Global estimates suggest that between a quarter and two thirds of prisoners are reconvicted within 2 years of release (Fazel and Wolf 2015), highlighting the need to develop innovative and evidence-based programmes that enhance prisoners’ prospects of desistance. The purpose of this article is to explore volunteers’ subjective experiences of a novel prison-based programme, the Community Based Health and First Aid (CBHFA) programme, which aims to enhance community health, hygiene awareness and first aid knowledge among prisoners through peer-to-peer education delivered by special status Irish Red Cross volunteers. Though the study was conducted in Ireland, the findings also contribute to international knowledge and practice. For instance, the aims of the CBHFA programme are consistent with European Prison Rules (2006), which pay special attention to hygiene, nutrition, mental and physical healthcare, and safety within prisons. Maculan et al. (2013), who monitored the implementation of European Prison Rules in eight European countries, found that most prisons had poor records in terms of healthcare, hygiene, food quality and rehabilitation opportunities. The current study thus constitutes a useful resource for individuals who want to learn more about an innovative programme, developed in an Irish prison setting, which can help to improve prison standards, health and welfare.

There is general consensus that evidence-based approaches to offender rehabilitation can enhance client outcomes (Welsh and Farrington 2011). Yet, disagreement still exists as to what exactly is meant by “evidence.” Historically, researchers adopted a relatively narrow and uncritical approach to the study of programme effectiveness, but were criticised for relying on recidivism as the sole measure of success and for assuming that treatment effects could be isolated from the surrounding socio-political context. The emerging literature on assisted desistance offers an alternative way to conceptualise and study programme effectiveness by exploring the impact of criminal justice interventions through the lens of desistance theory and research (Farrall 2016; King 2013; McNeill 2012a; McNeill et al. 2012).

Desistance scholars regard recidivism as an important outcome measure but recognise that abstinence from offending behaviour does not necessarily equate to desistance. Rather, desistance is best understood as the first step in a journey towards social inclusion. As McNeill (2012b: 96) observed,

“Desistance is, perhaps, best understood as part of the individual’s ongoing journey towards successful integration within society – towards living better lives as better citizens.”

Researchers should, therefore, focus on measuring change (and change mechanisms) across a range of domains, including offending behaviour, agency, generativity, identity and social inclusion (Nugent and Schinkel 2016; McNeill et al. 2012).

It is also important to remember that rehabilitation programmes operate as part of a wider change process that ultimately belongs to the offender (McNeill 2012a). Though rehabilitation programmes can play a crucial supporting role, outcomes are always influenced by the personal, social, political, legal and economic contexts within which the programme operates. For example, studies show that programme effectiveness can be reduced when participant motivation is low (Farrall 2016) or when participants encounter significant structural barriers such as poverty or social stigma (Miller 2014). Researchers should thus strive to understand programme processes and outcomes within these wider contexts. This necessitates a shift in focus away from examining whether a programme “works” to an exploration of how and why a programme might help people to desist from crime. In other words, the aim is not to evaluate the effectiveness of a programme but to understand and explain the change processes that the programme seeks to initiate or reinforce (McNeill et al. 2012). With this in mind, the next section reviews the theoretical and empirical background to the study, focusing in particular on the change mechanisms that are relevant to the CBHFA programme.

Theoretical Background

Though scholars differ in terms of the relative weight they assign to each dimension, there is widespread agreement that desistance occurs at the intersection between subjective and social/structural processes (Bersani and Doherty 2018). At the structural end of the spectrum, Laub and Sampson (2001) proposed an age-graded theory of informal social control, which contends that major life events such as marriage or employment create attachments to society that enhance the likelihood of desistance. Pro-social bonds help offenders to “‘knife off” their criminal pasts by monitoring behaviour, creating a daily routine that detaches them from criminal environments, and providing emotional and social support. Laub and Sampson (2001: 51) argued that agency was another important feature of the change process but concluded that desistance occurs largely “by default.” While there is ample evidence to support Laub and Sampson’s (2001) contention that desistance is linked to strong social bonds with romantic partners (e.g. Salvatore and Markowitz 2014), evidence regarding the link between employment and desistance is mixed (e.g. Skardhamar and Savolainen 2014). This is perhaps due to the limited employment opportunities available to ex-offenders in the economically insecure and risk-averse world of late modernity (see further Giordano et al. 2002).

At the opposite end of the spectrum, Maruna’s (2001) identity-based theory proposed that desisters formulate a redemption script to explain their transition from a “criminal” to a “desisting” self. This script allows ex-offenders to positively reframe their criminal histories as a prelude to the adoption of a pro-social identity. Typically, desisters begin by describing how they rediscovered their “true self” through desistance. They preserve a positive self-image by blaming the criminal past on circumstances beyond their control, but also present themselves as highly agentic beings who take full responsibility for achieving a crime-free life. Many ex-offenders also attempt to “make good” by engaging in generative activities, such as volunteer work. This perspective is among the most influential of all desistance theories and has been widely investigated, albeit with mixed results. For example, Liem and Richardson (2014) found that both desisters and persisters adopted elements of the redemption script, the only difference being that desisters’ narratives were more agentic. The mixed results may be due to the fact that most desistance research focuses on the early stages of change, when the fully fledged redemptive self is still at a distance (Healy 2012; Giordano et al. 2002). It is also likely that opportunities to achieve the types of redemption described by Maruna (2001) are relatively scarce. In this regard, Halsey (2016) noted that ex-prisoners receive little guidance to help them negotiate the criminal justice system or deal with the challenges they face on the journey towards desistance.

