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The Psychological Needs of Women Prisoners: Implications

for Rehabilitation and Management

Article  in  Psychiatry Psychology and Law · June 2002

DOI: 10.1375/pplt.2002.9.1.34

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The Psychological Needs
of Women Prisoners: Implications
for Rehabilitation and Management
Mitchell K. Byrne
University of Wollongong

Kevin Howells
University of South Australia

T
he rehabilitation and management of women offenders in prison are topics which continue to elicit concern,
controversy and, often, disillusionment based on the failure of previous policies and initiatives. In this paper
we argue rehabilitation and management should be based on the established needs of women prisoners and,
in particular, on the Responsivity principle (adapting programs and methods to the gender-specific needs and
requirements of women). Our review of the literature indicates major problems of psychological and psychiatric
morbidity, including psychiatric disorder (especially posttraumatic stress disorder; PTSD), substance abuse, person-
ality disorders, sexual/physical abuse and self-harm. The implications of such findings for good practice are discussed.

It is timely to re-evaluate the psychological and
social aspects of the imprisonment of women. The
increasing prevalence, internationally, of women
in prison (Browne, Miller & Maguin, 1999;
Carlen, 1998) and the perceived failure of govern-
ments and correctional systems to deliver the
reforms and changes in the management of
women prisoners that seem to be required
(Howells, Day, Byrne, White, Hart & Nakos,
1999a) require that the problems of female impris-
onment are considered anew.
These issues identified in the international
literature are of no less relevance in Australia, where
the number of female prisoners also appears to be
on the increase — in 1983 women comprised
3.9% of the entire prison population, in 1990:
5.4% and in 1998: 6%. Easteal (1992) noted this
increase as early as 1992 and suggested that a trend
towards lengthier sentences, “truth in sentencing”
legislation, a higher proportion of women on re-
mand, and an increased frequency of drug offences
were contributory factors to this rise.
The Needs of Female Prisoners
One of the most substantial reviews of the needs
and problems of women in prison was conducted
by the Prison Inspectorate for England and Wales
(H.M. Chief Inspector of Prisons; HMCIP, 1997).
Based on official statistics and interviews with
10% of the total population of female prisoners,

This paper was derived, in part, from a research report prepared for the A.C.T. Department of Justice and Community Safety
(Corrective Services). The authors acknowledge their permission to reproduce parts of this report.
Correspondence to: Mitchell K. Byrne, Department of Psychology, University of Wollongong, Northfield Avenue, Wollongong
NSW 2522, Australia.

