Safe Behind Bars

Question 1

Ch 1. Pg 3 Incarceration or Treatment : Are they necessarily in conflict?

General public wants ____________ (if not punishment) and safety. Most citizens are unlikely to willingly _________ making jails and prisons a more “____________” place.

Having a therapist or case manager on staff, even during regular work hours is considered a _________.
It takes time, insight and unfortunately, sometimes a law suit for agencies to acknowledge the need for mental health care inside their facilities.

Answer 1

justice;
fund;
“livable”;

luxury:

Question 2

Pg 4.

Concrete skills- Taser, defensive tactics, threat id, and cuffing are often easier to learn.

Soft skills - communication and body language.

Just with physical traits you must strive to train your verbal responses into “_________________” where you don’t have to think before you effectively react, something that takes practice.

Experts at de-escalation must have the ______________ to move from one style into another if the first doesn’t work.

Answer 2

“pseudo instinct”;

fluidity;

Question 3

Structural Issues pg 4

What are three long standing issues that often lead to the mentally ill inmate not receiving a comprehensive adequate level of care?

Answer 3

1.) PHYSICAL PLANT PROBLEMS: There are no dedicated space in jails to care and treat for the mentally ill. General Pop housing is converted for the use of the mentally ill, often lacking appropriate clinical space, step-down or intermediate care units and/or programs.

2.) INADEQUATE INFIRMARIES: not capable of providing crisis level mental health treatment.
Many older facilities do not have air handlers that maintain the proper temperature for heat sensitive medication.

3.) ACCESS ISSUES: Count time, lockdown, feeding , recreation, therapy and locked doors prevents an inmate from being able to physically travel to areas of the jail to routinely access services, as well as interfering the clinic staff from accessing them.

Question 4

The Revolving Door (Ch.1 pg 5)

Beyond the funding and structural issues that have already been described, these problems are exacerbated by:

Answer 4

Lack of Staff
Lack of Training
Lack of Mental Health Professionals
Treatment With Only Medication
Staff Turnover
Insufficient Level of Care
Inadequate Assessment and Information Management
Disruption of Care Due to Transfers
Mental Illness May Not Be Noticed
Disciplinary Methods Can Be Destructive

Question 5

Figure 1.1pg 6

How scheduling can impede care

Answer 5

Scheduling requires that inmates receive medication in the early evening. If given before bedtime, the inmate can appear to be drowsy and unable to follow directions, Inmate will then be viewed as non-compliant.

Question 6

Pg. 8

Time put in on the front end of a situation almost always pays off at the other end:

Answer 6

No Duplication of Services
The Inmate’s Time is Not Wasted
Reduced Training Costs
Limits Manipulation Opportunities for Inmates

Question 7

Pg. 10

Deliberate Indifference

Answer 7

Being aware there is a problem, but doing nothing to alleviate it.

Question 8

5 Behaviors of the Incarcerated Mentally Ill

Answer 8

• Chronic Mentally Ill Inmates: schizophrenia, schizoaffective disorder and/or bipolar disorder
• Developmental Delayed Inmates: IDD, affect cognitive abilities and maturity levels, low IQ below 70. (appear childlike)
• Violent Mentally Ill Inmates- highly violent and aggressive, hallucinations and delusions (psychotic), resist control (paranoia), make up one of the smallest portions of incarcerated mentally ill inmates.
• Crisis Inmates - life breakdown, deterioration in their level of functioning. (functioning members of their community)
• Victim Mentally Ill Inmates- controlled by another person, (prostitution);

Question 9

pg 12

Why do many attorneys avoid mentally ill inmates or put off working on their cases?

Answer 9

they have their own ideas about their cases, making it up as they go along, while completely believing everything they say. They can be referred as “speaking into being” meaning “if I said it, it’s real”- clinically referred to as magically thinking.

Question 10

pg 17 ch 3 Life for the Mentally Ill in Prison

If properly processed and housed at intake, ____________ MI Inmates have the best chance of exiting the justice system without becoming career criminals through proper referral and treatment with the medical and mental health teams.

Answer 10

Crisis

Question 11

pg 17. Ch 3 Life for the Mentally Ill in Prison

_____________ MI Inmates cannot operate within the parameters that society has decided upon and more often than not, cannot even function inside a correctional facility.

Answer 11

Violent

Question 12

Pg 18 Ch 3 Specialized Housing

___________ custody is when the inmate asked not to be housed with anyone else for fear of harm.

___________________ is when the facility decides to house the inmate separately because of one of the following reasons :
- The inmate would victimize others.
- Other inmates would victimize the inmate.
- Inmates possess a serious threat to the security and safety of the institution ( such as local crime lord or someone involved in a high-profile case)

Answer 12

Protective;

Administrative Segregation;

Question 13

Pg 18 Ch 3 Specialized Housing

Inmates housed alone and not allowed to participate in programs that involve other inmates are left with little day-to-day interaction soon learning to cherish any kind of attention or activity that is diversionary, be it positive or negative.

It is often in these circumstances that mentally ill inmates engage in _____________ and _____________ actions such as self-mutilation, destruction of their cell and their own possessions, and feces smearing.

Answer 13

damaging and degrading;

Question 14

pg 18. Ch 3

Can mentally ill inmates serve their sentences in the community?

Crisis MI Inmates - ?
Victim MI Inmats - ?
Violent MI Inmates - ?
Developmentally Delayed Inmates - ?
Chronic MI Inmates - ?

Answer 14

Crisis MI Inmates - can adapt to home monitoring and deferred programs.

Victim MI Inmates - may possibly benefit but inmates on programs cannot make money for their pinps or dealers. Therefore, effective parole/probation of Victim MI Inmates must factor in protection from the controlling criminal or they will surely fail.

