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Playing the Game: Behind the Fences at the Idaho Women's Correctional Center's Therapeutic Community

Therapeutic Community for female prisoners changes perspectives, raises controversy


"The game" plays out like a ping pong of charges bouncing from one inmate to another.

The women sit facing each other in a circle, and in polite attack, the accusations begin.

"I'm pulling you up for breaking a verbal commitment," one inmate said.

"If it seems little to you, it might be big to others. ... A slip-up could be a sign of relapse," another chimes in.

"I agree, it's a serious matter," one added.

The charges flew as the accused sat in silence. Then the group fell quiet and the condemned spoke:

"Thanks, I'll get on top of that," she said.

The charges, the allegations, the words of blame are spoken daily and, for the most part, remain private matters, kept within the walls of the community, unheard by the world that lives beyond the rolling sage-covered hills that buffer the accused and the accusers from freedom.

The community resides beside a vacant stretch of road that connects a vast desert landscape to the barbed-wire-encased Idaho Maximum Security Prison south of Boise. In the shadows of guard towers and an imposing fence sits a more diminutive building. Out of context, it could pass for a modern church or school. Women mill about the grounds, doing yard work, carrying out chores, passing in and out of the building's doors unbridled by security gates, fences and the fixtures of imprisonment. Sans the drab beige uniforms, the women could pass as cooperative members of a collective--a commune perhaps, or given their quiet rhythm of work and study, a religious community.

Communal living, cooperation, communication and contemplation define this community. Although housed as a part of the Idaho Department of Correction prison complex, the facility is set apart physically from the high-security facility it neighbors and philosophically from conventional institutions of reform. They don't call its surrounding walls a cellblock. They don't even call it a prison. Gone is the vernacular of crime and punishment, and the trappings of imprisonment remain purposefully absent.

This isn't a prison, it's a therapeutic community. This isn't a prison population, it is a "family." And these are not prisoners, they are "sisters."

Prison officials say therapeutic communities have become the preferred way to reform some inmates suffering from co-existing addictions, mental illness and criminal behaviors. They say the programs that aim to re-socialize inmates through cognitive therapy and peer accountability reduce recidivism rates and transform deviant personalities into functional, productive citizens.

But some former sisters say the program does more harm than good. A lawsuit filed against IDOC by a former inmate alleges the program denies prisoners their constitutional rights and subjects participants to false allegations and unwarranted punishment.

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Gretchen Cacciaguidi lived in the TC sisterhood for a month. She said she spent her time playing games, learning chants, dressing in costumes and learning the ways and culture of a community she was forced to call her "family." Her lawsuit challenges the efficacy of the program and charges IDOC with cruel and unusual punishment.

"It's not a family. It's a cult," Cacciaguidi said in an interview following her release last fall. "It's a totalitarian regime."

Inmates who pass through two locked doors and into IDOC's Therapeutic Community at the South Boise Women's Correctional Center find some familiarity. The concrete floor and cinderblock walls look customary to the repeat offender. But some things are different. An open floor plan replaces the panoptic design that came to define the modern prison. Conversation and movement replaces quiet confinement. And then there is the color.

Inmates don't enter cells at IDOC's Therapeutic Community for Women. They enter classrooms, and as they walk into the rooms adorned with dry erase boards and colorful magic marker drawings scrawled with the words "Define or be Defined" and "Life Isn't Fair"--a few of the values and rules of their community--they enter into a new model of prison reform.

"This program is teaching me how to live," said inmate Heather Hansen.

Before Hansen entered the TC program for women at IDOC's Boise facility last year, she knew of only one way to live. Addiction ruled her life, leading her to forge checks, steal and violate probation.

"Addiction comes before everything--before your kids, your job, your health," she said. "This program is teaching me how to live my life the way I've always wanted but didn't know how."

