Justice Undersecretary Corleone, responding to an interpellation by MP Cento, reported to the Parliament December last that, as of November 30, 1999, the inmate population amounted to an all-time high of 53,389. This, despite the granting of 6,999 house arrest arrangements, 22,030 social-service referrals, and 2,196 probation concessions. It bears pointing out that official capacity is 42,830 detainees, whereas "tolerable" capacity does not exceed 49,565 units. The present official capacity of penal institutions (defined on the basis of norms issued in 1988 by the Health Ministry) corresponds to a minimum single-cell area of 9 square meters, with a 5 square-meter increase for each extra inmate. Despite efforts by practitioners, these parameters are not always met. Broken down in juridical terms, the overall picture was as follows: 24,182 indictments (23,097 men, 1,085 women), whereas actual convictions totaled 28,602 (27,434 men, 1,168 women). Of the latter, 1,568 (1,499 men, 69 women) were released on probation. Of the total inmate population, 54% were serving out their sentence, while the remaining 46% consisted of "non definitive".

As of February 29, 2000, there were 14,416 foreign nationals detained in Italian prisons (accounting for 27% of the total inmate population), and of these only 391 were from UE countries. Of the 14,025 non-UE nationals, more than half were from African countries (out of 7,754 detainees all of 5,320 were either Tunisian or Moroccan), while the number of inmates from former Jugoslavia, Albania and other east-European countries (4,288) is rising markedly. Thus, the upward trend of foreign detainees is continuing, and it is interesting to note their relative exponential "growth" rate: 10 years ago, in 1990, they amounted to little over 4,000 (4,017), in ’92 their number had already increased to 7,237, in ’94, 8,481m, in ’96, 9,373, in ’98, 11,973, and in ’99, 14,057.

Less recent, but equally significant, is the last census conducted by the prison authority of inmates who were drug addicts and had contracted AIDS. As of December 31, 1999, figures showed that in Italian prisons, of the then 51,604 detainees, all of 15,097 (14,423 men, 674 women) – that is 29.2% of the total – were drug addicts. There were 1,638 cases of inmates who tested HIV positive, while those with AIDS totaled 163. The percentage of detainees coming from a situation of freedom and willingly undergoing screening for HIV is around 34%. This means that out of three new "arrivals", two refused to be tested.

As for work within the prison context, similarly as of December 31, 1999, working detainees totaled 11,903 (about 23% of the overall prison population), of whom the vast majority (10,421) were in the employ of the penitentiary administration, with all of 9,579 detainees employed not in productive activities, but in institutional service centers.

In 1999, penitentiary administration statistics recorded 53 suicides (two more than in 1998), 920 attempted suicides, 6,536 instances of self-inflicted wounds, and 83 in-prison deaths. Of a total 11,039 staged protests, 5,522 consisted of hunger strikes.

In 1999, 186 inmates escaped from Italian prisons; of these, 19 directly from institutions. Other forms of evasion were: failure to report back after having enjoyed the following benefits – parole (10), bonus paroles (105), outside work (7), alternative measures (45). The percentage of detainees evading while enjoying penitentiary benefits from 1992 to today has never exceeded 1%, which, in 1999, fell to 0.51%.

The situation as described is not typical only of Italy. This summer in Turkey, which has 72,000 inmates, a group of detainees rebelled in the central Turkish penitentiary of Afyon, holding six prison guards hostage, in order to bolster their request that the government keep its amnesty promises.

A "Committee for Penitentiary Problems", set up three years ago in the Parliamentary Justice Committee – comprising 13 deputies from all parliamentary groupings, recently released a study based on prison checks and conversations with surveillance magistrates, penitentiary police, educators, psychologists, doctors and prison directors.

The major flaw proved that of "rehabilitation programs", which continue to be rarely implemented as the prevailing wisdom "continues to be that of custodial activity, geared only to maintaining order". According to the Committee, what is missing is an overall plan in terms of promoting inmate socialization. The best results are due only to the good will of individual practitioners and some enlightened prison directors. The Committee similarly pointed out that results depend on the fact that the educator-detainee ratio is 1 to 60.

What emerges is that rehabilitation strategies have been provided for only generically by the legislature, without distinguishing precisely between roles and functions. Educators, especially, need having their professional status and role within the rehabilitation-process structure better defined.

