ABSTRACT
Reflecting a 35-year continuous rise in the use of incarceration, the number of people kept in US prison establishments today exceeds 2.2 million (Walmsley 2009). In Florida, the state in which a number of the studies and projects presented in this chapter were conducted, the prisoner population increased by 20 per cent from 2003 to 2007. By the end of 2007, more than 90,000 prisoners were held in Florida’s prison establishments. Meanwhile, as the Human Rights Watch reports, ‘[a] staggering number of persons with mental illnesses are confined in US jails and prisons – somewhere between two and four hundred thousand or more, according to expert estimates’ (Human Rights Watch 2005, 1; see also Cooke 2002). It is against this background that provision of mental health treatment in prisons has proliferated in recent years (see, e.g., Beck and Maruschak 2001). However, the types of therapy on offer and verbal therapy in particular may not always be appropriate. This is not only because prison inmates who cope with mental health issues are different from those in other settings. It is also because prison settings themselves are not conducive to verbal therapy. In the inherently antagonistic culture of prisons, that is, to seek or accept therapy may leave one vulnerable in the eyes of others, even more so when therapy entails the disclosure of personal weaknesses (Gussak 1997).