PSYCHIATRY, PSYCHOLOGY AND LAW

34 VOLUME 9 NUMBER 1 2002 pp. 34–43

this report identified a number of important
features, including the high prevalence of:
• Sexual, physical and emotional abuse.
• Substance abuse, particularly poly-drug and
heroin use.
• Self-harm and attempted suicide (40% of cases).
• Poor employment and poor educational
histories.
• Severe emotional or mental problems.
Similarly in Canada, Motiuk (1997) has identified
needs in a sample of 11,541 male and 182 female,
federally sentenced prisoners using the Case Needs
Identification and Analysis (CNIA) measure of
criminogenic needs. While a greater proportion of
males than females reported significant crimino-
genic needs, such needs were apparent in both
sexes. Among Canadian female offenders,
Blanchette (1997) has demonstrated that women
convicted of violent offences in particular have
very high levels of need. In Blanchette’s study,
violent female offenders had needs in the areas of
substance abuse, unstable living arrangements,
debt, poor problem recognition, low empathy
and, particularly, mental disorder.
From this wide range of identified needs, only
some have been shown to be criminogenic, in the
sense of being statistically associated with recidi-
vism. Although female offenders have many areas
of risk and need in common with male offenders,
some distinctive areas of need exist specifically for
women. While there appears to be no published
work on the needs of female offenders in Australia
using formal measures (this clearly being an
important area for future research), Moth and
Hudson (2000) have reported a small study with
female offenders in New Zealand. Noteworthy,
once again, are the high levels of psychiatric/
psychological problems reported. Mood problems,
anxiety, drug misuse and chronic physical/
medical problems were common. Over 70%
reported being physically, sexually or emotionally
abused as a child. Most of the New Zealand
offenders had multiple needs and more severe
levels of need than the Canadian sample surveyed
by Blanchette (1997).
Psychiatric/Psychological Needs
While there is relatively little research specifically
related to psychopathology among female offenders
(Hurley & Dunne, 1991; Keaveny & Zauszniewski,
1999; Raeside, 1994), there is a consensus that
REHABILITATION OF FEMALE OFFENDING
mental health problems are more common among
female prisoners than their male counterparts.
(Daniel, Robins, Reid & Wilfrey, 1988; Gorsuch,
1998; Mohan, Scully, Collins & Smith, 1997;
Morash, Bynum & Koons, 1998; Raeside, 1994).
Various Australian studies have noted that women
prisoners have a high prevalence of both Axis I and
Axis II disorders, as categorised by the Diagnostic
and Statistical Manual Mental Disorders (DSM;
American Psychiatric Association) (Denton, 1995;
Raeside, 1994). Prevalence rates range from 53%
(Hurley & Dunne, 1991) to 90% (Disability
Action Inc., 1997).
The mental health profile of a female prisoner
is characterised by high rates of depression, anxiety
disorders, substance abuse and personality disor-
ders, particularly borderline personality disorder,
(Hurley & Dunne, 1991; Keaveny & Zauszniewski,
1999; Raeside, 1994). It has also been observed
(Gorsuch, 1998) that there is a substantial incidence
of self-harming behaviour. Such consistent report-
ing of significant mental health needs requires
adequate (gender relevant) psychiatric screening
upon entry to prison, the consideration of diver-
sionary programs and adequate provision for
psychiatric and psychological services within
prisons (Denton, 1995). In the absence of adequate
psychiatric care, there is evidence that women’s
psychiatric needs do not dissipate during their
incarceration (Hurley & Dunne, 1991), and may
indeed worsen (Byrne, 2000).
Amongst those studies that do focus upon
psychopathology among female offenders, the
accumulation of women with major psychiatric
and psychological disorders in prisons has been
noted (Gorsuch, 1998). Female prisoners with
psychiatric disorders are often “difficult to place”
in psychiatric facilities and remain in prison
despite the need for psychiatric attention and care.
Gorsuch’s study (1998) throws some light on how
female prisoners who are difficult to place differ
from those who are successfully placed in psychi-
atric facilities. The former group have very high
levels of childhood abuse, have more serious index
offences, are chronic self-harmers, have more
serious histories of substance abuse, have diagnoses
of personality disorder and are eventually
discharged to the community rather than to a
psychiatric hospital. Gorsuch graphically describes
the plight of this group:
This catalogue of deprivation, disruption and
disturbance gives some indication of the exten-