In August, two pedophilia cases involving homicide again reminded both the authorities and the general public of the problem of punishment and prison treatment. Longer incarceration periods were urged for crimes connected with sexual deviation, thus ensuring a higher degree of societal protection. Incarceration, however, need not be longer, only more effective. At issue, rather, is how to reduce recidivism (which in this type of offence can be quite high).

Aggravating detention periods can prove dangerous, as for example the pedophile could be more readily induced to kill his victim for fear of being discovered because of the latter’s tell-tale accounts. Furthermore, the pedophile is doubly imprisoned, having to be kept apart from the other inmates who can attack him out of a sense of indignation arising from the particular nature of his offence. Clinical experience suggests that, if treated properly, recidivism in these cases diminishes significantly. However, such cases are not routinely treated with specialized techniques.

Psychotherapy treatment of persons manifesting antisocial behavior is a crucial topic in terms of offender rehabilitation training, as provided for by the Italian Constitution (art. 27/2). On one hand, the offender has to be re-educated, while on the other, society has to be protected from him. Psychotherapists have exerted themselves in this activity often with unsatisfactory results. This also depends on the fact that methods utilized aim at "curing" personality traits such as anxiety, low self-esteem, etc., which, in the opinion of specialized literature, are not to be correlated to criminal behavior and therefore to the risk of recidivism.

A distinction, in fact, has to be made between static risk factors, which are fixed in time and bear on, for example, the offender’s past history, such as the number of arrests, and dynamic risk factors, which can be affected by psychotherapy. The latter are to be further differentiated in terms of what relates to both personal clinical variables and crimino-genetic variables. For this reason, acting on personal clinical variables is not directly effective in curing recidivism. Possibly, in fact, some treatment programs can indeed improve personal traits, without however having any bearing on the crimino-genetic variables. Meta-analyses conducted to date to compare the results of various treatment programs have the merit of avoiding the confusion that exists in literature between these two types of approach. What has become clear, in short, is that in order to check recidivism it is necessary to refer therapeutically to those factors which appear crimino-genetic, such as , for example, an addict’s attraction to drugs, rather than to personal variables such as anxiety, low self-esteem, etc. This error, which is quite frequent in practice, has a paradigmatic value in that, as often happens in psychotherapy, the tendency is toward results that are not correlated to the desired effect. Usually, instead, in these as well as in other cases, effective treatment consists in adapting therapeutic techniques to the individual person type and to his particular context type (prison, community…), and not the other way around.

Unlike common patients, the offender often does not feel that his way of acting is extraneous to or distant from himself, but rather as an expression of his way of being (here the term ego-syntony, instead of ego-dystony, is used). His motivation to change is often unexistent, if not spurious, in that it stems from a desire to leave prison and to enjoy advantages, such as a pardon. This implies that he does not expect to change or become "cured", which in itself undermines one of the mainstays of a therapeutic approach – the expectation of therapeutic results.

Another factor limiting therapeutic success is that usually therapists do not expect the deviant to change his life style. This is so because research conducted in the 70’s viewed psychotherapy of the delinquent as ineffective.

Let us now take a look at some types of psychotherapy operated in this field.

Cognitive behavioral psychotherapy – which, according to research studies – is the most frequently applied and most effective approach in this field – is based on the assumption that cognitions determine emotions and behavior. It is also assumed that a limited number of thought patterns produce emotional and behavioral styles. Consequently, this approach primarily aims to change an offender’s cognitive aspects, with the purpose of effecting changes in his emotions and behavior. In substance, it is a matter of getting rid of undesirable cognitions and promoting adaptive ones. The approach, which at times even involves the family of the young offender, often consists in stipulating "contracts" with the offender in order to achieve psychotherapeutic objectives. This entails awarding prizes or meeting out punishment depending on certain behavioral manifestations. In addition, much time is devoted to a self-examination of sorts, which prompts the surfacing and elaboration of antisocial thoughts.

This approach is characterized by:

• good-quality interpersonal relationships which make it easier to create a setting wherein encouragement and modeling can take place.

• positive encouragement, which is both effective and operated on an one-to-one basis. It is not necessary to reward every mode of behavior clearly and explicitly; an immediate facial expression of approval of an adequate attitude, or a show of empathy, can suffice.

• negative encouragement, which is both effective and of the one-to-one type, and which also involves elaborating the reasons for the negative encouragement received in response to a given mode of behavior.

