13 October 2020

She’s determined and focussed in making sure everyone knows about the value of Occupational Therapy within Offender Care Services. 

As the Head of OT for Offender Care Services – a new role that means she’s part of the senior management team – Emma Holmes has been visiting the various Offender Care services across the CNWL family. 

It’s a busy and challenging role but one she wouldn’t change as it’s allowed her to promote the OT role while also encouraging her team to take up training opportunities and in networking, given that OTs in Offender Care tend to work on their own a lot. 

The Offender Care OT team is currently small – 11 – but Emma’s hope is to expand the team once the value to Offender Care Services is more widely understood. 

“It’s true that as OTs we don’t shout very loudly about what we can provide and it’s true that we often moan that we aren’t understood but it’s for us to make sure that people do understand. The evidence base is clear that we are a valuable part of any service,” she says. 

“We are dual trained (in physical and mental health) meaning we can work across a variety of areas.” 

The role of OTs in Offender Care Services is basically the same as an OT within non-secure settings. However, while OTs outside secure units tend to emphasise enabling independence and achieving goals, within secure settings the emphasis is also on building life skills and wellbeing. It is also about developing protective factors that can reduce the risk of reoffending and destructive behaviour. 

This is still a goal, but it’s more about helping prisoners to understand risks. 

She says: “If we put someone into a prison and we’re saying their whole life system is wrong and that the choices you made and your beliefs are what led you here, we’re saying you are wrong. If we take something away without giving something back it’s difficult to see how people can truly change. 

“OT is about enhancing their protective factors and helping them understand their risk factors, whether it be substance misuse or lifestyle that’s led to risk for them, and in helping them to find different ways of using their time or in finding other interests. 

“You will often find people in prison have a lot of skills but not much self-belief. A lot of people we’ve dealt with may not have had the life skills taught to them. They may not have been guided in the right way or have had consistant nurturing care as children. Some of what we do is about building skills for life.” 

Emma’s journey into Occupational Therapy will sound familiar to other OTs. Following a psychology degree she didn’t know what to do with herself. 

She recalls one friend, who at the time was a patient in a low secure unit, that the one thing that made him feel normal was working with the OTs. Seeing this help first hand helped her in her decision to take a Masters in OT. 

During one placement at a medium secure unit, she discovered her passion for OT within secure units, working with men with a personality disorder. For her it was fascinating territory and from then she was hooked. 

And most of her career has been in secure units or in prisons; before her current role, she was an OT at HMP Send for three years, where she worked on the PIPE services. 

Just once did she venture into community OT work but it never felt quite right and when the Send role came up she went for it. 

“I never thought I would work in a prison or a secure unit because I don’t like confrontation but I have loved working in prisons. There’s no better place!” 

“Tomorrow (Wednesday, 14 October) I'm looking forward to celebrating Allied Health Professionals (AHP) Day. I am so proud to work as an OT in the NHS and I am looking forward to recognising the amazing work that AHPs do across our service”