35
MITCHELL K. BYRNE AND KEVIN HOWELLS
sive and complex needs of these women and
the inappropriateness of imprisonment as
punishment or deterrent for their criminal acts.
Even against the background of past and
present psychosocial disadvantage which
characterises a large proportion of the prison
population, the chaos and suffering of these
women’s individual histories retain the power
to shock (p. 566).
Typically, psychiatric units are reluctant to admit
female offenders of this sort, although there are
grounds to believe (Gorsuch, 1998) that at least
some are amenable to psychiatric treatment or
psychological interventions. Dealing with such
people requires either a major humanisation of
typical mainstream correctional environments,
including the full provision of psychiatric, psycho-
logical and nursing support, or the transfer to
more appropriate provision outside of the correc-
tional system. There are dangers, too, of exagger-
ating the prevalence of psychiatric abnormality of
women in prison — what Maden (1997) has
referred to as the “psychiatrisation” of female
offending, whereby all female offenders are seen as
requiring psychiatric care. This tendency is as
unhelpful as the tendency to ignore the existence
of psychiatric disorder in this group.
Substance Abuse
Browne et al. (1999) attribute the rapid growth
(quadrupling) of female incarcerates over the past
decade in the United States to the increased use of
prisons for drug-related offences. A “spot survey”
during 1998 in New York State revealed that 60%
of all women in custody were serving time for
drug-related offences. Similarly high rates of drug-
related crime has been reported in Australia, with
Miller-Warke, (1999) observing that drug-related
crimes may account for as many as 80–90% of
West Australian female offences.
Many studies have reported a high level of
substance abuse among female prisoners, higher
than that of their male counterparts (Dowden &
Andrews, 1999; Kingi, 1996; Koons, Burrow,
Morash & Bynum, 1997; Maden, Swinton &
Gunn, 1990, 1994; Mohan et al., 1997; Morash et
al., 1998; Singer, Bussey, Song & Lunghofer,
1995). For example, Caddle and Crisp (1996)
found that 52% of their UK sample had a recog-
nised substance misuse problem while Krieg
(personal communication 1999) estimates 60% to
70% of her South Australian sample have
36
problems with the misuse of substances, consistent
with an earlier observation at the same prison by
Raeside (1994) of between 79% and 85%. Similar
levels of use have been reported in Victoria
(Australia) by Denton, (1995) who found a
lifetime substance dependence prevalence of 68%.
Substance abuse in particular is often associ-
ated with a history of physical and/or sexual abuse
and having inadequate strategies to manage
emotional distress. Indeed, Browne et al. (1999)
observe that risk of substance abuse is predicted by
a history of some form of physical and/or sexual
abuse in childhood. Substance abuse programs,
unsurprisingly, are a common feature of prison
rehabilitation programs (Morash et al., 1998),
however services are rarely able to meet the level of
need (Disability Action Inc., 1997).
Posttraumatic Stress Disorder
Histories of abuse are often associated with the
subsequent development of a constellation of
anxiety-related problems, with many women
meeting the criteria for a diagnosis of posttraumatic
stress disorder (PTSD), as defined by the DSM-IV
(APA, 1994). Raeside (1994) found that 81% of
his Australian female prison sample met the criteria
for PTSD, with a high comorbidity for depression
and substance abuse. Raeside compares this with an
8% to 16% incidence in the general population
and 53% for a combat population. Raeside
observed that a significant proportion of the PTSD
problems could be attributed to early childhood
victimisation and demonstrated that the most
frequently used strategy to manage the distressing
symptomatology associated with PTSD was the
abuse of substances. Thus, the comorbid substance
abuse disorder seemed to be functionally related to
the preceding PTSD and could not be treated in
isolation. Rather, Raeside (1994) advocated that
specific counselling services for women who had
experienced such traumatic events be provided
prior to, or in combination with, substance abuse
interventions. He cautioned against the use of
psychotropic medications alone in treating PTSD
symptomology, suggesting that this served to
perpetuate the offenders’ drug-related avoidance
strategies. This caution is consistent with the
observations of Vine (1994) that there is a high
rate of paradoxical reactions to benzodiazepines,
often prescribed for anxiety related conditions,
amongst women who have a personality disorder.