The self-training approach is when the offender exhorts himself – through an interior monologue – to check his antisocial drives while preferring their prosocial counterparts, as well as programs aimed at checking anger, and especially at keeping at bay those cognitive and emotional aspects that precede aggressive action. Also involved is an extensive use of modeling, which shows the offender how he is to behave, and of role-taking, whereby the offender is encouraged to assume the behavior of others so that he can "see himself from the outside", and even at times to impersonate the role of victim, in order to understand the harm produced by his own actions. Moral judgement-development training is at times applied in group-therapy settings in order to promote, from a cognitive standpoint, those very prosocial aspects which underlie behavior.

Yet another approach, which is akin to cognitive-behavioral therapy, is defined as social-skills training and social problem solving, which focuses on teaching the social skills that the offender is thought to lack. Owing to said lack, it is consequently assumed that the offender could proceed to commit victimizing actions. By undergoing and engaging in didactic-therapeutic activity, the offender is equipped with certain abilities, which make up one’s so-called skills, or social intelligence – the ability to communicate, to entertain relationships, to negotiate, and to make decisions (Gulotta and Boi, 1997).

Recent renewed interest in offender biopsychological theories, themselves an offshoot from the psychosocial point of view, has provided the treatment approach with fresh impetus.

More modern studies, as already indicated, have thus gone beyond the pessimism which lasted until the late 80’s and early 90’s, and which had challenged the efficacy of this approach. The results of recent meta-analyses confirm that psychotherapeutic treatment of offenders can prove effective especially under certain conditions, as listed below (see Andrews and Bonta, 1994; Andrews, Zinger et al., 1990; Basta and Davidson, 1998; Dorduin, 1998; Garrett, 1985; Gendreau and Ross, 1983-84; Gottschalk, Davidson et als, 1987; Greenwood and Zimring, 1985; Gulotta, 1997; Gulotta Del Castello, 1998; Hollin, 1993; Izzo and Ross, 1990; Lipsey, 1992; Marshall and Pithers, 1994; Palmer, 1978, 1983,1992; Ross and Fabiano, 1985; Ross and Gendreau, 1980):

• psychotherapy is to be operated in community settings, and not in prison;

• a highly structured social-training and cognitive behavioral approach is to be preferred to an insight approach, one that is which focuses on self-analysis and verbalizing;

• take into account an offender’s crimino-genetic needs and learning style;

• the program has to anticipate any future problems with which the offender may come to involve himself;

• consider the individual’s response, together with his needs and the risks to which he is exposed;

• help change risk situations in which the offender may come to find himself;

• help the offender identify risk situations and have a pre-prepared plan to cope with them;

• create concrete alternatives - such as school and work – to antisocial life styles;

• stimulate a reduction in drug abuse;

• help the offender to avoid frequenting other offenders;

• use role-playing, encouragement, modeling techniques, focusing that is on concrete model examples, skills training (social skills), cognitive restructuring, showing the results that can be achieved through a non-criminal conduct, teaching problem-solving and prosocial-value techniques;

• treatment objectives:

According to the Commission, a particularly worrying situation is that of the professional status of crime delinquency experts, formerly disciplined by art. 80 of the Penitentiary Code, who are linked to the Administration by freelance-type contractual arrangements, and whose activity has been markedly reduced owing to increasing budget restrictions. Included in this category are psychologists, social workers, pedagogy experts, and psychiatric-clinical criminologists who significantly complement the activity of other treatment practitioners.

In order to guarantee more specialized training, the Committee suggests that operators undergo a training period before actually undertaking their institutional roles. In other words, requisites for professional status should be revised, and candidates should possess a specific diploma (such as community educator), or a university degree. What is presently required for this type of career is a high-school diploma.

Educators have informed commission members of the priority need of setting up an office in order to harmonize treatment strategies among various institutions. This also in light of the often conflictual relationship existing with penitentiary directors, who generally tend to limit the scope of educators’ activities. The latter, in fact, signaled their availability to the Committee to carry out their work even outside the penal area.

In operative terms, it seems to me that, besides improving the prison structure, setting up different prison management forms, and diversifying present detention and freedom-depriving systems – topics which fall outside the purview of this analysis – it is necessary to timely address the issue of equipping psychotherapists with the special skills necessary to handle antisocial behavioral patterns, particularly in light of the concepts illustrated in this report. In this context, it would also be well to draw on activities performed in other countries where treatment – according to the empirical data contained in the literature cited – appears particularly effective.

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