Changing the System from the Inside Out: Triage Counseling

Dec 1, 2010 by Mara Leigh Taylor, PsyD

Coach Mara Leigh Taylor

I entered prison for the first time as a Pepperdine University psychology Masters student receiving a bit of extra credit for attending a two-hour tour of drug treatment programs provided to male inmates by the Federal government. That singular experience radically shifted my career from life coaching of entertainment industry executives and actors to spending long days in prisons and jails exploring how change happens and how we, as clinicians or mental health service providers, can assist our clients when “change” is their menu selection of choice. After completion of studies at Pepperdine, I continued my education which includes current studies with California Southern University to support my insatiable appetite for knowledge of the individual’s ability to mold, shape and change their life experience through perceptual shifts.

To support my volunteer effort inside prisons and to give structure to the growing number of fellow students and community members who wished to join me in my work, I founded a non profit organization called Getting Out By Going In (GOGI), named for the process of getting out of your own prison by going inward for the answers.

While a university tour was at the root of my volunteer work with Federal male inmates, how I expanded my work to women was just as happenstance. As a featured author at the Festival of Books in Los Angeles, California three years ago, I was seated in a booth signing the first GOGI book when I was approached by Sergeant Grady Machnick of the Los Angeles County Sheriff’s Department, a visionary law enforcement veteran who understands the importance of exploring alternative ways to enhance safety in our communities.

Sergeant Machnick asked if my method of working with incarcerated men could reduce recidivism among women detained in the Century Regional Detention Facility. I replied with a resounding “absolutely.” I expressed to Sergeant Machnick that I believed, and was collecting increasing personal evidence through my daily volunteer work with male inmates, that detained and incarcerated individuals almost always wish to return to their homes as productive citizens and, without exception, nearly all of them are not sufficiently prepared to return home. A majority of them are rearrested simply because they are ill-prepared for, and under-supported during, the reentry process.

The fact is there are 2.3 million men, women and children behind bars in the United States of America today. Most of these individuals, nearly ninety percent, will be released and return to our neighborhoods with very little modification to their lifestyle or choices. While the United States represents only 4 percent of the world’s population, we house and allocate huge tax dollars to support more than 25 percent of the world’s prisoners. And, to make matters worse, we have an 80 percent recidivism rate where an individual who is released has an 80 percent chance of being re-arrested within the first year.

Sergeant Grady Machnick, a two-decade veteran of the Los Angeles County Sheriff’s Department, was intrigued by GOGI’s self-improvement approach to reducing of recidivism. He spoke of Sheriff Leroy Baca’s appreciation for each and every citizen and the Sheriff’s intense interest in exploring new and innovative methods of restoring our communities back to health. He told me that on any night of the week in a non-descript brick building near the 110 and 105 freeways in an area called Lynwood in Southern California, there are more than 2,000 detained women dressed in blue, confined to small cells within the building’s three floors of secure housing. This, he said, concerned the Sheriff as the number of women being arrested was growing at a rapid rate.

Machnick and I entered into a series of conversations about the possibility of creating a custody environment for detained females based on my work with the Federal male inmates. Meeting the challenge head-on, GOGI directed all its efforts and all its donor-generated funding toward one mission: designing a cost effective model of incarceration which would reduce recidivism among women in Los Angeles County. We titled it GOGI Campus - the first Coordinated Collaborative Community Reentry Initiative because it was designed more like a school and relied entirely on the training and coordination of community participation. To offer this at no cost to the Los Angeles County Sheriff’s Department GOGI required very few things:

We believed we needed to address the inmates by their first name, not by last name and the booking number printed on their wristband.

  1. We believed we needed to consider them as GOGI Students rather than inmates.
  2. We needed their housing to be conducive to a “campus” environment in an area away from the general population.
  3. We knew for change to happen, we needed to provide a personal counselor to each women. We contacted UCLA, Pepperdine, Long Beach Community College, University of Phoenix, Alliant and others and became a practicum site for practicum students and interns seeking licensure as a PsyD, MFT, or Drug Treatment Counselor. These “GOGI Coaches” were trained and certified in RapidChange Therapy and the Twelve Tools of GOGI, our unique method of treatment.
  4. We needed permission to invite community members and organizations to engage daily with the “students,” teaching them in a full immersion therapeutic community from sun up until long after sundown, seven days a week.
  5. We constructed a system whereby the “campus” was self governing regarding their self-help efforts and a student body structure of administration would be elected by popular vote resulting in a the offices of class president, vice president, secretary, campus rules, standards, homework, inmate led classes, etc.

The very first replicable custody environment called GOGI Campus officially opened February 22, 2008 with 24 inmates who had volunteered to live in a segregated housing unit and participate in what was described to them as a new way of experiencing incarceration. Over the next two years, two distinctly different pilot initiatives were conducted with the women who rotated into the campus to explore recidivism reduction through the use of GOGI’s methodology and volunteer community support. At no operational cost to Los Angeles County, Getting Out By Going In coordinated thousands of hours of community volunteer efforts to support the therapeutic community of the GOGI Campus module within the largest female jail in the United States.

