The Pygmalion Effect and Treating Incarcerated Individuals with Severe and Persistent Mental Illness By Brooke Sheehan, LCSW on 8/17/21 - 2:38 PM

For as long as I can remember, I’ve always been fascinated by locked doors; what does society do with the individuals it tucks, or perhaps sends away, and why are they sent away to begin with? Prisons and psychiatric hospitals were always talked about so ominously, and as a young child I remember thinking, “I need to know what goes on in there.” Fast forward to the year 2015, when I signed an offer to begin working as a correctional social worker. I had spent the last year working in a correctional facility as an intern and made the decision that working in corrections was where I needed to be. I’ve always had a passion for mental health, and when I was offered a position in a psychiatric correctional unit, I knew I had to take it.

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Upon walking onto the psychiatric unit that first day, I knew instantly that I’d found my place. This place, this “unit” was just the opposite of what I expected it to be and believed as a child they were. It was painted with bright colors, residents’ art was on the walls, groups were running, and security and mental health staff members were working together to provide treatment to the men on the unit. The air on the unit was lighter—residents were able to joke with staff and clearly felt safe in this niche of the prison. I had always hoped a program like this could exist in corrections, and somehow I was lucky enough to stumble into this in one.


“I never thought it would work,” Melvin* said. This is a line I’ve heard Melvin repeat time and time again in our clinical sessions as he reflected on the birth and development of an innovative psychiatric unit where he resides inside a correctional facility. Melvin is a long-standing community member in the unit, and his role is anything but benign. He and a few other permanent residents serve as institutional memory—not only do they keep the mission of the unit alive, but they also keep the cultural expectations and norms of the unit thriving.

It may be tempting to think the culture of a unit inside a correctional facility to be harsh, ruthless, and violent; but with the right balance of residents and staff, the most astounding transformations can be seen—just ask Melvin. Melvin, an individual living with psychotic illness who walked onto the unit upon its inception, will be the first to tell you he never thought a structured mental health unit would survive in corrections. Having lived a life riddled by poverty, substance use, abandonment, dual-diagnosis, and trauma, it is not surprising Melvin ended up in an institutional setting. When he first arrived onto the unit, he appeared hardened and unreachable and had just returned from a hospital trip due to an injury inflicted during the throes of a psychotic episode. “Ya, I used to sit in the corner over there (referencing the group treatment room) and just stay silent all group, purposefully choosing to stay uninvolved.” Melvin is honest in his reflections that he didn’t think a unit could exist inside a correctional facility without strong-arming, victimization, and prison politics. He didn’t know then the power of the Pygmalion Effect.

The “Pygmalion Effect”¹ describes the way individuals present themselves in a manner akin to the expectations set before them, whether they are positive or negative. The psychiatric unit where Melvin resides was able to cultivate the expectation that individuals residing on the unit would drop behaviors typically seen in the prison culture (intimidation, bullying, violence) and promote ideals such as asking staff for help, utilizing town halls to address community issues within the unit, and speaking honestly about their lives in group treatment. The vulnerability and effort to curb well-developed criminal tendencies it took residents like Melvin to exhibit was extraordinary, and over time the unit has become what Melvin describes as a “safe place” and “my family.” Although staff may have initially brought forth these ideals and stayed dedicated and consistent to the mission of providing treatment rather than simple stabilization, the therapeutic and pro-social culture of the unit now comes directly from Melvin and other long-term residents. The “Pygmalion Effect” tends to be cyclical in nature and is seen daily in this psychiatric unit. The staff members show unconditional positive regard and a belief that typical prison behavior and defenses can be dropped in the unit because the residents are much more than their prison sentence or mental illness. The residents, in turn, begin to believe themselves to be individuals who are worthy and can contribute to the world through human connection. This spreads amongst the men through groups and psychotherapy, and eventually, the entire unit is finding positive ways to support one another along their journeys with mental illness, recovery, and imprisonment. The “Pygmalion Effect” has allowed for something uncommon to occur in a correctional environment—people are actually getting well, not just stabilized.


Here we are in 2021, and I now hold my doctorate in social work and am the director of this unit in which I whole-heartedly believe. The evolution of the unit has been extraordinary to watch. In an interesting way, we’ve grown together. I started working in the unit as a conditionally licensed professional, left and explored other avenues of corrections, and then returned as a fully licensed professional completing a doctorate program. As I’ve gained my clinical footing and found my stride, I’ve watched the men on the unit do the same. The residents who have been on the unit since its inception, such as Melvin, have gone from being acutely ill to now being peer mentors on the unit. Throughout these years on the unit these men have developed self-esteem and practiced being able to trust; skills they struggled with for most of their lives. If this is what happens in six years’ time, I cannot wait to see the growth that occurs within the next six.

1. Chang, J. (2011). A case study of the “Pygmalion Effect”: Teacher expectations and student achievement. International Education Studies, 4(1), 198–201.

File under: The Art of Psychotherapy, Musings and Reflections