Violent MI Inmates - rarely meet the needed criteria for most of these programs.

Developmentally Delayed Inmates - can successfully serve their sentences in the community if they have a support network or caregiver.

Chronic MI Inmates - are unlikely to meet the criteria for alternatives to incarceration unless they receive comprehensive wrap around services.

Question 15

pg 21 Ch. 4 What do mentally ill inmates need?

The ___________ ___________ determines where the level of care will be implemented; not what level of care is offered.

Answer 15

security classification;

Question 16

pg 21 Ch. 4 What do mentally ill inmates need?

In order to achieve a comprehensive mental health program within a jail setting, there a number of essential components:

Answer 16

Training and Consultation - Mental health training is absolutely necessary and in some states is mandatory. Staff should receive routine training related to signs and symptoms of the mentally ill, de-escalation tactics appropriate to specific behaviors as well as understanding the policies and practices of the facility’s mentally ill program.

Suicide Prevention Program

Acute Care intervention Program - a safe place must be established to house and monitor a suicidal inmate until they have been medically cleared, signed a safety plan, or other case management options have been put in place. Need padded cells, cocoon boards to restraint chairs and benches.

Reintegration Planning - spent a few days in transitional housing before returning to their previous or new assignment. (ie. no sharps unit)

Stabilization Planning - Jail populations are mercurial by nature and case managers are nearly always overlayed, operating with a concrete timeline for any of their clients.

Special needs unit - necessary for inmates not requiring inpatient treatment but those who require a therapeutic milieu due to their inability to function adequately within the general population. (ie small dorms or single units with increased accessibility to medical and mental health)

Outpatient Referral Services - Case managers try to send mentally ill inmates out the door with (at least) medication and referrals to outside case management.

Discharge/Transfer Planning - Adequate discharge planning is a fiscally sound process that goes along way towards reducing recidivism and a costly return to jail following a violation of parole or an entirely new crime.

Evolving Issues - include mental health input into the inmate disciplinary process, discharge planning for inmates with serious mental illness, management of inmates with inappropriate sexual behaviors, care of female mentally ill inmates.

Malingering - inmates malingering a mental illness while having a serious mental illness is not uncommon.

Question 17

pg 25 Ch 5. The Role of the Correctional Officer in Supervising Mentally Ill Inmates

Jails may be required to provide treatment for the mentally ill, therapeutic substance abuse programs, programs for the developmentally and medically disabled as well as sometimes jails will find grants to implement special treatment programs or other types of programs that enable the inmates to contribute and make _______________ to the community such as __________ or ______________.

Answer 17

restitution;

graffiti or campground clean up;

Question 18

pg 26. Ch 5

To be sure, there are times that the only appropriate response is to initiate a ___________ response so that a dangerous mentally ill inmate can be subdued, restrained and removed to a crisis unit for stabilization.

Answer 18

use of force;

Question 19

pg 26 Ch 5 A Collaborative Process

Officers, by definition, must remain detached and set themselves to _______________, not building a therapeutic relationship.

The focus of mental health professionals, in contrast, is characterized by __________________ ____________________ , informed consent, and to some degree in a jail setting, negotiated compliance.

Answer 19

resolving issues;

individualized treatment;

Question 20

pg 30 Ch 6 Gathering Critical Information

If an inmate requires special housing, their status should be reviewed every __________ days in order to keep track of any changes both bad and good.

Answer 20

thirty (30);

Question 21

pg 30 Ch 6 Different Layers in the Intake Process

Incarcerating a person is major violation of their rights unless you have the appropriate charging documents.

________ officers initially focus on the documents (while of course fully attending to safety issues) before their focus changes to the inmate.

Officers will ask if the y have any injuries or if they’ve tried suicide in the past 24 hours. If the inmate states that they are currently suicidal, a ___________ ___________ would be immediately initiated.

Answer 21

Wise;

suicide protocol;

Question 22

pg 31 Ch 6 Booking Process

After _________ hours, an inmate has usually detoxed enough (if needed) to be able to give coherent answers.

Answer 22

24;

Question 23

pg 42 Ch 8 Policies to Mitigate Drug Availability

What are some of the jail drugs and alcohol reduction strategies?

Answer 23

-Zero-Tolerance
-Training
-Direct and Random Testing
-Sanctions
-Random Searches
-Searches of Visitors
-Searches of Staff
-Monitoring of Correspondence
-Secure Storage of Medical Supplies
-Monitoring of Medications Distributed to Inmates
-Monitoring of Over-the-counter (OTC) Medications
-Proper Equipment
-Drug Detection Dogs
-Inmate Clothing
-Yard Scheduling
-Control of Foodstuffs
-Control of Material Used to Fabricate Pruno
-The Opportunity for Spiritual Support
-Education
-Substance Abuse Groups
-Treatment
-Support Services
-Specialized Unit

See book on descriptions.

Question 24

pg 45 Ch.9 Specialized Units

Prisoners with pre-existing psychiatric disorders are of greater risk of suffering further _______________ _________________ when placed in isolation, or segregation/security housing units.

Answer 24

psychological deterioration

Question 25

pg 45 Ch.9 Specialized Units

_______________ inmates have a very high suicide rate, far more than the suicide rate of inmates in general population. Therefore, ____________ _________ _____________ must occur either prior to or within a short period of time following an inmate’s placement in a segregation unit.

Answer 25

Isolated;

Suicide risk assessment;

Question 26

pg 46 Ch.9 Specialized Units

Classification officers should also complete __________ days reviews in which they meet with each inmate.

Floor officers are the ___________ ___________ _____ _______ for an inmate whose mental health is deteriorating.

