Pulling-up

Managing Negativity in Prison
Psychoeducationalgroups.com, David Barry
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Pulling Up:
Managing negatvitiy in Prison
What “Pulling Up” is About

This manual “Pulling Up: Managing Negativity in Prison” outlines a group
psychoeducation approach to teach inmates with a serious mental illness
skills that will help them manage their prison experience.

Negativity can come in many forms and has many expressions in prison. Almost all inmates
entering prison have a long-term history of experiencing negative messages. Their arrest,
conviction and sentencing also become negative experiences. Once in prison the “pecking order”
in the prison environment provides the individual with a serious mental illness numerous negative
messages. Individuals frequently manifest this negativity by either withdrawing into their cells or
becoming hostile and management problems.

This is an eight-session group psychoeducation program for inmates receiving mental health
services. The intent of the program is to help inmates examine how their negativity can be
debilitating and to help them develop skills that will enable them to more effectively manage their
negative emotions, thoughts and behaviors.

The overall theme of the program supports the strategy of helping inmates successfully adjust to
their prison environment rather than having them persists that the environment should adjust to
them. This re-framing of their orientation to prison is no simple tasks and this psychoeducation
program needs to be presented in concert with at least individual, if not individual and group
psychotherapy. There are three assumptions that are the foundation to and interwoven in this
manual.

 A series of eight group psychoeducation sessions, using a variety of learning strategies,
with a core group of individuals is enough time to develop new skills and creative a positive
learning environment. The skills demonstrated in this manual are important and will be
helpful for individuals. And, in learning new skills they are beginning to mobilize their
strengths and taking positive action. The sessions are also structured to create a positive
learning experience. This positive learning experience can also serve as an example that
not all aspects of an individual’s life in prison need to be negative.

 No single intervention in itself is going to work for all individuals. This group
psychoeducation program will be effective when used in context with other mental health
treatment interventions. In fact, many clinicians state that if there is no opportunity for
patients to talk about more personal or pressing issues they will subvert the
psychoeducation session to address their individual needs. Negativity is a consequence of
prison not a mental health condition. This program can help individuals manage that
negativity. However, once that negativity is minimized the individual will still require mental
health treatment.

 The focus for change needs to be on the person not the system. Individual inmates are not
going to change the prison system. If an inmate is going to learn how to better manage the
negativity in prison, is he or she that need to change, not the prison system.
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What is Meant by A Group Psychoeducation Approach

Group psychoeducation is an evidence based
Psychoeducation has been found to be
treatment intervention. The efficacy of group
effective in helping individuals
psychoeducation has been recognized by the
understand their mental illness…and in
Department of Health and Human Services and
the teaching of coping skills that helps
specifically SAMSHA.
decrease the severity of psychiatric
symptoms.
This manual is meant to be a “semi-structured” group
Muesser, et al “Illness Management
psychoeducation program. Each of the sessions has a
and Recovery: A Review of the
clear set of goals and learning activities. The goals
Research” Focus, Jan 2004; 2: 34 - 47.
and learning activities are reinforced in assignments
the participants are to complete between sessions.

The sessions are to be conducted much more like a class than a traditional group session.
Members of the group psychoeducation program are referred to more as participants than group
members. The person conducting the sessions is referred to as a facilitator not a group leader or
group therapist.

The sessions are developed to be sequential and cumulative. Concepts and skills learned in
Sessions 1 and 2 are helpful when learning the concepts and skills presented in Sessions 4 and 5.
The sessions are also cumulative and will help develop a positive learning experience. The
beginning sessions are general discussions about negativity and stressors in prison. The sessions
in the middle focus on how individuals manage negativity and helping them identify strengths they
have to help them manage their prison experience. The sessions at the end of the program teach
new skills to re-evaluate the stressors that confront them and develop new ways of responding to
those situations.

While there is a specific structure and sequentially developed set of exercises included in this
manual, it is also recognized that each class will be different. Different facilitators may have
additional skills and examples of exercises they want to include in their programs. And on occasion
there may be such a pressing issue in the overall prison environment that those issues will “spill
over” into the group psychoeducation session. Skilled clinicians conducting these sessions need
to incorporate their understanding of the participants needs into the overall delivery of the program.
When the clinicians have “more to bring to the table” in terms of new concepts and skills for the
participants the clinicians should assimilate the learning of those new skills and concepts into the
delivery of the program.

How the What you will review in the sessions:

Session1 “Don’t be surprised when In this beginning session participants review what
you pray for rain” the program has to offer and examine how
negativity affects individuals physically, emotionally
and behaviorally.
Session 2 “Yin and Yang” People can often get trapped at looking at the
negative aspects of many situations. This session
helps individuals explore how to look at situations
from different perspectives.

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Session 3 “Understanding Stress” Stress plays a large role in wearing individuals down
and experiencing negative thoughts. This session
helps understand how stress impacts on people in
different ways.
Session 4 “The Weight” It is not easy to be overcome many negative
aspects of prison. In this session individuals identify
resources that can help minimize the impact
negativity has on them.
Session 5 “The Prisoner in the Stone” This session focuses on helping identify the positive
characteristics that define the cores strengths that
will help individuals survive prison.
Session 6 A “Decision Balance In this session participants learn how individuals can
Worksheet” make better decisions by more closely examining
the positive and negative consequences to their
decisions.
Session 7 “The Fly in the Ointment” At times no matter how much people try, negative
situations and statements can still confront them.
This session will provide a new skill to help minimize
the impact of negative situations.
Session 8 “Do you see what I see?” In this final session group participants take inventory
of the skills and resources they have and need to
help manage prison life.

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PULLING UP-
OVERCOMING NEGATIVITY IN PRISON

EXERCISE: DON’T BE SURPRISED WHEN YOU PRAY FOR
RAIN

INTRODUCTION: Negativity can come in many forms and has many
expressions in prison. This introductory exercise gives participants a
chance begin thinking about how negativity can impact on people and
what are some of the ways they can minimize negativity.

GOALS- During this session individuals will have the opportunity to:

1] Compare the eight session “Pulling UP” workshop goals with their individual needs.

2] Define negativity and discuss how it can impact on the physical, social and emotional aspect of
a person’s life.

3] Evaluate their potential to become “locked into” negative thinking styles.

LIST OF MATERIALS:

1. “Pulling Up” Workshop Overview.
2. Individually cut “When it Rains” quotations.
3. The Impacts of Negativity Worksheet.
4. Negativity Checklist.

SPECIAL NOTES FOR THE FACILITATOR:

The intent of this exercise is to help participants begin to examine how negativity can
impact on individuals. This session contains:
 A brief “ice breaker”
 A general discussion about negativity
 A self-examination focusing on the extent to which negativity impacts on the client.

Steps

Overview to Pulling-Up Workshop: Handout the “Pulling Up” Workshop Overview and provide a
brief overview of the “Pulling Up” Workshop goals and individual sessions. Reinforce that while the
topic of negativity can be depressing the intent of this session is to look at it in a more general,
objective sense. The in the program participants will learn “psychological tools’ that will help them
not just in prison but also in life outside of prison.

2] Icebreaker- “When it Rains” – There are 15 phrases on the “When it Rains” quotation sheets.
Have each of the phrases cut on individual strips of paper. Pass out different strips, with the
quotations, to the group members. Have members work in dyads.
 Give each member a minute to read and think about the quotation on his strip of paper.
 Ask the participants to talk for 2-3 minutes with their dyad partner about the quotation they
received and what they think it means.
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 Go “round robin style” around the room asking each of the dyads to read their quotations
and state what it means to them.
 Let the other group members know they can also respond with their interpretation to the
quote.

3] Keeping members in dyads, facilitate a brief discussion of what negativity is. Use some of the
questions below to focus the discussion.
 How do different people in the room define negativity?
 What are the differences between responding negatively to a specific situation and being
negative in general?
 What are some of the characteristics of negativity?
 Why might it be easier to be negative all the time?
 What are some of the costs of being negative all the time?

4] Following the brief discussion on “What is Negativity” hand out the Impacts of Negativity
Worksheet. Let the members know you are interested in seeing who can identify the most impacts
of negativity on a person.
A. Have the dyads work on completing the worksheet
B. For each of the 3 categories, ask dyads which group identified the most impacts of
negativity on:
 A person’s health
 A person’s interactions with others
 A person’s emotional well-being
As the dyads with the most responses report out see if other dyads had additional impacts
that had not been listed by the reporting dyad.

