A Day in the Life of a Prison Social Worker

Have you ever wondered what a typical day would be like for a social worker who works in a prison setting?

This week, I had the pleasure of interviewing Lisa Kays, a social worker, LGSW, who works with women at a prison in the Northeast region of the United States and will be able to provide us with a view of what her work entails.

While Lisa has less than a year of post grad work under her belt, she exhibits the insights and learnings of someone with far more experience…

Lisa – Could you provide a bit of your background? What led you to become a social worker?

I have always had an interest in psychology, but pursued a degree in English literature as an undergraduate. Then I served in the Peace Corps as an English teacher. Upon my return, I got a master’s in journalism and decided I was wholly unfit to be a journalist. 

One of my professors said, “You’re an advocate. Use your voice on that.” She was right. I kept trying to put the voices of vulnerable populations into my stories and to write from that perspective—not exactly how journalism works.

While in school, I was working in international development, so I stayed on that track, focusing primarily on work in Africa and girls’ education. Eventually, I got tired of the travel and shifted into communications and marketing work for a local non-profit focused on economic development for women. 

Throughout my years in international development, and then at the local non-profit, I kept finding myself drawn to direct practice work. I enjoyed talking to the women that were associated with the projects that we funded. When in Rwanda on a monitoring trip for a girls’ scholarship project, I kept saying, “But who is providing the counseling to help with the post-traumatic stress these people must be facing?”

One day, I got to interview Dr. Satira Streeter, who founded Ascensions Psychological and Community Services, Inc., in an under-served area of D.C. She had found a way to bring therapy to those who normally wouldn’t have access to it, and I was fascinated and inspired by her and the work she was doing. I took her to lunch to ask her more about it, and I think that’s when I really decided that I was going back to school. 

I had been gradually realizing over the years that I wasn’t a good fit for macro-level work, and knew that my interest was in clinical therapy. I thought that you had to go back for a PhD for a million years to do that, so when I found out about the MSW, and that it allowed you to practice clinical therapy and had a focus on social justice, I was sold. 

It took me a few years to work up the courage to leave the working world and make that leap into the unknown, but now I look back and don’t understand how I ever thought I could do anything else.  

Was there a particular reason that you chose to specialize in substance abuse and work at a women’s prison? 

It was sort of an accident. My main priority upon graduating was to get a job as a therapist, and those aren’t easy to come by. Most LGSW positions in this area seem to be for case management or work in hospitals, not necessarily therapy.

During my search, I remembered a previous experience in my former life of interviewing and learning about Friends of Guest House, a program for formerly incarcerated women to help get them on their feet once they are released.

I had been so inspired and impressed by the women’s stories, and horrified to learn about the many challenges and difficulties that face women upon release from prison – how so many, even if they want to turn their lives around, almost have the cards stacked entirely against them.

With this in mind, I wondered if I might be able to find a job doing therapy in corrections or in a similar program and did a Google search for something like “therapy + prison.” I found my current employer and emailed them.

They have a number of programs in different sites, so it was kind of funny because when the HR woman called me, she sounded almost apologetic when she said, “Well, the only opening we have right now is in our women’s prison.” I think she probably thought I was nuts when I said, “Oh great, that’s where I was wanting to go!”

So, the addictions piece was an accident, and the prison piece was sort of a fluke. I still have no idea why I’m so drawn to this work or this population. I’m a middle class girl from the mid-west who barely broke any rules growing up. 

I’m still trying to learn what most of the drugs are, what the slang means, how you ingest which drugs. There’s really no reason that this would make sense for me. But for now, at least, it feels like a great fit and I’m enjoying it immensely.

I understand you have some knowledge and experience in improvisation. How did you get involved in this?

I got into improvisation about 3 years ago…summer of 2008, I think… I got into it primarily because I was looking for a new challenge. I always like to be doing something a little outside of my comfort zone. 

People have always told me I’m funny, but I was terrified of the idea of performance or acting–though I think I’d always thought it looked fun. A friend of mine introduced me to a friend of hers, who worked at WIT (Washington Improv Theater).

He convinced me that anyone could do improv, and it took a number of months and I finally signed up. It’s also one of those things that I now wonder, how did I ever not have this in my life? 