The high incidence of abuse in female offend-
ers (Browne et al., 1999; Caddle & Crisp, 1996;
Disability Action Inc., 1997; Krieg, 1999; Morash
et al., 1998; Raeside, 1994) and the strong associ-
ation identified between early abuse and the devel-
opment of PTSD in the generic literature (Breslau
& Davis, 1992; McFarlane, 1989) leads us to sug-
gest, by extrapolation, that the treatment of PTSD
conditions should be a priority in rehabilitation
planning. This necessitates early identification of
the disorder in prisoners and the development of
adequate screening procedures to do so.
Low Self-esteem
While Andrews and Bonta (1994) have suggested
that self-esteem is not a criminogenic need in the
male offending population, Koons et al. (1997)
suggest that treatment programs which target
female offender self-esteem and issues of victimisa-
tion may yet prove to be particularly efficacious in
the rehabilitation of female offenders.
Consistent with Koons et al.’s (1997) observa-
tions, Morash et al. (1998) suggest that the
amelioration of low self-esteem, the origins of
which lay in early victimisation, would provide an
appropriate criminogenic target for rehabilitation
service providers. Low levels of self-esteem prior to
release have been linked to recidivism. Programs
to address self-esteem difficulties should, there-
fore, be a priority for correctional administrators
(Hardesty et. al., 1993), notwithstanding the diffi-
culties in implementing such programs within an
institutional environment.
Personality Disorder
A diagnosis of borderline personality disorder
(BPD) is common among women who have a
history of childhood sexual abuse (Gorsuch, 1998;
Herman, Perry & van der Kolk, 1989) and in
female offender populations (Coid, Wilkins, Coid,
& Everitt, 1992; Gorsuch, 1998; Hurley & Dunne,
1991; Raeside, 1994). The behaviours associated
with BPD, (impulsive behaviours, rapidly shifting
moods, intense anger, self-harming behaviours,
difficulties in relationships and impoverished self-
esteem) are challenging and often evoke negative
reactions from peers and staff (Gorsuch, 1998).
Rehabilitation programs should, nevertheless,
target these behaviours as therapeutic goals
because they may be integral to the amelioration
of offending behaviour (Coid, 1993). Given that
behaviours such as self-injury are often functional
REHABILITATION OF FEMALE OFFENDING
in reducing subjective experiences of tension
(Coid et al., 1992), care must be taken not to target
such behaviours in isolation from the cognitive
antecedents which precipitated them. These will
often relate to histories of childhood victimisation.
Physical/Sexual Abuse
Some 25% to 40% of the general female popula-
tion experience some form of sexual abuse before
the age of 18 years (Dutton, Burghardt, Perrin,
Chrestman, & Halle, 1994). Given these high
rates of sexual victimisation, it is surprising how
few studies have been undertaken with female
offenders (Browne et al., 1999; Sargent, Marcus-
Mendoza & Ho Yu, 1993).
Estimates of the incidence of childhood abuse
amongst female prisoners vary. For example,
Sargent et al. (1993) state that nearly 70% of their
sample reported experiencing some form of abuse
before the age of 18 years. Raeside (1994), in his
study of posttraumatic stress disorder amongst a
cohort of Australian women offenders, found that
55% had experienced childhood sexual abuse and
21% (potentially overlapping) had experienced
childhood physical abuse. However, a study by
Disability Action Inc. (1997) of prisoners in the
same institution suggested that 85% had experi-
enced sexual abuse as a child. This is in keeping
with observations in Western Australia where 80%
of incarcerated women are reported as having
experienced “child–adult victimisation” (Miller-
Warke, 1999). The incidence of sexual abuse in a
New South Wales sample was estimated to be
48% (Butler, 1997).
The long-term sequelae of abuse can include
behaviours and actions that mask the underlying
pathology and obscure the offender’s treatment
needs. Posttraumatic stress disorder, for example,
involves distressing emotional, physiological and
perceptual/cognitive experiences. These symptoms
elicit coping behaviours that, more often than not,
involve the use of alcohol or other drugs.
Offending behaviour, therefore, may be a product
of the original abuse itself, of the PTSD that
follows or of the substance use involved in coping.
Establishing whether abuse can be proven to
be a cause, as opposed to being merely a correlate
of crime, is not useful. Even if abuse is not directly
causal, there would be a requirement on the
correctional system to “treat” abuse effects as part
of the duty of care. However, there is evidence that
treatment of abuse sequelae is an appropriate
37
MITCHELL K. BYRNE AND KEVIN HOWELLS
