Plenty of research has examined preparation of inmates for life outside prison, but few studies have examined supporting them while they're there, says psychologist Robert Morgan, PhD. That's why Morgan has devoted his career to providing and doing research on basic mental health services, which help inmates adjust to prison life.
It all began with a 1992 summer internship at Kansas's federal penitentiary in Leavenworth, which he took to make himself a "more worldly" therapist. There he discovered his motivation to help a largely overlooked group. "There's a great need for these folks to receive psychological services, and most people don't want to work with them," he explains, adding that only 6 percent of psychologists work in prisons.
Morgan saw that need first-hand during his first full-time jobs at the El Dorado and Winfield correctional facilities in Kansas. In both jobs he provided basic mental health services--not to be confused with services aiming to reduce recidivism. For example, some inmates need help coping with the length of their incarceration, dealing with being separated from loved ones and friends or accepting that the prison is going to be their home for a period of time--or forever. Others need to be taught how to live and survive in the prison environment. For example, Morgan worked with a 17-year-old inmate who began receiving sexual pressure early in his incarceration.
"I worked with him to adjust his physical appearance to look older, taught him basic prison safety, and then counseled him about the institution's unwritten inmate rules," Morgan says. "When we terminated our work, he had successfully adjusted to the environment and was no longer experiencing sexual pressure."
Attending to inmates' basic mental health needs also helps with prison safety, Morgan says. Take a prisoner who has been placed in "lockdown" or segregation for 23 hours a day in maximum security for threatening other inmates or guards. If he begins to show signs of psychosis or depression due to being isolated, Morgan says it's in everyone's best interest to give him "crisis intervention"--involving, for example, a "no-harm" contract in which an inmate and a therapist agree verbally or in writing that the inmate will not harm himself for a designated period, or until at least one therapy session is held. Providing such services can be a challenge, he notes, because of limited resources, an environment that limits social support and the inmates' confinement to a small space.
Indeed, crisis intervention in prisons sometimes requires nontraditional methods. For example, inmates in segregation don't have access to radios, televisions or other entertainment. So Morgan and colleagues at one prison developed a "recreational behavioral contingency program" that allowed inmates to receive puzzle books for good behavior. "This helped mentally ill inmates have something to focus on and placated inmates with behavioral problems," Morgan says.
During his tenure in the Kansas corrections system, he realized that group therapy is frequently used in overpopulated prison settings, while few studies evaluating therapy outcomes existed in the psychological literature. So Morgan tried his own brand of psychotherapy that draws participants' attention to the impact of their criminal thinking and behavior patterns on others, and on others' treatment of them.
Seeking to investigate the effectiveness of his and other psychotherapy approaches with inmates, Morgan enrolled in Oklahoma State's counseling psychology PhD program in 1995. In the late 1990s, he bolstered his corrections résumé with a predoctoral internship at the Federal Correctional Institution at Petersburg, Va., and a postdoctoral fellowship in forensic psychology at the University of Missouri-Kansas City School of Medicine and the Missouri Department of Mental Health. After that, he took a position as an assistant professor in the counseling psychology division at Texas Tech University in Lubbock--while consulting as associate clinical and forensic director with the Lubbock Regional Mental Health and Mental Retardation Center.
Morgan's numerous studies on prisoners' psychological needs include a meta-analysis of 26 empirical studies on group psychotherapy effectiveness with the incarcerated. Published last year in Group Dynamics: Theory, Research, and Practice (Vol. 6, No. 3) with psychologist David B. Flora, PhD, the study found that group therapy with inmates improves their psychological functioning and prison adjustment, as compared with control groups.
Such analyses are only the beginning, Morgan says. "The dearth of research evaluating the effectiveness of basic mental health services remains the main service gap in prisons," he explains. Certainly Morgan has heard the call. He's developing grants from the National Institutes of Health to study mentally disordered offenders and from Texas Tech's Research Enhancement Fund to study inmates' perceptions of mental health services. He's also developing research-based therapy programs for inmates, which he intends to put in the hands of mental health providers.
Once he's developed a few such programs, he plans to take them for a test run in a prison--with a few doctoral students in tow. "It'll give me a chance to expose them to the opportunities and needs of offenders," he says, and perhaps to launch a few careers.
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