Freedom to think – the value of multiple clinical narratives in women’s prisons^†

Abstract

The merits of being multi-lingual are widely recognised. This paper considers the application of this metaphor to the conceptualisation of clinical work in a women’s prison. We suggest that sharing ‘languages’ from different theoretical orientations in open fora enables teams to build deep and nuanced understandings of clinical and systemic complexity, of particular value in secure settings. This discussion reflects the service model developed and used within HMP/YOI Holloway, a large women’s prison in London, which has recently been closed. We utilise a case example, with formulations and recommendations from several perspectives, to illustrate the value of maintaining a rich, inclusive discourse. We describe the benefits of such an approach to staff teams, to institutions and to those we serve, and consider the implications for organisation of services to maximise potential for change and recovery.

Keywords:

• Women offenders
• formulation
• multiple perspectives
• prison
• borderline
• personality disorder
• psychological treatment

Acknowledgments

We would like to thank Annie Bartlett for her comments on the early manuscript, Samantha Reynolds for assistance with literature searching, CNWL NHS Trust for hosting the conference at which this idea was first presented and the staff and women of the prisons in which we work for helping us to develop our clinical expertise and providing us the opportunity to develop and share multiple narratives.

Notes

^† We would like to dedicate this article to the memory of Professor Gill McGauley who died recently after a short illness. Gill was an inspiration to all the authors and epitomised the values of clinical wisdom, integration and respect for different models which we recommend here. Gill is greatly missed by us all.