5] Take time to reinforce the participants’ involvement in the exercises. Let them know that talking
about negativity is sometimes like dealing with that “500-pound” gorilla in the middle of the room.

6] Let participants know this is the final exercise of this session. It is a quick checklist designed to
help theme estimate the extent to which negative thinking can impact on them.
A. Hand out the Negativity Checklist
B. Give participants 15 minutes to respond to the questions and score the checklist.
C. Reinforce that participants will be asked to talk about the general impressions of the
checklist, but the decision to talk about their specific score or response to specific items it
their decision.
D. Ask participants if any of them were surprised by their ratings on the sheet.
 Ask which items they though most represent them
 Ask which items they could not relate to at all or did not apply to them
Summarize Session:

 Review some of the ways the group members described negativity
 Review the ways negativity can impact on people
 Ask participants to keep their Negativity checklists so they can review the checklist at the
end of this workshop.

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 Briefly preview that in Session 2 participants will what will be helps exploring how to look at
situations from different perspectives. And maybe talking about some ways to minimize the
affects of negative messages they may receive.

 Ask for questions and thank people for coming and participating.

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Pulling Up-
Maintaining a positive attitude in prison is a large challenge. Arrest and
conviction, separation from family and friends, confinement to prison all are
difficult obstacles to cope with.

This program cannot change your arrest history, separation or confinement
conditions. However Pulling-Up can give you some tools that will help you
better manage some of the obstacles that prison life presents.

Pulling-up is an eight-session psychoeducation program to help inmates receiving mental health
services. The program examines ways of minimizing negative thoughts, feelings and emotions.
The program also teaches some life-skills on how to minimize the impacts of negative situations on
our day-to-day functioning.

What you will review in the sessions:
Session 1 “Don’t be surprised In this beginning session we review what the program
when you pray for rain” has to offer and examine how negativity affects us
physically, emotionally and behaviorally.
Session 2 “Yin and Yang” We can often get trapped at looking at the negative
aspects of many situations. This session helps explore
how to look at situations from different perspectives.
Session 3 “Understanding Stress” Stress plays a large role in wearing us down and
experiencing negative thoughts. This session will help
better understand how stress impacts on us.
Session 4 “The Weight” It is not easy to be overcome many negative aspects of
prison. In this session we will try to identify some
resources that can help minimize negativity.
Session 5 “The Prisoner in the This session will focus on helping identify the positive
Stone” characteristics that define who we are and the cores
strengths that will help survive prison.
Session 6 A “Decision Balance In this session we will study how individuals can make
Worksheet” better decisions by more closely examining the positive
and negative consequences to their decisions.
Session 7 “The Fly in the At times no matter how much we try, negative situations
Ointment” and statements can still confront us. This session will
provide some “psychological tools” to help minimize the
impact of negative situations.
Session 8 “Do you see what I In this final session we will work with other group
see?” participants to take inventory of the skills and resources
we have and need to help manage prison life.

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WHEN IT RAINS QUOTATIONS SHEET
Listed below are a series of quotations that are often
used when talking about negativity. Hand out the
individual quotations to group members. Give
participants a minute to think about the quotation and
what it means to them individually.

Ask the group members who wants to read their
quotation and discuss it’s meaning first. Let other
members know they can also add to the
interpretations of the quotations that have been read.

Victory has a hundred fathers but defeat is an orphan.
Galeazzo Ciano

If you pray for rain, don’t be surprised if you are struck by lightening.
Damien Cannon

A skeptic is a person, who when he sees the handwriting on the wall, claims it
is a forgery.
Morris Bender

What causes most people to fail is that after one failure, the stop trying.
Frank Burford

To expect defeat is nine-tenths of defeat itself.
Francis Crawford

Use the losses and failures of the past as a reason for action, not inaction.
Charles Givens

No man ever became great or good except through many and great mistakes.
William Gladstone

Notice the difference between a man who says I have failed three times and
the one who says I am a failure.
S. I. Hayakawa
The man who tries something and fails is better off than the one who tries
nothing and succeeds.
Lloyd Jones
It is better to talk about the 500-pound gorilla in the room than to try to ignore
it.
Unknown

Most people would rather be certain they're miserable, than risk being happy.
Robert Anthony

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A fault is sooner found than mended.
Ulpian Fulwell

Regret is an appalling waste of energy; you can't build on it; it's only good for
wallowing in.
Katherine Mansfield

Our greatest glory is not in ever falling, but in rising every time we fall.
Confucius

Give some people a piece of pie and the want to know where the ice cream
is.
My grandmother

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THE IMPACTS OF NEGATIVITY WORKSHEET
Following the brief discussion on “What is Negativity” hand out the
Impacts of Negativity Worksheet.

Let the members know you are interested in seeing who can identify
the most impacts of negativity on a person.
C. Give members 5 minutes to complete the worksheet
D. Ask members who identified the most impacts of negativity on:
 A persons health
 A persons interactions with others
 A persons emotional well-being

Ways negativity can impact on a person’s health:

Ways negativity can impact on a person’s interactions with others:

Ways negativity can impact on a person’s interaction’s with others:

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NEGATIVITY CHECKLIST
We all use score sheets and checklists to help us understand how we
are doing. Being able to objectively examine how we are doing is
essential in improving our performance. This principle holds true for
great athletes as well as anyone who is trying to improve.

This section of the exercise gives participants an opportunity to evaluate
for themselves how negative thinking can impact on their well being.

It is a “self-report”, “self scoring” checklist. By self-report we mean that
you rate the items for yourself. By self-scoring we mean you can score
the inventory yourself.

Please take 15 minutes to complete the checklist.
You may be asked to discuss your overall impression of the inventory,
but the decision to talk about your specific score or response to the items is totally your decision.

Please use the scale below to rate your responses on the Negativity Checklist survey.
1 2 3 4 5
Never applies to Rarely applies to Sometimes this This often This frequently
me me happens happens to me happens to me

Score
Question
1 2 3 4 5
Think of how bad others have treated me and get bitter, angry
Not willing to look at new ideas or accept suggestions for change
Spend much of the day thinking about what is wrong with my life
When I meet someone new try to figure what they want from me
Think I can not ever get things right
Say what “I am not” rather than what “I can be”
Would rather be myself, alone, than with others
Think critically about myself
Say “yes, but” when people suggest new ideas
Do not like to think about the future
Score
Scoring:
10-15 Very optimistic
16-25 A little negative but manageable
26-40 Negativity can become problematic and is generalized
41+ Negativity is difficult, but you are responding honestly

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PULLING UP-

SESSION 2: YIN AND YANG

INTRODUCTION: Negativity can come in many forms and has many
expressions in prison. This introductory exercise gives participants a
chance to examine the ways individuals either experience negativity
and attempt to manage it. The key to the exercise is that individuals
gradually begin to accept that there are different ways to look at any
one situation. The Yin and Yang symbol and underlying principles of
that symbol are the foundation for this exercise. This introductory session also help provide an
overview of some of the concepts that are more deeply examined in the following sessions of this
program.


1. Compare and contrast negative thoughts and attitudes with more positive thoughts and
attitudes.
2. Discuss how individuals can look at any one event and see both the positive and negative
aspects of that event.

LIST OF MATERIALS:

5. Individually cut, ‘Yin and Yang’ cards. For this specific exercise it is recommended to have
4, 6 or 8 cards per individual or per small work group. More variations and options for use of
the cards with various size groups are described at the end of this section.i
6. Score sheet of flip chart for keeping score.


The intent of this exercise is for participants to examine more positive approaches to their
negative beliefs and attitudes. To the extent that participants discuss and examine how
there are more positive ways of looking at a situation the exercise is successful.

When doing the exercise if a participant matches a card with another card that is not
necessarily identified as the correct response, but he can justify his answer, the participant
has succeeded and met the intent of the exercise. So give the participant the points.

BEFORE STARTING THE EXERCISE

Make sure you have the correct number of “matching pairs’ of responses for the exercise.

