Professional Psychology: Research and Practice

Ethical and Professional Conflicts in Correctional Psychology

Linda E. Weinberger and Shoba Sreenivasan

The role of the mental health professional in a prison setting has changed to reflect the prevailing ideology of the correctional administration that deemphasizes treatment and emphasizes security and custodial concerns. As a consequence, mental health professionals who work in corrections have experienced unique ethical and professional conflicts. Standards were developed to address the conflicts and provide guidelines for professional conduct, but dilemmas continue to exist. The au- thors believe this can be attributed to (a) the standards being vague and (b) correctional personnel not understanding or supporting the standards or the psychologist’s role as a mental health profes- sional. This article examines these propositions in more detail, using vignettes and discussion, and offers other approaches to resolving the dilemmas and improving the delivery of mental health ser- vices to incarcerated individuals.

Historical Perspective

Mental health professionals who work in corrections have ex- perienced ethical and professional conflicts that are unique to these institutions. Appreciating the mental health professional’s role within a prison entails an examination of how our society has treated those who violate the law. Historically, most socie- ties have adopted a philosophy that those individuals who com- mit criminal acts should be punished. Modern Western judicial systems have justified their use of punishment on four major grounds: retribution, deterrence, incapacitation, and rehabili- tation (Grilliot, 1983; Kerper, 1972). Retribution has Biblical roots referring to “an eye for an eye.” Deterrence operates from the core belief that those who see individuals punished will be less likely to follow the example of offenders because of the fear of punishment. Incapacitation has as its primary goal the pro- tection of society by rendering offenders unable to repeat the offense. Rehabilitation is conceptualized as treating or “correct- ing” offenders so that they can live in society and not reoffend.

The theory of rehabilitation is a relatively new objective used to justify punishment and has undergone many reformulations as our society’s attitude toward criminal offenders has changed (Travin, 1989). Early American colonists believed that rehabili- tation could be accomplished through severe punishment (e.g., stocks or gallows). It was not until the 18th century that an in- stitution incarcerating offenders was viewed as having correc- tional properties. Reflecting the largely held Protestant values of the time, it was believed that rehabilitation in such institutions

LINDA E. WEINBERGER is Associate Professor of Clinical Psychiatry at the University of Southern California School of Medicine and Chief Psychologist at USC Institute of Psychiatry, Law and Behavioral Sci- ence. SHOBA SREENIVASAN is Clinical Assistant Professor of Psychiatry at the University of Southern California School of Medicine and StafFPsychol- ogist at West Los Angeles Department of Veterans Affairs Medical Cen- ter. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Linda E. Weinberger, USC Institute of Psychiatry, Law and Behavioral Science, P.O. Box 86125, Los Angeles, California 90086-0125.

could be achieved through solitude, hard labor, and contempla- tion of one’s criminal acts. The mainstays of this rehabilitation evolved into the “penitentiary” stage of corrections. Strong op- position developed against the hardships of this mode of reha- bilitation, and the late 19th century heralded the “reformatory” era. Reforms included the use of indeterminate sentences, pa- role, vocational training, and a system to reward good behavior with early release. An additional reform advocated was that of individualized treatment. From the early to the mid-20th cen- tury, psychological interventions were based on the medical or treatment model. Through the 1940s and 1950s, the Federal Bureau of Prisons actively engaged the use of psychologists and psychiatrists to rehabilitate prisoners (Roth, 1986). Initially, mental health professionals focused on the treatment of the in- dividual inmate toward the goal of psychological behavioral changes (Adams, 1985). This medical model or treatment ap- proach became tarnished somewhat in the 1960s and much more appreciably so in the 1970s and 1980s. There were many reasons for this, not the least of which was the failure of such efforts to significantly lower recidivism rates (Roth, 1986). Con- sequently, the role of the mental health professional changed to better reflect the prevailing ideology of the correctional admin- istration (viz., deemphasizing treatment of the individual and emphasizing security of the institution as well as protecting the community at large; “Board Approves,” 1989; Ochipinti & Bos- ton, 1987).

Organizational Models

Currently, the delivery of mental health services for individu- als sentenced to correctional facilities tends to fall within four basic organizational patterns. The individual may receive treat- ment under one of the following: (a) in a correctional setting where both the mental health services and security needs are provided by the department of corrections; (b) in a correctional setting where the mental health services are provided by a sepa- rately administered mental health agency and security needs are administered by corrections; (c) in a mental health facility (e.g., a state hospital with a forensic unit) where both the mental health services and security needs are provided by the depart-

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ment of mental health; and (d) in a mental health facility where the mental health services are provided by the department of mental health and the security needs are administered by the department of corrections (Nelson & Berger, 1988). The states vary with respect to mental health services being provided by a department of mental hygiene versus a department of correc- tions. In those state systems where mental health services are administered by the department of corrections, the institution’s warden has authority over chief psychologists and other mental health departmental heads.