Do you draw upon improvisation in your work with the women in the prison (and if so, in what way)?

I perform and teach improvisation and have found that to be tremendously useful to me in this work—both in terms of my own self-care and in how I sit with clients.

Improv has a lot to do with being in the moment and listening, and I’m fairly certain that my practice of those skills—and others—as an improviser serves me as a therapist.

But I also use it more directly. My professors were kind enough to indulge me in allowing me to do my research papers during my MSW on the intersection of improv and creativity and therapy, and I was shocked by how much literature was already out there on the subject.

So, while I don’t use a ton of improv in my work, I do bring in some of the games. Prisons are not quiet places. There is almost constant yelling, banging on doors, and interruptions in groups and sessions. For safety reasons, you can’t shut doors all the way when with clients, so the traditional “therapeutic space” we think of is nearly impossible to achieve.

I use improv games sometimes for a few moments to start off groups partially as a way of transitioning everyone into the space or the room, to draw a differentiation from the “prison space” of chaos into a safer, quieter space of the group. I use a lot of games that focus on building trust, freedom to make mistakes, physical movement, group cohesion, and just having fun. There is not a lot of genuine laughter or fun in prison, so I try to create some space for that.

I find that the games can be tremendously helpful. Sometimes, they can shift the mood of a group from sullen and disengaged to a little more lively. This helps the clients to understand the process of “fake it until you make it,” or that they can do something even if they’re in a bad mood, or that by getting active, they can even shift out of a bad mood. These aren’t things I’ve told them to realize; they typically report the insight after the game.

I can also do a lot of assessing of where someone is by using the games, often more so than I can just by going off of what they say in a group. For instance, does someone choose to participate or sit it out? Are they able to go with the flow, or do they get caught up in “doing it right” or getting impatient when someone else makes a “mistake”? I can also use the games to assess the level of group cohesion or to facilitate more cohesion.

I’ve also found that processing the game afterwards, which I always do with them, produces some astounding insights, for individuals in terms of seeing their behavior or approach in a new way or in ways that they’re able to tie the game to the process of recovery. It’s pretty cool.

Could you describe one of the improv games/exercises you do with the women?

One of the games I think they have a love-hate relationship with is called Zen Count. In it, a group of people stands pretty close together in a circle and tries to count to 21. The trick is that it’s completely spontaneous–no order, no planning–and if anyone says a number out of order or if two people speak at the same time, the group has to start over from 1.

I originally thought this would be a good one for building group cohesion, as that’s how it’s frequently used for improv groups. But it turned out to have a lot more to do with frustration tolerance, patience, and being okay with “mistakes” for them. This game drives them crazy. Some clients laugh and can have fun, but often it’s really frustrating for them. Sometimes they get so frustrated they’ll try to cheat by forming a pattern, and when I notice this, I usually step in and mess it up, which they don’t like very much.

The processing discussions from this one have been very rich. One discussion ended up being about people apologizing and saying, “I’m sorry” for messing up, even though obviously it’s not anyone’s fault. So we talked about those people tend to do that in life, saying “I’m sorry” all the time even when they don’t really need to, and taking responsibility or blame for things beyond their control.

Another time, I shared with them that some groups can do this for a long time–like they hit 21 and keep going, to 30, 40, even 100. I’m not sure they believed me, but we had an interesting discussion about how it’s kind of like recovery in that you have to keep at it, all the time. And how even if you mess up (relapse), you don’t have to give up. You can just begin again and get back on track.

We also sometimes talk about sitting things out, because some people will admit in the debrief that they avoid messing up by just not saying anything and letting everyone else do it. So we discuss if that’s their attitude towards recovery, too, or other things, to maybe avoid things when they might make a mistake or fail, instead of giving it a try. And how does that affect their life? Or about support, and whether or not you participate in and support your group, or are kind of removed and not really invested. 

Their relationship with this game is interesting. They usually like it at first, then get frustrated and hate it, but sometimes a few weeks later a group will ask me if they can do it or someone will say, “Hey, we haven’t done that counting one in a while.” 