The women we served in the GOGI Campus module were in jail, not prison. Most of the general public is not aware that jail is not prison. Jail is that place you go before a judge or jury sends you off to prison. Jail, in many respects, is more stressful than prison because of the uncertainty. In jail there is the uncertainty and question about the future, the question of their children being adopted to strangers, and endless days spent with no direct sunlight or familiar foods. By the time the woman gets to prison she has lost her freedom, her children and oftentimes all hope. There is an odd finality in prison which is less stressful than jail.

To better understand how the penal system works, here is a hypothetical situation. If the authorities are called to a scene and you are arrested for, let’s say, driving while under the influence of one-too-many-glasses of beer, it is likely you will be arrested and taken to the local police station. If you are not released to go home from the station, you will be transferred to Sheriff’s Department custody and placed in jail. After your arrest, you might be detained for a night or two before family or friends post your bail, or you could be detained in the jail for years as the evidence in the case against you is assembled by the investigators and presented to the District Attorney’s office in preparation for a hearing some time in the future. Many detained individuals are transported from jail in handcuffs on a bus to court several different times spanning several months as the case makes its way through the system. For some, the day of their arrest was the last day on earth they had the choice of where they would awake each morning, or the last time they would ever eat a strawberry, walk on a beach, go on a walk to a park.

Jail provokes anxiety. Prison provokes depression.

Over the period of two years, more than 250 arrested women detained in the Los Angeles County jail called GOGI Campus their home after waiting, sometimes for months, on a wait list for one of the 24 beds within the module. Nearly 45 percent of our students left GOGI Campus after the judge sentenced them to spend time in prison in the custody of California Department of Corrections. The other fifty five percent of our students were either released to drug treatment programs, released to our supervision or released to home under the supervision of probation authorities.

The first year of our pilot the women received fulltime immersion curriculum taught by community volunteers which is the core of our replicable custody environment. The first year pilot participants also received a personal “GOGI Coach,” a practicum or intern student seeking university credit toward licensure through supervised training at our therapeutic community. As part of the therapeutic process we used the Twelve Tools of GOGI, twelve simple cognitive tools and perceptual concepts they could use to make better decisions. The recidivism rate among the first year’s participants was so low it raised questions with authorities as to the reason why the self-titled “GOGI Girls” were not getting rearrested at anywhere near the county rate. Year one was our finest success in reducing recidivism because we benefited from the combination of community volunteers and clinicians certified as GOGI Coaches. Statistics are only as good at the intention of the statistician. For those who calculate our statistics with an interest in our successes their recidivism rate shows less than 20 percent recidivism among participants in the first year of release. For those who calculate our statistics with an interest in diminishing our successes, somehow their calculations hover near 30 percent. Regardless of who is calculating what, the women of GOGI Campus are refusing to fail; they are just not getting rearrested at the 80 percent which marks the county’s average.

In the second year of our initiative we became convinced of the value of the role of the clinicians. In the second year we were unable to utilize the “coaches” for the therapeutic component of the initiative. Instead, we relied greatly on inmate-led classes and student-generated self help to sustain the therapeutic culture of GOGI Campus. While we are still in the process of tracking the recidivism of those participants, all indicators suggest recidivism was significantly lower when utilizing trained practicum and intern students under supervision who were certified as GOGI Coaches to facilitate the therapeutic process.

Early in my work I came to believe change is possible, and in fact probable, for the willing and dedicated, even for those behind bars. During the two separate pilot periods for GOGI Campus at the LA County jail for women, I spent considerable time contemplating the most rapid way of promoting perceptual shifts within the inmates. I also suspected that budgets for prison education and mental heal services would continue to decline and a method of self empowerment had to be put into place quickly for the increasing number of individuals who landed behind bars with heavy addiction problems.

Combining appropriate aspects of different theories I had been taught in graduate school and my practicum sites, my unstructured and oftentimes spontaneous therapeutic contact with inmates forced me to synthesize my learning into a method which proved effective, especially when contact with the inmate was limited or time restricted. I called this form of catch-the-moment-when-you-can therapy as 'Triage Counseling', an even briefer version of brief therapy with which those of us who work with incarcerated are all too familiar.

Triage Counseling is that form of counseling you do when all you have are a few moments sitting on the bench outside the jail medical clinic office with a woman who has just been sentenced to 18 years in prison and who also received the news she has cervical cancer. Not only will her children be adopted by someone because of the length of her term, but she will undoubtedly never see her children again. Added to this is her strong belief, and likelihood, that she will die in prison.

If the opportunity presents itself and the guard permits, I have fifteen or so minutes with her while she waits for a nurse to dispense whatever pain killers she can qualify to receive.