Punishment has changed considerably in the last century, notes the late sociologist Michel Foucault in his work Discipline and Punish: the Birth of the Prison. In his evaluation of our assumptions about prison reform in the West, Foucault looks backward, taking readers through the history of punishment: Crimes of passion ended with hard labor and grisly public spectacles of violence; prisoners felt their limbs drawn and quartered; guards threw nearly lifeless bodies on the stake then set blazes. But things have changed. Punishment no longer targets the body through public displays of torture, Foucault noted. The modern prison aims to reform by privately targeting the mind.

Idaho entered into a new era of prison reform in the late 1990s--one that aimed to reform criminal thinking and behavior using cognitive-behavioral techniques. Therapeutic communities were introduced in the state in 1997 in an effort to give criminals with co-occurring substance addictions the tools they need to change the thoughts and behaviors that lead to criminal activities. The emphasis in TCs went from serving time to changing the mind through what IDOC calls cutting-edge therapies that include support-group programs, relapse-prevention strategies and education. A TC inmate's prison sentence isn't confined by cell walls but takes the offender through days of therapy, classes and exercises in problem solving. A TC sentence resembles something between intensive therapy and a busy academic schedule.

But not everyone gets a chance to leave a traditional sentence and enter a therapeutic community. Judges recommend TC programs for nonviolent inmates with substance issues that lead to their criminality. Some enter TCs on rider programs. Participation in the community remains voluntary, but completion of the roughly year-long program could yield an early release for the approximate 400 inmates who take part in TC programs across the state. Soon-to-be graduates credit the program with changing their lives, but some inmates say the intensive participation required of TCs and the litany of rules and rituals woven into the programs aren't for everyone.

Boise Weekly caught a glimpse into the guarded world of modern reform with an inside look at the workings of one of Idaho's therapeutic communities. But the tour didn't come with full access. Prison officials carefully selected model prisoners for interviews, and most staffers opted to speak off the record.

Officials and experts painted a contrary picture of an innovative approach that reduces recidivism by changing the way offenders think and behave. But court records and former inmates paint a picture of a system that still uses torment as the crux of reform. The methods may not scar the body, but they scar the soul, critics say.

Idaho's eight prison-based therapeutic communities aim to reform criminal ways of thinking with a model that uses the community as the method.

British psychiatrist Thomas Main coined the term "therapeutic community" in 1947 to describe psychiatric treatment methods that allow patients to become active participants in their recovery through democratic, group-based therapies. The method caught on. Therapeutic communities became standard practice at mental institutions in England by the 1960s. The United States adopted the approach that same decade as a tool in addiction recovery. Also in the 1960s, one of California's more infamous early therapeutic communities, Synanon, made the news for its cultish tactics, IRS violations and sometimes harsh methods. Criticism waned with the evolution of the model, and by the 1980s, penal systems began embracing the approach as a way to change deviant behaviors through peer accountability. The first IDOC therapeutic program opened its doors in 1997, offering stages of rehabilitation.

"Prison has its own culture. It's a very anti-social culture. Even if a person is not very anti-social, they're pressured to conform--don't talk, don't tell, mind your own business--all of these things that allow criminality to happen," said Scott Brooks, IDOC program coordinator.

Idaho's TCs segregate offenders from the general prison population during the first phase of the program and induct them into the TC culture. The segregation removes inmates from the deviant subcultures found in the general prison population, Brooks said.

"The socialization there just increases the anti-social [behavior]," Brooks said. "It can become physically dangerous to go against the criminal code. You can get beat up. You can get hurt or ridiculed."

Idaho TCs are set aside within an existing facility, often as its own tier or unit. The nine- to 12-month program targets an offender's parole date and offers a minimum of one year of after-care.

Researchers note that such programs can yield good results in male prison populations, but research on the application to female populations remains limited. Idaho Department of Correction officials say the outcomes of TCs remain promising, boasting lower-than-average recidivism rates: 14 percent of 2008 female TC graduates and 42 percent of male graduates relapsed and were back in prison after three years, according to IDOC data. Department of Justice figures put national recidivism rates between 43 and 51 percent during the past two decades.

The program works by creating a sense of community, Brooks said. But the community must first bind with the glue we call culture.