With any of these games it’s so interesting, because often once we talk about it, the behavior in the game is similar to their approach or behavior to other things in life, whether it’s the program, their recovery, or other goals they have. I’m not surprised by that, as I’ve found it to be similar for me in my work as an improviser.

Could you describe what a typical day is like for you at your job? (Also, what percentage of your work is clinical vs. case management?)

Very little of my job is case management. There is some case management in terms of looking up resources or writing letters to parole boards or judges, but for the most part, the prison itself has case managers that handle this. Also, usually the client isn’t leaving the prison right after completing our program, so we don’t handle their transition out. Sometimes a client is, but it’s the exception, not the rule.

A typical day for me begins around 7:45 a.m. Prison days start early, and end early. I come in, get searched and have my belongings scanned, grab my keys and walk down to “the pod,” which is the cell block where our program is housed.

It’s sort of like walking through a college campus in some ways. When I get on the pod, it’s silent for the last time all day. I typically do some paperwork, like writing treatment plans or printing and signing notes until about 8:30, when count clears, and the clients are released from their cells.

Then we have our Morning Meeting, and if I’m the Point Staff for the day, I go down to facilitate it. Then at 9:00 or so, our clinical day starts, and I have 1-2 clients or groups until 11 a.m., when the clients go to lunch, which means we have lunch then.

Our staff typically eats together in our office, and it’s usually a mix of chitchat and checking in on clients. It’s sort of an informal opportunity to do some case consultations or problem-solving.

The afternoon is similar, with three groups or individual sessions until 3:00 p.m., when the clients are locked back into their cells so we lose access to them. I’ll then do more paperwork until around 4:30, and head home.

There’s also supervision and staff meetings thrown in for good measure, of course. And on Fridays, we have the Weekly Activity, which is an hour where we try to program something fun for the community, such as playing games, or watching a movie.

This is designed to help them see that there are ways to have fun while sober. Obviously, we’re limited in prison with what we can do here, but it’s a nice opportunity to interact with clients in a slightly less formal way.

What are the aspects of your work that you enjoy the most?

I really like working with my clients. I find that they have tremendous strength, despite the challenges they’ve faced in their lives. They are, by and large, innovative, creative, spunky, and resilient. 

I think many people are surprised to hear that I like my clients, that I don’t dread going to work each day, but it’s quite the opposite. While I don’t approve of or like many of the things that my clients have done, I do like them as people, and find that when 

I see them through the lens of the totality of their experience, that it’s very hard to not appreciate and respect the fabric of their stories and how they ended up making some of the choices they did. 

In many ways, I take a very “There by the grace of God go I” approach to this work, and to my clients. I don’t know, had I faced the challenges they did, or had the influences they had, that my story would have had a terribly different outcome. 

I’m grateful that I had different experiences and resources available to me. That’s the principle that guides me when I get frustrated in this work: I appreciate the opportunity to try to help provide a chance for my clients to learn some of the skills and ideas that I think many of us take for granted, and to, if they want, use them to make better choices for themselves, and to achieve what they want in life. 

I also enjoy the challenge of working with “mandated” clients. Most of our clients are required to complete the program as part of their requirements to be released, or for some it’s a way of getting their sentence reduced. So they may have absolutely no interest in actually being there. 

For some reason, I enjoy working with those clients, in forging a relationship and finding some way to foster trust and a sense of hope that they can improve some part of their life. It’s great practice in truly letting go and meeting a client where they are, rather than trying to impose goals or “shoulds.”

What are the parts of your work that you find most challenging? (Were you initially scared working at the prison?)

I was never scared at the prison. I don’t know why and I’m not sure what this says about me. It might have been because I had worked in inpatient psychiatry for one of my internships, and I had worked out some of my “fear” in that setting. 

It was funny, because when my boss was walking me across the prison for my interview, some of the clients were greeting her and asking about me and at one point she said, “It’s like they’ve chosen you already.” I was actually just saying in a staff meeting when we were discussing the challenges of adjusting to the environment that I’m always a little concerned by how quickly I acculturated.

Working in addictions is challenging. The disease produces such distortions of thought, and so much deception, that that part can be frustrating. Therapy is predicated on a notion of an alliance and a space where a client can be honest and genuine, so it can be hard when so much of the work feels like uncovering deception or having to constantly wonder if a client is being sincere.