Developing a new identity is not an easy process in a prison setting where systems and policies often prioritise punishment over rehabilitation. In such environments, the achievement of desistance requires significant determination and cognitive change on the part of the prisoner. One of the ways that imprisonment has a profoundly negative impact on those imprisoned is its effect on individuals’ concept of self. People become defined by their new social role of prisoner (Hattery and Smith 2010) in ways that change “the entire set of beliefs, evaluations, perceptions, and thoughts that people have about themselves” (Swann and Bosson 2010: 69). This reflects what is seen more broadly in labelling theory which posits that, once society becomes aware of an individual’s perceived deviance, the individual is segregated from society and comes to internalise the deviant label (Stevens 2012).

To facilitate desistance in criminal justice settings, desistance scholars have recently turned their attention to developing and researching practice models, often termed “desistance-focused” (McNeill 2012a) or “strengths-based” (Maruna and LeBel 2015) approaches. McNeill et al. (2012) argued that practitioners should: recognise desistance as a long-term process that may involve relapse episodes; tailor interventions to individual experiences and needs; foster hope and agency; build strong working relationships with clients; help clients to discover hidden strengths; provide opportunities to enact social capital; and avoid stigmatising language. In particular, the evidence suggests that organised generative activities, such as volunteering, peer mentoring and rehabilitation work, can support individual efforts at desistance. LeBel et al. (2014) found that ex-offenders who were employed as rehabilitation workers experienced a range of benefits, including a sense of belonging, agency and life satisfaction, as well as a stronger commitment to desistance. Similar findings have emerged from studies of sponsors within the Narcotics Anonymous community who provide peer support and mentoring to others on a voluntary basis. Sponsors claim that these activities help to maintain desistance, increase feelings of empowerment and reduce stigmatisation (Marsh 2011). Such activities enable desisters to embrace the identity of the “wounded healer”; that is, an individual who has suffered adversity and uses their experiences to mentor and help others in a similar situation (Esping 2014; Maruna 2001). Generative activities also provide opportunities to gain external validation for desistance efforts, which can reinforce positive changes in identity through a phenomenon known as the Pygmalion effect (Maruna et al. 2004). The Community Based Health and First Aid programme is another example of this type of programme.

The Community Based Health and First Aid (CBHFA) Programme

The CBHFA programme is a global International Federation of the Red Cross and Red Crescent Societies approach used in over 100 countries to empower communities to improve their health. Ireland was the first country in the world to implement such a programme in the prison community context and has inspired other jurisdictions, including Northern Ireland and Wales, to introduce similar initiatives within their prison systems (Betts-Symonds 2015). The Irish programme is operated on a partnership basis between the Irish Red Cross, Irish Prison Service, Education and Training Boards and the Probation Service and is currently being delivered in all 14 prisons across Ireland. The remit of the programme was recently extended to include volunteers released into the community, but this dimension is not the focus of the current article.

The CBHFA programme is delivered through peer-to-peer education by special status Irish Red Cross volunteers. Volunteers are selected by teaching staff, prison management and healthcare staff on the basis of their commitment to Irish Red Cross principles and their “length of sentence, credibility in their prison community, representation in different sections of the prison and approval of discipline staff/governor” (Irish Red Cross 2017: 8). All Red Cross volunteers endorse seven fundamental principles: humanity (show kindness, understanding and respect to everyone), impartiality (avoid discrimination according to nationality, culture or crime), neutrality, independence (from the Irish Prison Service, but follow their rules), voluntary service, unity, and universality (recognise that all volunteers are equal and share responsibilities). Over a 4–6 month period, volunteers take part in weekly training sessions and design healthcare projects to benefit their particular prison community. By way of illustration, CBHFA volunteers in one prison developed a Weapons Amnesty Project and met with gang leaders to gain support for the initiative (Betts-Symonds 2012). Afterwards, prisoners reported a greater sense of safety and a willingness to dispose of their own weapons. Furthermore, official statistics revealed a 90% reduction in “cutting” incidents after the project was introduced. This illustrates the programme’s transformative effect on the prison community, as it was not only CBHFA volunteers who benefitted from the project, but also other prisoners and prison staff. Other recent projects include HIV rapid testing, health awareness programmes and Overdose Prevention classes; the latter in partnership with Merchant’s Quay Ireland (Irish Red Cross 2017). By July 2017, a total of 950 prisoners had participated in the programme, with approximately half successfully completing the training. Non-completions occur for a range of reasons, including volunteers being transferred to another prison, being released from prison, missing too many sessions or leaving for personal reasons.