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Overview to Session 2:
Review what was covered in session 1.
 Briefly discuss some of the impacts of stress that participants identified.
 Discuss participants general responses to the Negativity Checklist
Highlight what will be covered in this session.
 Looking at some ways to see both the positive and negative ways of thinking about an
event.
Steps

1. Up to 8 participants can individually play or you can participants break into 4-6 subgroups.
[You can vary the number of participants but need to pre-sort cards so there will be
matching sets and they can be evenly distributed among the participants.]
2. Deal 6 cards to each of the individuals [if using small groups then 6 to the group] from the
“Yin and Yang Deck” to the participants.
3. Describe the components of the deck to the participants.
• They are four suits of cards in the deck;
a) The Yin [black symbols] in a white circle.
b) The Yang [white symbols] in a black circle.
c) Blade-up, a triangle with the base facing up.
d) Blade down, a triangle, with the base facing down.
• There are ten [10] Yin and ten [10] Yang cards that have specific matches in the
deck. There are tow additional Yang Wild Cards that can be matched with a
corresponding Yin card.
• There are ten [10] “Blade up” and ten [10 “Blade down” playing cards with phrases.
And, two [2] “Blade Down” wild cards with out phrases.

4. Review how the participants can earn points my matching the following types of cards.
• 5 Points for matching the saying on the Yin card with the exact counterpart to the
saying on the Yang Card.
For example: The Yin Card states-“Complaining is easy and the matching Yang
card states- “Complaining rarely solves a problem”
• 5 points for developing your own match, using to a Yin with a Yang wild card. For
example The Yin card says “Complaining is easy” and your response is something
like- “Complaining is cheap but rarely gets accomplishes anything.”

• 5 Points for matching Blade up and Blade down cards. That is the saying on the
Blade up card in the exact match to the saying on the Blade down Card. For
example:
The Blade down card says- “Here I can never be a success”
The Blade up card says- “My being successful depends on what I can make
of my current situation.”
• 3, 5 or 7 points for developing your own match to the Blade up card with a Blade
down wild card.
For example: The Blade down card states-“Here I can never be a success”
The participant with the blank Blade down wild card says something like:
 3 points for matching the topic “For here success is keeping out of
trouble”
 5 points for a good match “Maybe I need to redefine what success is
for me here”

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 7 points for words of wisdom “Success is when I feel I have done the
best I can do given my situation.”
Points can only be awarded for responses that have a matching suit. Only a Yin card can
match a Yang card, and only a Blade up can be matched to a Blade down card.

5. Review the how participants can receive new cards. [The exercise can be done with either
individuals or teams. This same procedure applies.]
• The teams will have four opportunities to pass their cards to the members other
teams.
• The teams can pass any one card they want to the team on their immediate right.
• The object of passing cards is to get either matching Yin or Yang, Blade cards or a
wild card that they can use.
• A team may decline to pass a card. In this case the team passing the card passes it
to the second team on the right.

6. At the end of four passes the members show their cards to the rest of the class and the
facilitator. The facilitator then scores the cards and lists the scores on a board. Teams will
need to justify the rational for using wild cards. And, if a team does not have what is
identified in the instructions as a correct match, but the teams their response is valid they
can present to the facilitator an appeal for points.

7. The first team to get 33 points wins.

8. If there is time remaining teams can play a second round.

Summarize:
 Summarize the session by discussing how participants were able to demonstrate that
people can look at the same situation in more than one way. Discuss that how we look at
the situations can greatly influence how they can impact on us in either a negative or
positive manner.
 Briefly describe Session 3: Triggering Negativity.

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Yin Yang

Life is unfair, so why even try. Life is unfair I need to try
harder.

Yin Yang

When people treat me bad I When people treat me bad, I
get bitter. try to get beyond it.

Yin Yang
If someone says something When someone says
bad about me I cannot let it something bad about me I
go. think of it is more their
problem.

Yin Yang
When I think there is too much
Most of my conversations
complaining I try to change the
end up in complaining. topic of conversation.

Yin Yang

Complaining is easy. Complaining never solves a
problem.

Yin Yang

When a problem happens I When a problem happens I
look at who is at fault. look for the solution.

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Yin Yang

This system needs to better My first challenge is to adjust
understand my needs. to this system, and then
maybe try to change it.

Yin Yang

I can often find something
When anything happens I fear
good out of almost all
for the worse.
situations.

Yin Yang

I spend much time thinking of I often think of what I can
what I could have been. become.

Yin Yang
To change my future I need to
If people give me break change myself.
things will get better.

Yang Yang

Wild Card Wild Card

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Blade Down Blade Up

He really knows how to get He is someone who is always
under my skin. trying to irritate me.

Blade Down Blade Up

I have so many problems I will I need to try to match my
never be able to break free of strengths against my problems.
this.

Blade Down Blade Up

I have really screwed up my life Things are really tough for me
and now nothing else matters. but at least I have a few friends
and my health.

Blade Down Blade Up

They say I am a convict so I Maybe to them I am a convict
might as well behave that way. but to me I am a man.

Blade Down Blade Up

They say I am a screw-up so I Let them think what they will, I
might as well act that way. still have my dignity and no one
can take that from me.

Blade Down Blade Up

He is pushing me, just waiting He really wants me to explode.
for me to explode. My keeping calm is getting to
him.

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Blade Down Blade Up

Think the worse of people, that I need to judge individual
way you are never disappointed. people by their behavior.

Blade Down Blade Up

It is his fault I hit him and am I really let him get to me, and
now in SHU. now I am the one who is paying
for it.

Blade Down Blade Up

Trusting others is for suckers. Trusting or not trusting
someone depends on their
behavior.

Blade Down Blade Up

I have tried all this @@XX! once Last time this didn’t work,
before and it did not work then maybe I can do better this time.
and will not work now.

Blade Up Blade Up

Wild Card Wild Card

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PULLING UP-

SESSION 3: TRIGGERING NEGATIVITY
INTRODUCTION: This session teaches participants how to begin to
understand the difference between an event and how the person
responds to that event. This session in many ways is the beginning of
that process how the can choose how to respond to what is happening
in their environments.

While the activity itself is a stress index scale this principle of “differentiating the event from the
experience of the event” is the key learning point to the session. In latter sessions {Sessions 8 and
9] this principle will be used in examining and reframing situations that normally could produce
negative emotions.

1] Discuss events situations they may encounter and how much stress is associated with that
event.
2] Compare and contrast their reactions to stressful events with the responses of the other group
members.
3] Identify factors that influence how an individual may experience an event and explore the
“subjectivity” of individual reactions to eventssituations.

The intent of this session is for participants to begin to differentiate between events they encounter
and their reactions to those events.
 Individuals each completing a stress index scale
 Small groups of 4-6 completing a group stress index scale [same scale]
 A review of small group scores
 A discussion of factors influencing how individuals would react differently to the
events listed on the scale
 A discussion of the individual’s experience of the event is what influences his
reactions.

LIST OF MATERIALS:
7. Copies of the stress index scale for each group participant.
8. An extra set of copies of the stress index scale for small group experience
9. A flip chart and pad for listing group responses

Review what was covered in Session 2.
 Briefly discuss how the participants were able to compare and contrasts negative and
positive ways at looking at the same situations.
Highlight what will be covered in this session.
 Looking at how stress can impact on us and it’s potential to increase negative thinking and
emotions.
Steps

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1] Briefly discuss with participants the history of the Holmes Ray Stress Index scale.1

2] Let participants know they are going to look at 10 potentially stressful items. On the scale they
will be asked to distribute 100 points amongst the various items based on how stressful they think
that event would be to them. For example for some people “being transferred to another prison”
might only be 5 stress points while coming up for a “parole board hearing” might be 20 stress
points. Give participants 10 minutes to individually distribute a total of 100 points between those 10
items.

3] After participants have individually rated the events on the “Stress Index Scale” they will be
asked to rate the same items as a group. [Small groups of 4-6 work best for this part of the
exercise.] The small groups will have 15 minutes to complete the group list.
SPECIAL NOTE
 Participants need to reach a consensus on how much stress the average inmate
would experience if he or she had any of the events identified in the scale happen to
them.
 If the small groups seem to be having problems reaching consensus have them
identify the three most stressful events and the three least stressful events. Once
this is done they can begin to distribute the values.

4] Have a flip chart prepared listing items on the Stress Index Scale with room to the right of the
items to list the small groups weighting of the events. 6] Give participants 10, 5 and 1-minute
warnings

5] Ask the small groups to report out their results and list results on the flip chart.

6] Ask participants which types of items they had difficulty reaching consensus on.
 Ask what factors influenced how they rated the different items.
 Review how those factors influenced the participants’ reactions to the events.
 Ask participants, “If the same events do not cause the same stress for everyone…. then
what is the main factor determining how an individual experiences stress?”

7] Reinforce the concept that it is not the event that causes an individuals reactions but how the
individual experiences that event.

