When Kim Mapp left the jail where she counseled women in Bergen County, N.J., four years ago, something unexpected happened. Women inmates gave her handmade cards and gifts made from their pillowcases. “It was rewarding to me, and it was a chance for them to tap into their artistic skills, to give back and to work together,” says Mapp, whotoday works for the Center for Alcohol and Drug Resources and as a student assistance counselor in East Rutherford, N.J.While some people may question whether counselors can have much of an effect working with prison populations, Mapp says she was encouraged to see not only that she could help, but that this population of women actually desired help.

About 10 years ago, the state of Texas fired all of its prison counselors as part of a cost-cutting measure, recalls Joycelyn M. Pollock, professor of criminal justice at Texas State University-San Marcos. Yet Pollock believes that counseling is actually a very effective and necessary process in prisons. “Of course, you can run a prison without counselors, but I’m not sure what you are accomplishing besides incapacitation. Women in prison respond to treatment,” says Pollock, the author of Counseling Women in Prison. “In fact, they plead for it, and they give high marks to any kind of group or treatment program.” While counseling does have a positive effect on incarcerated women, she says that effect is often hard to measure right away. “The treatment may not take effect until years later when they are ready to put it into action,” she says, “but that doesn’t mean that they didn’t listen and remember.”

According to recent incarceration data published by the U.S. Department of Justice Bureau of Justice Statistics, an estimated 1.8 percent of women will serve time in prison (compared with 11.3 percent of men). Many experts believe that women end up in prison based on issues and experiences that distinguish them from most of their male counterparts. As explained by Pollock, the pathways model, a model developed in the criminology field, contends that women commit crime as a result of different life pathways, specifically histories of sexual and physical victimization as children, drug issues and the effect of having children. In addition, she says, the pathways model teaches that relationships have a much greater influence on women’s psychological development. According to Pollock, about 40 percent of women offenders have been victimized sexually or physically. In addition, she says, “More women offenders have drug dependencies than men do in prison populations. It seems to be more of a salient issue for women. Drug use for women may have stemmed from earlier life experiences” that differ from those of men. For example, she says, women may use drugs as self-medication to get over childhood abuse or for a mental health issue.

An “inside” look

As most counselors would anticipate, the therapeutic environment in prison is drastically different from that of the “outside” world. Even so, counselors might be surprised by some of the distinctions. For example, counselors, prisoners and prison officials won’t necessarily have the same goals. “All prison employees are expected to promote and protect security,” Pollock says. “Issues of confidentiality may come up if there is a security threat.” If a client reveals confidential information that could affect the security of the prison, the counselor must tell prison authorities. She says some counselors have also reported that prisons expect mental health professionals to make prisoners more docile through the use of prescription drugs rather than focusing on improving the inmates’ mental health.

The challenge of optimizing the mental health of women prisoners is further complicated by the fact that many inmates bring significant problems with them from the outside. These problems might include a lack of life skills, sexual victimization, codependency, serious mental health issues, drug addiction and high-risk sexual behavior. “All these are impossible to treat in isolation, and all are difficult to address in prison,” Pollock says. “I think it is a perfectly acceptable goal (for counselors) to help a woman deal with the prison experience itself and learn to have healthier relationships in prison rather than reduce the possibility of recidivism.”

Dianne Barber, a counselor for the Hillsborough County Department of Corrections in Londonderry, N.H., points out there is long-term value in beginning the process of counseling in prison because it increases the likelihood that these women will also seek treatment after their release. “In addition to problems with prior abuse, there is a significant percentage of women (prisoners) diagnosed with personality disorders that are very difficult to manage,” says Barber, a member of the American Counseling Association. “It can be a long and tedious process. These women benefit greatly from weekly counseling.”

Another consideration when working with incarcerated women is that, in many instances, their needs and concerns aren’t just individual. Whatever happens to them is likely to have a powerful impact on their families, says Vanessa Alleyne, associate professor and coordinator of the addictions studies program in the Montclair State University Department of Counseling and Educational Leadership. “Because women occupy a central and organizing role in so many families, incarceration then has a major disruptive effect on families in ways that are unique to women,” she says. “That’s not to say that men don’t play an important role, because they do, but women are the primary caregivers in families.” Children are especially affected when someone is removed from the role of primary caregiver, she asserts. In many instances in which the mother goes to prison, families are dissolved and children go to foster care. At that point, there is often a domino effect. “Children who are put into foster care are not always able to stay connected to their mom who is incarcerated” because prisoner contact with the outside world is limited, Alleyne says. “Contact is seen as a privilege, not a right, in the correctional world. If there are any infractions, that is the first privilege to go. You lose your visitation rights or phone rights, or you get put in lockdown or solitary confinement.”