A recent evaluation of the CBHFA programme indicated that the programme may improve health awareness, feelings of empowerment and sense of community among volunteers (Abiodun and Betts-Symonds 2016). Because of the strict selection criteria (described above), most volunteers have already embarked on the journey towards desistance. Thus, it is likely that the programme helps to reinforce, rather than motivate, change. The evaluation also acknowledged the need for additional outcome-based research, a gap that this article aims to address. The study uses an assisted desistance framework to explore the subjective experiences of volunteers on the CBHFA programme, focusing in particular on its perceived impact in key areas such as identity, agency, generativity and social bonds. These themes were chosen because they are regarded as core mechanisms in the desistance process and are pertinent to the CBHFA programme theory. The paper argues that the programme constitutes an example of what we term “transformative rehabilitation” as it provides opportunities to engage in generative and pro-social activities, which have a transformative effect not only on the lives of individual volunteers but also on the prison community as a whole.

Methodology

The study used a qualitative approach to examine the subjective experiences of volunteers who took part in the CBHFA programme. Qualitative research seeks to produce a data-rich account of respondents’ subjective experiences and elicit in-depth reflections on these experiences, adding depth and authenticity to the study findings (Banister et al. 2011). Such methods are ideally suited to research with small samples or study populations and also allow for the emergence of themes in the data collection process not initially considered by the researcher (Mills and Birks 2014). A qualitative approach was thus deemed appropriate for this study, which aimed to produce an in-depth account of CBHFA volunteers’ lived realities and explore whether participation in the programme activated or maintained core desistance mechanisms.

The method of data collection used was semi-structured interviews, which are less restrictive than structured interviews, but still allow for comparisons between interviews (May 2004). Semi-structured interviews have also been widely utilised in prison-based research in the past to great effect (see e.g. Beyens et al. 2015). The interview schedules were largely inspired by the theme of generativity, looking mostly to the Generative Behaviour Checklist (McAdams and de St. Aubin 1992) and other themes that emerged from a review of the desistance literature, such as identity, agency and social bonds. Questions were worded simply in plain language and examined themes such as relationships, self-image and volunteer’s experiences of the programme itself. While questions posed by the researchers in their interview schedules were similar overall, small differences did emerge, with one researcher questioning volunteers on the importance of peer-to-peer education within the programme. The researchers sought to avoid leading and overly complex questions, and also included prompts within questions in case informative answers were not immediately forthcoming.

Procedures

The researchers used convenience sampling to ensure that all volunteers had first-hand knowledge and experience of the CBHFA programme. The volunteers in this study are thus not representative of desisters (or prisoners) as a whole; rather the study explores the lived experiences of a small group of prisoners that engaged in the CBHFA programme. The experiences of these prisoners are undoubtedly different to the experiences of volunteers in other prisons, which raises a question with regard to the generalisability of the data collected. It is contended that the use of a qualitative approach greatly reduced any limitations caused by the small sample size due to the depth and richness of the information collected.

The recruitment and interviewing of volunteers was facilitated by the Irish Prison Service, the Irish Red Cross and teaching staff at the prisons. The researchers initially visited the prison sites in April 2017 to introduce themselves to the volunteers, discuss the research that they would be conducting and gauge the level of interest in the study. At this stage, the volunteers who took part in these sessions indicated an interest in taking part, and interviews were arranged with the assistance of teaching staff in the prisons and the Irish Prison Service’s CBHFA programme director. Volunteers were recruited from three prisons, including two medium-security prisons and one low-security, open prison. Two volunteers were post-release and interviewed in the community. In all, two volunteers were serving sentences in an open prison, two were post-release and seven were incarcerated in a medium-security prison. The two volunteers who were post-release were employed but did not mention the exact nature of their employment.

Data collection took place between May and July 2017. In total, the researchers gathered data from 11 volunteers using in-person interviews, telephone interviews and written questionnaires. One of the researchers conducted six face-to-face interviews in a closed custodial setting. Interviews normally took place in a classroom within the prison school so as to ensure privacy. Interviews on average took 50 min. The second researcher used a different data collection approach as he was denied access to prison settings due to his insider status (discussed further below). He used telephone interviews and a written questionnaire to collect data from five volunteers who were recruited by the Irish Prison Service’s CBHFA programme director. Four of the volunteers were interviewed by phone, with interviews lasting approximately 30 min, and the fifth was interviewed using a written questionnaire.

It was clear that conducting research in the prison setting was a unique experience and came with challenges that would not be encountered in other research settings. One of the most challenging aspects of conducting research in a prison setting was the highly controlled environment and the way in which the prison regime often disrupted data collection (Sutton 2011). This research was not an “institutional priority” (Sutton 2011: 58) within the prison environment and it was not uncommon for interviews to be interrupted by prison staff, or for interviews to end abruptly. This raised obvious challenges in the collection of data and in some instances meant that the full interview schedule could not be completed.

Data Analysis

All interviews (with the exception of the written questionnaire) were digitally recorded and later transcribed verbatim by the researchers without censorship to allow for a full understanding of the data and to ensure that the authentic voice of the volunteers was recorded. The interviews were transcribed soon after interviews took place so as to keep an accurate record of what was said. Accuracy in the transcribing process was seen to be of paramount importance in terms of supporting the validity of the data and subsequent findings (Robson 2011). Though identifying information has been removed to preserve volunteers’ confidentiality, the researchers chose not to censor the interviews in any other way when presenting the findings to ensure that the authentic voice of the volunteers was presented.

