‘I might once have doubted that counselling could help women stop offending but I see women gaining self-respect and a sense of self-worth, their dignity restored and feeling able to say “no”. That makes a big difference. The woman feels she has choices.’

Sister Enda Gorman has been working with women on the streets of Balsall Health, once a red light district in south Birmingham, for over 21 years. Today she is Head of Counselling at Anawim, a women’s centre established in 2005 by her order, Our Lady of Charity, to work with offenders, women street workers and any vulnerable women at risk of harm or offending.

Anawim offers a ‘one-stop shop’ for women serving community sentences as an alternative to custody. It is one of some 40 such centres, all very individual and rooted in their local communities across the UK, that are successfully cutting reoffending rates by addressing the myriad factors that led their clients to commit crime in the first place. Anawim achieved a one per cent reoffending rate in 2012; the comparable national rate for women serving a community sentence on probation is eight per cent, and 63 per cent among women serving custodial sentences of less than 12 months. Anawim costs around £1,500– £2,000 per place; probation alone costs some £8,000 per woman and prison up to £50,000.

The centres were originally recommended in 2007 by Baroness Corston, in a radical report to Parliament that called for the closure of all women’s prisons in the UK and their replacement with small local custody units for the tiny number of women who pose a real danger to the public, and the use of community alternatives, such as these women’s centres, for the rest. But, while some government funding followed her recommendations and enabled the pre-existing small network of women’s centres to expand, there is no political appetite for wholesale closure of the women’s prison estate. The recent announcement that the 12 women’s prisons will become ‘resettlement prisons’ is, say campaigners, cosmetic. Women continue to be sentenced to custody for relatively minor crimes, with far-reaching consequences not just for them but for their children too, and little benefit in cutting reoffending rates and helping them turn their lives around.

Says Jackie Russell, Director of Women’s Breakout, the umbrella organisation for the women’s centres: ‘Most women don’t need custody. Most of their crimes are benefit fraud and shoplifting, so why lock them up? The majority are doing it to support their family, to feed their children. Our member centres use the model of wrap-around holistic support, addressing wider issues than simply the offending behaviour, and recognising that most women are coming from a place of trauma. And that is why counselling is so important. A woman who simply needs her housing situation sorting out is very different from a woman whose housing is in a mess because of domestic violence, who has drug or alcohol problems, or a history of sexual violence and abuse. The ability to meet all those needs is what characterises our members.’

BACP has recently joined the national campaign for more use of community alternatives to prison for women offenders, and more access to counselling. Says BACP Chair Amanda Hawkins: ‘It isn’t that men don’t need that kind of support too but the advice of our Criminal Justice Reference Group was to focus on where we could make the most impact. We are advocating for more counselling inside and outside prison for women. It should be part of the initial offer when women enter prison and it should be more widely available in the wrap-around support offered in the community, both to offenders serving community sentences and women at risk of offending, in a preventive strategy.’

BACP is currently surveying the existing network of women’s centres to map the mental health support they provide and identify best practice and any gaps and areas for development. ‘So many women offenders have mental health issues and histories of trauma, it is an obvious focus for BACP,’ Hawkins says. There is some evidence of effectiveness of counselling and psychotherapeutic programmes for women offenders, a BACP review of the research has found, but the studies are primarily from the US. BACP will be contacting potential funders to commission research here in the UK to back its campaign.

The argument for women’s imprisonment is weak. Women represent less than five per cent of the total UK prison population. In May 2013 there were 3,893 women in the UK’s 12 women’s prisons. Most (81 per cent) have committed a non-violent offence, and more than half are serving sentences of six months or less. By far the most common crime is shoplifting (58 per cent), followed by benefits fraud (nine per cent) and theft (seven per cent). Women in prison are among the most vulnerable members of society: one in four have been in local authority care as a child; 46 per cent have experienced domestic violence; 53 per cent report emotional physical or sexual abuse in childhood; some 30 per cent were either homeless or sleeping rough when they were arrested, and nearly a third (30 per cent) have had treatment in psychiatric hospital. Women in custody are five times more likely to have a mental health problem than women in the general population. Nearly three quarters of women coming into prison are on medication – mostly benzodiazepines, methadone, antidepressants or sleeping pills; 75 per cent have used illegal drugs and 40 per cent are drinking alcohol at dangerous levels. More than one in two have used crack, heroin or cocaine in the four weeks prior to custody. Many have made suicide attempts and self-harm is endemic in women’s prisons.