Women who are more verbal and assertive about needing help are more likely to receive counseling assistance, Alleyne says. “It is very much a squeaky wheel environment,” she asserts. On the other hand, “There are counseling avenues. Most prisons and jails are required to have health networks in place. Help may come through a nurse or physician who is treating something physical and who then may make a referral for counseling as well.”

There are also certain populations of women prisoners which counselors are unlikely to hear from or see, Alleyne says. These include illegal immigrants who have been picked up for immigration charges. “Many women cannot speak English, and translation is very limited, so they are cut off in ways that are unimaginable,” she says. “In theory, translating services are provided by the INS (Immigration and Naturalization Service), but they are not at the level that they need.”

Areas of need

While prisons aren’t the first place most counselors think about when expressing their desire to better society, the needs and opportunities are plentiful. “If you are interested in doing clinical work, jails and prisons are ideal places to do that kind of work,” Alleyne says. “There is a tremendous need for short-term counseling, crisis counseling and group counseling. Certainly, this is one of the best places to get solid experience in drug and alcohol counseling.” She adds that direct service in prison humanizes a very dehumanizing environment. In addition, she says, well-trained counselors can provide models and learning opportunities for correctional staff, potentially making a positive difference in how incarcerated women are treated.

“There’s lots to do for incarcerated women,” Alleyne notes. “Talented counselors and academics are needed to bring their expertise to the forefront. These are environments where one can truly get involved and make a real difference for good.”

Alleyne is a member of ACA, the International Association of Addictions and Offender Counselors and the Association for Counselor Education and Supervision. After graduating, she gained an in-depth knowledge of women’s issues while running groups in the women’s unit of the Bergen County jail in New Jersey. At the request of the sheriff, Alleyne also produced a needs assessment, which led to a collaboration between the jail, the Council on Alcohol and Drug Abuse (under the leadership of Ellen Rocca) and the master’s counseling students at Montclair State. A report produced by the team provided the evidence needed to develop an in-house women’s drug treatment program.

“A counselor goes to counteract all the negative effects of prison life,” Pollock says, adding that therapeutic groups, in particular, can have a positive effect on inmates. She cites an example in which an art teacher ran a group for five women prisoners who had committed multiple infractions during their incarcerations. During the entire time the group was running, the women stayed out of trouble with prison authorities. When asked why, the inmates said they looked forward to the group and knew the art teacher wasn’t going to judge them. That provided enough support for the women to make good choices and maintain themselves. After the teacher left and the group ended, Pollock says, the women started getting into trouble again.

Another area in need of more counselors is case management, Alleyne says, particularly in terms of helping people connect with services outside of jails and prisons after they are released. “People usually get released at 12:01 midnight, with just enough money for a bus ticket and what they came with,” she says, “so their life is out of sync. What are they supposed to do? There is lots of help needed with linking people up to viable services.”

According to Barber, counseling women in prison can also reduce recidivism rates by addressing some of the problems people had before entering prison. “Education on mental illness, where applicable, and drug and alcohol addiction is so key to creating awareness and insight into their individual diseases,” Barber says. “Empowerment is also important because the majority of incarcerated women were never taught healthy functioning and appropriate coping skills. If they had more insight into all the contributing factors that bring them back to jail or prison, the recidivism rate would decrease.”

Alleyne says the biggest challenge counselors must overcome to counsel incarcerated women is probably just facing personal fears — “the fear of getting hurt, the fear of being locked in. It is very intimidating to go behind bars and have your movements monitored so closely. It takes some appreciation and adjusting. People have a fear of working with incarcerated people that starts to diminish once they do it. But (women prisoners) are the same people as you and me. They have the same fears, joys and desires as everyone else. As long as you are genuine and professional and offer appropriate assistance, you’re going to have a good experience and be able to help.”

Counselors may also find that their own struggles come up in the process of interacting with women inmates, Mapp says. For example, issues of rape, abandonment and not receiving the care one needed while growing up might be issues that both inmates and counselors have in common. Having appropriate supervision in their work with incarcerated women can help counselors in these situations, says Mapp, who was supervised by Alleyne.

Alleyne suggests that counseling students interested in working with people who are incarcerated take course work on substance abuse and treatment, as well as learn more about co-occurring disorders and the impact of trauma on women. Adds Barber, “Training in criminal justice as well as mental health and psychology is important, as well as having general knowledge of the psychological nature of those who have been incarcerated more than once or twice.” (See sidebar above for more suggestions.)

In preparing to work with incarcerated women, Mapp suggests that counselors pay attention to their own biases. For example, she says, most women prisoners are not what society regards as “hardened criminals”; roughly 80 percent are there for drug-related offenses. “In many ways, those women were like me,” Mapp says. “They just made a lot of different choices along the way. But many of the women I encountered were educated, were mothers, daughters.”