In the Field: An Application of Cognitive Therapy in Iran: The Khorasan Prison Project

Abstract

The practice of psychotherapy in Iran is burgeoning. New training programs are being set up in clinical psychology, reflecting a general acceptance in the professional sector as well as among the public of the legitimacy of psychology as an agent for diagnosing and curing mental illness. Among the therapeutic approaches being used in Iran is cognitive therapy. At Ferdowsi University, Mashhad, cognitive theory and therapy have been on the clinical psychology curriculum for over 10 years. When Mr. Ali Shams, Director of the Khorasan District Security and Corrections Center, consulted with the psychology department at the university for help in devising comprehensive rehabilitative services for inmates, it was only natural that cognitive therapy should play a role in this program. The prison reform project, now in its third year, has been considered a success nationally and has received international acclaim. The program is based on the premise that individuals who commit crimes are displaying a conflict with their environment. This conflict often reflects deeper conflicts on the intrapersonal, interpersonal, and transpersonal levels. Individuals who develop harmony and integration, known to be critical elements in the healthy personality (Allport, 1937; Angyal, 1956; Bonner, 1961; Levy, 1970; Ryckman, 1989), are less likely to have criminal behavior. To this end, a treatment modality, integration therapy was developed for use in the prison project. Based on Islamic principles of unity and oneness, and related to psychological principles of personality integration, integration therapy recognizes the human being as optimally one integrated organism, comprised of various subsystems. Each system must be working properly for there to be overall health and harmony. Thus, integration therapy involves the total human being in reform and change, approaching it from as many angles as possible. To give direction to treatment, intensive research and networking was carried out internationally to ascertain current findings in criminal behavior research. One important finding from the Netherlands and echoed in theory, if not practice, in the United States, has been that far from lacking a conscience, persons who commit crimes are often troubled by their actions but trapped in a cycle of low self-esteem and impulsive behavior. Ironically, the atmosphere in prisons is often such that it destroys selfesteem, triggers impulsive behavior and causes human dignity and honor to suffer?what Corsini (1996) has called slow death. It is our belief, however, that the jail that rehabilitates inmates is the one whose environnent is therapeutic. Milieu therapy, thus, has played an important role in total treatment. Psychological service personnel, as well as prison staff serving in the program, were carefully chosen and undergo regular in-service training. Program participants report that the interaction with personnel has become a source of meaning and self-respect in the lives. One of the major tools used in the program to help inmates learn to deal with impulsive behavior has been cognitive therapy. The use of cognitive therapy has helped them learn the importance of beliefs as a mediating force in behavior. The cognitive therapy practice at the prison has three main phases. The first is to teach the inmates the role that thought has in behavior. As crimes are often committed through impulse rather than deliberation this was a new idea for many. The second phase is to teach inmates to discriminate and choose between irrational thoughts or beliefs, and rational thoughts and beliefs. We have helped them identify what thoughts implicitly underlie their behavior and how to choose thoughts that are more rational. These first two stages, which are largely didactic, are carried out through group lectures delivered to inmates and staff, and to any family members who choose to attend. Finally, inmates are taught to implement these principles and are supported in their efforts through milieu, individual, group, and family therapy. …