“Abi continued to make progress, but there have been some bumps in the road. I think I did and said things I wish I could take back.” With an unusually low tone of voice, while sitting hunched in his seat, Roberto articulated these words to Karen, his supervisor, who looked at him, paused, and said, “There has been progress, there have been bumps in the roads and there have been mistakes. Like in any relationship, mistakes happen. The important thing is that we learn from them and use these moments as an opportunity for repair, growth and modeling.”

This is the fifth of the articles in the series, New Strategies to Working with Justice Involved Individuals. I have explained the five reasons why all of us need to master these new strategies and described the five principles to master, as well as outlined the ten techniques to use. Roberto has been successfully using these principles and techniques; he has been enjoying the work, seeing much progress. “But there have been some bumps in the road. I think I did and said things I wish I could take back,” he explained to his supervisor. While mistakes can ultimately be used for the benefit of a therapeutic relationship, at times, too much damage may have already been done. There are things you can do to minimize some of these types of mistakes, and below are the Do’s and Don’ts when working with justice-involved individuals. I will elaborate on only a few of them here, in this specific article.

Do:

1. Make them feel safe:

This is related to one of our five principles to master, and it is essential when working with this population. To start, feeling safe is essential for anyone—including us, as clinicians—to do their needed work, to learn and to heal. When working with the justice-involved population, those who have been traumatized and subjected to discrimination and prejudice, it is essential to establish safety. And this has to be one of our main priorities.

2. Risk stratify:

Follow the technique of being and remaining non-judgmental and, as I often say, strike a balance by always wearing your scientist hat and using the rigorous steps of the scientific method, prior to drawing any conclusions: observing and hypothesizing, as well as testing and experimenting. Once you have the conclusion, be sure to stratify.

Three additional Do’s that we will be explore in subsequent articles are:

3. Pay attention to body language—both for you and your client.

4. Remember they are humans first.

5. Explain the WHAT and the HOW.

In addition, three of the Don’ts we will be exploring in subsequent articles are:

Don’t:

1. Confront

2. Interrupt

3. Defy

References:

1. Wang EA, Wang Y, Krumholz HM. A high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010. JAMA Intern Med. 2013;173 (17):1621–1628.

2. Williams B, Abraldes R. Growing older: challenges of prison and reentry for the aging population. In: Greifinger RB, editor. Public health behind bars: from prisons to communities. New York (NY): Springer; 2007. pp. 56–72.

3. Baillargeon, J., Binswanger, I.A., Penn, J.V., Williams, B.A., & Murray, O.J., (2009a). Psychiatric disorders and repeat incarcerations; the revolving door. American Journal of Psychiatry, 166, 103-109.

4. Balyakina, E., Mann, C., Ellison, M., Sivernell, R., Fulda, K.G., Sarai, S.K, Cardarelli, R. (2013). Risk of future offense among probationers with co-occurring substance use and mental health disorders. Community Mental Health Journal, published online: 14 June.

5. Lehman Held, M., Brown, C. A., Frost, L. E., Hickey, J. S., & Buck, D. S. (2012). Integrated primary and behavioral health care in patient-centered medical homes for jail releases with mental illness. Criminal Justice and Behavior. Advance online publication