Ward Staff as a Tool to Promote Wellbeing among Prison Employees

: Since 2011, the organisational and management process of the Italian Prison Administration has started to change. The Open section and Dynamic supervision measures introduced into the Italian penitentiary system, requires that all prison workers participate in the observation and treatment of the prisoners’ activities, carried out within a multidisciplinary perspective. This may imply a signiﬁcant increase, in both the workload and possible sources of stress for prison workers and, therefore, hinder the organizational change. To enable the process of change, while monitoring the employees’ wellbeing, monthly multidisciplinary meetings have been planned, involving the ward staff of each prison. This study aims to both understand the impact of the organisational change on the employees of a prison in northern Italy and to explore the sustainability of the ward staff tool. Ten multidisciplinary meetings were analysed over a year, focusing on topics discussed within the group and relational positions assumed by the members. Content analysis has been performed through the T-LAB software, whereas the analysis of the interactive modalities has been carried out through the application of the Interaction Process Analysis grid. Results showed the group’s tendency to focus on the task, neglecting the relational dimension and moments of shared reﬂection related to the process. The study allows us to reﬂect on those aspects that may undermine the organisational and employee wellbeing and to assess the sustainability of a new organizational tool.


Introduction
In the last ten years, through Ministerial orders No.445330/November 2011, No.206745/ May 2012, and No.36997/January 2013, Italy has gradually witnessed the organizational change of the national prison administration. Even though the 1975' prison reform proposed a conceptual paradigm shift from a control-oriented organisational model to a re-education and reintegration one, daily practice has continued to highlight an anchoring to the concept of prison as a punitive measure for many years.
The organisational change led the introduction of the measures Open Section (i.e., the possibility to serve a sentence with greater freedom of movement within the prison) and Dynamic Supervision (i.e., detention not merely as custodial, but as an opportunity for education of the person for social reintegration), representing a shift from a quantitative (e.g., number of years) to a qualitative concept of punishment and its execution [1].
The open sections and dynamic supervision involve all prison workers who actively participate-each with their own experience and training-in the process of observation and prisoners' treatment, requiring the assumption of a multidisciplinary perspective. Accordingly, each case should be tackled from different points of view, mediating between different approaches. For example, educators could be oriented towards a re-education and resocialization model, according to the approach they have been trained in, while prison officers could be more control-and security-oriented.
On a systemic level, the set of interdependent relationships involving individuals, roles, resources, and domains of an activity can hinder the implementation of the organisational change due to difficulties of the whole system adapting to the new operating model required. Specifically, Lines [18] stated that from a systemic point of view, reasons for resistance could be related to: 1. Organizational culture and power structure; 2. Interdependence between parties; and 3. Group dynamics [19].
Here the system under analysis is a prison in Lombardy, which depends on the Regional Penitentiary Administration. As mentioned above, in order to meet the users' care needs, many different professionals work in prisons at various levels. The highest hierarchical level is occupied by the director of the prison. In addition to the staff provided by the prison administration, volunteers play a key role in terms of treatment activities, although they are not an integral part of the organisation.
In Italy, there is a lack of psychological literature on prison organisations [20]. Despite understanding their operating mode, social factors and the relationships that occur among them, represents an essential goal for increasing work wellbeing and promoting the best prisoner treatment. Manzoor (2014) found out that there is a positive relationship between workers and organizational effectiveness, but organisations should aim to recognize, empower and allow workers participation in the decision-making and implementation process of changes [21].
Given this background, the present explorative and longitudinal study aimed to monitor the progress of the recently introduced ward staff tool by assessing its sustainability.
We assume to observe over time equal engagement by the staff members, the improvement of communication and relationships between parties which will enable them to focus on their new tasks and to manage the issues arising from the introduction of the open sections and dynamic supervision measures.
Promoting the integration between the ward staff 's members represents a central objective for the increase in work wellbeing and to facilitate the transition process from the old to the new organisational model. Prison's staff represents a key factor in the progress of the institution which means that their behaviour and wellbeing directly affect the services it provides [22,23].
The assumption is that organisational change occurs through and because of changes in employees' attitude and values. Thus, organisations need to make systematic, planned, and proactive efforts to improve employees' subjective and relational wellbeing to receive beneficial outcomes in turn [5]. In this sense, through the current research, we tried to assess the sustainability of the ward staff tool.

