Jenny Marshall

This is a story of hope-of profound, personal change from a life of obesity and depression to a life of love and freedom. As a child, Jenny Marshall endured emotional, psychological, physical, and sexual abuse. Using food as comfort, her weight began to increase through adolescence, as did the bullying she experienced at school. By the time she reached 12, she weighed 300 pounds (132 kg) and was ashamed of her body. When she left home and entered the workforce, the bullying continued. At her largest, she weighed 600 pounds (over 250 kg) and was the object of disdain from many. The future was bleak, and her severe obesity affected her health and self-worth. To find an answer, she sought help from a fundamentalist church. Some saw her affliction as demon possession and sought to exorcise it. But others saw beyond the behavior and understood that the root cause was shame. A close friend finally convinced her that her life mattered, and that if she died, she would be missed. With the realization that she was deeply loved, she slowly set about making a change. With many twists and turns along the way, she lost over 220 pounds (100 kg) and created a new life for herself. Ultimately, it was love that healed Jenny and gave her the courage to persist on her journey to health.

Working in forensic services requires clinicians to deal with complex trauma on both a professional and personal basis. Professionally, they must care for and rehabilitate people who have not only experienced trauma but also behaved in traumatic ways toward others. And on a personal level, they are inevitably touched by this trauma – by reliving it in dialogue, or by observing its effects. A key challenge they face is to build strong therapeutic relationships with those for whom past relationships have faltered and often become incendiary. Innovative Practice in Forensic Settings explores issues of how to simultaneously hold in mind risk, safety and vulnerability, and how to maintain a capacity to think alongside a capacity to feel. Focusing on a relational and contextual understanding of trauma and offending, the chapters explore how to make use of a CAT approach across different forensic settings, clinical presentations and services.

Working in forensic settings with clients who have histories of damage and abuse can be a demanding, disturbing, thrilling and unique experience. It means building connections and instilling the capacity to think before acting - far more than just providing therapy. At a service level, it requires a compassionate culture that promotes the ability to reflect on complex interpersonal dynamics at all levels of the organization. Cognitive Analytic Therapy (CAT) is an accessible model for understanding human relationships that offers a common language for teams and organizations. Reflective Practice in Forensic Settings brings together a range of clinicians to share their experience and approaches, exploring ways in which the CAT model can be applied to develop reflective practice in secure contexts. Together, they also offer valuable guidance for any practitioner seeking ways in which to develop a more relationally informed and reflective therapeutic service.