Summarize Session 3:
 Review how different people can experience the same event in different ways.
 Briefly discuss that in Session 4 participants will discuss some of the negative impacts of
prison and explore some resources that could help minimize those negative impacts.

1
Holmes and Rayhe developed the Holmes-Rayhe Stress Index Scale were workers in a crisis clinic in
Boston. After a number of years and seeing hundreds of individuals in crisis Holmes and Rayhe decided they
could quantify different events in terms of levels of stress associated with those events. The listed over 50
different types of stressors and assigned a numerical value to those events. The numerical value was
associated with the level of stress that even would have for an individual. Holmes and Rayhe would then
interview individuals using the scale and check the various stressor the incoming client would identify. From
the number of items checked, Holmes and Rayhe would then total the accumulated stress points and identify
if the individual was experiencing one of 5 levels of stress.
20

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Exercise: Stress Index Scale

Introduction: There are ten items listed below. You are to distribute 100 points to the total ten
items. The number of points you assign to any one item will represent how much stress that event
would have for you. For example, having your wife win $100,00 in a lottery might only be 2 stress
points while finding out she is pregnant might have 50 stress points. Some of the items might not
apply to you, such as the item about having a younger brother, still rate the item thinking that if that
item could apply to you, how would you respond. You have 10 minutes to complete this task.

Stress Points Event

Being transferred to another prison

Find out your mother is ill

Lose visiting privileges

Parole hearing

Become sick for over a month and not know why

Younger brother gets sentenced for 4 years

The inmate in the cell next you told you he is thinking about suicide

Mother wins $100,00 in lottery

You are facing a hearing for a 3 month ticket

Your 18 year old sister is pregnant

21

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Sample Exercise: Stress Index Scale

Introduction: There are ten items listed below. You are to distribute 100 points to the total ten
items. The number of points you assign to any one item will represent how much stress that event
would have for you. For example, having your wife win $100,00 in a lottery might only be 2 stress
points while finding out she is pregnant might have 50 stress points. Some of the items might not
apply to you, such as the item about having a younger brother, still rate the item thinking that if that
item could apply to you, how would you respond. You have 10 minutes to complete this task.

Stress Points Event

Being transferred to another prison

Find out your mother is ill

Lose visiting privileges

Parole hearing

Become sick for over a month and not know why

Younger brother gets sentenced for 4 years

The inmate in the cell next you told you he is thinking about suicide

Mother wins $100,00 in lottery

You are facing a hearing for another 3 month ticket

Your 18 year old sister is pregnant

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PULLING UP-

SESSION 4: THE WEIGHT

INTRODUCTION: In a highly stressful environment it is often easy to solely
focus on negative factors and disregard potential resources and
supports. This primary function of this exercise it to have participants
begin to identify and discuss potential resources.


1] Discuss negative factors in the prison environment that can cause stress and lead to a sense of
futility.
2] Identify potential resources that can help balance some of the negative influences of prison.

3] Explore options for gaining additional supports and resources to help them in their environment.

LIST OF MATERIALS:

1] A weight worksheet for each participant.
2] The Envelop Worksheet for facilitators

The intent of this session is to have participants begin to shift their focus from looking solely at
negative factors to begin to explore some potential resources. For many inmates the only resource
they will be able to tap into is themselves. For some, there may be potential to re-unite with family
and friends, find a greater sense of spirituality or identify some other external resource.

Review what was covered in session 3.
 Briefly review how participants discussed that they would experience
similar events in different ways. Discuss how factors like values, previous
experiences, relationships and supports all impact on how we
experience an event.
 Introduce Current Session- Facilitator briefly describes how in this
session participants will examine some of negative factors in the Pri
prison environment and some of the resources they need to help
overcome the “weight” of prison life.

Steps

1] Facilitator begins this exercise by briefly discussing how scales work and weights on one side of
the scale are needed to counteract and thereby measure the weight on the opposite are of the
scale.

2] The facilitator segues this part of the discussion into how life is similar and we often need
something to give balance to our lives. It may be necessary to give a concrete example of this
need for balance.
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Example of a Story: In the movie “Cast Away” Tom Hanks is stranded alone on an Island with no
one to talk with. The isolation is beginning to really bother him until one day he finds a soccerball.
He paints a face on the soccerball, names it Wilson, and feels he has someone to talk with. Now
the character new the soccerball was not a person but used the soccerball as an object to talk to.

The point of the story is that in difficult situations we have to look hard for resources and think of
things that normally would not mean a lot as things that can have value for us.

3] Tell participants you are going to ask them to begin to think about things in prison that can be
stressful and result in negative thinking for them. Also let them know you are going to be asking
them to think about things that can potential resources for them.

4] Hand out a copy of the “The Weight Worksheet” to each participant. Ask them to first circle the
items and scores of the negative Factors on the sheet they think apply to them. Have participants
feel free to add additional negative factors [i.e. their girlfriend want to stop seeing them]. Allow
some flexibility in terms of the weighting [i.e. if an inmate thinks being in prison should have a
weighting of 75, ask the group if they think that is true for him and go with their opinion].

SCORING OPTION: Some
individuals may have difficulty
adding numbers on the Weight
50 10 Worksheet. At the end of the
materials in this session there
lbs are several pages of “weight
bars”.

The facilitator can distribute the weight bars to group participants so they can more easily score
their Weight Worksheets. The weight bars with the blackened center are for negative points and
those with the unfilled center are for positive points.

5] Ask participants to then circle and score the positive factors. As they do this you can bring a little
humor to the exercise if some participants are beginning to despair. For example you might tell an
inmate “his stubbornness” can be a positive factor, because it is a sign he has his own mind.

6] Ask participants to tally up the positive and negative factors. The facilitator will most likely need
to help many of the inmates do this task. If an inmate seems very well skilled in doing the tally tell
them to give themselves an extra positive 5 points.

7] Ask participants to read of the differences between their scores to the rest of the group. Have
them discuss some of their reactions to the various factors. Ask how they felt about the issue of
remorse being both a positive and negative factor.

8] Let participants know you are now going to see if there is some additional resources they can
use to help counter the differences between the negative and positive factors.
 Read off the statement and scoring options for Envelope #1. Ask participants to add
the weight of importance that item has to their positive score. Have a brief
discussion with participants about their perceptions of that item.

24

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9] Ask participants to take a second tally of their positive and negative factors. Ask if
there were any significant changes for any of the members.

10] Calling in the Big Guns: Facilitator should begin to end the exercise. If participants begin to
ask about the final item on the Weight Worksheet, “Calling in the Big Guns” YOU ARE MAKING
PROGRESS.
 This indicates the participants are beginning to think of what can do to help themselves…
maybe they are even looking to explore new ideas.
 Calling in the Big Guns is when we ask the audience for their opinions. Ask participants if
they have ideas to help other group members overcome their negativity. Let this concept
“sit’ for while with the group.
Some suggestions you can make to this section are:
1. Just being able to begin to identify positive and negative factors is a positive step.
2. It is probable that some participants’ scores increased from the first to the second part of
the exercise. And, that improvement demonstrates that there can be change.
3. Sometimes we have to learn to establish a “new normal.” That is accept where we are now
with our life rather than what we had or wanted. In accepting some of that new normal we
can begin to think of ways to improve what we now have.

Summarize Session

Discuss why it is necessary to take an honest accounting of events before your can change them.

Let participants know that he following session they will be exploring how some people get “out of
touch” with themselves while in prison. How it is often so necessary to “cover up” to protect oneself
that individuals can loose track of what has been important to them.

Ask two of the more oriented group members if they will do the report out next session on what
was covered in today’s session.

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 THE WEIGHT WORKSHEET

Negative Factors Positive Factors
Weight [lbs] ConditionSituation Weight [lbs] ConditionSituation
50 Prison 20 No major mental illness
20 SMI 10 15 20 Family, friends
10 No family, friends 5 10 15 Good health
Pri
5 10 15 Enemies in prison 5 10 15 Supports in prison
5 10 15 Isolated from others 5 10 15 People to turn to when
needed
5 10 15 Feel remorse about 5 10 15 Feel remorse about
what happened what happened
5 10 15 Little to no money 5 10 15 Able to care for self
5 10 20 30 SHU Time 5 10 15 Have a spirituality
5 10 20 30 Illness 5 10 15 Can enjoy music
5 10 20 30 Facing additional 5 10 15 Can enjoy sports
charges
Other Other
5 10 15 5 10 15
5 10 15 5 10 15
0 5 10 15 20 Envelope #1
0 5 10 15 20 Envelope #2
0 5 10 15 20 Envelope #3
0 5 10 15 20 Envelope #4
Total 0 5 10 15 20 Total
Difference between Negative and Positive Factors

Help Lines

Envelope 1:

Envelope 2:

Envelope 3:

Envelope 4:

Calling in the “Big Guns”

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THE ENVELOPE WORKSHEET FOR THE FACILITATOR

Envelope 1: How much does the difference between the negative and positive factors
bother you?
Add number of points for your rating:
0 5 10 15 20
Not at all No big deal A little Bothers me Really upsetting
For Facilitator: The differences between the scores can be motivating factors for participants to
begin to do something about their situation. Reinforce the concept that people often change
because they do like the way their life is going.