Thematic analysis was the chosen method of analysis, as this method allowed the greatest flexibility for the researcher and would assist the researcher in uncovering a rich collection of data (Braun and Clarke 2006). Throughout the transcription process, the researchers sought to familiarise themselves with their data and keep note of the broad themes that were emerging, including quotations that summed up themes particularly well. Once transcription was complete, one researcher then coded and analysed the data with the assistance of the computer programme MAXQDA. The second researcher conducted manual data analysis, also using thematic analysis, by taking note of themes as they arose. The researchers then met to discuss the themes in detail and identify points of convergence and divergence across the two datasets.

Ethics

The researchers gained approval from the UCD Taught Masters Research Ethics Committee – School of Law and the Irish Prison Service Research Office and the research was conducted in compliance with the ethical guidelines set out by the UCD Code of Good Practice in Research. All volunteers gave informed consent and permission to record interviews. To maintain anonymity, the researchers created pseudonyms for the volunteers, with each being assigned a new and different name from the top 100 babies’ names registered in 2014 (CSO 2015).

A Note on “Insider Status”

Insider research is a term used to describe studies where researchers have a direct attachment to, or experience with, the research setting, giving them a level of ready-made knowledge and insight into the topic that an outsider may only acquire after extensive study, if at all (Robson 2011). For example, a researcher may be a member of the community under investigation, such as the recovery community, or, as is the case with one of the researchers on this study, a desisting ex-offender. Insider status can have a profound impact on openness, trust and validity, as can be seen from the following extract from one volunteer.

Noah: Well if you’re going to transcribe it, you will be transcribing word for word, I presume, not an interpretation?

Researcher: No, no, no, it would be word for word. Yeah.

At this point, the researcher, from personal experience, had a good idea where the conversation was going. The decision was made to reveal some of the researcher’s past to try to alleviate the volunteer’s fears and/or trust issues.

Researcher: I get the feeling you have a question you’d like me to answer?

Noah: [Nervous Laughter] Yeah. Were you ever in prison? I’m assuming you saw that coming?

Researcher: Like a 40-ton truck [Laughter]. And yes, I was, so I know where you’re coming from, pal. Everything will be above board; that’s why I gave you all the ethical, consent and information forms. By the way, they wouldn’t let me into the prison to do this because of my record from Garda vetting.

Noah: We’re on the same page so. Not to generalise, but I had the feeling you were in prison alright. I’m glad you have that experience. I’m not surprised they didn’t let you back in. That’s what they do, put up barriers instead of helping people, and want us to trust them [laughter]…I’m relaxed now [laughter]...

Negotiating barriers and developing rapport can be a delicate process in criminological research (Noaks and Wincup 2004). As seen in the above extract, insider access can help to build rapport (Hodkinson 2005), foster a sense of equality and legitimacy (Chavez 2008) and encourage participants to engage with researchers (Hodkinson 2005). While two volunteers felt particularly reassured by the insider status of one researcher, both researchers felt that a rich set of data emerged from their chosen methods of data collection. Indeed, the nature and quality of the data was consistently high across the two datasets.

Desistance in Practice

This section explores the subjective experiences of volunteers on the CBHFA programme, focusing in particular on its perceived impact on core desistance mechanisms such as identity, agency, generativity and social bonds. The findings are discussed under the thematic headings of agency, generativity and the new self with a particular focus on the wounded healer identity; social bonds, with a particular focus on social recognition; and future plans. Data is drawn from all volunteers and quotes from nine of the volunteers are used to illustrate and contextualise the findings. As will be shown, acceptance and enactment of CBHFA principles seemed to encourage volunteers to develop pro-social identities, adopt a self-reflective attitude and strengthen relationships with prisoners, staff and families.

Agency, Generativity and the New Self

Volunteers believed that the nature and ethos of the wider prison system are fundamental for the preservation of long-term desistance, but may sometimes impede the change process (see further, Swann and Bosson 2010). Within this context, the adoption and enactment of the Red Cross principles provided a powerful alternative template for volunteers, facilitating the emergence of a pro-social identity. The impact of this alternative identity template can be seen in the following extract which describes a volunteer’s motivation for taking part in the programme.

Noah: ...it was something new to the prison system…it was an opportunity to do something outside of the mundane there, which would drive you demented with bureaucracy … They say they're doing things to rehabilitate, but they're not actually. …Oh, yes. It's very punitive, is it not? ...how are lads to stop offending if there is no rehabilitation…box-ticking organisation which is… covers its ass at every corner by ticking boxes. The reality isn't shown and is because the prisons and ex-offenders are never asked. The programme gave me a new perspective of myself and what I could change, as in my thinking.

Participation in the CBHFA programme allowed volunteers to positively revise their self-narratives and impose order in their lives. As the following quote shows, the opportunity to assume a leadership role acted as a key turning point for some volunteers.

Harry: I took a lot of pride, and it mightn't sound an awful lot, being the chair of the group ... I was also very respected in a lot of ways by staff, that shit doesn’t happen unless you have changed. Which was a result of me taking ownership of my past and moving forward positively, you could say it was a major turning point in my life.