Moreover, four out of 10 women in prison are mothers, and around two thirds of these have children under the age of 18. An estimated 18,000 children are separated from their mother by imprisonment each year, and 12 per cent end up in local authority care. Others are cared for by their wider family, but only five per cent stay in their own home while their mother is detained. The disruption to their lives is immense, and needless when women are often serving such short sentences, campaigners say.

‘We aren’t saying women should never go to prison. If someone has committed a crime, they have to be called to account. But these women are a highly vulnerable population. When so many are themselves victims of serious crimes such as domestic violence, sexual abuse and rape, it challenges the idea that there is a clear-cut difference between perpetrator and victim,’ says Juliet Lyon, Director of the Prison Reform Trust and a BACP Vice President. ‘I think most prison governors and staff would agree that prison serves no useful purpose for the majority of women. So few present any risk to the public; they are more likely to be a risk to themselves.’

Clive Chatterton retired from his post as governor at Styal women’s prison in Cheshire two years ago, having worked in the prison sector for 36 years. ‘Styal was an eye-opener. I have never seen such a concentration of damaged, fragile people,’ he says. ‘The levels of mental ill health and self-harm are staggering. And when most of the women are serving such short sentences, there isn’t much you can do to help them by placing them on education or offending behaviour courses. They’re not there long enough to complete them. Rather than spend all that money on custody, it could be much better spent on interventions and programmes that would address the things in their lives that brought them to commit the crime in the first place.’

He cites a coaching initiative set up by volunteers at Styal. ‘Most prisoners wish they could get off the cycle of offending and prison. That hour to reflect and just talk one-to-one about the events that led them to where they were, it was a rare opportunity for these women to take stock and think how they might do things differently in future.’

A community alternative

Counselling and psychotherapy can be helpful to women while they are in prison, but the prison environment is hardly conducive to establishing the trust, stability and continuity that is fundamental to building a therapeutic alliance. As Maureen Mansfield, Mental Health Inclusion Coordinator at Women in Prison, points out, ‘the needs of the prison and security will always come before the needs of the therapy, and there is always that tension between what happens in the counselling room and what happens outside on the wing. You may be asking the woman to let go of unhelpful behaviours that are an essential part of her coping strategies while she is still in an environment where she needs them.’ Mansfield says that, despite the challenges presented by the environment, a lot of high quality therapeutic work does take place in the female prison estate. She commends the psychological therapies service provided by Central North West London NHS Foundation Trust in HMP Holloway and HMP Bronzefield. ‘Some women do make huge progress in prison and if they go on to access our community support services, the improvement rates double,’ she says. ‘To be heard and listened to is always valuable, but there is generally a lot more going on outside the room, outside the prison – additional life difficulties that need additional support.’

And this is where women’s centres, with their ‘wrap-around’, holistic approach, have their unique role. Lancashire Women’s Centres offers a generic one-stop-shop support and advice service to any woman in need through its 10 centres across the county. Its stated aim is to ‘support, encourage and enable all women to get the best out of life for themselves and their families’. The centres offer legal, housing and benefits advice, employment support and life skills training to help women find work, and a wide range of group work, personal development courses and individual counselling.

Some of the women are attending the 10-week Vision Programme, under a court order, specifically to address their offending behaviour. The programme covers the nine ‘pathways’ identified in the Corston report as key to women’s offending: accommodation, employment, finance and debt, drugs and alcohol, children and families, health, attitudes and behaviour, abuse and prostitution. ‘We see the Vision Programme as an engagement tool,’ says Chief Executive Officer Sarah Swindley. ‘Women have to attend but we aim for them to want to attend when they realise we are here to help them turn their lives around. Ideally we then mainstream them as soon as possible into the wider service. There is a lot of commonality of experience.’

Counselling and CBT are not included in the Vision Programme: ‘We can suggest it if it is appropriate but we find in most cases it should be offered slightly further down the line. We apply Maslow’s hierarchy of needs: are you safe, have you got enough to eat, do you have shelter? Women have to have enough stability in their lives to be able to attend the centre regularly and to engage with the service and feel safe enough to put down the barriers. You need that very gentle engagement work before therapeutic work can be effective,’ Swindley says.