criminogenic focus (Koons et al., 1997). Browne
et al. (1999) argue, for example, that treatment
programs could “markedly improve the potential
for adjustment within the incarcerated setting and
successful integration when women return to the
community” (p. 319). These authors describe an
outcome study by Canestrini (1994), based
within the New York State Department of
Correctional Services. This study involved
women offenders participating in a program for
survivors of abuse. At 21 months follow-up,
women who participated for 6 to 12 months in
the program had less than half the recidivism rate
of those who did not participate.
While the statistics regarding the experience of
childhood abuse among female offenders are
disturbing, the incidence of abuse in adulthood is
also significant. For example, Fletcher, Rolison
and Moon (1993) observed that 69% of their
sample reported recent abuse as an adult, includ-
ing both physical and sexual assaults. More
recently, Browne and her colleagues (1999) have
observed that one particular after-effect of sexual
molestation as a child consistently reported in the
literature is later involvement with violent
intimates. These authors reported that the lifetime
prevalence rates for severe violence was greater for
female offenders than the lifetime prevalence rates
for all acts of physical abuse reported by women in
the general female population. From a treatment
perspective, such findings suggest that interven-
tions targeting protective behaviours and domestic
violence be included in the “package” of rehabili-
tative services offered to female inmates.
The abuse experiences of women, both in
childhood and as adults, and the psychological and
psychiatric sequelae, including substance abuse,
place female offending into an important social
and psychological context. Singer et al. (1995)
observe that, “the crimes these women commit are
often a reaction to negative life events, a response
to crisis or prolonged disadvantage” (p. 103).
Self-injury and Suicide in Prison
Literature regarding the management of suicide
and self-injury in prison has been reviewed in a
recent paper by Howells, Hall and Day (1999). In
this paper the authors describe a number of factors
associated with increased risk of suicide in prison-
ers. Whilst much of this literature refers to risk
factors in male prisoners, there is evidence to
suggest that some of the areas of need discussed
38
above are likely to be associated with increased risk
of suicide and self-injury in female prisoners.
For example, the literature consistently reveals
that a disproportionate number of self-injurious
adult prisoners appear to have been raised in
dysfunctional and abusive family environments
(De Souza & Doyal, 1998; Keaveny & Zaus-
zniewski, 1999; Sheridan, 1996b; Towl & Hudson,
1997). Substance abuse has been consistently associ-
ated with self-injurious behaviour in female adult
prisoners (Gorsuch, 1998; Keaveny & Zaus-
zniewski, 1999; Ryan, Parle & Babidge, 1998;
Sheridan, 1996c). In one study by Shaw (1999),
three-quarters of the women who self-injured
had a history of alcohol or drug addiction.
Psychological disorders also appear to be related to
an increased risk of self-injury and suicide
(Crighton, 1997; Gorsuch, 1998). Sheridan (1996c)
found that women who engaged in self-injury had
problems with depression, self-esteem, personal
stress, and aggression. Raised levels of anxiety
have also been consistently associated with
self-injurious behaviour in females (Keaveny
& Zauszniewski, 1999), as has the occurrence
of major recent life-events (Livingston, 1997;
Ryan et al., 1998).
A small, but focused, study by Snow (1997)
examined 11 female prisoners, aged 16 to 40 who
had self-injured and included interview data from
seven staff members of the prison. Snow found
that these women tended to be younger, were
more likely to have had previous psychiatric treat-
ment, and were more likely to be serving sentences
for violent offences. Most of the women had previ-
ously harmed themselves or attempted suicide.
When asked why they had injured themselves in
the first instance, their responses included refer-
ences to domestic problems, childhood experi-
ences, jealousy, depression, anger at themselves,
and a wish to die. The reasons for continued self-
injury were the relief of stress, tension, anger and
frustration, to inflict pain on themselves, as a
means of moving to another location, and the
intention of killing themselves. A majority of the
women claimed their self-injurious behaviour was
impulsive and that they never planned to injure
themselves. These women thought counselling or
therapy which addressed the problems that led to
their self-injury would be beneficial. They also
believed anger and stress management, relaxation
and sexual abuse therapy would help reduce or