Maruna (2001) posits that a successful mechanism of desistance is the “redemption script”. Here, there is an acceptance that the person is naturally of good nature, and that the past is a direct result of social exclusion and social disadvantage. Likewise, volunteers in the current study viewed themselves as victims of social circumstances who became caught up in a cycle of crime and deviance. The programme provided opportunities to perform a redemptive script, which helped volunteers to transition from a negative to a positive self-image. This rejection of the “past self” is highlighted in the following quotation from Jack, who was on remand and had previously been imprisoned.

Jack: Yeah, I was a little cunt before so I was, yeah? Before I started this, yeah? So I was a horrible, horrible little cunt, yeah? Over 50 something P19sFootnote 1... and I have 51 P19s for fighting and stabbing people and phones and drugs and everything.

Through participation in different voluntary activities, such as collecting food for charity, teaching overdose prevention to other prisoners and facilitating smoking cessation courses, volunteers were enabled to discover a positive sense of self, which they described as their “true self” (cf. Maruna 2001). Indeed, the discovery of the “true self” emerged as a key theme within a number of the volunteers’ narratives, as can be seen in the following extract.

Researcher: Yeah. Eh, just leading on from that - you've answered this tenfold, but do you think that you've gained anything from your involvement? What is the thing that you think [pause] wow that was such a change for me? This thing that I've gained.

Adam: I found me true self.

Researcher: True self?

Adam: Yeah.

Researcher: Yeah. And who is your true self?

Adam: I'm not a bad man if you get to know me. That's the whole thing like. People take me up the wrong way, by reading the papers, by reading things about me, but um- I kind of hated meself for years about it, I just had so much [pause] it helped me an awful lot. Helped and all that. And thinking-wise.

In total, nine of the volunteers described a positive shift in their self-image arising from their involvement with the programme. However, two volunteers did not perceive any shift in their self-identities. One of these had no prior experience of custody and therefore had only limited exposure to the label of “prisoner,” at least compared to other volunteers. Conor, who had no previous experience of imprisonment, saw himself as different to other prisoners, stating: “I wouldn’t be an everyday prisoner, kind of.” The second volunteer who perceived no change was part of a social group that rejects the label of prisoner. This suggests that labelling and stigmatisation is not experienced to the same extent by volunteers with little experience of imprisonment, reducing the scope for identity change. Nevertheless, the opportunity to develop and enact a new, non-criminal self can enhance motivation to change and feelings of self-efficacy among volunteers, as Luke’s quote illustrates.

Luke: I found something that I'm passionate about, and that's what I've found, ya know…Like I said, it's part of my rehabilitation. It's part of my change in life and that, ya know. This is playing a massive part for me in my new behaviours and not having that desire to reoffending…this has given me a different perspective of myself and my past man.

The CBHFA programme also provided volunteers with opportunities to enhance their sense of personal agency. As part of the programme, volunteers develop projects that identify and address the needs of their particular prison community. The volunteers were particularly enthusiastic when discussing the projects that they were involved in. One factor that enhanced their enjoyment of these programmes was the fact that volunteers “had a say” in the programmes that they would run in the prison and were encouraged to come up with their own suggestions for projects. For many, the experience of volunteering was something they took considerable pride in, as described by Sean.

Sean: It felt great, going on doing something productive on the [prison] landing, rather than going on the landing chasing drugs, or trying to find out who has drugs, and when the next package is coming in.

Maruna (2001) regards the idea that reformed criminals should accept blame and feel ashamed for all of their crimes as a stretch too far. Instead, it is common for offenders to attribute their offending to circumstances outside their control, laying the blame at society’s door (Maruna 2001). Yet, volunteers in the current study who accepted guilt for their criminal actions also associated themselves with successful desistance. At the same time, their admissions were often coupled with excuses and justifications, as can be seen in Luke’s quote.

Luke: I knew no better growing up. I know I’ve done wrong but I come from the street you know yourself man. So ya know I have the experience to help people today, addiction robbed me of humanity, no one wanted to know or help me. I lived like an animal man for years. I’m a good person today, kind, compassionate and caring, fuck even saying that sound nuts, man. Thank God for the principles of the programme man and I have a job now. I’m a productive member of society these days. I take responsibility for my actions today and no one can take that from me, ya know, man.

Overall though, participation in the CBHFA programme appeared to prompt volunteers to take full responsibility for their behaviour and feel confident in their ability to lead a crime-free existence. This is evident in the following quote.

Dylan: I have learned through the programme to give people the benefit of the doubt, give people a chance the way I have been as a result of the programme. As it has had an impact in my life relationship-wise, I've become an awful lot more in touch even with me kids, with me wife…Whereas what the programme has taught me big time is having compassion and empathy for people come with taking responsibility for my past and, Jaysus, my future too…I find myself being that bit more empathetic, responsible and compassionate and stuff like that.

These findings are consistent with the work of desistance scholars, such as Maruna (2001) who contends that cognitive change and an evolving sense of self is essential to the desistance process. The findings also suggest that agency plays an important role in the process of reconfiguring the self, which is again consistent with the wider desistance literature. For instance, Giordano et al. (2002) argue that desisters draw selectively on components within their environment to create meaningful life changes.

