ABSTRACT
The tension between maintaining safety and providing recovery-oriented mental health treatment presents a dilemma in many forensic settings. This chapter describes an approach to carrying out therapeutic work with a young man presenting emotional, cognitive, and behavioral disturbances in a forensic setting. Therapeutic work in such a setting involves both mobilizing systemic support and overcoming systemic obstacles. In the case described in this chapter, a window is provided into the complex therapeutic and organizational factors required to carry out a recovery-oriented therapeutic approach in such a setting. Some of the factors involved in this process that are described in this chapter are: (1) legal factors that define and influence treatment, such as legal commitment and court-ordered steps toward discharge; (2) investment of personnel, time, and resources by hospital administrative staff; (3) eliciting engagement of clinical team members; (4) paraprofessional staff support in providing a trauma-sensitive and recovery-oriented treatment environment; (5) support and cooperation of security staff; and (6) patient engagement. This chapter provides a perspective on the imperfect process and results of navigating such a therapeutic path.
