PRESUPUESTO INICIAL

Provide each woman with the space and time to explore her thoughts,

experiences and feelings in her sessions with you. Talk little, listen lots, keep a focus on the topics you agreed to discuss, but be flexible, keep your voice low and your eye contact in the form of a respectful gaze – regardless of how she treats (tests) you. She has to know you can cope with whatever she tells you – she has to see for herself that you are capable of managing the chaos inside of her. Plan your sessions so that she has some control over where and when they happen, and always allow about 10 minutes at the end of a review, some reflection, and a discussion of what she will do next so as not to dwell painfully on what you have discussed.

Validate emotions with empathic responses. Therefore, if she expresses anger towards someone she is telling you about, you could say something like ‘It sounds to me like it makes you angry to talk about this person – is that right? Can you tell me more about these feelings you are having right now?’

Be honest and reliable with your contact arrangements. If you are running late or need to cancel your planned session, keep your client informed. Inconsistency, unreliability and being ‘fobbed off’ are likely to trigger dysfunctional beliefs about you and your trustworthiness, and high emotional arousal along the lines of you ‘just being like all the others’ who have let her down in the past. This is a hard position to recover from.

Be interested in the stories of each of the women you work with. Genuinely held interest leads to genuinely expressed curiosity and compassion, which will be gratifying to hear and will make a big contribution towards your working relationship and engagement.

Help those who also work with the women in your care to understand the reasons why clients can be challenging – that they can be rejecting when they are really desperately seeking their care and support, that they can be rejecting of individuals when they are only trying to express their fear of being rejected. Formulation is the process we engage in when we try to understand and explain complex behaviour in order to try to respond more sensitively and compassionately and to encourage belief in alternative ways of being.

Helping the woman to express powerful emotional struggles helps her to see that she can tolerate such feelings, just as can you, and this will be in contrast to the rejection she perhaps anticipated.

Regular and fairly frequent sessions rather than widely spaced sessions interspersed with reactive responses to crises will help women to develop emotional tolerance and self-management skills.

Instil hope – validate feelings but remind the woman that she doesn’t always feel this way and that she is entitled to feel okay sometimes, whatever she has done.

If over-aroused and struggling, consider asking the woman to take ‘time out’ to compose herself, returning to the session as quickly as possible to resume with an initial focus on facts rather than feelings till she feels comfortable returning to the state of her emotions.

Help women improve their self-esteem and worth through self-care and opportunities for self-improvement or development. Stress their resilience, competencies, strengths and social capital of each of the women in your care. Do not infantilise or patronize the women – consider how language may contribute to this, for example, as when they are referred to as ‘girls.’ Ask your clients how they would like to be referred to, challenge the use of labelling, and stick to the terms you agreed to use.

Be flexible – don’t always expect the woman to come to you. Every practitioner can be a ‘one stop shop’ and expect to take your skills to the woman and to try to work collaboratively on their application.

Be aware of anniversaries – for example, of their offence or their sentence, or their children’s birthday, and so on.

Test how gender responsive your service is – for example, check it our by going here: centerforgenderandjustice.org/response.php

Ensure women have opportunities to be meaningfully engaged in how the

service is designed and delivered, including being involved in decisions about the physical environment where possible.

If the woman you are working with tells you that you are useless or that you don’t care, rather than try to tell her you do care or list all the things you have tried to do for her, respond to the underlying feeling she is expressing ‘You feel than no one can help you right now’ or ‘You feel no one cares enough about you’. Such a response helps you to avoid feeling victimised and is much more likely to generate further helpful discussion about what is going on for her rather than your role in it. MANAGING SELF HARM

Put an appropriate crisis management plan in place before any crisis emerges that results in actual, attempted or threatened self-harm. Crisis plans should outline who is to be contacted in a crisis, what should be done to help and what response should be avoided, and who the plan and the crisis is to be shared with and for what reason. It is good practice to review crisis plans following a crisis to reflect on what worked and what did not, and to amend the plan accordingly. Discuss with your client what you can and cannot do in relation to any act of self- harm – your likely responses to threats, your responses to actual incidents of self- harm. Encourage her to make her feelings known before she harms herself to give you both the best possible change of averting that outcome and demonstrating that the behaviour is manageable.

Working with women | 109 Do not make promises in order to reduce self-harmful behaviour initially.

Abstinence should not be your goal – this is just setting your client up to fail. Self- harm is a very powerful activity that works for women though only in the very short term. Help her find alternative ways of expressing her feelings and coping with them, and help her see that though not initially as powerful or as effective as self- harm, she doesn’t feel so ashamed or hopeless afterwards if she does something different like talk to you or some other non-damaging response.

Develop your formulation for self-harmful behaviour together with your client if at all possible. Share your collaborative formulation with other relevant professionals, in order to ensure a consistent approach to her.