Skip to content
Raising the bar for excellence in CBT. Enroll in Beck Institute CBT Certification today!
September 23, 2020
Chain link fence

By Shelby Arnold, PhD
Staff Psychologist, Center for Recovery-Oriented Cognitive Therapy

Consider “John,” a man sentenced to life without parole for a gang-related murder committed as a teenager. During his time in prison, John successfully passed his General Education Development (GED) test and was working toward a college degree. He ran a GED tutoring program for his peers. He started a book club. He wrote pages and pages of brilliant poetry detailing the stigma he experienced from his family, society, himself, and the challenge of defining his identity outside of “inmate.” He reflected on finding meaning in a life path he did not think would be his.

Throughout my work in forensic settings, I have discovered that John’s path is uncommon. Most justice-involved individuals express feelings of powerlessness, hopelessness, and being stuck. These can lead to an increase in any underlying mental health challenges and contribute to an overall lack of fulfillment.

Chain link fence

I met John when I was an undergraduate, volunteering for a prison-based literature and writing group. The experience of working with John stayed with me throughout my training and in my clinical practice. I knew that something had gone right for John, but I couldn’t put my finger on how to replicate it. I found it difficult to fully incorporate strengths-based principles within systems primarily concerned with reducing psychiatric symptoms or navigating justice involvement. For individuals so often defined by these challenges or mistakes, a meaningful identity might be difficult to access, or the person might feel too vulnerable to share hopes and desires with others.

Recovery-Oriented Cognitive Therapy (CT-R) provides a framework for understanding John’s success. John had discovered the core principles of CT-R on his own. He thrived when connecting with others about literature, so he was always ready with personally tailored book recommendations. Mentorship and sharing knowledge are important to him (John hoped to become a teacher), so he found ways to live out this meaning in a maximum-security prison, working towards his own education and tutoring peers. John valued creativity and expression, so he wrote poems and read them to others. Instead of focusing on hopelessness and powerlessness, John found ways to control what he could and base his identity on the same foundational values and meanings he would have in the community. He fought hard to be viewed by others in the way he wanted to be seen, and in the way he had come to see himself: “generous,” “talented,” “capable,” and “a good person.”

CT-R can provide concrete steps for systematically helping those who have been stigmatized, marginalized, and institutionalized to succeed at creating their best selves in trying circumstances. CT-R empowers individuals who were previously “passing time” to find personalized meaning. It promises to make John’s experience the rule, rather than the exception.

Having had some exposure in graduate school, I discovered the full power of CT-R during my postdoctoral fellowship at the Beck Institute Center for Recovery-Oriented Cognitive Therapy. The beauty of CT-R is that its essence can be applied by any person in any interaction. Our team at the Center has seen tangible success across disciplines, from psychologists to security officers.

When working in forensic settings — or with individuals who may experience similar themes of stigma and isolation — consider the following CT-R principles:

1) Connection is key.

Connect over shared interests. Do an activity together. Tap into an individual’s strength or knowledge base and see if there’s something new they can teach you. Higher security settings may require flexibility and creativity, but there’s always a way to connect and empower individuals to feel like an expert.

2) The values and deeper meaning underneath a person’s goals can be your roadmap.

While their life path is not the one they had planned or hoped for, they can still gain meaning and a sense of fulfillment. See if there are ways to take positive action toward this underlying meaning. For example, teaching others may involve many steps and take quite a long time, but the person can still find ways to care for and help others regardless of the setting.

3) Focus on an identity outside of a person’s challenges or the setting they are in.

Help individuals unlock their own strengths. Draw conclusions about what those strengths say about them as a person and focus on their resilience and on positive action they can take toward a meaningful life.

4) Notice success as a team.

Nothing succeeds like success. Officers, therapists, and medical staff should make it a point to notice what’s working by sharing with each other individuals’ aspirations, steps that bring important meanings into their daily life, and connections they have made. This unity as a team helps everyone collaborate better along the same mission of realizing the person’s best self.

If I had the opportunity to go back, knowing what I know now, I would want to ask John what it means about him that he was able to turn his incarceration into an opportunity, and what he believes about himself as a person that he might not have before. I wonder if he’d see himself as resilient, capable, or strong. I wonder if he’d make the connection that his helping others provides purpose or a way to live his life in line with his values. I like to think he would.

Dr. Arnold and Joseph Keifer, PsyD, BSN, will be teaching our Forensic Settings and CT-R webinar on March 12 from 12 to 1:30 PM Eastern Time. This training will review the basic theory of CT-R and its application to various forensic settings, highlighting specific strategies that can be flexibly applied by staff of any discipline.

Forensic Settings and CT-R

March 12, 2021