Conducting Group Therapy in a Prison
As told to Cliff Williams
“It was my job to listen to them describe their experiences. . . . And, I believe, respectful listening has healing power.”
Edited by Cliff Williams from a recorded and transcribed conversation with Kate on September 22, 2023. While Kate was working on a master’s degree in mental health counseling and expressive arts therapy, she conducted weekly group therapy sessions in a prison for a school year. “Kate” is a pseudonym.
In the Prison
The prison in which Kate worked had two sections. “One section was for people who had not yet been convicted or sentenced. They had been accused of all levels of crime, from petty theft to murder. Some of the inmates had been there for years. Those in the other section were serving sentences of fewer than two and a half years, most of whom had offenses lower than murder. My therapy sessions had people from both sections.
“I was invited to do the sessions when I talked with the supervisor at the prison. She asked, ‘What are you interested in?’ I said that I was interested in working with people who had experienced trauma. She asked, ‘What is your approach to trauma?’ I said that the most important thing is to establish a sense of safety. ‘You can’t just dive into someone’s deep, dark secrets or into how they can regulate their emotions before they know they can safely re-experience traumatic memories.’ The supervisor said, ‘Can you start tomorrow?’
“To get into the prison, everyone had to go through a metal detector and give up their IDs so that the prison administration could immediately see who was in the prison if there was a lockdown. Cell phones were not allowed, nor was any glass or metal because they could be used as weapons. You could have small earrings, but no dangly ones. And no scarves. Shoes with shoe laces were okay, but not clogs or open-toed shoes because there were diseases everywhere, and you might come in contact with feces or urine. It was recommended that you take your shoes off before going into your house, and some guards even changed clothes before getting into their cars.
“I never found the prison to be dirty, but there were risks. So it was a little intimidating to be there.”
Kate conducted two sessions each day she was at the prison. “These sessions were for those who were in medication-assisted treatment because of their heroin, fentanyl, or opiate addiction. The twenty or so people in each group were required to do the therapy.
“Most people go to therapy because they want to, so it was unusual to be doing mandatory group therapy. How do I evoke openness and authenticity in people who don’t want to be in therapy? And to what extent is it even safe for people in prison to talk in a group setting? It might be that one person has got beef with someone else in the room. They could get into a fight over something they said, or they could have a preexisting fight threatened with someone in the group. I didn’t know the dynamics in the groups or what was safe for them to say.
“To deal with these uncertainties, I drew on some training I’d had in sales. The idea is not to express more enthusiasm than a prospective customer’s level of enthusiasm. If someone is lukewarm, you don’t say, ‘Come on. You want to buy this product!’ Instead, you let the person say that they would like to know more. You get them to ask for it. So I thought, ‘How can I avoid getting beyond the level of enthusiasm of these prisoners?’
“What I did was to start off each group by saying, ‘This is your group. I know you have to be here, but I don’t have an agenda for you. What do you want out of this group?’
“I also said, ‘Let’s start with some guidelines you think are important to make this group work for you.’ I made some suggestions, such as, ‘Do you want this group to have an agreement of confidentiality? Do you want people to stay in the room or to be able to come and go?’ And so on.
“Then I had to shut up and listen. That was kind of scary. But I wanted to show that I respected them and wanted to build rapport. I was not going to push an agenda on them from the perspective of some middle-class White woman. Or from the perspective of one who has herself experienced severe trauma, which I have, and thus could prove that I have something to tell them about trauma.
“It was my job to listen to them describe their experiences. They had gone through all kinds of stuff that I didn’t know about. It was very likely that many of them never had anyone just say, ‘Tell me about yourself,’ without an agenda to fix them or change them. So in listening to them, I would be honoring their experiences. And, I believe, respectful listening has healing power.
“The men—the groups were all men—told me what guidelines they wanted for the group and what topics they wanted to talk about. I listed them on the whiteboard. For the guidelines, I asked who was in agreement. When they raised their hands, I said, ‘Now we know who’s in agreement and who’s not, so at least we have an understanding.’ For the topics, I said, ‘Okay. I’ll come prepared next time with something we can look at and talk about.’ Forgiveness, anger, and recovery were among the topics they were interested in.”
Reactions to the topics varied between the two groups. “One day a therapy session went really well with the first group but was a dud with the second group. I had run across a video about a former inmate at a different prison who had started a group called the Forgiveness Project. The former inmate told the story of his horrific abuse as a child and how angry he was as a teenager, plus all the trouble he had gotten into with the law. He had been violent and had hurt people.