Another challenge is working in a Therapeutic Community (TC), wherein I’m not just a therapist, but I’m also a disciplinarian. We give consequences for inappropriate behavior, and this is an odd dimension to have in the therapeutic relationship. 

It’s also different in that I see my clients all day. I watch how they behave with others, see them interact in various ways, and can also consult with colleagues who interact with them when I’m not around. This isn’t necessarily “bad,” because it definitely adds a lot of “grist for the therapy mill,” but it’s different, and maintaining the alliance can be challenging with these dual roles. 

On the other hand, it can also allow therapy to progress faster and be a little deeper, because you’re constantly processing real-time interactions, instead of descriptions of other situations. And for addictions work, where so much deception or distortions occur, this is really quite critical. 

I sometimes wonder about what it would be like to have a therapist following me around everywhere, saying, “Hmmm, that interaction didn’t really happen the way you described it. Here’s what I saw. Interesting. What is that about?,” instead of just having to trust my report. 

I also have an entire caseload of clients who know one another. Many are cell-mates. This creates interesting challenges in terms of confidentiality, because you have to keep straight who said what in group versus in individual sessions. 

It’s also a challenge in terms of perceptions of fairness, because just as we watch the clients, they are also watching us and can “compare out,” so it’s important that I treat each of them the same, that their session times are the same, that conflicts get mediated objectively. 

It’s also interesting because so much of what they bring in to sessions is about other clients, so maintaining those boundaries and remembering who said what, and not letting heresay influence my perceptions of clients is an ongoing challenge.

How important do you feel it is for social workers (who are not focusing on a population suffering from addictions) to study about substance abuse?

I think it’s helpful for any social worker or therapist to have training in substance abuse because it impacts so many people. Even if you’re not working with the individuals who are directly abusing substances, you’re likely to be working with families or friends who are affected by it, or with adults who grew up in a household with it.

And, typically, with substance abuse, it’s not likely to show up as the initial presenting problem, unless you’re in a setting focused on that. So I think that makes it important for clinicians and case workers to understand the dynamics and signs of substance use, so that they will be able to identify it even if it’s not being articulated as “the problem” or so that they can be prepared to work on it if it shows up months or years into treatment—as I think it often could due to the nature of the disease.

What were some of the things that you did in order to adequately prepare yourself for this position?

I got this position straight out of my MSW program, so beyond the Chemical Dependency course I took, I didn’t have additional training. I definitely feel I still have a lot to learn, so I use my supervision sessions and interactions with colleagues who have been in the field longer than I have to learn, and do as much reading as I can. I hope to take CEU courses related to substance abuse as well.

Finally, what key piece(s) of advice would you offer MSW students who just recently graduated or are about to graduate? 

I am so grateful to my MSW program for teaching us about self-care. When I first started this job, I was plagued with feelings of insecurity and a constant sense that I wasn’t doing a good enough job. I felt like I didn’t know enough clinically to be helpful, that I was constantly falling short.

Then, one day, I remembered these meditations that one of my professors had given us in a presentation on vicarious trauma for clinicians, about being kind to ourselves in the work, letting go of the outcome, and trusting the resiliency of our clients, etc. I printed those out, stuck them above my desk, and had a serious chat with myself.

And that maybe I could give myself a break, and trust that I didn’t need to know it all right now and that as long as I kept doing my best for my clients, learning and asking for the help I needed in supervision, and learning on my own, that I was doing a good enough job.

I think the first job out can be challenging. You are put into a new environment with much less support than we got as students. You have a larger caseload and more responsibility. It’s important to recognize that, I think.

Yes, we need to have high standards for ourselves and constantly strive to improve our practice, but we also need to be realistic about our own humanity and give ourselves the time to learn and adjust.

One of the things I find that I work on a lot with my clients is helping them gain a sense of compassion for themselves, and I have found that it’s been extremely important for me to cultivate this within myself as I do this work.

I think that’s probably the most important lesson that I’d want to share with others starting out in this profession.

You may follow Lisa on twitter at @LisaKaysMSW.
 
What questions/comments come to your mind about working with clients in prison or group work in general? What are your thoughts about this type of work and self-care?

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