In many ways, dealing with incarcerated patients is like dealing with a patient in any setting. After all, diabetes, hypertension, and arthritis are conditions experienced by patients in general practice, too. However, correctional nurses must also interact with prisoners as our patients and it is the personality, motivations, and mindsets of our patient population that can often trip us up.

That’s why I recently read the book “Game Over! Strategies for Redirecting Inmate Deception” by Bill Elliot and Vicki Verdeyen. I interviewed Dr. Elliot for a blog post about his session at the 2017 NCCHC Fall Conference and was immediately drawn to the practical actions he has developed for managing patient interactions with prisoners. Here are my thoughts on the book, section by section.

Part I: Learning the Game

This first section of the book provides an understanding of the criminal mindset and the basics of con games played by the correctional population. Understanding the psychology of deception helps us to avoid it, deflect it, and even use it to therapeutic advantage. Being a basically honest person coming from an average middle-class family, I don’t seek to actively deceive and manipulate people. It has taken a while for me to see these actions in the correctional patient population and to not take it personally. Understanding your patient is foundational to helping your patient.

Part II: The Con Maneuvers

This second section gets into the basics of inmate manipulation and focuses on a sense of entitlement and the power orientation. I especially benefitted from the power orientation information including testing, using diversion, and ingratiation. This section is full of examples of inmate/clinician conversations and statements from the experiences of the authors.

Part III: The “Gender” Strategies

Gender matters when it comes to patient interactions. Chapters in this section cover the use of blaming, sentimentality, and ‘looking good’ by female inmates. It is not surprising that women will use tears more than men to manipulate staff.

Part IV: It’s Your Move: Staff Counter Plays

All of the prior sections lay a foundation for this most important one. How do we respond to manage inmate deception? In this section, the three R’s of managing deception and manipulation are extensively described with examples. In addition, there are prevention strategies like

• Trust your intuition that something is just not right
• Pay close attention to speech patterns, facial expressions, and body movements
• Be aware of your own nonverbal behavior. How we come across is more important than what we say
• Be honest and direct when talking with inmates. Stay professional. Be firm, fair, and consistent
• Seek out collateral information to confirm what you are told

Conclusion

This book is well worth reading if you are serious about your correctional nursing practice. We need to develop skill in identifying and effectively countering the standard methods some of our patients use to manipulate, deceive, and exploit staff interactions.

The book is full of excellent examples of staff-patient interactions and the chapters make good use of headings and subheadings so that you can find information quickly. I love lists and bullet points – both are considerable in this text. My favorites are:

• Eight Cognitive Patterns of the Criminal Lifestyle
• The Three R’s of Managing Deception and Manipulation
• Ten Commandments for Prison Staff

Click on this link or the cover graphic to order your copy from Amazon.

How do you handle inmate interaction? Share your tips in the comments section of this post.