Culture permeates every aspect of therapeutic communities: values, morals, rules, beliefs, rituals and communication. Walk past the locked doors of IDOC's therapeutic community and you'll see, hear and read the signs of a unique culture. A different language ties one prisoner to another. Throughout the day, you'll hear inmates greet each other as "sisters," as they offer "pull-ups," "flag" one another and hand out "learning experiences," for "fake nutties," "dropping lugs," and "dope-friending."

"This creates a very tight bond because with it comes their own language," Brooks said of the TCs own vocabulary.

And then there are the rules, complete with a 19-page guidebook filled with missions, rules and guidelines that include principles such as "Live and Let Live," and "Secrets Keep Us Sick." A marker-colored poster reminds inmates how they came into this community: "Whenever you disagree with the program ... remember that your best thinking resulted in your current predicament."

Rules take the form of five dozen written values that include concepts such as family, spirituality, order and compassion. These values form the foundation of 45 principles that aim to reshape inmates' thinking and behavior. They are reminded of these principles throughout the day by fellow inmates who call each other out when they deviate from principles such as "Do what's right, even when no one is looking" and "Surrender to win." The principles appear in chants, colorful drawings that adorn the prison's walls and in the repercussions, or "learning lessons," inmates must perform if they violate a rule of the community.

"When you go into a TC, there's written and unwritten rules," Brooks said. "The unwritten rules we call concepts. And it's like the 'I am my brother's keeper.' You want to follow that concept. The rules that are attached to that are not necessarily written down--like being polite or making sure that my brother who is in the program doesn't get into trouble."

While language, rules and values aim to tie one sister with another, rituals aim to bind the entire community.

"It's very ritualistic," Brooks said. "Because when you identify rituals, the community comes together much more quickly."

Therapeutic communities offer 24 hours of structure for inmates who were largely socialized in an unstructured world. The day begins at 4:30 a.m. and follows a schedule laced with classes, chants, Alcoholics Anonymous meetings and ample doses of ritual. They call one daily ritual "The Game."

The Game

"Thanks, I'll get on top of that," an inmate said during a second round of "the game." She uttered the words spoken again and again by inmates accused by their peers for a range of offenses: going to someone's defense, possessing property gifted by another inmate, failing to exercise, and according to at least one former prisoner, praying. The inmate swallowed the charges, acknowledged the blame and followed her script. She thanked her peers for the "pull-up," promised to "get on top of that," then accepted the staff-determined punishment: a 250-word essay on the benefits of keeping commitments. And the game continued. "I'm pulling you up for lying and verbal outbursts." "I'm telling you this because you are an amazing woman. But sometimes we need to take a close look at our behavior," a peer chimed in.

"Thanks. I'll get on top of that."

The punishment: 500 words on righteous honesty. And the game went on.

"I'm pulling you up because of cross communication."

"Thanks. I'll get on top of that."

"I'm pulling you up for lying and possessing a photo of another inmate."

"Thanks, I'll get on top of that."

Punishments, or "learning experiences," range from essays to dressing up in costumes to acting out scenarios in front of the entire community. Sometimes, the punishments aim to align with the infraction. A prisoner recently accused of "rescuing" another inmate or aiding a peer in distress was "pulled up" for what staff termed an enabling behavior then offered a learning lesson that included wearing a superhero's costume for a set period of time.

Other learning experiences are purely random. On this day, one inmate performed her punishment at an afternoon meeting before the entire community. She didn't know what her punishment would look like until she drew a slip from a box. The piece of paper she selected read something like, "Pretend like you see a hot guy and trip in front of him."

The inmate sheepishly walked before her 64 peers who moments earlier recited the Serenity Prayer, sans any reference to God, in drab unison. They followed announcements and accusations with claps and chants carried out with military precision and the enthusiasm seen in most detention halls.

The accused looked again at the paper. She walked a bit, looked over her shoulder and fell into a near stumble, catching herself before her body met the floor. She straightened out only to assume a folded posture as she made her way to her chair amid precise rows of prisoners and bowed her head.