The “Wounded Healer” Identity

Amongst the volunteers who perceived a shift in self-identity, the identity of the “wounded healer” was the most common. The volunteers in this study indicated their adoption of the wounded healer role in a number of ways. Firstly volunteers viewed their offending history as an asset in their work on the CBHFA programme, expressly stating that their history of offending gave them an authenticity, empathy and relatability in their work that they would not otherwise have had. Secondly, the CBHFA programme is strengths-based, focusing on the personal development of volunteers as opposed to their risks and deficits, and presupposes that volunteers are actively looking to improve and develop their skills. This allowed volunteers to earn their redemption and reconcile their criminal past with their desired future selves, making their criminal history meritorious rather than stigmatising. This re-purposing of the past is evident in the following quotes.

Harry: It's not me today, but I wouldn’t change my past as I am where I am today because of it….

Adam: …because you can go into a prison and turn around and say I've come from Wheatfield prison, and I've been a governor for 12 years and all that. Yeah, yeah, yeah. I come in, or somebody else will come in [...] [clicks fingers] have their attention. Straight away you have them. And that's when you go in. But you can relate to them.

The voluntary work they carried out meant that the volunteers were able to take on the identity of “wounded healers” who viewed their previous offending behaviour as an asset in their efforts to help others (see further LeBel et al. 2014). This in turn gave volunteers a sense of purpose and meaning, enabling them to re-design their self-narratives along the lines of the redemption script.

Luke: …it has given me focus and drive, man. You feel really, really good about yourself knowing you're helping others in your community. I mean, I always seen myself as a useless lowlife. And for me, this is my new high to realise I’m not …

Re-scripting their past with a redemptive narrative, some volunteers stated that their past lives had led them to their present mindset and positions in life, as illustrated by the following quote.

Luke: On the streets, you know how it is, plus you walked the landings, man, you can’t show weakness. I mean, always seen lads as targets if they showed compassion or guilt [laughter]… Now I’ve been shown a new way to live; I’m kind and understanding now. I guess it’s because I was never shown that shit, but know it’s the right thing to do; its human, man. You’ve been there, you’re wise to what I’m saying, man…It’s about giving back as we took so much.

Interestingly, the theme of generativity emerged strongly among all volunteers, regardless of perceived shifts in identity. This is presumably due to the range of volunteering activities on offer in the CBHFA programme, and their visible and positive impact on prison life and the prison community.

Through engaging in the generative work offered by the CBHFA programme, volunteers were able to achieve what Maruna (2001) calls “making good,” namely expressing the desire to help the next generation avoid making the same mistakes. These changes ultimately made reoffending less likely and created a very positive attitude for their futures. It was clear from the interviews that volunteers were in the process of desistance and were beginning to realise their positive qualities and goals through generative work. The following extracts describe some of the positive changes cited by volunteers.

Noah: Yes…learning to take full responsibility for my previous actions. It does give you purpose to believe in your future and mentally helps you to focus on goals…

Dylan: …And so numerous times, I had people come to me and sit in my cell and tell me things that they couldn't tell anybody else. So, it gave me this degree of trust between people, which is a huge thing to have in prison or outside, especially for our criminals. I have used these skills in the return to community schemeFootnote 2 while delivering the programme…Who knows, maybe this was my true path in life.

Social Bonds

As noted previously, the chances of an ex-offender staying crime-free very much depends upon the development of new identities, values and beliefs that are incompatible with offending (Giordano et al. 2002). This is known as the process of knifing off from the past (Laub and Sampson 2001). The CBHFA programme involves a type of voluntary knifing off since all volunteers made the decision to disassociate themselves from people, places and things with whom they had been criminally involved. One of the advantages identified by CBHFA volunteers was that the programme provided new community and pro-social networks as acquaintances were replaced with deeper friendships, particularly with other CBHFA volunteers. This nurturing of a different life through new associations, activities and behaviours was particularly important to volunteers who had been released from prison and was cited as a major factor in maintaining their crime-free lifestyle. Therefore, it is worth considering in detail how the CBHFA programme facilitated the development of new bonds and routines.

The analysis made it clear that these mechanisms outlined were provided by the programme. The programme provided a new start, a knifing off of the past and the possibility of a new community bound by a common thread. Volunteers made new friends, established a support structure and became responsible to each other and their new social bonds both inside and outside the prison. These elements were regularly highlighted by volunteers in the CBHFA programme, as can be seen in the following quote.

Luke: Like I said already, I didn’t care about anyone before I did this programme, ya know. So, the impact on my relationships is massive, man. I wasn’t shown all this stuff growing up... As for education, you got that on the streets. My hero was the General,Footnote 3 for fuck sake, man. I had no goals in life other than criminality, and me da encouraged that shit; ya know the way it is, man, you’re from the same side of the street…

Luke’s comments are reminiscent of differential association theory (Sutherland 1939), particularly the suggestion that he learned the values and methods associated with criminal behaviour through exposure to deviant associates and their deviant value system. He went on to explain that his engagement with pro-social others through the CBHFA programme helped him to re-evaluate this perspective. Dylan described a similar shift in his mind-set, evident in his belief that he will be able to lead a crime-free life once given a chance to become a responsible and productive member of society. Again, his statement emphasises the role of pro-social mechanisms, values and commitment in the desistance process.

Dylan: …I feel I have changed a lot and I have better relationships with my family and friends…my family tell me I have a very positive attitude…I know I will face challenges getting a job, but I have confidence that I will be given a chance by an employer and I won’t let him down.