Envelope 2: How much more of yourself can you depend on to help?
0 5 10 15 20
All tapped out Hardly anything A little Some reserve More than I realize
For Facilitator: With this item we are asking participants to begin to think of how much they are
willing to try to change their situation. We are also trying to help them feel that they need to draw
strength from themselves to help overcome negativity. For many this item might be difficult to score
but for some it could be beneficial.

Envelope 3: Intellectually, do you have ability to make some of this better?
5 15 20
0 10
Trying to figure it Maybe able to Think I can figure
All tapped out A little
out do more out situation
For Facilitator: Hopefully this item is playing to the participants’ egos and will get some positive
ratings.

Envelope 4: Are there Positive factors you can develop or increase? Which ones? Why?

10
0 5 15 20
Might be
None Maybe one Possible three There are several
two
For Facilitator: Ask participants to look back on the list at the Positive Factors. Have them think are
there items in the positive factors they can make more use of. For example they might have friends
or family they have not contacted in a long time, they used to gain strength from religion and no
longer feel spirituality.

Points FactorsChangesDifferences
Total from Lifelines
Remaining difference between Negative and Positive Factors

Calling in the “Big Guns”: Refer to Step 12 in session overview.

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NEGATIVE Prison 50 lbs

50 50 50
lbs lbs lbs

50 50 50
lbs lbs lbs

50 50 50
lbs lbs lbs

50 50 50
lbs lbs lbs

50 50 50
lbs lbs lbs

50 50 50
lbs lbs lbs

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Prison 50 lbs

Prison 10 lbs

10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

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10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

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10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs

10 10 10
lbs lbs lbs
10 10 10
lbs lbs lbs

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3
32

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3
33

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3
34

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3
35

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10 10 10

10 10 10

10 10 10

10 10 10

10 10 10

10 10 10

36

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10 10 10

10 10 10

10 10 10

10 10 10

10 10 10

10 10 10

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3
38

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3
39

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PULLING UP-

SESSION 5: PRISONERS IN THE STONES

INTRODUCTION: The intent of this psychoeducation group session is to
help participants identify at least one positive characteristic they feel is
still part of their core person and explore ways they can more
effectively utilize that characteristic.


1] Participants will learn identify a “positive quality” that they believe they often exhibited as a child.

2] Participants will discuss obstacles to becoming “in touch” with that positive quality.

3] Participants will explore options they have to begin to re-develop that positive quality in their day
to day lives.

LIST OF MATERIALS:
Prisoners of the Stone Worksheet
The Phoenix Rising Worksheet


 Facilitator asks the two participants selected from last week to review Session 4: “The
Weight”. Try to reinforce their responses and wiliness to take on a group role. Also review
the key principles that it will often be up to the individuals in the group to change the level of
negativity they experience in prison.

 Introduce Current Session- Facilitator briefly describes how in this session participants will
try to examine some personal characteristics they might be able to use to help minimize the
negative impacts of their prison experience.

Steps

1] The facilitator presents a brief lecture on how individuals start out in one direction but events,
situations and even their own behaviors often change how they feel about themselves and respond
to others.

2] Briefly discuss the “prisoners of the stone” story on the attached worksheet.

3] Have participants begin to think of how others, whom they had a special relationship with,
described them when they were young children.

4] Hand out the Prisoners of the Stone worksheet to each of the participants.
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5] Ask the participants to briefly fill out the questions on the worksheet. Give participants about
5-10 minutes to complete their worksheets.

6] Ask each participant to describe the quality they think is hidden in the stone that they identified.
Ask participants begin to describe these qualities begin to identify some common themes.

7] Ask each of the participants to then identify 2 or 3 events, situations or behaviors that they think
keep that special quality hidden.

8] Ask each of the participants to then discuss some ways they can help their lost quality re-
emerge.

OPTIONAL ACTIVITY:

The second activity in this session is optional. It builds on the first, but there might not be enough
time to complete the exercise and it might not useful be for all patients.
1] Hand out “The Phoenix Rising” activity sheet.
2] Ask participants to take 10 minutes to complete the worksheet.
3] Many participants will need help thinking of things they can do know to “recover” that lost quality.
This part might require some individual attention for the participants.
4] After completing the tasks ask participants what is was like to think about trying some “new-old”
behaviors. Ask if any of them want to describe the personal contract. But remind the participants
that it is their choice to talk about this part.

Summarize Session

 Reinforce the positive attributes the various participants identified in themselves and maybe
identified in other group participants. Acknowledge that it is difficult to think of some ways
that they can change. Review some of the changes that the members stated they thought
they could make.

 Let participants know that he following session they will be exploring some ways of making
better decisions that might help them not just in prison but also in the community.

 Ask two of the more oriented group members if they will do the report out next session on
what was covered in today’s session

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Prisoners’ of the Stone: Michelangelo’s David
Michelangelo- Painter, Sculptor and Architect
(1475-1564)
When asked how he completed his sculptures Michelangelo replied, “I first
start with a big block of stone and then chip away at everything in the block
that is not the statue.”
The artist Michelangelo believed there was a work of art in every stone.

This story also translates into how people have something buried deep inside them that is their
“gift” to others. That gift is something that has grown in the person since childhood.

It is the quality that as young children, people often commented on. Statements like “he is so easy
going” or “she wants to help others so much” represent those qualities.

Often growing up events happen, situations and people change. That quality of the child that was
so special and remarkable becomes hidden.

That quality and the person in many ways become their own “prisoners.” Events, situations and
new ways of behaving cover the special qualities

1] What was the quality that people often used to
describe you as a child?

2] What are some of the events, situations and
behaviors that have hidden that special quality?

3] What are two things you can do, right now, today,
to remove some of the obstacles you have from
being in touch with that special quality?

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Phoenix Rising

The myth of Phoenix Rising is a story of hope and rebirth and is a common
story I many different cultures. The story of Phoenix tells of a mythical, bird-
like creature that is consumed by flames and rises new from the ashes.
One of the meanings associated with the Story of the Phoenix is that of redemption, or of having a
second chance. It is very much a story of a creature that was beautiful and destroyed yet was able
to come back.

In an other interpretation it represents a creature that has great vision and can see what is ahead.

1] What is the quality you identified as how people often used to
describe you as a child?

2] What would be some behaviors you would exhibit to show that
those qualities still can exist?

PERSONAL CONTRACT:
This is your contract, for yourself, in hoping to become regain a
quality that has been hidden for a long time. It is a quality that
others saw in you and you felt pride when others saw it in you.

Fill out the contract form below. It is yours to keep. You may or
may not share it with others in the group. That is your decision.

I was often known for my ________________________________________________ and felt
that that quality was important and made me feel good about myself.

Some of the behaviors I would often do to demonstrate that quality were:
1]___________________________________________________
2] __________________________________________________
3] __________________________________________________

For the next week I want to try to see what part of that quality is left and will try the following
activities to see what can be done.
1]_____________________________________________________
2] _____________________________________________________
3] _____________________________________________________

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PULLING UP-

SESSION 6: THE DECISION BALANCE WORKSHEET
INTRODUCTION: The key principle of this unit is that if patients have some
tools to help them change then they will feel less negative. It is doubtful
that the prison system will change for them. If they have a serious
mental illness they will have to learn how to manage their symptoms.
The one thing people can change is themselves.

The intent of this psychoeducation group session is to help participants
evaluate the positive and negative factors associated with changing their behaviors. The session
is based largely on understanding the “stages of change” and utilizes a motivational interviewing
technique. [References for background reading for both of these topics are easily accessed on the
Internet. Six sources are listed below in the Special Notes for Facilitators section of this session.]