Answer 26

thirty;

first line of defense;

Question 27

pg 46 Ch.9 Specialized Units

In an ideal situation, a segregated mental health correctional program should offer ______ to ______ hours per week of out-of-cell structured therapeutic activities in addition to unstructured exercise or recreation time.

Answer 27

ten to fifteen;

Question 28

pg 49 Ch. 10 Mental Health Assessments

It is necessary that any inmate manifesting what appears or is known to be mental illness, undergoing a disciplinary proceeding must receive a mental health assessment to determine if their current mental state is a barrier to the inmate’s ____________ of the disciplinary proceedings.

Answer 28

understanding;

Question 29

pg 50 Ch 10 Medication

Officers should be present during medication passes to ensure the inmates are actually taking their medications and not “_____________” them (pretending to swallow the medications but actually hiding them in their mouths to save for later, to trade or to store up medications to overdose).

Answer 29

Cheeking;

Question 30

pg 50 Ch 10 Medication

The authors recommend that every unit in every correctional facility be supplied with _________ __________ _________ ___ ________ or similar guide, or have a direct link to a reliable online source, approved by the jail medical staff, in order to help familiarize officers with the various medications available.

Answer 30

Mosby’s Drug Guide for Nurses;

Question 31

pg 51 Figure 10.1 Why do they stop taking their medication?

There are many reasons inmates resist taking their medication, discontinue them, or take them intermittently. Among them are:

Answer 31

-Unwelcome side effects
-No effect (or so it seems)
-No effect (in truth)
-The illness is better than the cure
-Mania, the “Up-Side” of Manic-Depression
-Intoxicants Preferred to medication
-Taking Own Medication is Impossible

Question 31

pg 51 Figure 10.1 Why do they stop taking their medication?

There are many reasons inmates resist taking their medication, discontinue them, or take them intermittently. Among them are:

Answer 31

-Unwelcome side effects
-No effect (or so it seems)
-No effect (in truth)
-The illness is better than the cure
-Mania, the “Up-Side” of Manic-Depression
-Intoxicants Preferred to medication
-Taking Own Medication is Impossible

Question 32

pg 51 Figure 10.1 Why do they stop taking their medication?

There are many reasons inmates resist taking their medication, discontinue them, or take them intermittently. Among them are:

Answer 32

-Unwelcome side effects
-No effect (or so it seems)
-No effect (in truth)
-The illness is better than the cure
-Mania, the “Up-Side” of Manic-Depression
-Intoxicants Preferred to medication
-Taking Own Medication is Impossible

Question 33

pg 55 Ch11 In Between: Continuity of care requires restoration of benefits

It is imperative that a specific individual within your jail is responsible for helping mentally ill inmates get their benefits ______________ before they leave incarceration. Any lag time in the reception of benefits only leaves the inmate open to __________________ and __________________.

Answer 33

reinstated;

victimization and decompensation;

Question 34

pg 57 Ch 12 The Sequential Model for Jail Diversion

Sequential Model - ?

Answer 34

Sequential Model - a call is made to a local community mental health agency and refer him for diversion.

If you can secure his compliance, you drop the individual off at an evaluation center, and inform him that if he follows up with the referral he will not be cited and may have an opportunity to get treatment and housing.

Question 35

pg 57 Ch 12

What does “intercept and treat versus adjudicate and house” mean?

Answer 35

having a warrant and going to jail. A second diversion point can occur at the jail, the jail staff and the court chooses to review his case and refer him for diversion rather than wait for another hearing date.

Question 36

pg 57 Ch 12

Mentally ill offenders will be incarcerated ___________times longer than the average inmate in jail or prison and at seven times the cost, this is obviously a very expensive “________________.”

Answer 36

eight;

revolving door;

Question 37

pg 59 Ch 12

Behavioral health diversion provides :

Answer 37

time-saving to law enforcement;
decreases the number of event related injuries;
improves access to crisis triage systems;

Question 38

pg 60 Ch 12.1

Upon release from jail, the state now provides each participant with ____________ days of medication.

Answer 38

fourteen (14);

Question 39

pg 63 Ch 13

There are multiple opportunities for intervention (sequential intercept) from pre-arrest through post-adjudication (Chapter 12). __________ and ____________ services, then, is one of the filters for developing interventions.

Answer 39

Probation and parole;

Question 40

pg 63 Ch 13

____________ and _____________ release planning are imperative for any client a PO believes will naturally fall back into the arrest cycle. Case management planning for these offenders should include ____________ or _____________ meetings with local correctional personnel to ensure there is a continuity of care for at-risk offenders. Client decompensation poses a risk of harm (violence, suicide or medical emergencies) to all parties involved.

Answer 40

Pre-arrest and Post;

Bi-weekly or monthly;

Question 41

pg 65 Ch 14 Mental Health and Psychiatric Services on the Outside

Taking the lead however, does not eliminate the need or the participation of the other parts of what would otherwise be treatment team. Services must be “ ______________” not one-at-a-time.

Answer 41

wrap-around;

Question 42

pg 65 Mental Health Services

It should be the responsibility of jail social services to:

Answer 42

-Find out what services the agency actually has, and what type of client they are able to offer treatment .

• Ensure that the inmate is correctly diagnosed.

-Ensure that parole/probation is aware of the inmate’s mental health needs, and what barriers to treatment the inmate presented while in custody.

-Release should include both trip-wires and sanctions to encourage or even enforce compliance with treatment requirements.

Question 43

pg 66 Ch 14

Under healthcare reform, hospitals that readmit patients within ______________ days of discharge are to be fined for readmissions. On the positive side, this has created incentives for hospitals and managed care to reduce the over-utilization of hospital stays and to create a system where follow-up, “care management,” and treatment coordination is mandated.

