Working with women prisoners who seriously harm themselves: Ratings of staff expressed emotion (EE)

Background Prison staff are repeatedly exposed to prisoners' suicidal behaviours; this may impair their capacity to care. Expressed emotion (EE), as a descriptor of the ‘emotional climate’ between people, has been associated with challenging behaviour in closed environments, but not previously applied to working alliances in a prison. Aims To investigate the feasibility of rating EE between staff and suicidal women in prison; to test the hypothesis that most such staff–inmate alliances would be rated high EE. Methods All regular staff on two small UK prison units with high suicidal behaviour rates were invited to participate. An audiotaped five‐minute speech sample (FMSS) about work with one nominated suicidal prisoner was embedded in a longer research interview, then rated by two trained raters, independent of the interview process and the prison. Results Seven prison officers and 8 clinically qualified staff completed interviews; 3 refused, but 17 others were not interviewed, reasons including not having worked long enough with any one such prisoner. Participants and non‐participants had similar relevant backgrounds. Contrary to our hypothesis, EE ratings were generally ‘low’. As predicted, critical comments were directed at high frequency oppositional behaviour. Conclusions EE assessments with prison staff are feasible, but our sample was small and turnover of prisoners high, so the study needs replication. Attributions about problem behaviour to illness, and/or traumatic life experience, tend to confirm generally supportive working relationships in this sample. Copyright © 2010 John Wiley & Sons, Ltd.