One of the first games dished out a round of attacks at Synanon. Established in Santa Monica, Calif., as a therapeutic community for drug addicts in 1958, Synanon--which derived its name from sin and anonymous--started to attract self-help enthusiasts seeking a self-examined life through peer accountability and the truth-seeking methods that came to be known as the Synanon Game.

The game that came to define the unorthodox practices of the now-defunct Synanon holds its theoretical roots in attack therapy, a controversial form of psychotherapy that aims to reform through highly confrontational interaction between a patient and therapist or members of a group. The method subjects the patients to harsh criticisms, denouncements, abuse and humiliation by the therapist or peers.

In a recent game at IDOC's TC, women recovering from abuses, addictions, mental illness and years of self-destructive behavior attacked each other, one after the other, for gossiping, not exercising, associating with an unfavorable inmate and being too cliquish.

A 1990 report from the Institute of Medicine on attack therapy suggests that the method could yield good results on people with a positive self-image. But it warned that individuals subjected to attack therapies assessed as patients with a negative self-image could potentially be harmed by its tactics.

The sometimes brutal accusations thrown from player to player of the Synanon game drew a host of critics. But the game nonetheless spread beyond the walls of Synanon and found its way into the living rooms of addicts looking for self-help through a peer-help prescription for addiction. Thousands of alcoholics, dope fiends, junkies and those generally tired of the highs of vice created their own games.

Instead of spending their Saturday nights drunk and wasted, they joined together in a circle and began to attack. In groups of six to eight at a time, they'd face each other and begin the merciless confrontations and brutal allegations. Players exposed one another's deep-rooted fears, hidden prejudices and personality flaws. The game held only three rules: honesty, nonviolence and no heading for the door.

IDOC security measures ensure the last two rules stay in place at its therapeutic communities but one lawsuit alleges that the rules of honesty fall short at Idaho prisons.

Gretchen Cacciaguidi called the therapeutic community home for 35 days then abruptly left, forgoing her chance at an early parole.

"I took the long way home," she said.

The two-time DUI offender was riding out a five-year sentence with one year fixed when she was offered the chance to enter the therapeutic program and shave two years off of her sentence. She said the courts offered the program as a choice, but in the end, she felt compelled to join if she wanted to see more days of freedom. She went through a month-long probationary period in the program when inmates are schooled in the ways and culture of the community before they become active participants in the game and other ritualistic forms of peer accountability.

Then it came time for her to sit in the "hot seat," or play the game as the accused. And the first trumped-up charges flew her way, she said.

The accusation: inappropriate communication for what she said was simply praying out loud. The only words Cacciaguidi was allowed to say in her defense: "Thanks, I'll get on top of that." The learning experience: wearing elf ears before the community.

Where the accusation came from was just as unsettling as the false allegations, Cacciaguidi said. The woman calling the charges was the same woman Cacciaguidi had just refused to share her hair conditioner with.

For Cacciaguidi, the game wasn't a practice in peer accountability but a sort of witch trial in which criminals play out their petty beefs and conflicts with one another through lies, false allegations and humiliation.

"It's like the secret police," Cacciaguidi said of the program. "Basically [inmates] sit around and spy on each other and tattle on each other. That's what the 'pull-up' system is--an indictment."

Cacciaguidi filed suit against IDOC and its officials, claiming infringement on her constitutional rights and a falsification of prison records. She said the tactics of the therapeutic program, particularly the game, denied her due process and subjected her to cruel and unusual punishment through humiliation and mental harm. And now she says she's got a new record to shake--prison documents that paint her as a less-than-model inmate thanks to the alleged trumped-up charges that emerged as part of the game.

"They're painting a totally new institutional history on me," Cacciaguidi said. "I was told that's it's an honesty-based program, and I couldn't understand why people were being so dishonest."

Cacciaguidi hasn't received a response to her claim that alleges cruel and unusual punishment and her suit requesting a retraction of the falsified prison record. IDOC officials refused to comment on the case.