Answer 43

thirty (30);

Question 44

pg 67 Ch 14 The Emergency Room

Systems need to change and adapt, hospitals, community mental health, and jail systems need to work together. Doing this shares the costs and creates opportunities for new alliances and funding opportunities.

Adopt the following goals in your hospital referrals:

Answer 44

1. Communicate and build a relationship with the treating physicians and medical staff in the local hospitals.
2. Time for a mental health admission to the emergency room should not exceed the time it takes for a standard medical patient to clear,
3. Use of drug screen for a medically stable patient may be unnecessary and delay discharge or referral.

Question 45

pg 67 Ch 14 The Emergency Room

The goals of emergent psychiatric services are ______________ ___________ and __________ ______________ .

Answer 45

rapid stabilization;

brief treatment;

Question 46

pg 71 Ch 15 The development of safety Mindset

The development of correctional awareness is based upon the following three fundamentals assumptions:

Answer 46

1. Being proactive
2. consistency and a common understanding in the application of safety procedures and emergency protocols at all levels.
3. safety preparedness and correctional awareness

Question 47

pg 71 Ch 15 The development of safety Mindset

Beyond those systemic issues just mentioned, attendance to a number of factors will definitely make a safer worksite:

Answer 47

1.) Solid boundaries
2.) Adaptability
3.) Presence and Accessibility
4.) Good training and regular price
5.) Integrity

Question 48

pg 73 Ch 15 AAR

AAR’s must focus solely on what can be done to ___________ ______ __________ and enhance everyone’s safety for future operations.

Answer 48

improve the process;

Question 49

pg 79 Ch 16

A sense of of spatial awareness, of potential escape routes, likely weapons, and access to help should become a natural part of the correctional officer’s personal and professional life.

This routine attentiveness is often referred to as “_____________ _____________.”

Answer 49

Correctional awareness;

Question 50

PG 81 Ch 17

Most importantly, the correctional officer should not _______ ____ _______, particularly by losing his or her own temper. Most people can’t sustain anger for more than a couple of minutes, so if you can keep your composure, many inmates will come down on their own.

Answer 50

feed the anger;

Question 51

ch 17 pg 83

________________is the ability to be consciously aware of what is going on in your interactions with another person.

Answer 51

Mindfulness;

Question 52

ch 17 pg 83

By taking notes later on your physical reactions, one type of “after action review,” you’re training yourself to recognize the patterns _____________ that your survival brain notices ________________.

Answer 52

consciously;
unconsciously;

Question 53

ch 17 pg 84

Always pay attention to what your body tells you, the body is linked to structures in the brain that serve to protect us from danger, through ______________ ______________rather than verbal cognition.

Answer 53

pattern recognition ;

Question 54

Ch 18 pg 87

_____________ can fuel cynicism, or anxiety, as well as eliciting feelings of contempt or hatred toward inmates.

Answer 54

Stress;

Question 55

pg 91 Ch 19

A __________ _____________ is an extraordinary event that forces a correctional officer to face vulnerability and mortality during the course of their official duties.

Answer 55

critical incident;

Question 56

pg 92 ch 19

Typically, the __________ _________ ________ ____________ member will contact the affected Officer once a week for at least one month following the incident and remain in contact with them until they are confident that the affected officer’s physical and emotional needs have been addressed.

Answer 56

Critical Incident Stress Debriefing;

Question 57

ch 20 pg 93 It’s Not Personal Unless You Make It So

Responding to an inmate, perhaps mentally ill, on a personal or emotional level, no matter what the provocation, will cloud an __________ ____________, while distracting him or her from legitimate safety concerns.

Answer 57

officer’s judgment;

Question 58

Ch 20 pg 94 It’s Not Personal Unless You Make It So

When our buttons are pushed we react as if we are threatened with bodily harm.

Anything that pushes our buttons and sets us off balance puts us at risk. A technique call _________ makes it harder, if not impossible for others to even get to our buttons. Bracketing is a technique that entails facing your vulnerabilities head on and making them bulletproof.

Answer 58

bracketing;

Question 59

ch 21 pg 99 Circular Breathing: Be the Eye in the Center of the Hurricane

Chaos doesn’t only take over the day; it may also overtake you. However, when you can respond by stepping coolly into the worst of situations, you embody the eye of the hurricane, with all the chaos coalescing and revolving around you. The root of this skill lies in breath control. Using a method called “__________ ___________” you regain control of your physical self. When you control your body you control your life. Then you are in position to take control of the crisis as well as the person causing it.

Answer 59

circular breathing;

Question 60

Ch 21 pg 102 Circular Breathing: Be the Eye in the Center of the Hurricane

PTSD is not defined by how horrible the event sounds in description. It is defined by the victim’s response to the event. PTSD is not exactly a problem of memory; it is a problem because the event has not fully become ________, and rather, is still experienced as if it is happening in present time. When an event is fully a memory, it is experienced as something in the past, over and done with.

Answer 60

memory;

Question 61

ch 24 pg 111 Rigid Personality: Asperger’s Syndrome and Other Similar Disorders

People with ______________ syndrome are frequently socially withdrawn, often very intelligent outcasts, who may live their lives mostly in an online environment. Such individuals are becoming more involved in computer crimes, particularly hacking.

Answer 61

Asperger’s;

Question 62

ch 24 pg 111 Rigid Personality: Asperger’s Syndrome and Other Similar Disorders

If you’re dealing with an inmate with a rigid personality, stating or reiterating, the rules is the first method of _______________.

Answer 62

intervention;

Question 63

Ch 25 pg 115 Tell It Is: Communication With Concrete Thinkers.

___________ ___________have a lot of difficulty or even a complete inability to understand, metaphors slang, or imagery. Instead, they take everything you say literally.