Moreover, Sean’s quote highlights how the programme enabled volunteers to provide loved ones with evidence that positive changes were occurring in their lives.

Sean: Yeah, your family comes up, they go through all the programmes that we've been doing, all the stuff we've been doing while we were in here, and you get to see your family and you get to see that achievement, and you’re getting a cert off the governors and stuff like that. So, it looks… I know myself, like, I'm not in here doing anything. I'm doing good in here.

The suggestion here is that volunteers view pro-social values and institutions as the way forward and believe that these pro-social bonds will ultimately control future temptation. This is consistent with Laub and Sampson’s (2001) theory, which suggests that social bonds aid desistance by enhancing emotional attachments, altering daily routines and encouraging people to strive towards non-criminal identities (see also Hirschi 1969). When individuals value and are committed to social relationships, the costs of crime increase because individuals risk losing these relationships if they commit further criminal or deviant acts (Laub and Sampson 2001; Hirschi 1969). As Dylan stated “I’ve learned to identify the right type of people I need to be around.” This quote suggests that Dylan places high value on these social bonds and that “the right type of people” will be a major factor in sustaining his belief that a crime free lifestyle is possible.

Hirschi (1969) further submits that pro-social attitudes by themselves do not motivate people to avoid crime, but can constrain people from committing crimes if strong social bonds are in place. The link between attitude and behaviour was very evident in the exchange between a member of the prison staff and one of the volunteers on the CBHFA programme, described by the following volunteer.

Harry: …He goes, "I'm grateful what you're doing, what you're doing". It's mad because his belief in us kept me out of trouble in prison…the difference that made to me knowing that he appreciated what I'd done and a bit of manners and a bit of respect goes an awful long way…

Social Recognition

By engaging in generative activities, volunteers in this study felt that their volunteering activities had changed how others in their lives viewed them, particularly prison staff and their own families. Volunteers often described how their voluntary activities with the CBHFA programme was a source of comfort for their families, providing reassurance that they were “doing good” (Conor) in prison and not engaging in unsafe or illegal behaviour. Involvement in the programme was also a source of pride for volunteers’ families, who regularly communicated this sense of pride to the volunteers. In the following quote, Conor discusses how his family took comfort from his involvement with the programme.

Conor: Yeah it'd be- with my family it'd be fairly happy that I was doing something like that like. I think they would have been a bit- I don't know, people outside would probably fear what prison is like. Or what it can be like, you know what I mean.

Additionally, volunteers reported how their involvement with the CBHFA programme had improved relations with prison staff, assuring staff that they were individuals who could be trusted and given responsibility. It is submitted that staff acted as “certifiers” for volunteers, supporting the belief that they had positively changed through their involvement with the CBHFA programme. Additionally, volunteers discussed how their experience of volunteering helped them to view themselves in a more positive light and allowed them to feel that they became more than just a “number” (Sean) in the prison system.

Sean: That's…that's the big thing that it goes back to. I'm not just a prison number anymore, I'm a volunteer, you know.

As Adam explains, the self-respect developed and displayed by CBHFA volunteers encouraged others to do the same, ultimately transforming relationships across the prison community as a whole.

Adam: It did, ‘cause I always thought they were just animals locking us up. Well, not animals, that's the wrong word, but just [pause] they call us pigs, we call them pigs, just locking us up, throw away the key. But we didn't realise you can meet them in everyday life as well. But there is good officers here, and chiefs, and it broke down many things for us. And with that breaking down [pause] we came together, and worked together. It's very hard to work on a programme if youse are against each other.

Future Plans

When questioned about their plans following release, volunteers expressed an aspiration to continue their involvement in voluntary work. This suggests that the identity changes elicited by participation in the CBHFA programme were genuine and had become embedded in their sense of self, as indicated by Adam.

Adam: But now, I've something to give back to the community. That I can save people when I go out there. I'd love to be- I would love to be a volunteer when I get out.

When discussing their desire to continue volunteering after release, several volunteers expressly stated their desire to reach young people and to prevent them from following a similar path. As noted previously, volunteers felt that their history of offending made them more likely to be respected and listened to by young people. James, for example, discussed his desire to help young people at risk of becoming involved in crime in Dublin’s inner city.

James: Some of the programmes would be perfect out there in the inner city. You know what I mean, especially with this, the feud that's going on at the minute, it might kind of divert young fellas away from that.

The remaining volunteers were aware that their criminal histories and the ascription of a criminal label would be a major barrier for them in engaging in voluntary activity following release.

Researcher: Just on that- do you want to keep volunteering once you're out of prison?

Conor: That's what I was saying, I'd love to be able to still go and volunteer, you know. I was looking, there's another thing they do as well. Red Cross were doing it at the times of the floods and all in Ireland, I seen they were doing that.

[...]

Researcher: But also you can kind of… you're a bit sceptical, or unsure about whether you'd actually be able to get involved because of your record?

Conor: Yeah. Yeah. Basically yeah. So that's… it's going to be a lot of them kind of challenges when you get out from prison like, you know? Unfortunately.