Materials and Methods
In this study, qualitative content analysis (CA) and interaction process analysis (IPA) were conducted to analyse the process of setting up the ward staff. The term "process" refers to a set of interrelated actions carried out within an organization [24]. According to Gelo and colleagues [25], the process analysis assists in: Observing what happens during the process under examination; 2.
Identifying which variables are most appropriate to describe the phenomena of interest; 3.
Describing the frequency of occurrences; and 4.
Evaluating the relationship between the selected phenomena and their distribution among different groups over time.
Content analysis is defined as a technique used to extract desired information from a body of material (usually verbal) by systematically and objectively identifying specified characteristics of the material [26] (p. 313). It is a technique for making replicable and valid inferences from texts (or other meaningful matter) to the contexts of their use [27]. Berelson first defined it as "research technique for the objective, systematic and quantitative description of the manifest content of communication" [28].
Interaction process analysis was introduced by Bales in 1950 [29]. It is a technique for studying interaction in small groups. Researchers record and target every expressive act and classify them into twelve categories: shows solidarity, shows tension release, agrees, gives suggestion, gives opinion, gives orientation, asks for orientation, asks for opinion, asks for suggestion, disagrees, shows tension, and shows antagonism.
Through CA and IPA, we were able to study both the content of each ward staff meeting and its relational aspects.
As regards the meetings' content, we hypothesised that regular ward staff meetings would allow the evolution of the themes dealt with by the group. As ward staff was a newly introduced tool, we expected it to produce a change over time. Specifically, we hypothesized a shift from a focus on role organization aspects to the work tasks (i.e., on the prisoners and on the operational practices).
On the relational aspects, the study refers to the theoretical model proposed by Tuckman [30] concerning the development phases of a work team and its relationships: firstly, team members meet and begin to develop a mutual opinion and an idea of the objectives and methods adopted; secondly, the group faces its first structural conflicts; thirdly, the group moves to the task and operationalisation; fourthly, the group moves as a focused unit; lastly, closure and suspension.
In our study, the process of setting up the ward staff of a Lombardic prison was observed for one year, focusing on two variables: themes discussed in the group; and relational positions taken by the members.
The aim and the sampling process of the research was defined in agreement with the local prison administration.

Participants
Using convenience sampling, the research involved a prison indicated by the local prison administration because it had been struggling with the organisational changes resulting from the introduction of the orders mentioned above.
At the time of the research, the prison housed 599 inmates in 15 male sections. The total number of staff consisted of 373 prison officers and 4 educators. In addition, the prison also employed many professionals such as health workers, experts, volunteers, and teachers.
The ward staff involved in the study consisted of workers employed in the prison's open sections. Therefore, the selection of this group is linked to its direct exposure to the organisational changes.
The ward staff included 7 different professionals: educators, prison officers, teachers, members of the Addiction Treatment Service, psychologists, physicians, volunteers, and a priest.
The number of workers in each professional category who attended the ward staff meetings varied over time.

