Working in prisons can be challenging, but a prison based therapeutic community can bring about genuine change, say Claire Illingworth, Kate Cookson, Monica Sumner and Rachael Ashcroft.
Delphi Medical is a leading independent provider of drug and alcohol treatment in the UK, ensuring excellent clinical and psychosocial provision as part of a recovery pathway. We are a part of the larger Calico group, an organisation made up of charities and businesses that focus on improving lives and creating a social profit.
Delphi specialises in drug and alcohol recovery services in prisons, including the HMP Wymott therapeutic community (TC). A therapeutic community is a community-led, living and learning environment that helps to promote social, psychological and behavioural change. HMP Wymott TC addresses substance use and is an intensive structured programme where residents live and work together. TC residents are encouraged to challenge and unlearn addiction and offending-related attitudes and behaviours – therapeutic communities use the community itself as a way to change.
HMP Wymott TC is a 70-bed unit separated from the wider prison. Residents will have access to healthcare, gym, visits and chapel in the main prison. The TC, a 12-month programme, is 24/7 and residents work together, live together and learn together. New residents will be given a buddy, and recovery peers help to support and mentor residents throughout their time in the programme.
Our aims:
- Put responsibility on individuals to recover from their dependency and lead a substance-free and more fulfilling life.
- Reduce substance-related offending.
- A holistic approach tailored to individual need and aspiration – to tackle wider physical and psychosocial needs.
- To prepare clients for living and working back in society.
Stages of treatment
Connect – three months In the Connect stage, new residents participate in the welcoming stage where job roles are shadowed, and attend five group sessions specifically about the TC programme. At this stage, new residents receive a buddy and settle into the community. Once a new resident is in Connect, they are expected to fully engage in the community. The Connect stage is an introduction to recovery and TC treatments, with residents participating in group sessions, peer support, feedback pledge groups and social prescribing groups alongside other Connect residents.
Dependence – five months In the Dependence stage of the programme residents focus on relapse prevention techniques, the self, communication, personal values, positive routines, and introduce new patterns of behaviour. Dependence residents will share their life story and take on more responsibilities in their job roles and through mentoring and supporting Connect residents.
Freedom – four months In the final stage of the TC programme, Freedom, residents focus on progression from the TC by looking at what’s next, transitioning from the TC, resettlement needs, relationships, and exploring the recovery peer offer. Freedom residents take on more responsibility by mentoring, and delivering SMART Recovery groups as well as social prescribing groups. At the end of a resident’s journey on the programme, a celebration is held with the whole community and an end-of-treatment review with other agencies such as prison offender managers, prison key workers and family members can also be invited.
HMP Wymott DARS Service
The DARS team stands for the drug and alcohol recovery service. The service has a service manager, care coordinators, recovery practitioners and recovery peers to offer prisoners at HMP Wymott the best opportunities to reach their personal recovery goals.
There are three different stages of support:
Connect – When clients are first referred into our service, a DARS duty worker will visit them and assess their immediate needs. They will be allocated a recovery practitioner who will complete their triage assessment with them.
Dependence – Once clients have completed their initial and triage assessment, they will be moved to Dependence. Their recovery practitioner will work with them in a client centred way, to form a holistic recovery plan. During Dependence they can engage in group work and one-to-one work with their recovery practitioner and refer to the TC if they need to. Clients will stay in Dependence until they feel they have completed all their goals.
Freedom – The Freedom offer is available to all clients being released from custody with an option to refer to community services if they wish. This can be their local drug and alcohol service, community groups, rehab and supported housing. Freedom clients can also apply to become a recovery peer to support others and continue to engage in peer support sessions.
What else can clients get involved with?
The DARS team understands that everybody’s recovery journey is unique to them. It offers a service that tries to reach as many people as possible, and can provide even more support through the following group sessions:
- Lancashire release • Life skills
- Mutual aid • Acupuncture therapy
- Recovery gym • Creative therapy
- Awareness • Relaxation
- Peer support • Recovery peers
- Family days • SMART recovery
- Motivational speakers
Claire Illingworth
Delphi Medical, area operations
manager – central
Having worked in prison substance misuse treatment for over 20 years I sit here pondering the changes in the offer I’ve seen, and our clients have experienced, over the years.
I often describe working in prisons as Marmite – you either love it or hate it. It’s a restrictive and challenging environment, and equity of treatment is vital. In the prison, treatment is not mirrored to the community in my experience. One example is that community-based rehabs are all over the country, but when we look at our prison offer there’s only one and we’re fortunate that it falls in the Northwest – HMP Wymott TC.
We have other options across the country including supportive environments, enhanced living, drug-free environments, recovery wings – these are having a good impact, but this isn’t mirroring the community offer.
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Rachael Ashcroft
Delphi Medical, care coordinator DARS lead – HMP Wymott
Having worked in HMP Wymott for 18 years in various roles it’s been interesting to see services develop over time and see the different drug trends throughout the establishment.
At times, it can be challenging due to the ever-changing selection of psychoactive substances and their effects. But for me, I enjoy working in Wymott as no two days are the same.
Working in substance misuse brings variety as you get to engage with many different people from different backgrounds who are wanting to achieve different goals, but all wanting to recover from substance misuse and really change their life.
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Kate Cookson
Delphi Medical, service manager health and justice – HMP Garth, HMP Wymott, HMP Manchester, Barton Moss and Marydale
Working within prisons is not everyone’s cup of tea, and for some it can be too restrictive while others thrive.
Prisoners are able to engage with services and get a top-quality service, but we must remember this is voluntary and change happens when someone wants recovery, not when forced. This is often forgotten in the prisons, and it can be pushed on from various places – often meaning recovery is not genuine, and we can see a lot of revolving doors. But when it is genuine it works and it’s amazing. Having more TCs, recovery wings and funding for prison substance misuse services would support this journey and allow the amazing work being done by our teams all across the country to be even more successful.
Why work in prisons? Because change can and does happen!
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Monica Sumner
Delphi Medical, therapeutic community care coordinator lead – HMP Wymott
I’ve worked on the therapeutic community at HMP Wymott for over five years, starting as a volunteer, and now managing the programme.
From my experience, I can say this is an extremely challenging, yet extremely rewarding, field to work in. We face different obstacles each day regarding drug use and offending behaviours, right down to prison regime restrictions. Nevertheless, being able to say that as a team we deliver an intense structured treatment programme for 70 men, daily, is something we’re very proud of.
Being one of the only prison-based drug and alcohol rehabilitation programmes left in the UK is a very sad statement to make. Further intensive support within prisons, in my opinion, is urgently needed.