Book Review: Therapeutic Community for Women Prisoners: Re-imagining Rehabilitation and the Loss of Liberty by Elaine Player and Elaine Genders

Player and Gender's Therapeutic Community for Women Prisoners is a notable exception to the pressures of fast academia and short-term research; it makes a significant and needed contribution to studies of punishment by drawing on many years of research at the Democratic Therapeutic Community (DTC) at HMP Send, a women's prison in England. A DTC is an immersive, group-based rehabilitation and management regime where both staff and prisoners are meant to share responsibility for the convivial running of the wing. Through daily small-group therapy and larger community meetings, residents hold each other accountable for how their actions impact others. The DTC operates under the Personality Disorder Pathway which seeks to therapeutically treat people with personality disorders by breaking down conventional prison hierarchies. The DTC at HMP Send is the only one available for women prisoners and according to Player and Genders it ‘embodies the most psychologically intrusive programme for women serving medium to long term sentences, […] in terms of its duration and […] required levels of immersive participation’ (p. 8).

In this important book, the authors make an intervention in conceptual and empirical discussions on gendered punishment, rehabilitation, and the uncomfortable relationship between therapy and imprisonment. The study underpinning the book combines ethnographic observations of therapy sessions and group meetings at the DTC at Send, semi-structured interviews with women across various stages in their residency, engagement with the community's staff in group and staff meetings, and analysis of documentary records, including individual treatment plans developed by therapists. In this sense, this is a unique study of a prison-based context that benefited from unprecedented access to participants, spaces, and documents.

The book makes several intellectual interventions. First, the book is both about the practice and experience of ‘doing therapy’ and the experience of that therapy within a prison context. While the authors seek to identify the distinctive features of the DTC and emphasise that living in it means being in a fundamentally different social institution to the rest of the prison, especially in the sense that the former strives to enhance rather than deprive one's sense of self. In doing so, they still examine the vulnerability of the DTC towards wider penal power and offer a rich analysis of the ambiguous relationship between therapy and punishment.

Second, writing about the DTC with the wider prison context in mind, the authors offer insights on how women experience punishment, especially in Chapter 4 where they contextualise the DTC within women's broader corporeal experiences of pain endured both during incarceration and prior to it via long histories of neglect, abuse, and deprivation. The authors map how these biographical experiences impact the design of programmes for women, warning against applying standardised (male) models to treatment and rehabilitation. This leads to a critical discussion on whether long sentences are ‘destined’ to reinforce harm, or whether they can be re-imagined as potentially progressive and transformative, particularly in the context of these women's lives. In so doing, Player and Genders craft an original and provocative reading of the relationship between liberty deprivation and transformative justice.

A third substantive intervention concerns the book's discussion around gender. The authors highlight the unique needs of medium and long-sentenced women (including their histories of trauma, caregiving, relational vulnerabilities) and illustrate that a male centred rehabilitation and therapeutic model would distort those needs. Those familiar with Player and Genders’ broader contributions to the field will not be surprised to see that the book also offers a comparison of the therapeutic community at Send with that available for men at HMP Grendon, Europe's only fully therapeutic prison which has received considerable researcher and policy attention. The authors handled this comparison delicately, being conscious of the potential shortcomings of comparing men and women's experiences and of the clear differences between the two establishments, while holding on to the value of such comparisons, particularly for re-imagining a gender-specific version of rehabilitation.

Relatedly, the book also seeks to examine how rehabilitation can be more than risk management. Chapters 8 and 9 show how the DTC at Send produced real reparative change for several women – including increased self-understandings, improvements in emotional regulation, reduced isolation and positive shifts in identity and coping strategies, including reductions in self-harm incidents. In Chapter 10, however, the authors discuss the limitations of the DTC in its duty of care, especially towards women who leave the community prior to the recommended 12–18 months. Thus, we might describe the affective tone of the book as expressing cautious hope for the promise of the DTC.

The therapeutic model at Send suggests some ways in which therapeutic rehabilitation can be reimagined as a feminist kind of therapeutic model. For instance, while the DTC still operated under a criminogenic risk model, Player and Genders found that these risk-based factors were explored in a different manner compared to non-therapeutic prison settings. First, the participants at Send could exercise a degree of self-determination, and the therapy was based on women's self-defined needs. Second, the DTC adopted a holistic approach to rehabilitation, going beyond risks. Third, it made space for structural and systemic factors to be considered in the therapy setting, so participants could make sense of their individual agency within a wider, social context. In Chapter 9, the authors offer a measured analysis of how this fragile promise for feminist therapy may be reinforced, while warning against the possibility of its co-option into neoliberal penal logics. While they frame this promise of rehabilitation at the DTC as fragile, the authors invite us to consider a new vision of rehabilitation through the lens of ‘duty of care’ (p. 242). Drawing on a series of principles from domestic and Strassburg courts, they recall the state's legal responsibility to protect persons in its custody (p. 249). They ultimately call activists and scholars of the prison to consider a social justice lens in reimagining rehabilitation. By drawing on the work of Iris Marion Young (1990), particularly the notion of relationality in considering justice, they acknowledge the limits of distributive justice and highlight the need to apply non-distributive principles to the functioning of the DTC. This is one of the most critical insights emerging from this rich book and offers a new theoretical framing of rehabilitation that is much needed in criminology and in policy discussions on prisons.

Like with all thought-provoking books, this one also raises some important questions. Player and Genders focus on medium and long-term sentenced women prisoners whose population is small but has grown in recent years; a rare focus in the field of feminist criminology. They thus invite feminist scholars to consider the difficult question of why feminists, both abolitionist and ‘carceral’, have neglected long-term women prisoners in their research and partly also in their activism. A wider political question raised is whether feminists and others are fully prepared to contemplate the needs of this cohort of prisoners. Going back to their own argument, one might ask whether it is really possible to reconcile ideas of structural violence and injustice, which define most of these women's biographies, with long-term sentences.

The book also raises interesting questions around abolitionism. In the introduction, they write:

We develop an argument that can be considered abolitionist. Its classification within this school of thought rests on the denial that the state can legitimately inflict the types of harm that are routinely perpetrated through the culture and institutional practices of prisons. However, it does not refute the entitlement of the state to punish offenders for the wrongs they have committed, provided that sentences are proportionate to the seriousness of the offence and guided by the principle of parsimony. Nor does it prohibit the infringement of liberty as a defensible penalty in a liberal democracy… (emphasis added, pp. 7–8)

Therapeutic Community for Women Prisoners is another example of the seriousness, rigour, and measured tone that defines these two scholars’ work. Through a deep dive into pressing but often under-explored aspects of punishment, Player and Genders invite critical prison scholars to re-imagine the very terms we work with in this urgent moment of growing punitiveness. This book will undoubtedly interest, and likely influence, researchers and students of both feminist criminology and prison sociology.