When communicating with concrete thinkers, correctional officers should use short clear sentences using simple language that is easy to understand. Remember, they only understand what you say, in a very literal manner, complying with the specific, while, not even understanding the general principle.

show a minimum of emotion. Don’t get irritated when the inmate does not immediately understand you. They respond much more to your tone of voice than to what you say.

Answer 63

Concrete thinkers;

Question 64

ch 26 pg 117 Information Processing and Retention Consolidating Gains

In dealings with the mentally ill, the following points have been proven helpful:

Answer 64

1.) least effective method - the least effective method is to repeat using other words.

2.) Repetition by inmate- have the inmate repeat your instructions.

3.) Open Sentences - a better method is open sentences.

4.) Write Down Important Points

Question 65

Ch 27 pg 119 Coping With Stubborn Refusals

If it is not your approach that is creating the problem, what, if anything, can correctional officers do to elicit compliance, without having resort to the violation process?

Answer 65

1.) Focus on the task
2.) Clarify, the message
3.) Control the interview
4.) Use a strong and calm voice
5.) De-personalize your role
6.) state the consequence
7.) Play the power in the inmate’s hands

Question 66

Ch 30 pg 125 Dealing With Mood Swings

They can be verbally abusive, provocative, complaining, passive-aggressive, blaming, apologetic, ingratiating, and friendly all in the space of an hour or less. They often try to get control of others even when they have no control over themselves.

Remain balanced and emotionally non-reactive.

A correctional officer can influence them by being exactly what they are not.

Answer 66

Inmates with Mood Swings

Question 67

Ch 31 pg 128 They aren’t moving what to do?

Don’t do for them what they can do for themselves.

Don’t require them to do things that they are in capable of doing.

If they are truly noncompliance, use the ____________ _____________for motivation (or sanction if they continue to refuse.

Act with dignity don’t try to “cheerlead” them into compliance berate them, complain or anyone of a number of actions to compromise your integrity in the interest of getting them moving.

Answer 67

violation process;

Question 68

Ch 32 pg 129 Should a correctional officer ever apologize?

if you have wronged the inmate, if it does not put you in danger and if it, thereby, enhances your authority, then you should apologize.

If an inmate is using the grievance or complaint to get control of the exchange, distract you, or simply complain for the sake of complaining, shut it down. Call them on their game and don’t allow it to continue.

Answer 68

1.) Acknowledge their concerns - recognize their complaints and then move forward, do not, however, allow the inmate to revisit the issue at every encounter.

2.) Apologize- if you were wrong apologize.
be wary of apologizing, an apology may lead the inmate to believe they are now in control and the CO will act cautiously so as not to upset them in the future.

3.) In an apology is not enough - example “You are still upset about this. you want to talk about it again, don’t you? “

Notice that you don’t ask the inmate; you merely state your understanding. This gives them the opportunity to correct or adjust your understanding so that if their complaint is legitimate, you are able to effectively put it to rest.

4.) Complaints as their own reward

Question 69

Ch 32 pg 129 Should a correctional officer ever apologize?

if you have wronged the inmate, if it does not put you in danger and if it, thereby, enhances your authority, then you should apologize.

If an inmate is using the grievance or complaint to get control of the exchange, distract you, or simply complain for the sake of complaining, shut it down. Call them on their game and don’t allow it to continue.

Answer 69

1.) Acknowledge their concerns - recognize their complaints and then move forward, do not, however, allow the inmate to revisit the issue at every encounter.

2.) Apologize- if you were wrong apologize.
be wary of apologizing, an apology may lead the inmate to believe they are now in control and the CO will act cautiously so as not to upset them in the future.

3.) In an apology is not enough - example “You are still upset about this. you want to talk about it again, don’t you? “

Notice that you don’t ask the inmate; you merely state your understanding. This gives them the opportunity to correct or adjust your understanding so that if their complaint is legitimate, you are able to effectively put it to rest.

4.) Complaints as their own reward

Question 70

Ch 33 pg 131 Useful Tactics for Dealing With Symptoms of Paranoia and Persecution

The paranoid inmate has a motto of life: “if there is a problem here, that would be your fault.” The paranoid world is one of dominance and submission: they try to dominate the people in their life, and are terrified or enraged at being forced to submit.

Character traits and behavior patterns of paranoid inmates include:

Answer 70

• Paranoid Inmates Interpret Relaxation as Vulnerability
• being Mistaken or Wrong is another Form of Vulnerability
• Paranoid inmates live like detectives - they have ideas of reference- in which they believe that other conversations, glances, or actions are directed at them.
• Paranoid Inmates Make others Uncomfortable Or Afraid.

Question 71

Ch 33 pg 131 Useful Tactics for Dealing With Symptoms of Paranoia and Persecution

Paranoia is an “__________” that drives rage in all its various forms. De-escalate the inmate using tactics specific to the mode of rage they are exhibiting rather than de-escalating paranoia itself. Paranoid inmates can exhibit traits of fear, frustration, intimidation and manipulation.

Answer 71

engine;

Question 72

Ch 34 pg 137 Divide and Confuse: Borderline Personality Disorder and Splitting

An inmate with borderline traits believes that whatever feeling they are having right now is their only __________ __________.

When the team associated with a borderline inmate get tangled up in intense disputes about what is best for them, this type of conflict is called _____________.

Answer 72

possible reality;

splitting;

Question 73

Ch 35 pg 141 Bad intentions: Recognizing the Strategies of Opportunistic and Manipulative Inmates

_____________ _____________ can result from a variety of emotions and intentions, such as those born of revenge, malice, desperation, laziness, guilt, or as the result of drug and alcohol use.

This seemingly compliant behavior may in fact be nothing more than an attempt to manipulate and control your behavior. Require _________ ____________ of any information given by the inmate.