stop their self-injurious behaviour and suicide
attempts (Snow, 1997).
What is striking about this literature is that
female prisoners are likely to have high levels
of need in many of the areas identified as risk
factors for suicide and self-injury in prison.
This, perhaps, helps to explain the high levels of
self-injurious behaviour in women prisoners
(Livingston, 1997). Management strategies that
are successful in reducing this level of need are
likely to reduce the levels of suicide and self-injury
by women in prison.
Differences in the Management
of Male and Female Prisoners
A critical question in the management of women
prisoners is whether they should be treated and
managed, fundamentally, in the same way as male
prisoners. Carlen (1998) has argued, persuasively
in our view, that:
A coherent and effective policy towards women
in the criminal justice and penal systems will
only be developed when it is recognised: that
women’s crimes are committed in different
circumstances to men’s; that women’s lawbreak-
ing is, on the whole, qualitatively different to
men’s; and that therefore the response to both
men and women lawbreakers should be in-part
gender-specific, rather than merely crime and
sentence specific. (Carlen, 1998, p. 10).
The phrase “in-part” in Carlen’s statement is an
important qualification, given the evidence that
men and women prisoners do have some crime-
related characteristics in common (Maden, 1997).
There is no inevitable contradiction between an
insistence on the partial specificity of the needs of
female prisoners and the necessity for parity
between women and men in work, leisure,
programs or education provision.
Worrall (1997) and Carlen, (1998) note, as
have others, that in most countries imprisonment
is perceived as particularly problematic for women
because of the social expectation that women are
more important as carers for their children and
families. Lashlie (personal communication, 1999),
for example, draws attention, from a New Zealand
perspective, to the need for prison management to
be based on a:
…recognition of the different reality for women
who are in prison — children in care, husband/
partner off with another woman — and no
REHABILITATION OF FEMALE OFFENDING
family unit left to speak of (for male inmates,
the reverse is generally true — ‘she’ maintains
the family home and goes without so he can
have money for smokes in prison).
The requirement is for a needs based management
and rehabilitation system in which the distinctive
features of women offenders are acknowledged.
HM Chief Inspector of Prisons (1997) concluded
from a survey of female prisoners that:
Women have different physical, psychological,
dietary, social, vocational and health needs and
they should be managed accordingly. As one
correspondent put it to us, it is not merely a
question of women receiving equal treatment
to men; in the prison system equality is every-
where conflated with uniformity; women are
treated as if they were men… ‘Cons in Skirts’.
(p. 28).
Prison staff working with women often concur.
Carlen (1998) summarises her interviews thus:
Interviews with the staff of the women’s
prisons made it very apparent that, throughout
the women’s prison sector there is strong
awareness that women’s imprisonment is
different from men’s for three main reasons:
biological — women’s physical needs are essen-
tially different to men’s; social — women’s role
in the family is different to men’s; and cultural
— women’s experiences of imprisonment are
different to men’s and have different meanings
attached to them, both by the women
themselves and all those for whom, subse-
quently, they become ‘prisoners’ or ‘ex-prison-
ers’. (Carlen, 1998, p. 133).
Such arguments seem to us to be entirely consis-
tent with the “Needs” and “Responsivity” princi-
ples (Howells et al., 1999b) — that effective
management of female prisoners, as with other
offenders, should be based on a comprehensive
needs analysis of the female offender population in
the particular jurisdiction and adapted to the
characteristics of the group. A corollary to Carlen’s
argument, and one she highlights, is that all prison
regime changes should be submitted to what she
calls a “gender test” by asking whether the
proposed innovations require differential imple-
mentation in women’s and men’s prisons because
of the biological and culturally induced differences
between female and male prisoners.
39
MITCHELL K. BYRNE AND KEVIN HOWELLS
Rehabilitation and Management
Programs for Women Offenders
Some distinctive considerations arise in planning
programs for women. Peters, Strozier, Murrin,
and Kearns (1997), for example, recommend that
treatment programs for female inmates should
take into consideration this group’s multiple
psychosocial problems and thereby, should follow
the principles that have emerged in the treatment
of co-occurring disorders. The principles outlined
include:
• Multiple problems/disorders should all be
treated as important.
• Co-occurring problems/disorders should be
treated simultaneously rather than sequentially
where possible.
• Where the latter is not possible, the problem/
disorder that causes the most functional distur-
bance should be addressed first when selecting
the sequence of potential treatment services.
• A “baseline” assessment should be conducted
so as to recognise the complexity of the
psychosocial problems.
• Training should be provided for staff concern-
ing the nature of co-occurring problems/
disorders and their interactive effects.
In Australia, different prisons have different “core
programs”. Most often however, these programs
include anger management, domestic violence (for
perpetrators and survivors), alcohol and drugs,
cognitive skills, and literacy and numeracy
(Howells & Day, 1999). These programs rarely
differ in content for male and female offending
populations, although some have argued that
specific criminogenic needs, such as anger control
(Suter, Byrne, Byrne, Howells, & Day, 2000) vary
between the sexes. Programs designed especially
for women currently offered in various Australian
states include self-esteem, parenting, communica-
tion and assertiveness, skills and change, life
choices and stress management.
The Correctional Service of Canada has a
comprehensive collection of “core programs” for
women prisoners. The programs are grouped
under the headings:
• Living Skills Programs.
• Substance Abuse Programs.
• Literacy and Continuous Learning Programs.
• Survivors of Abuse and Trauma Programs.
40
• Mother-child Program.
• Other Programs and Services.
(Correctional Service of Canada, 1999a).
Living Skills Programs are similar in scope to those
for male offenders, but have been modified to
meet the special needs of women. They encompass
Cognitive Skills Training, the Parenting Skills
Program, the Leisure Education Program and the
Community Integration Program. The Substance
Abuse Program has been specifically designed for
women offenders and is based on the Prochaska
and DiClemente (1996) model of change. The
Survivors of Abuse and Trauma programs assist
female offenders in dealing with and working
through the violence they have experienced.
These programs include education and awareness
type programs as well as more in-depth therapeu-
tic programs. The Literacy and Numeracy
program is based on the employment and
personal needs of women. The Mother-Child
Program provides mechanisms that foster and
promote stability and continuity for the child in
its relationship with its mother. The child and its
physical, emotional and spiritual wellbeing is the
primary consideration. Other programs and
services are available to enhance the opportunity
for successful re-integration of women offenders.
The development of these programs is the respon-
sibility of each institution and region and may
include multicultural, recreation and leisure,
vocational and educational, peer support team
and health programs and services (Correctional
Service of Canada, 1999a, b, c, d).
In England and Wales there are no national
core programs for female offenders, thus different
programs are run in each institution. Anger-
management programs delivered in UK prisons
account for 10 per cent of all group work in
prisons and are offered in both an individual and
group format (Horn & Towl, 1997). The
programs are substantially similar to those offered
to male prisoners and draw on cognitive-behav-
ioural approaches incorporating relaxation train-
ing, assertiveness and problem solving. Horn and
Towl (1997) note that there are no published
guidelines for adapting this approach to meet the
needs of women prisoners.1
Responsivity and Programs for Women
The Responsivity principle proposed by Canadian
correctional researchers (Serin, 1998; Serin &

