Thesis

186 Chapter 7 a thorough approach is needed to create what the report from the World Health Organization stated: that ‘all prison staff should have basic training in [..] the ethical duties of [all] staff and health professionals working in prisons’ (Enggist et al., 2014). ‘The delivery date [in this case: of our research results and of the last MCD sessions in the series] is not the climax, but the beginning of a change process in which the organization must adapt to a new style of working. [...] It is impossible that a first implementation can also be the last’ (Pater et al., 2011, p. 273). Pater et al. (2011) stated that a continued implementation plan and attention to communication about the follow-up of implementation is needed. This would prevent a level of ‘fatigue’ during the process because, after a while, there is a risk that other developments in the organization will blur the focus on the implementation of the intervention. A continuous process focused on ‘anchoring’ and ‘improving’ is needed. Organizing reflection and doing reflection takes time. Based on reflections from MCD sessions, creating impact in practice takes even more time and effort (Molewijk, 2009; Van Dartel & Molewijk, 2014, p. 270). Unfortunately, after a project a result is often seen to crumble, involved staff goes back to other tasks, and the momentum disappears (Pater et al., 2011, p. 273). Prison management, at DCIA and their Educational Institute, could stimulate and facilitate that MCD does not only take place ‘ad hoc’ but is incorporated into regular structures of the organization (Molewijk, Verkerk, et al., 2008, p. 51). This implies that there must be structural time for participating in and preparing moral reflections and MCD sessions (Kanne, 2016, p. 237). Chapter 3 additionally advised that attention is needed to improve the dialogical skills of prison staff, e.g., in the basic training of (new) prison staff. It also showed a need to train more MCD facilitators with experience in the prison context. Furthermore, it would be beneficial to keep working with national and local working groups to improve (the implementation of) moral reflection within all prison institutions. These groups can and should help develop and secure the needed structures for ESS and maintain a relationship with prison staff from all disciplines to listen to their needs for ethics support and to create shared ownership.

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