What the compliant inmate is likely to accomplish is to manipulate you so that you do not see what they are up to.

Manipulative inmates ask correctional officers for personal information, such as marital status, children, in which part of town the CO resides, and so forth.

They are quite adept at reading body language.

They are likely to blame others for their failures and their behaviors.

They can be manipulative when they are being flirtatious and sexual.

Answer 73

Manipulative strategies;

Proper verification;

Question 74

Ch 36 pg 145 Tactical and Safety Considerations Related to the Supervision of the Psychopathic Inmate

Although ___________ inmates can be charming and ingratiating, they can also be violent, provocative, dishonest, arrogant, and quite willing to break any rule.

They feed off vulnerability just like a ______ or a _______;

They view themselves as utterly unique and special (grandiose narcissism) and therefore they do not view themselves as being incarcerated for the purpose of rehabilitation.

They are good at reading other people;

Answer 74

Psychopathic;

leopard, cougar;

Question 75

Ch 36 pg 145 Tactical and Safety Considerations Related to the Supervision of the Psychopathic Inmate

What are the Tactical and Safety Consideration when Dealing with a Psychopathic Inmate?

Answer 75

1.) You will be attacked through your “best” and your “worst” points.

2.) Notice when others start making excuses for the inmates.

3.) Track any manipulative strategies, document well, and alert all other members of your team to the tactics an inmate is using.

4.) You may be intimidated. The most obvious manifestation of intimidation is fear. There is always a reason for fear.

5.) Be aware of grooming behaviors. - making you feel a little off balance, making you anxious, scared or flattered. Then they lessen the pressure while making a request that the correctional officer would have granted anyway.

6.) Guard all personal information.

7.) Don’t get beyond the horizon line- Don’t meet psychopaths alone!

8.) Detected calculated splitting - inmate uses gossip, rumors, misdirection, and blatant lying to set all stakeholders involved in their supervision and treatment agains each other. Communicate with members of the treatment team to detect and confront splitting.

Question 76

Ch 37 pg 152

We can choose to speak to the illness, or speak to the ___________ who is ill. For both humane and tactical reasons, it is that _______ part of his or her psyche that we are trying to reach.

Answer 76

person;

core;

Question 77

Ch 38. pg 153 Struggling in a Fog: Dealing With Symptoms of Disorganization

______________ is a general term used to describe what is like when inmates can’t adequately organize their thinking, perceptions, behaviors and/or emotions so that they can function well in the real world.

Due to their cognitive limitations, Developmentally disabled inmates are not skilled at problem solving.

Psychotic inmates also become disorganized when they deteriorate.

Question 78

Ch 39 pg 157 Latency: Dropping Stones Down a Well

__________ is a behavior in which inmates respond in a much-delayed manner. It is often a manifestation of disorganization.

Answer 78

Latency;

Question 79

Ch 40 pg 160 Withdrawal Inmates

Use whatever tactic necessary to de-escalate and control them, based on their behavior, as described in the latter sections of this book.

The signs of withdrawal can include:

Answer 79

Unstable Coordination

Restlessness and Agitation

Unpredictable and Sudden Actions

Slurred or Incoherent Speech

Abnormally Rigid Muscles

Being Argumentative and Demanding

Question 80

Ch 41 pg 161 Psychosis: Delusions and Hallucinations

A __________ is first and foremost a belief that does not fit reality; it is fixed belief that is not reality based.

A _________ is an unreal perception through any of the senses.

Answer 80

Delusion;

Hallucination;

Question 81

Ch 41 pg 161 Psychosis: Delusions and Hallucinations

What are the types of delusions?

Answer 81

Grandiose- a belief that they have been appointed to a special mission, that they have extraordinary or unusual powers, or are special, remarkable beings.

Religious - Often linked with grandiose delusions.

Jealous- a belief that their partner is unfaithful to them.

Delusional Stalking (Erotomania) - A belief that another person is in love with them.

Persecutory (Paranoia) - A fixed belief that people, institutions or other powers have hostile intentions toward them or have committed evil actions against them.

Question 82

Ch 41 pg 162 Psychosis: Delusions and Hallucinations

What are the types of hallucinations?

Answer 82

1.) Auditory - (Two levels) auditory distortion - one mishears what it is said.
Auditory Hallucination the voices are real to them as the voice of your co-worker or spouse is to you.

The psychotic inmate actually hears the voices.

Paranoid inmates in particular often display a “listening attitude”

2.) Visual - Visual distortions - images move, melt, emerged toward them or even speak.
Visual hallucinations- objects or beings appear that no one else can see.

3.) Olfactory - If a previously non-psychotic inmate complains of hallucinatory smells, get them immediately checked medically.

4.) Tactile - sensations felt within the body. Formication, the sensation of bugs crawling under the skin.

Question 83

Ch 42 pg 169 Communication With Inmates Experiencing Delusions/ Hallucinations

Differentiation: Distinguish Between Your World and Theirs

If you should neither agree nor disagree with their delusions, how can you respond in an effective way to the inmate’s delusional thinking, while also trying to get them to recognize the distinction between your world and theirs?

Answer 83

Differentiate yourself from them. To differentiate is to perceive or express difference. Differentiation simply helps you keep the lines of communication open.

example: Sal, I only hear two voices in this room, yours and mine. I don’t hear a woman’s voice at all. What do you hear they say?

Question 84

Ch 43 pg 175 Welcome to the Rollercoaster: Tactics for Dealing With Symptoms of Mania

Mania is a state of ______ _________.

Manic inmates need little sleep, and can be excited, grandiose, agitated, or irritable.

The manic state is associated with bipolar disorder (1/2 manic-1/2 depression)

The manic person feels way better when they don’t take their medication.

