse problem.

I was speculating with myself about the type of patient that would present at the ward round. Some of the patients were lifers and seemed resigned to their sentence, others were on remand awaiting a court date.  Seeing patients with suicide ideation can be draining especially when some talk at length and in great detail about how they would seek to end their life.  I felt helpless and powerless, was this my counter transference?  It is also frustrating to hear the evident need for talking therapy resources in such institutions at a time of cut backs and limited resource. However, I was there in an observing capacity and actually witnessed an upbeat and cheerful psychiatrist who seemed to take the ward round very much in his stride.

Resources

RAPt delivers drug and alcohol services – in prisons and in the community – which help people move away from addiction and crime.
Mental Health Care in Prisons a guide to mental ill health in adults and adolescents in prison and young offender institutions.
CARAT (Counselling Assessment Referral Advice and Throughcare) is a drug service that is available in every prison in the UK. CARAT teams were introduced in 1999 as part of HM Prison Service’s strategy to tackle drugs in prison.
Prison Reform Trust a registered charity that works to create a just, human and effective penal system. The organisation was established in 1981 in London by a small group of prison reform campaigners who were concentrating more on community punishments than on traditional prison reform issues.
Evaluation and Treatment of Patients with Suicidal Ideation  

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