I call that part of my work Triage Counseling; putting a tourniquet around an emotional artery and hoping someone from the Chaplain’s office or a sympathetic Bunkie might take the time to offer compassion after she is escorted by a guard back to her cell. In those short moments I must give her something which will last longer than, “It will be alright,” or “It will be ok.” I have come to understand and believe I must give her clear instructions on one of the Twelve GOGI Tools I use with inmates. It is more like psycho-educational rapid-fire instructions to aid them in their self-repair efforts. The conversation might go like this:

“May I sit here a moment?” I ask.

“I don’t care,” she might respond.

I might pull a real Kleenex out of my bag. Inmates never see real tissue. They blow their noses on sandpaper like, cheap toilet paper. The tissue is a real treat.

“I think I can teach you a way to breathe so you can sleep better tonight, if you like. I am going to tell you something I want you to do when you get back to your room, OK?”

Regardless of her response I continue.

“Here is a little tool I teach to the girls in here when there is pain so big it almost seems like dying is easier than living. Tonight I want you to put one hand on your belly and another hand on your chest and I want you to make certain you belly moves up and down, not your chest, alright?”

I put one hand on my own belly and the other on my chest to demonstrate.

She might nod or just look at me with a skeptical glance.

“That is called Belly Breathing and it will calm you and make you feel better. One hand on your belly. One hand on your chest. Make certain the hand on your belly moves up and down, OK? Will you try that for me?"

She is likely to nod before the nurse calls her last name and she enters the mini pharmacy within the jail.

When working with the incarcerated, especially those in the early stages of moving through the justice system there is uncertainty about the future which causes an uncommon emotional intensity. As they sober up in jail, they face the chaos which represents their life, sometimes for the first time. For many, the drug addiction which was at the root of the crime was simply a coping tool for unspeakable childhood horrors. In the safe space of GOGI Campus and with the tender touch of the GOGI Coaches, the participating women could not only address the current state of addiction, but together, as a unified force for change, they individually and collectively as a student body and learning campus addressed the root cause of their addictions. As I described it to the first participating inmates and newly training coaches, GOGI Campus provided a space for that emotional intensity to promote healing; a place of self healing from the initial break and the subsequent abuses which followed.

Somehow when I began my graduate work I never imagined finding my place as a mental health professional working with the incarcerated; it never would have entered my mind. I was more interested in a higher priced practice and more posh office accommodations. For me, prisons were good backdrops for action movies or television dramas but were never a part of the world in which I lived. But I have followed my passion and have found a way in which I can contribute to the lives of those who desperately need something, anything to ease the pain.

I guess I am on the right track with my career, as out of place and odd as it may seem for how my life might have unfolded. Since 2002 I have been actively exploring ways to facilitate change within the hearts and minds of our Nation’s incarcerated. And, it seems, GOGI has created quite a stir.

Currently, there must be 20,000 or so of the GOGI books in circulation in prisons and jails with more copies being sold on Amazon and online book sellers for the family of prisoners who wish to read the books at home. Our Post Office Box for Getting Out By Going In is filling each week with letters from inmates across the US seeking support for lasting change with our books our correspondence course and workshops. Increasing number of GOGI groups are forming in prisons and there are even GOGI Twelve Steps and GOGI Twelve Step meetings. In fact, I received word this week that all women attending a church service at one California prison were offered their own copy of 'Women in Prison: Women Finding Freedom', the book I wrote with the help of contributing inmates during the 2 year pilot period.

For the 250 women who participated in the GOGI Campus initiatives, their lives are irrevocably changed; most of them are remaining out of prisons and jails for the first time in their adulthood. For the ones sentenced to prison, they are teaching the Twelve GOGI Tools to others on the yard. Our GOGI Coaches are excelling as well. One GOGI coach has authored a book based on her contribution to the campus called “GOGI Yoga” which incorporates the Twelve Tools of GOGI into yoga moves and intentions. Another GOGI Coach is completing his book based on the spiritual concepts behind the Twelve Tools of GOGI taught to the inmates. More than 60 GOGI Coaches have contributed to the efforts of GOGI and a second GOGI Campus site has opened in the Wasatch County jail in Heber City, Utah. Our graduates from GOGI Campus are attending colleges, remaining sober, getting jobs, reuniting with their children, and one of our graduates has even assumed the role of Regional Manager overseeing our Utah Campus.

While the conclusion of the pilot period has significantly diluted our presence in the Los Angeles County jail, our growth remains rapid and solid in the prison and jails across our Nation. Working with the inmates has taught me this; no matter how dysfunctional, addicted, confused or complicated, people want and can change. And, with the right ingredients carefully provided during the therapeutic process, change happens. Fortunately, my insatiable appetite for understanding of the human potential has 2.3 million possible clients just waiting for an opportunity to Getting Out By Going In. And, with any luck, the foundation being laid now as an alternative custody environment will let GOGI live long after I have left this earth as a strong support of changing the system from the inside out.

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