Moreover, volunteers believed that their capacity to engage in generative activities even within the prison community was significantly curtailed. In particular, volunteers felt that the volunteering activities of the CBHFA programme were regarded by the prison staff as secondary to the smooth running of the prison regime. This meant that activities could often be cancelled at late notice.

Adam: Any issues that we really had is through the prison service, through just bad communication between…. Everything is an operation like, and I mean like the simplest thing. Yeah, it's all political stuff and yeah. It can end up a bit of an operation for us, you know.

Together, these findings corroborate previous research on the CBHFA programme which found that involvement in the programme helped volunteers to develop a positive self-view, as well as improved confidence and self-esteem (Betts-Symonds 2012). They are also consistent with the results of other studies which show that voluntary work helps ex-offenders to engage in self-reflection, build hope, formulate meaningful social bonds, construct a positive self-identity, gain trust and social recognition from others, and circumvent negative labels and environments (Marsh 2011; Perrin et al. 2017).

Conclusion

This article explored the subjective experiences of 11 volunteers on the Community Based Health and First Aid programme, which is currently being delivered in 14 prisons across Ireland. The findings suggest that the programme provided volunteers with opportunities to develop a new identity, engage in generative activities, enhance pro-social bonds and gain confidence in their ability to resolve obstacles in their paths. Moreover, volunteers perceived their engagement with the CBHFA programme as a key step on the journey towards successful desistance. In addition to its impact on health, the CBHFA programme may thus help to promote key desistance mechanisms through its emphasis on empowerment, volunteering and community-building.

The findings have a number of important lessons for international policy and practice. As the first country to introduce the CBHFA programme in a prison setting, the experiences of volunteers in Ireland will be of particular interest to international scholars and criminal justice professionals who may be thinking about establishing similar programmes. Additionally, the findings provide important insights into programme mechanisms that promote desistance and are in accord with international evidence. Theoretically speaking, participation in the CBHFA programme appeared to provide volunteers with a template for a desistance script. Volunteer narratives were reminiscent of the redemption script which offers a vision of the desister’s true self, creating a perception of agency coupled with the desire to become a productive, responsible member of society (Maruna 2001). Maruna and Matravers (2007) describe this self-narrative as a version of the truth that is often quite different from historical facts, but provides desisters with a sense of purpose and meaning. Furthermore, the CBHFA programme enabled volunteers to formulate, or deepen, pro-social bonds with other prisoners, prison staff, and families (cf. Laub and Sampson 2001). Their experiences in this regard call to mind Maruna et al.’s (2004: 279) analysis of the “Pygmalion effect”, whereby offenders negotiate a new and reformed identity through the pro-social labelling of others. Maruna et al. (2004) suggest that positive changes in an individual’s self-concept are reinforced when accompanied by a heightened sense of expectation from others, particularly people in positions of authority who can both recognise and reinforce participants’ changing sense of self (see also Perrin et al. 2017). Engaging in the generative activities of the CBHFA programme thus allowed volunteers to signal their new pro-social identities to others, manage stigma and ultimately achieve redemption.

Finally, the CBHFA programme appears to adopt many of the principles of desistance-focused practice and provides a useful real-world example of a desistance-focused prison programme. For instance, the training and volunteer activities enabled the discovery and display of personal strengths; volunteers’ role in the design of interventions encouraged feelings of hope and agency; and the description of participants as “volunteers” rather than “prisoners” reduced stigmatisation. Additionally, opportunities to enact a pro-social self through volunteer work had a transformative effect, changing the nature of volunteers’ interactions with others and building social capital. As noted earlier, volunteers are carefully selected for the programme, which means that participation probably helps to maintain, rather than motivate, change. Nevertheless, research suggests that the programme is also having a transformative effect on the prison population as a whole. For instance, volunteer campaigns have reduced misuse of over-the-counter painkillers by 30% and the demand for dental care by 40% (Betts-Symonds and O’Halloran 2013). Because of this, the programme could be described as an example of transformative rehabilitation practice, a concept originally introduced in disability studies (see e.g. McPherson et al. 2015). Practitioners of transformative rehabilitation aim to transform the structural conditions that create and reinforce social exclusion. They operate at the intersection between the person and the social world to reconfigure the relationships between social actors. Their work is person-centred but not solely concerned with individual change, in recognition that skills acquisition is of limited value in the absence of social opportunity. Instead of teaching people how to fit into existing structures, transformative rehabilitation practice focuses on changing the social, economic, legal and political contexts that can undermine personal change efforts.

While the CBHFA programme can be described as transformative, its effects may be limited to the prison environment. Volunteers in the current study were well aware that legal barriers could undermine their ability to continue this work after release. Ireland was one of the last European countries to introduce provisions to expunge adult criminal records. However, the provisions introduced under the Criminal Justice (Spent Convictions and Certain Disclosures) Act 2016 allow convictions to be expunged only in limited circumstances, which may not apply in the case of many CBHFA volunteers. Ex-offenders who wish to engage in volunteering activities also face significant legal barriers since the introduction of the National Vetting Bureau (Children and Vulnerable Persons) Act 2012, which requires people working with children or vulnerable adults to undergo mandatory police vetting. Nonetheless, the findings of this study suggest that participation in the CBHFA programme has a profound impact on the lives of volunteers despite a challenging external environment.