Kennedy, 1997), and widely acknowledged inter-
nationally, is a feature of best practice. The issue
arises, therefore, as to whether standard offence-
focused programs, such as anger-management or
substance abuse, should be presented in a different
way for female offenders. There has been little
discussion in the literature as to which variations
in practice are required. The HMCIP (1997)
report suggests, and we have argued above, that
substance abuse has different antecedents and
functions for women than for men and that drugs
and alcohol have more of a “numbing” of emotion
function for women. If this were true, programs
for women would need to be modified to reflect
this difference.
Pre-release courses would need to have a clear
focus on relapse prevention and on developing
skills for survival and independence in the
community. The content of such courses should
reflect what is known (above) about the specific
needs of women that cause offending and re-
offending. It is unrealistic to think that the multi-
ple and severe needs of female offenders can be
fully and permanently dealt with in a prison
setting. Thus a major focus of pre-release
programs needs to be liaison and continuity of
care with community, social, medical and correc-
tional agencies.
Staffing Considerations
Working with women prisoners can create diffi-
cult working conditions, and consideration needs
to be given to the needs of the staff. Given the
traumatic background of female offenders, staff
require specific training in empathic listening and
counselling skills, to ensure best practice. The
issues raised in managing female offenders may be
personally difficult for staff members. It is impor-
tant that staff are provided with adequate support
in their working environment to reduce the stress
which can be caused, for example, by disclosures
of abuse.
Prior abuse may result in some female offend-
ers having difficulty trusting male staff members.
Casale (1998) stresses that women should not be
placed in settings where only male staff are avail-
able, and recommends a ratio of 4:1 of female to
male staff. Having predominantly male staff in
women’s prisons may cause the women to feel
unsafe, and can increase the sense of vulnerability
of the prisoner.
REHABILITATION OF FEMALE OFFENDING
Women’s role in society often places them in
an inferior position to males. The conditions of
detention and incarceration, which include the
diminution of the offender’s rights and power,
place female prisoners in a potentially precarious
position. The possibility of abuse of power by the
staff in correctional facilities may be of greater
concern for female than male prisoners. Screening
of staff applicants should include assessment of
attitudes which include sexist views and the
propensity for abuse (Hampton, 1993).
Conclusions
Concern about the appropriate treatment and
management of women in prison can best be
addressed, by ensuring that treatment and
management are fully informed by available
research findings. Additionally, good practice in
this particular area should be based on general
principles that apply to offenders in general (for
example, the principles of Risk, Need and
Responsivity). While male and female prisoners
share some psychological and social characteristics,
nevertheless women prisoners also have distinc-
tive, gender-based needs. The literature we have
reviewed suggests the needs of women prisoners
are substantial, extensive and reciprocally related
(co-occurring disorders). It follows that the core
tasks of offender assessment, custodial manage-
ment, treatment delivery, rehabilitation and
discharge planning are likely to require attention
and resources, to ensure the gender-related needs
of women in prison are appropriately met.
Endnote
1 Recent programs have been developed in the
United Kingdom specifically addressing women’s
anger needs. These are currently under review by
Hollin, McGuire and others and should be avail-
able on the Home Office web site (www.homeof-
fice.gov.uk/rds/).
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