The inmates hand-picked by IDOC for interview by Boise Weekly described their experience in the TC as a life-changing path, one wrought with epiphanies, self-reflection and insight. But Cacciaguidi said that if all prisoners were free to speak, we'd hear a much different story. We'd hear about forced cultish conformity, humiliation and psychological suffering. We'd hear about a pointless waste of taxpayer money and high recidivism rates. But those stories won't be told, Cacciaguidi said.

"They're afraid," Cacciaguidi said of dissenting inmates. "They don't want to speak up because they want to be paroled. They want to go home to their kids and family."

Several inmates have filed complaints against IDOC's therapeutic community with the American Civil Liberties Union of Idaho. But ACLU counsel Lea Cooper said there's little they can do on a prisoner's behalf. Cooper said that if prisoners were forced into the therapeutic program, they would have a claim on constitutional infringement for cruel and unusual punishment. But since the program is a requirement for parole and therefore not mandatory, it's technically voluntary.

"This is how they get away with it not being a constitutional issue, which is why we can't get involved," Cooper said. "We're really frustrated telling all of these women, 'Gosh, this sounds really gruesome, but there's nothing we can do.'"

Cooper said that the shame-based group therapy works off of the philosophy that rehabilitation begins with breaking an individual down, so that the group can then build them up.

"I don't get the point. I would want to know as a taxpayer why we're paying people to get dressed up like Donald Duck and be shamed."

Today, the program looks a little different than the community Cacciaguidi knew. Participants play the game a little bit differently and officials retired the 2007 version of the contested "hot seat." A kind of due process replaced the "encounters" that left prisoners exposed to allegations, criticisms and accusations without defense or recourse. Now a denial, argument or explanation can precede the customary, "Thanks. I'll get on top of that."

Dr. George de Leon, a New York University psychologist and therapeutic communities expert, said that the evolution of therapeutic communities produced some critiques--both real and imagined--mostly for the harsh treatment at early facilities. But he said that those critiques have mostly disappeared, and today's research describes an approach that uses the community to reduce recidivism and aid in addiction recovery.

"The research shows that the prison-based communities do very well with these clients," de Leon said. "Individuals who do best are those considered to have the most serious addictions as well as lifestyle issues that could be moral and value based."

But even the model prisoners IDOC officials selected for interview said that the therapeutic program isn't for everyone.

Kristina Hand of Boise used to steal cars and bikes to get high on meth. Now she's a part of the therapeutic community sisterhood. Hand is riding out her third attempt in four years to complete the program as a requirement for parole. She said she just wasn't ready the first or second time around to confront her destructive thinking and behaviors. But things have changed since she walked into the sisterhood for a third time.

"It's changed enormously in those years. It used to be way strict," she said.

The game has changed a lot, too, she said.

"You used to not get the chance to say, 'I didn't do it.' Now you can respond."

And just as the therapeutic community in the southern desert of Boise has evolved, Hand has evolved, too. The program changed her mind, her way of thinking, her way of dealing with the world, she said.

"It's made me realize a lot of things--like I can't get what I want when I want it. ... I learned respect and accountability--respect for others as well as myself," Hand said.

A wall of letters greets the sisters as they take their seats at an evening meeting. The emails and the notes written in pink cursive address the inmates with, "Dear Family" and "Hey Sisters!" The authors write of their lives after the TC. Some graduates are looking for jobs. One lives with family. They all have the same message: Keep your chin up, things will get better, you can do anything. And I miss you.

Jennifer Englesby walked past the wall one last time. Five days before Christmas, she left the community and entered a Boise halfway house. Her Christmas came with dreams, bigger than the ones she had as an addict. She sees life as a student at the College of Western Idaho in her future. She wants to focus on building a relationship with her 12-year-old daughter. She forged tight ties with some of her TC sisters--bonds she says she'll miss. But Englesby said she's ready to do things right this time. And she doesn't plan to come back.

"The program is powerful," she said. "It gave me a foundation for life."