Lancashire Women’s Centres offers an initial eight sessions of counselling or CBT, which can be extended up to 16 weeks. ‘We have to keep a flow through. I have used long-term and brief intervention and I believe a lot of the change happens in the first five sessions. If you’ve not seen some benefits by then, you have to ask if this is the right practitioner or the right therapy,’ Swindley believes. They also offer a wide range of groupwork – for sexual abuse survivors, for transgender women, for confidence and self-esteem, depression and anxiety, and activities such as craft courses. Over 4,500 women attended their centres last year, of whom around five per cent were offenders. ‘But a large percentage are on the cusp or at risk or involved in risky behaviour or have partners who are involved in criminality,’ Swindley says.

‘Something very special happens in a gender-specific environment. Women feel safe to disclose. They know they are not going to be judged, that they will be seen for who they are. A lot have had abusive relationships, horrific abuse, and they can feel free of that here. And women work therapeutically in a different way. They get to depth faster and, if they feel safe, they will disclose and share and want to investigate what has happened to them. We have really good rates of mental health recovery and reduced reoffending.’

Julie Langstaff is the Counselling Clinical Lead across all the Lancashire Women’s Centres. She says all the women attending the centres bring very similar experiences of past trauma, mental distress and abuse, but some of the women offenders can be harder to engage because they are having to cope with so much in their lives at the same time. Those who do engage value counselling ‘as something for them, a space where someone listens to them’, she says. ‘It’s something they may not have had much experience of in their life. But it isn’t always an easy process for them, if they have been living in crisis for a long period, dealing with many external influences. It’s important that we understand why they may need to keep themselves emotionally safe.’

Maureen Mansfield agrees. Only about 50 per cent of referrals to Women in Prison’s counselling service actually make it to the assessment stage, but if they get that far, they generally continue, she says. ‘It’s much harder to get them to engage in the community, to prioritise that hour for themselves, whatever else is going on, and stick with it.’ The women’s caseworkers have a vital role: it’s important that they can hold some of the women’s pain, anger and distress until they are ready for counselling. ‘If a woman is referred too soon and the counselling breaks down, it can feel like something else she has failed at.’

Not a soft option

A community sentence is not a soft option, Mansfield argues, and nor is counselling. ‘It’s really tough, what we are asking them to do. There is a high amount of risk and pain and bravery to be in a therapeutic relationship.’ And it does make a difference: ‘It is always better to face the truth and have someone witness that and acknowledge ?it and not have to run away from the pain and the feelings. We don’t blame them; we work to support them to take responsibility for their actions. That is a hard balance, but achievable with empathy and understanding of a woman’s history. But it is just a step in a much longer journey. It’s a success if we can encourage a woman to feel just slightly curious about herself; then she can go on to develop that, and make links between what has happened to her and how she is in the world now.’

The counselling at Anawim is primarily person-centred and open-ended. Clients are offered an initial 10 to 12 sessions but then can continue for as long as they need if they feel it is helping. ‘They need time to build up a relationship with the counsellor and to trust us,’ Sister Enda says. ‘Usually they feel there is a catch in it – they’ve been pushed so often to do things they don’t want to do. I explain to the women that how much you are prepared to put into it is how much you will get out of it. We will be here and willing to work with you but you need to do the work. Often they are frightened; they think they will have to revisit the things that have happened to them. I tell them, I don’t need to know what happened to you; what we are working with is how you are feeling now and how it affects your relationships now. You only have to go as far as you can. Some of their experiences are so painful they can only bear 10 minutes of working with them. Then we chat about something else – the children, their progress with the programme. It allows the woman to gradually move back into the world before she leaves the room.’

Anawim’s 2013 Impact Report includes the testimonies of many clients. Carmel writes: ‘[The workers] encouraged me and made me feel like a special person especially on my down days… Things in the past made me feel not worthy, like I’m nothing. I have started to believe the positive things people are saying to me. I didn’t believe in myself. I do now.’ Shazia recalls: ‘When I first came here I was angry, emotionally hurt, at my wits’ end. With the help of my support worker Netty and Sister Enda I am a changed person. I had a few issues in my life that really needed addressing and I wasn’t getting any help anywhere. I’ve had one-to-one counselling which really helped me see things from better views. I’ve come to Anawim on a few occasions quite upset and angry and always leave feeling positive.’