“While the person in the video was in prison, he had to do a therapy session in which he imagined talking to his mother. He suddenly realized that she had harmed him and that he had become a perpetrator just like her. It was a poignant moment in the video, because it broke him open. He didn’t want to be that way.
“We watched the video. When it was over, I could sense a solemnity in the room. I said, ‘Maybe let’s not talk about this. If you want to do a little meditation, you can close your eyes, put your hand on your heart, and feel what’s present for you and honor whatever you’re feeling.’ I also said, ‘If anyone wants to share something, you can, but it seems as though people need some space to be with themselves.’ A couple of the men made comments about how deep the video was for them.
“One of them had walked into the room at the beginning of the session saying, ‘This is bullshit.’ He had never come to the therapy sessions before, so I said, ‘Come on in. I’m glad you’re here.’ At the end of the session, when they all were walking out, this person said, ‘That was pretty good.’ I thought, ‘This went well. I’ll do the same thing in the next group.’
“In the second group, however, one person left in the middle of the video. When it was over, I saw traumatized reactions, totally unlike the openhearted reactions of the first group. They looked horrified at the dreadful story in the video, which the person in the video had told in some detail. The prisoners in the second group looked as though they felt violated, made to watch a video about trauma that was too much. Their bodies were tight and their faces looked stricken.
“I had blown it. The first group, I noticed, had felt something in me that was honoring and respectful to them. In the second group, I had focused less on the inmates and more on how I had had a successful time in the first group.
“I learned from this experience that doing therapy—all therapy—is like being on sacred ground. In the prison, especially, it is like being present to the Holy of Holies—the inner sanctuary of the Tabernacle described in the Hebrew Bible where God’s presence appeared.”
During one session, Kate became alarmed. “The therapy group I was leading had to move to another room. Correction officers were lined up watching every move as we walked along the hallway, making sure everything proceeded smoothly. They did not have guns, but they did have batons and spray.
“I had been given a walkie-talkie, but I could barely operate it. There was a very specific sequence of things you had to say, and I was never going to remember it if I actually had to communicate in an emergency. I was shaking as I walked down the hallway with my group.
“One of the men in the group was double my size, at least. He was in for murder. He had been acting up in the therapy sessions, showing that he wasn’t having much of what we were doing.
“When we got to the new classroom, everyone grabbed a seat. The big guy sat right by the door. First of all, I’m supposed to be between the inmates and the door so that I have first access to the door if anything happens. Plus, he’s sitting in front of the panic button, which is a big red button right beside the door that says PANIC on it. So I wouldn’t be able to hit the panic button and get out the door if I had to. And I couldn’t use the walkie-talkie. In addition, the classroom had no windows. People were watching on camera, but there were no guards in the room or in close vicinity to the classroom.
“I was nervous.
“That class session was something of a disaster. The big guy was making fart sounds. Every time someone reached forward, whether me or someone else, he’d make a fart sound. When I asked a question, someone across the room started talking and commandeering things. The same thing happened when I had tried to set guidelines with them at the beginning of the session. Things were chaotic, like a bunch of teenagers. I couldn’t get order.
“At the next session of that group, the big guy wanted to sit in his chair again. I said, ‘Nope. You’re sitting across the room.’ He goes, ‘That’s where I like to sit.’ I said, ‘Nope. Your chair’s over there.’ He went across the room. Now I at least had a position of safety.
“For that next session, I had made a talking stick out of paper. I have used a talking stick when leading discussions in which the topic is highly charged, and I’ve used it myself as a participant. ‘It will be a great solution to the chaotic talking in the last session,’ I thought. ‘And it will allow the quiet people in the group to talk.’
“I said to the class, ‘Last week was a little rough. It was hard to have a constructive conversation. Today we might want to try using a talking stick. The only person who can talk is the one holding the stick.’
“They said, ‘No, we don’t want to do that. That’s ridiculous.’
“I replied, ‘For today I’m going to pass the talking stick around, and you can all weigh in on whether you want to use it.’ So they passed it around, and every one of them said, ‘You know what, we’re responsible adults and we are respectful of each other. We can talk without this childish talking stick.’
“‘All right,’ I thought. ‘We don’t need a talking stick. They’ve just told me that.’ I said to them, ‘Fine.’ The class session worked out well without the talking stick.”
Art Therapy Classes
After Kate finished the first set of sessions, she conducted sessions in art therapy for inmates who had volunteered for them. “I started off by making a really big mistake. It had not been made clear to me that I couldn’t bring in my own art supplies. So I brought in some marker pens. I had been told to take an inventory of my supplies at the beginning of each session and also before the inmates left.