This session works best if presented as a “life skill”. As a life skill it is a skill that can be beneficial
for all people to learn.

GOALS-

1] Participants will review the “stages of change” and relate how at different times they have made
changes in their lives.

2] Participants will describe how an individual can effectively evaluate the options to changing a
behavior by completing a “Decision-balance” worksheet.

LIST OF MATERIALS:
The Stages of Change Hand-out
The Decision Balance Worksheets [1 and 2]

For additional references on the “Stages of Change”:
 TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment,
Referenced at http://www.samhsa.gov/centers/csat2002
 http://coce.samhsa.gov/cod_resources/PDF/ReadinessforChangeandManagingMultiplePro
blems.pdf
 http://www.pathprogram.samhsa.gov/pdf/Motivational_Interviewing_Slides_2_11_03.pdf

For additional references on “The Decision Balance Worksheet”:
 Chapter 5 in TIP 35 referenced above.
 http://www.motivatehealthyhabits.com/pdfs/0TASK1page.pdf
 http://www.aodgp.gov.au/internet/aodgp/publishing.nsf/Content/tobacco-7

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Prisoner in the Stone”.
o Reinforce the members’ review of the previous session and their willingness to take
on a group role.
o Review the key principles from Session 5. Frequently people have qualities that can
become lost or hidden because of their current situations. Those qualities are still
there but it might take some extra efforts to have those qualities re-emerge.
o Ask if any of the patients wants to discuss how they tried using their personal action
plans.

look at how change can happen and how participants will learn how to better evaluate big
decisions in their lives.

Steps

Stages of Change:

1] The facilitator presents a brief 10 minute lecture on stage of change. Use the Stages of Change
Hand-out when presenting the material.
 The Stages of Change Worksheet has examples of behaviors representing each of the
stages of change.
2] After your brief lecture break the group into smaller groups of 3-4 participants each. Ask the
groups to come up with one example of a problem behavior someone might want to change.
[These examples can range from quitting smoking, having safe sex, to deciding to take prescribed
medications.] Have the participants then list out what could be some examples of behaviors the
individual experiencing that specific behavior might demonstrate at each of the stages of change.
3] Have the small groups report each example to the larger group of participants.

Decision Balance Worksheet:

1] Deciding to change is not easy!
Discuss how the most difficult shift in going from one stage to another in the “Stages of Change” is
when an individual is going from contemplation to preparation. In this shift, the individual is
beginning to recognize some of the consequences of the problem behavior but does not fully want
to recognize the difficulties associated with the problem behaviors. Completing a “Decision
Balance Worksheet”.

2] How to objectively begin to think about changing.
Explain how the Decision balance Worksheet is a way that people who are beginning to think
about making a change can objectively evaluate the costs and benefits of the old behaviors in
comparison to changing their behaviors.

3] Hand-out the Decision Balance Worksheet 1 and review each of the cells in the table. Have
participants look at how while some of the questions at the top of each of the cells may sound the
same the questions are really different.

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4] Hand-out the Decision Balance Worksheet 2. Have participants return to same small groups of
3-4 from previous exercise. Ask the groups to review the problem behavior they identified in the
earlier exercise on Stages of Change. Have the participants then complete each of the cells in the
Decision Balance Worksheet. Ask each of the small groups to identify at least three “reasons” that
would fit in each of the cells on the worksheet.

5] Have the small groups report each example to the larger group of participants.

Summarize Session

 Reinforce how making change can be difficult but also helps people become more in control
of their lives.
 Discuss how this is a life skill people can use no matter what type of situation they are in.
 Review some of the interesting perspectives participants had on examining change.
 Ask participants to complete a “Decision Balance Worksheet” on a behavior they want to
think about changing.

 Let participants know that he following session they will be exploring options they have for
changing some of their behaviors or at the very least to have some ways so problems they
encounter will not bother them as much.

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STAGES OF CHANGE WORKSHEET
Stage Examples of Someone
Characteristics
of Change Experiencing this Stage
“Ignorance is not necessarily bliss” Example: A person is arrested for
driving while intoxicated, but
The person does not see hisher continues to drink and drive.
PRE-
behavior as a problem. Others might YOUR EXAMPLE:
CONTEMPLATION complain about the behavior or
person has gotten into bad situations
because of the behavior.
“Maybe I’ll quit tomorrow” Example: Well it happened to
Paris Hilton, maybe it could
The person begins to see the happen to me the next time.
C O N T E M P L A T I O N behavior as a problem. Might even YOUR EXAMPLE
think of changing…. but not
necessarily right away.

“ I’ll be giving up a lot if this works.” Example: My wife and I agreed
that if I need a ride home she will
The person intends to actually pick me up…. no matter what
P R E P A R A T I O N perform the new behavior, but first time.
they have to get organized and YOUR EXAMPLE
everything in order.

“The new me!” Example: “Honey, it’s me and I
am at Joe’s but do want not to
The person changes the behaviors drive home. Can you pick me
that were problematic. They up?”
ACTION implement a plan, learn new YOUR EXAMPLE:
behaviors and adapt new attitudes.
This stage lasts from 3-6 months.

“This is me!” Example: Well my wife and I just
figure this is better than getting
The new behaviors become another DUI.
M A I N T E N A N C E integrated into the way the person YOUR EXAMPLE:
behaves and thinks about
himherself.

“I should have known better” Example: Well it was a few blocks
home and I did not really have
There is great potential for relapse that much to drink.
R E L A P S E with any behavior that has been YOUR EXAMPLE:
chronic. Relapse is a set-back, but
not a sign of failure,

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D E C I S I O N B A L A N C E W O R K S H E E T [1]

Reasons to Stay the
Reasons to Change
same
WHAT ARE SOME GOOD THINGS WHAT ARE SOME “NOT-SO-GOOD” THINGS
ABOUT MY CURRENT BEHAVIOR? ABOUT MY CURRENT BEHAVIOR?

W ell dr inking and dr iv ing is Ther e m ight be s om e not- s o- good
not all t hat bad. t hings about dr ink ing whil e I
dr iv e.
 I am not conf ined t o
hour s dur ing t he day  I c ould get in an ac c ident
when I need t o leav e t o ev en if it is not my f ault.
go hom e.
CURRENT  A t ic k et c ould c ost s m e as
 I do not have t o depend m uc h as $5, 000. 00.
BEHAVIOR
on anyone els e.
 I c ould loos e m y dr iv er ’s
 I have a good t im e. lic ens e.

 As long as I do not hur t I will not be s o par anoid ev er y
anyone it is m y t im e I dr iv e down t he s t r eet and
business. s ee a polic e c ar behind me.

WHAT ARE SOME “NOT-SO-GOOD” WHAT MIGHT BE SOME GOOD THINGS
THINGS ABOUT CHANGING MY ABOUT CHANGING MY BEHAVIOR?
BEHAVIOR?
W ell s om e good t hings about
Ther e ar e som e “ not - s o- good” c hanging my behav ior m ight be:
t hings t hat m ight happen if I
st op dr inking while I am  I will elim inat e m y c hanc es
dr iving. of get t ing arr es t ed.

 M y buddies wil l think I  I will pr obably not dr ink out
CHANGING am a wuss. as muc h and m ay be ev en
s av e s om e m oney .
BEHAVIOR
 Som eone will hav e t o
dr ive m e hom e.  Hec k , I m ight ev en c ut
down dr ink ing a bit .
 I wil l not be able to
f r eely go fr om one plac e  My c ar won’t sm ell lik e the
t o the next . “ night bef or e” ev er y
m or ning when I get in.
 Taxis ar e expens iv e.

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Reasons to Stay the
Reasons to Change
same
WHAT ARE SOME GOOD THINGS WHAT ARE SOME “NOT-SO-GOOD” THINGS
ABOUT MY CURRENT BEHAVIOR? ABOUT MY CURRENT BEHAVIOR?

CURRENT
BEHAVIOR

WHAT “NOT-SO-GOOD”
ARE SOME WHAT MIGHT BE SOME GOOD THINGS
THINGS ABO UT CHANG I NG M Y ABOUT CHANGING MY BEHAVIOR?
BEHAVIOR?

CHANGING
BEHAVIOR

50

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PULLING UP-

SESSION 7: GETTING THE FLY OUT OF
THE OINTMENT!

INTRODUCTION: This session provides participants with a very concrete
technique that will help them better understand their emotions before
they act on them. Part of the session involves learning the technique in
a very rote manner. The participants then will have the opportunity to
practice using the skill in a variety of situations.