Answer 84

high energy;

Question 85

Ch 45 pg 186

What are warning signs of suicidal inmates?

Answer 85

1.) Inmates booked and are under the influence have a higher risk as they don’t have the clarity of thought needed to reason themselves out of it.

2.) negative changes in life : divorce, break up, death of a loved one, pressure form gang, sexual assault,

3.) radical changes in appearance, weight loss, loss of appetite, removing themselves from a work detail.

4.) the Officers intuitive sense.

Question 86

Ch 45 pg 186

What are warning signs of suicidal inmates?

Answer 86

1.) Inmates booked and are under the influence have a higher risk as they don’t have the clarity of thought needed to reason themselves out of it.

2.) negative changes in life : divorce, break up, death of a loved one, pressure form gang, sexual assault,

3.) radical changes in appearance, weight loss, loss of appetite, removing themselves from a work detail.

4.) the Officers intuitive sense.

Question 87

Ch 47 Essential Questions pg 193

What are the four essentials questions for assessing suicide risk?

Answer 87

1.) Are you planning to kill yourself?

2.) how would you do it?

3.) Follow up questions like Do you have any pills, what kind, where are they, Do you know what would happen if you took them all?

4.) When will you do it?

Do not ask this questions as a mere checklist!!!

Question 88

Ch 48 pg 199 Self-Mutilation

When it is potentially life threatening, but somehow has survival “built-in” it is referred to as “_________-_________ _________.” This primarily includes cutting ones wrists or other actions that could, taken to an extreme, have resulted in death.

Other actions are not life threatening, and are referred to as “self-injurious behavior” or “self-mutilation”.

Answer 88

Para-suicidal behavior;

Question 89

Ch 48 pg 199 Self-Mutilation
What are some of the reasons why an inmate would commit self-mutilation?

Answer 89

1.) Self- hatred

2.) Attention Seeking

3.) A struggle to feel something

4.) Stress reduction

5.) Primitive Medicine

6.) Rehearsal

7.) Psychosis

Question 90

Ch 49 pg 206 The Cycle of Aggression

When we are calm we are at baseline, which is represented “________” at baseline we used the parts of the brain most responsible for our better human characteristics: thinking, creativity, and forming social relationships.

Anger represents the numbers _______________.

To de-escalate and control an angry inmate, the correctional officer should attempt to “line-up” with them.

Rage is represented as ________.

when someone is angry they may be concerned, upset, hurt, confused and/or frustrated.

When someone is enraged they are in effect trying to switch themselves on to becoming violent.

Answer 90

0-20;

20 through 95;

95-99;

Question 91

Ch 49 pg 206 The Cycle of Aggression

What are some of the prime inhibitors an inmate is trying to overcome when enraged?

Answer 91

Fear of Consequences

Morality

Self-Image

The Relationship

Learned Helplessness

Question 92

Ch 49 pg 206 The Cycle of Aggression

_____________ is a set of behaviors, including both physical actions and verbalizations that serve to do away with one’s self-inhibitors, so that nothing holds them back from violence.

Inmates in a rage state they are no longer trying to communicate they are working themselves up to an attack.

Fear is just a wake up call; remember a sense of powerlessness is not fear. It is a conclusion that some people reach when they are afraid, limiting their ability to control the situation or to defend themselves with the end range inmate do my sis tablets control.

Answer 92

Rage

Question 93

Ch 50 pg 211 Why would an inmate become aggressive?

What are some of the factors that can drive an inmate to become aggressive?

Answer 93

-Feels confused or disorganize,
-Feels enclosed trapped in or visit with problems.
-Has a fear of an attack
-Feels wrong, or feels a loss of power
-Is hallucinating or having delusions,
-Drugs, alcohol and other organic stressors,
-Feels shame, or humiliated,
-Is acting out of protective aggression
-Act out of a sense of entitlement, or they simply enjoy it
-Anything that elicits Profound emotion can cause an inmate to become volatile or aggressive,
-Prison gang subculture.

Question 94

Ch 56 pg 244

Guidelines for limit setting

As soon as you draw a line, it will become the main focus of your interchange don’t ever set a limit that you can not enforce or one that is not reasonable and simple to understand.

When dealing with a profoundly anxious inmate limit setting is a _____________ rather than oppression

Answer 94

kindness

Question 95

Ch 56 pg 244

The following will help in setting a full stop limit:

Answer 95

-Your tone of voice should be matter-of-fact
-Give clear directives with no wiggle room
-Give praise if he complies
-If he does not comply with the directive depersonalize the reiteration
-Don’t get them caught up in manipulative word games

Question 96

Ch 56 pg 245

After interrupting the inmate, the first thing you should do is to _____ ____ your understanding of what he or she just said this proves that you were indeed listening to them and are interested in solving the problem. Once you have summed up, you can either go in to problem-solving mode, or if they are still heated shift into tactical paraphrasing.

Answer 96

sum up

Question 97

ch 57 pg247

What is paraphrasing?

Answer 97

Paraphrasing is perhaps the most important technique for calming angry inmates. You sum up in a phrase or sentence what the angry inmate has just said in a paragraph. If you paraphrase accurately, you have establish that you have gotten it that far so they don’t have to repeat it, or try to say it in other word the best thing about Parra pricing is that you don’t have to be smart and interpret anything you simply had to listen carefully.

Question 98

ch 57 pg 247

We select what we will sum up from the complex, sometimes almost incoherent, communication that the inmate has just given us shows in the most rational aspect of what they have just said this matter is ___________ ___________ whereas passive summation call mirroring can make things worse .