“As we got near the end of the first session, I was feeling awkward about counting the pens in front of the participants. It felt contrary to what therapy was about: ‘I respect you, and I’m going to treat you with dignity, but I’m going to count the pens and make sure you didn’t steal any.’
“I let them leave, and when I counted the pens I found that five or six were missing.
“All of a sudden I broke out in a cold sweat. It hit me that those pens could be turned into weapons. If somebody died or was seriously injured with one of them, it would be on me. The pens could also be used to snort or do drugs or make tattoos, which was illegal for the prisoners.
“I had to tell my supervisor. The prison did a series of things to try to get the pens back. One was simply to tell the inmates to turn the pens in if they had them. The next level was to say there would be no more art therapy until the pens were turned in. Then they had a shakedown—two guards went through the cells, one by one, and searched everything to find the pens.
“It had broken my heart when they said the art therapy sessions would not continue if the pens were not turned in. I love doing art therapy a great deal. But after a few weeks, things cooled down, and three of the five pens were retrieved. I was allowed to continue with the art therapy, though the administration became very restrictive with me.
“I could not bring in any new art supplies, so it was a challenge figuring out what art we could make with pencils that were only three inches long. They were like the pencils that come with board games or that are used for bowling—little, itty-bitty things. The prisoners could use paper and glue, but no scissors. They made collages and did a lot of coloring. They liked these, and I loved watching them color. There was often a childlike feeling that was present when they colored.
“They also did origami. More than once one of the guys who had nerve damage in his hands or who was shaking from withdrawals was not able to do the tiny folds in origami. The other guys would help them: ‘Oh, you gotta fold it like this.’ Or, ‘Here, I’ll get that fold for you.’ There was a sweetness that you don’t see in prisons.
“There was also an openness that was beautiful to watch. I took a computer to the sessions sometimes and played music they liked. I wrote their requests on the whiteboard so that individuals would not dominate by saying, ‘Play this next. Play this next.’ They reacted to the music: ‘Oh, I love this song. It reminds me of such and such.’ And they talked about their lives on the outside as we worked on our art projects.
“By the end of the art therapy sessions, I could tell that I had gotten rapport with them by the way they talked, totally unlike the time when someone had remarked, ‘Oh, you’re scared.’ As I was counting the pens one day, one of them said to a new participant, ‘You should have seen her when she first started. She didn’t know what was going on, and we were grabbing the pens and stuffing them into our pockets.’ That felt like good natured teasing.”
Kate invested a great deal of emotional energy into her work at the prison. “I found that I identified more with the inmates than I did with the correction officers or the administration. My uncle went to prison for shooting someone, and I grew up with people like those in my therapy groups. I could have been one of them.
“I didn’t feel that I was giving the inmates anything. And I didn’t feel different from them. I was just being with them. I experienced the power of listening in an environment in which listening can shift the whole feeling in a room.
“One thing the inmates hated so much occurred when the guards were demeaning and controlling in petty ways. The guards could shut down the prisoners’ little enjoyments on a whim. That was painful for them, and it was painful for me to watch. In the end, that was the reason I left.
“I was brokenhearted to leave. I enjoyed the inmates, but it was deeply disturbing when they told me things. One of them lifted his pant leg to show that his leg was black with rot. He was clearly in pain. He said, ‘I’ve been trying to get to the doctor. I’m afraid I’m gonna lose my leg.’ I was afraid that he was going to lose his leg too.
“When I brought this up to prison authorities, they said, ‘Oh, he’s just being manipulative.’ On other occasions, they said, ‘Everybody complains in prison. They’re not going to get five-star treatment,’ or ‘What did they expect? Of course that happens, and why should they count on anything else?’ That callousness was beyond my ability to bear. I walked out tight and distraught nearly every time I was there.
“Plus, many of the prisoners had not even been convicted. If they had gotten thrown into prison on a mistaken identity, they could sit there for months and not get the medications or medical services they required. If you had money to pay for a good attorney, you were likely to get out. But if you didn’t, you might suffer for no reason.
“I learned the limits of what I could tolerate when witnessing trauma, especially trauma that was ongoing and systemic. Their trauma moved me, but it was too much, and I had to let it go.
“At the same time, I would do it all over again.
“The inmates were generally kind toward me. They gave me a lot of gratitude and warmth. They said 'thank you' a lot and made me drawings and wrote me notes. It brings tears to my eyes when I think of them.
“After I left, they made a collage of drawings for me. My supervisor got special permission for them to do it. They weren’t allowed to sign their names, so I don’t know who did each part of the collage. Still, it is one of most precious belongings.”
© 2023 by Cliff Williams