This session works best if presented as a “life skill”. As a life skill it is a skill that can be beneficial
for all people to learn.

GOALS-

1] Participants will describe the “What, how and why, then what, how and decide” technique for
managing difficult situations.

2] Participants will apply the What, how and why, then what, how and decide” technique to a
variety of situations they might experience.

LIST OF MATERIALS:

Much of the material in this session is an adaptation of Cognitive Behavior Therapy. Some
references can easily by found on the Internet at the sites listed below.
http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
http://psychservices.psychiatryonline.org/cgi/content/full/53/10/1272
http://www.springerlink.com/content/k641p02j62135731/

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Decision Balance Worksheet”.
on a group role.
o Review the key principles from Session 6.
 People are at different stages of the change process and the most critical
stage for many individuals is going from contemplation to planning to
change.
 Using a decision balance worksheet can help individuals objectively examine
the pro’s and con’s of change.
o Ask if any of the patients wants to discuss how it they tried using a decision balance
worksheet.

learn a technique helping them evaluating their options before they act on their emotions.

Steps

Learning the “What, How and Why then What, How and Decide” Technique

1] The facilitator, using the outline below, presents a brief 5 minute didactic presentation on how
people can respond to situations in a way that can minimize negative outcomes. In many ways this
exercise using the hand to count off the steps to the technique is a metaphor involving the persons
briefly thinking to himherself and then opening their hand.
[PARAPHRASE PLEASE]

 Almost all people, at one time or another, say or do things they regret afterward. It is part of
being human and needing to respond to our environments. Most of us probably remember
at some point when we have said or done something that got us in trouble.

 Today we are going to examine a way to minimize those situations where we react before
thinking. How we will minimize those situations is by using the “What, Why and How then
What, How and Decide” technique.

 At first this techniques might seem a little awkward but like learning any new technique or
skill it is often something we need to practice before it becomes more natural.

 Think of your hand and each of the phrases being one of the fingers on the hand or the
whole hand itself. Now watch
o Thumb -What
o Index finger -How
o Middle finger -Why
Then
o Ring finger -What
o Little finger -How
o Opened hand -Decide

 Repeat this process several times.

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______________________________________________________________________________
2] Explain the technique to the participants, still using your fingers and hand as you explain.

An event happens in our environment. Someone
might say something to us, give a strange look or
Thumb What The Event bumping into us as we walk along

We have an emotional reaction to that event. It might
Index be anger, shame, feeling happy or alone.
How Our Reactions
Finger

We try to understand that emotion and some of the
Middle assumptions we might have about what just
Why Initial Thoughts happened to us. What are some alternative
Finger
explanations to what just happened.

Then is the transition from the event and how we experience that event to how we respond.

When we think for a moment about how we feel and
Ring Looking at our assumptions it is easier to look at some of our
What options for responding.
Finger Options

This is time to look at the consequences of the
Little Examining options for responding we have identified.
How
Finger Consequences

Having thought about our options and consequences
Opened Responding to to our actions it is time to act. Acting can range from
Decide walking away or ignoring a situation to expressing our
Hand the Situation
thoughts or asserting our rights.

53

______________________________________________________________________________
3] Hand out the “What, How and Why then What, How and Decide” Worksheet. Complete the
worksheet using the example of an event where someone is “looking at you and you do not know
why.”

WHAT, HOW AND WHY THEN WHAT, HOW AND DECIDE WORKSHEET

Someone you do not know is looking at you and you
Thumb What The Event
do not know why.

Index
How Our Reactions It makes you mad.
Finger

Maybe he is thinking something bad about me.
Or, maybe he is someone I know from somewhere
Middle
Why Initial Thoughts else.
Finger
Or, maybe he is “sizing me up.”
Or, …………


I could go over and confront him.
Ring Looking at
What I can ignore him.
Finger Options
I can ask him if we know each other from someplace.

If I confront him it could start a situation where I will
get in more trouble than I am in now.
If I ignore him maybe he will stop or maybe he will
Little Examining
How think I am weak.
Finger Consequences
If I ask him if we know each other from someplace
that will get him talking and I can figure out what is
happening.

Opened Responding to
Decide
Hand the Situation

54

______________________________________________________________________________

4] Divide the participants into groups of 3-4 each. Give them a scenario where an Event has just
happened and they would feel a need to respond. Examples might be:
 Someone standing to close to them in a line
 Getting bumped
 Thinking someone is saying something bad about them
 Someone else is sitting in their chair
 Having phone call to family stop in middle of the call
 Getting asked to do something that is not there job
 Not getting enough time out for ‘Rec”

5] Have each of the groups complete one example and then report their example back to the larger
group. Review responses and talk about other options. Reinforce the overall concept of thinking
first and then responding.

Summarize Session

 Reinforce how it is often easy to make harsh and rash decisions and that these decisions
frequently end up in us getting in more trouble.
 Review the technique
o Thumb -What
o Index finger -How
o Middle finger -Why
Then
o Ring finger -What
o Little finger -How
Opened hand -Decide
 Discuss how this is a life skill people can use no matter what type of situation they are in.

 Review some of the interesting perspectives participants had on examining change.

Ask participants to complete try using this technique at least once between now and the next
session.
 Let participants know that he following session they will be working with one another to
identify potential strengths that can help them manage some of the negative aspects in
their environments.

55

______________________________________________________________________________


Index
How Our Reactions
Finger

Middle
Why Initial Thoughts
Finger


Ring Looking at
What
Finger Options

Little Examining
How
Finger Consequences

Decide
Hand the Situation

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______________________________________________________________________________


Index
How Our Reactions
Finger

Middle
Why Initial Thoughts
Finger


Ring Looking at
What
Finger Options

Little Examining
How
Finger Consequences

Decide
Hand the Situation

57

______________________________________________________________________________

PULLING UP-

SESSION 8: DO YOU SEE WHAT I SEE
INTRODUCTION: Negativity often grows when people are unable to see
strengths in themselves or feel isolated from others. This session
provides participants the opportunity to share perceptions about one
another and identify skills they see in the individual group members.
The session is based on the Johari Window and is a feedback exercise
designed to affirm the positive characteristics of the group members.

Goals-

1] Participants will discuss the uses and potential pitfalls of feedback and self-disclosure in the
prison setting.

2] Participants will explore how receiving feedback can increase their understanding of themselves
and how the discretionary use of self-disclosure can help others better understand them.

3] Participants will give each other feedback on skills they see that other group members have that
will help them manage negativity and have the option of sharing information about themselves.

LIST OF MATERIALS:
Johari Window drawing for participants
Strips of paper or small index cards [Enough cards so each person in the group can use one card
for each other person in the group. If there are 6 people in the group each person will need 5 cards
for a total of 30 cards for the group.]
Cards can be optional if facilitator thinks the group can just do this verbally
Carlson, Self-Esteem Subscale

Much of the material in this session is an adaptation of Cognitive Behavior Therapy. Some
references can easily by found on the Internet at the sites listed below.
http://unpan1.un.org/intradoc/groups/public/documents/unssc/unpan022136.pdf
http://www.mindtools.com/CommSkll/JohariWindow.htm
http://www.cps.usfca.edu/324sh/johari.htm#top

What, How, Why then What, How and Decide” technique.
on a group role.
o Review the key principles from Session 7.
 It is natural to act before thinking about the consequences of our actions.
But, many times the consequences of those actions can get us in trouble.
 Practicing the What, How, Why then What, How and Decide” technique may
seem awkward at first but like any new skill it will become natural is used
frequently.

58

______________________________________________________________________________
o Ask if any of the patients wants to discuss how it they tried using What, How, Why
then What, How and Decide” technique since the last session.
Introduce Current Session- Facilitator briefly describes how in this session participants explore how
receiving feedback can increase their understanding of themselves and how the discretionary use
of self-disclosure can help others better understand them.
 Highlight how each individual will need to evaluate with what they are comfortable sharing
about themselves and giving feedback to others.
 Also reinforce there are things you might say to a mental health professional, a family
member or religious leader that you would not share with the general public.

Steps

Brief Lecture on Feedback and Self-Disclosure

1] The facilitator briefly reviews how there are often qualities in us that we do not see. At the same
time there are things about us we want to share and have others know about us.
 Getting information from others is receiving feedback.
 Sharing information about ourselves with others if self-disclosure.
o In the prison environment the type of self-disclosure an individual provides others needs
to be very carefully evaluated.
 Getting feedback from others and discretionary self-disclosure are part of getting to know
others and ourselves better.
 This sharing of information and getting to know others better is one of the methods of
combating the negativity that often a part of prison life.