If you sum up an aspect of what they have said, that is in direction of conflict resolution, you will draw out of them that which does wish to resolve the conflict

Answer 98

self-correcting

Question 99

ch 57 pg 252

We know we have reached the core level when there is no more progress. the inmate _________ _____ _________ they may use different words, but they say essentially the same thing over and over again

Answer 99

spins his wheels

Question 100

Chapter 59, page 261 working with incarcerated youth

When one’s parents use drugs and alcohol, their attentiveness and caring towards their children, is lessened in the best of such circumstances abuse of all kind increases _________________ in drug or alcohol abusing homes.

Answer 100

exponentially.

Question 101

Chapter 60 page 263 no brake pads, a consideration of the impulsive youth

Per Orthodox theory, attention disorders come in two major forms. in the first type the main manifestation is a short attention span attention deficit disorder ADD. in the second type hyperactivity is also present attention deficit hyperactivity disorder.

_________________ can be particularly valuable with these kids, because you demonstrate that you get their desire and frustration rather than argue with them

Answer 101

Paraphrasing;

Question 102

Chapter 61. Conduct disorder, fierce youth.

The majority of the children who fully merit the diagnosis of conduct disorder don’t grow up to be psychopaths.

The fierce youth typically displays rages in three major categories, fury, manipulation and ________________.

Answer 102

predatory behavior

Question 103

Chapter 63 opposition defiant kids “even if you make me I’ll still make you miserable”

If you’re losing your temper, they are winning, and they hold you in contempt for it.

The watch word in dealing with these kids is to pick your battles. Don’t waste energy arguing about anything that isn’t important when it is important become _______________.

Answer 103

implacable

Question 104

Chapter 67 page 281

_______ __________ is typified by profound disorganization of cognitive and perceptual processes, and can be engendered by severe psychosis that has crossed over into a delirium state wether engender from Mania, intoxication, drug withdrawal, severe intellectual, developmental, disabilities, snail, dementia, overwhelming emotions, or as a result of rain, injury, or trauma

Answer 104

chaotic rage;

Question 105

Chapter 67 page 281

____________ ___________ inmates are often very impulsive and unpredictable and striking out in all directions. our symbol for this state is TAZ, the fanged whirling tornado of arms and legs in the Warner Bros. cartoons

Answer 105

enraged disorganized

Question 106

Chapter 67 page 283

____________ is a very rare very bizarre condition in which an inmate stays in a fixed posture, not congruent with injury or seizure. It is cause either by mental illness schizophrenia, or an organic condition for example, drug use. The intimate posture may be quite awkward or twisted, seeming to require great flexibility a classic symptoms of true catatonia is waxy inmobility.

Answer 106

catatonia

Question 107

Chapter 67 page 284

when dealing with a ____________ inmate, as you move them, treat them like a bomb about to go off firm hands, lots of them in one person talking. Stay smooth in control and powerful do not grab at their limbs, digging your fingers into the flesh.

Answer 107

catatonic

Question 108

Chapter 67 page 284

_____________ ________ is a rare condition at the extreme end of the hyper aroused wing of the delirium spectrum. etiology can be varied, but it is most commonly associated with long-term use of stimulants, particularly cocaine and methamphetamine.

This people die this is a medical emergency, manifesting a physical danger.

The longer the struggle in the more intense the exertion the more likely the person will die.

Answer 108

excited delirium;

Question 109

______________ inmates believe that they will be violated or abuse they appear apprehensive and furtive looking halfway ready to run halfway ready to strike.

Terrified rage can be like a the wolf.

Answer 109

Terrified

Question 110

Chapter 69 page 293

The primary method of de-escalation for hot rage is called _____ __________ the technique itself is simple identify the most dangerous behavior and repeatedly demand that it cease.

Use short sentences and easily understood commands. Once they stop that particular dangerous behavior, identify the next problematic behavior and use the same technique, continuing until the inmate is under control. This technique is only effective right before during, and after the peak of the crisis because it is a control tactic, rather than the lining up de-escalation tactic used for anger. As described earlier facing an enraged inmate causes us to experience fear in a way that anger does not.

Answer 110

the ladder;

example: step back step back Jamison will talk about it. When you step back Jamison step back step back Jamison. We will talk about it when you step back.

Question 111

Chapter 69 page 296 Hot Rage Subtype #1: Fury

What does fury look like?

Answer 111

Furious inmates are very tense, looking as if they are about to explode for a mental image If they are of a big stature, think of a grizzly bear they are smaller think of a wolverine.

Question 112

Chapter 69 page 297 hot rage subtype #2

In keeping with the animal analogy, when describing the furious inmate, the aggressively bluffing inmate is like a ___________ beating his chest a display of aggression designed to keep you at a distance.

Answer 112

gorilla;

Question 113

Chapter 69 page 300 heart rage subtype #3

aggressive manipulative inmates

the symbolic image for this inmates is a __________ ____ not because it is meant to be demeaning but because rats are survivors, they are all about winning not honor, not image winning by whatever means they can dealing with the aggressive manipulator is like being placed in a maze your test is to walk right through the wall

Answer 113

large rat.

Question 114

Chapter 70 predatory or cool rage

Inmates with this type of rage are intimidators, who threaten with either vague innuendos or explicit threats. Their aggressive behavior is calculated, but unlike the manipulator violence is often the first choice rather than one of many options. The predatory inmate deliver threats in cool danger tones often after a clear and strongly stated demand.

Our symbol for them is either a _____________ or ___________, depending on if they present as warm blooded or stone cold

Answer 114

leopard or shark

Question 115

Chapter 74 page 314 the aftermath

If the mentally ill inmate is really frightened or devastated by what happen, the first priority is _______________ and ____________.

If the inmate has the cognitive ability to understand, then an educated follow up is necessary.

Answer 115

Reassurance and orientation