2] Review the Johari Window
The Johari Window is both a concept and a technique used to help people learn more about
themselves and others. It is an interpersonal learning techniques used in professional settings,
schools and mental health settings.

The Johari Window Self
was developed by The Johari
two psychologists Window Known Unknown
Joseph Luft and
Harry Ingham and
came up with the K Blind area
name for the Johari
Shared area
n Known to self and What others see
window by using but we do not
O o others
their first names.
t w
Looking at the h n
Johari Window we e
U
see there are things r Private area Hidden area
we know and do not n
s Known to self What neither we
know about k
ourselves and n but not shared Not others know
things others know o with others
and do not know w
about us. n

59

______________________________________________________________________________
 Shared Area: For the population in general there is a good part of our lives that we know and
share with others. Examples of this area might be favorite foods or ideas we have talked about
with other people.
 Private Area: All people have parts of their lives or their experiences, thoughts and emotions
that they know but keep to themselves. Examples of this area might be feelings and thoughts
we keep to ourselves and do not share with others.
 Blind Area: There are some things about us that others see but we do not. This area is often
jokingly referred to as the “bad breath” area.
 Hidden Area: There are things about us that we do not know and others do not know about us.
Examples of this might be motivations for certain behaviors or ideas we do not like to think
about and avoid.

3] Implications for the Johari Window in the Prison Setting

Prison is a place where there Self
are many secrets. It is a place The
where giving feedback to Johari Known Unknown
someone could have very Window
negative consequences.
Shared area Blind area
Prison is also a place where Known Known to self What others see
disclosing information about and others but we do not
yourself can get you in trouble. O
t
Consequently, the four areas h U
of the Johari window for e n
people in prison often is r k Private area
different than it is for people in n Hidden area
s Known to
the general population. o What neither we
self but not
w Not others know
shared with
 Shared Area: The Shared n others
Area, things others and we
know about us, is reduced
in the prison setting.
People are less likely to share information about themselves and many inmates are reluctant to
give feedback to other inmates.
 Private Area: The Private Area becomes expanded. On a day-to-day basis people still
experience many events, have many thoughts and emotions. But, in this environment it is often
difficult to share those experiences, thoughts and emotions.
 Blind Area: Prison is a place where people watch and where rumors abound. While many
things might be said very rarely does information go to the source of the rumor to verify fact
from fiction.
 Hidden Area: The Hidden Area enlarges the most in prison. Without getting feedback from
others and being apprehensive about sharing information about ourselves this area expands.

4] Consequences of minimal sharing of information
As we have talked about in many different ways in this workshop on Overcoming Negativity in
Prison there are trade-offs with almost all decisions. Some of the consequences to keeping too
much to ourselves are:
 Isolation: It is easy to become isolated from others when we do not share some of our thoughts
and feelings. When we do not talk with others about some of our perceptions we can become
less interesting to talk with.

60

______________________________________________________________________________
 Others misinterpret us: When people do not know much about us or how we perceive what is
happening and therefore why we act like we do it is easy for them to misinterpret our actions.
 Misinterpretations of others: When we do not share our perceptions and others do not share
their perceptions with us it become easy to misinterpret their actions.
 Negativity: Becoming isolated, having others misinterpret us and not being sure how to
understand others are factors that can lead to negativity.

5] What are the Options?
Learning how to carefully evaluate who we say what to is a life skill. This skill is constantly being
revised and modified to fit new situations, different people and different events. Sometimes
starting out with smaller bits of information on carefully chosen topics is the safest way to begin.
Learning whom we can trust and share with and whom we interact at a more superficial level with
is a way we begin to select our friends.

Building positive relationships, learning how to better express ourselves to others and how to give
others feedback on our perceptions of them are ways we can help overcome some of the
negativity of the prison experience.

The Johari Window Exercise

1] The facilitator describes how getting feedback on skills or attributes we have that can help cope
with negativity is a good way to conclude this workshop.

2] Facilitator ask participants to think of each of the other members of the group and identify one
skill or one attribute that the person has that will be helpful in managing negativity in prison.
 For example a skill might be: The person is able to clearly express himself
 An attribute might be: The small stuff does not upset the person.

3] Hand out strips of paper or cards. Each participant should have enough pieces of paper to write
out at least one skill or attribute that he or she sees in each of the other members of the group.

4] Ask each participant to complete a piece of feedback for each of the other members of the
group. Tell participants they need to put the persons name who is to receive the feedback on the
paper, but not to put their own name down,

5] Collect the strips of paper for one member at a time. Until all participants have strips of paper
with feedback for them.

6] Let each of the participants read off the feedback they have received from others. At the end of
each persons turn they need to also identify one skill they have or one attribute they have that
helps them manage negativity.

7] Continue the process until all members have had a chance to read their feedback and identify
one skill.

61

______________________________________________________________________________
For Doing Verbal versus Written Feedback-
Eliminate steps 3-7 above.
Alternate

1] Still give members time to think about the skills the other group members have.
2] Have one member sit in the middle of the room. Each of the other members give that person
feedback and that member has to identify one skill he or she had that will help them manage
negativity.
3] When that person has received all their feedback and identified a skill it is the next persons turn.
4] Repeat process until all members have had their turn.

Summarize Session

 Reinforce how learning how to give and receive feedback is an essential life skill.
 Also briefly highlight that learning who to share what information with is a critical skill that
often needs to be re-visited.

Summarize Workshop

Thank individuals for being participants in the group.
Discuss how important it is to keep the lessons they learned in the workshop and to practice the
skills.
Ask members to identify one specific skill or concept they learned that they think will help them.
Hand out and ask members to complete the Carlson Self-Esteem Survey at the end of this
session.
Collect the completed Carlson Self-Esteem Surveys
Thank the

62

______________________________________________________________________________
THE JOHARI WINDOW

The Johari Window
The Self representing equal
Johari Known Unknown
distribution for all four
Window squares.
Blind area
K Shared area What others
n Known to self see but we
O o and others do not
t w
h n
e
U Private area
r Hidden area
n Known to
s What neither we
k self but not
n Not others know
shared with
o others
w
n

The Self
The Johari Window
when self-disclosure Johari Known Unknown
Window
and feedback are
minimized. Shared area Blind area
Known Known to self What others see
and others but we do not
O
t
h U
e n
r k Private area
n Hidden area
s Known to
o What neither we
self but not
w Not others know
shared with
n others

63

______________________________________________________________________________
CARLSON PSYCHOLOGICAL SURVEY
SELF-ESTEEM SUB-SCALE

1. My life is:
1) ___ good
2) ___ good, but a little mixed-up
3) ___ mixed-up, but I can do O.K.
4) ___ my head is all mixed-up

2. I think my future will be:
1) ___ very good
2) ___ pretty good
3) ___ not too bad
4) ___ bad
5) ___ nothing ever went right and nothing ever will

3. Compared to other people, I have:
1) ___ a lot less problems
2) ___ less problems
3) ___ about the same number of problems
4) ___ more problems
5) ___ many more problems

4. Most people seem to think I am:
1) ___ a very good person
2) ___ a bit better than others
3) ___ just like everyone else
4) ___ a bit worse than others
5) ___ a very bad person

5. I think I do the best thing:
1) ___ all the time
2) ___ almost all of the time
3) ___ much of the time
4) ___ some of the time
5) ___ once in a while

64

______________________________________________________________________________
6. People seem to like it better when:
1) ___ I talk a lot
2) ___ I talk a little
3) ___ I am there but do not bother them
4) ___ I just listen
5) ___ I am not there

7. When I do things, I do them:
1) ___ very good
2) ___ good
3) ___ better than average
4) ___ average
5) ___ poor

8. My life has been:
1) ___ better than most peoples
2) ___ as good as most peoples
3) ___ average
4) ___ as bad as most peoples
5) ___ worse than most peoples

65

______________________________________________________________________________

66

______________________________________________________________________________

67

i
Basically the 40 cards can be used in many different ways with groups. For example individuals or small
groups can have 4 to 5 cards each. Individuals can pass cards to one another or can use the remaining cards in
the deck to draw from and discard to. The next participant can then either use a card from the discard pile or pick
up a new card from the remaining deck.. The facilitator just needs to calculate the number of participants in the
group and how many draws for each section there will be.

Pulling-up

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