Data Analysis
Data collection required the researcher (LDL) to attend 10 ward staff meetings which took place over a year. In line with Gobo's classification, data collection was characterised by a moderate level of participation by the researcher [31]. The researcher was at an intermediate level between being a member of the group and being totally outside of it.
All meetings were recorded and transcribed, then content analysis (CA) and interaction process analysis (IPA) were done.
The content of the meetings was transcribed into Italian, and CA and IPA were conducted on the original transcriptions. Then the results were translated into English for this publication taking care to preserve the original meaning.
CA was conducted through the software T-Lab 5.5 [32], that allows a linguistic, statistical, and semantic analysis of written texts based on occurrences or co-occurrences between words. Content analysis-conducted through T-LAB-allowed emerging topics to be highlighted in a specific and/or transversal way during the meetings and subsequently, to group them in specific thematic areas observing central transitions from a procedural point of view.
Specifically, we conducted thematic analysis of elementary contexts, which belongs to the broader category of thematic analysis which could build and explore a representation of the contents of the text under analysis through significant thematic clusters. Each cluster is made up of a set of elementary contexts (sentences, paragraphs, or short texts) characterised by the same keyword patterns. Each cluster is also described through lexical units (words, lemmas, or categories) and variables that if present, most characterises the elementary contexts of which it is composed. The set of clusters thus makes it possible to reconstruct the thread of the discourse within the overall plot constituted by the text (or a subset thereof). At the end of the thematic analysis of elementary contexts, the researcher will be able to propose a mapping of isotopes intended as general or specific themes characterised by the co-occurrence of semantic traits, as well as to explore the relationships between clusters and between clusters and variables (if any) [32].
In reference to the IPA, to delineate the process of the constitution of the ward staff tool, an analysis was conducted of the typical ways staff members interact with each other. To this aim, the observation and classification procedures of interactive behaviour, described by Bales (i.e., IPA, Interaction Process Analysis) [29][30][31][32][33], was applied by 3 independent judges (LDL, AS and ES).
IPA is based on a system of categorisation of minute-by-minute interactive behaviour. It represents a system of analytical and sequential detection and filing of acts as they occur.

Areas Categories and Behavioural Indicators
Socio-emotional Area: positive

Content Analysis
Thematic Analysis of Elementary Contexts (TAEC) were performed through the T-LAB software on the transcriptions of each of the 10 ward staff meetings.

1st Meeting
Twelve prison workers attended the meeting: 3 educators, 1 prison officer, 2 physicians, 1 psychologist, 1 member of the Addiction Treatment Service, 2 teachers, 1 volunteer and a priest. During the first meeting, the members of the ward staff were all present. Subsequently, some absences occurred, which will be specified for each meeting.
TAEC was carried out on the transcription of the first recording-highlighting the occurrence of four thematic clusters, respectively covering 19.9%, 15.8%, 34.2% and 30.1% of the total variance (see Figure 1). Based on their content, clusters were named as follows: − Cluster 1, "the importance attached to the health workers contribution" − Cluster 2, "organising prison treatment: a shared challenge" − Cluster 3, "ways of sharing in the decision-making processes" − Cluster 4, "integrating different perspectives" The first meeting's clusters deal with the methodological aspects of prison work. Cluster 3 covers the highest percentage of the total variance (34.2%). In fact, during the first meeting, the ward staff mainly focused their discussion on how to share the decisionmaking processes within the working group. Employees highlighted the need to activate a real and concrete communication flow concerning practical and organisational issues, as required by the rule of the Dynamic Supervision (e.g., see the quote extracted from the first meeting in Table A11 in the Appendix A).
Cluster 4 (30.1%) and Cluster 1 (19.9%) deals with the need for integration between different points of view and the importance of the health professionals' contribution to the choice of many aspects related to prison treatment activities. It was mainly the educators who tried to involve health professionals in the process of sharing their work. They asked health professionals many questions and gave them plenty of time to speak, underlining the urgency of integrating their contributions and creating synergy between different areas and perspectives.
Lastly, cluster 2 refers to the needs of the ward staff to ensure that the organisation of the prisoners' treatment is a shared challenge.

2nd Meeting
Attendance corresponds to that of the first meeting. TAEC was carried out on the transcription of the second recording highlighting the occurrence of 4 clusters, respectively covering 38.8%, 24.5%, 25.7% and 10.8% of the total variance (see Figure 2).
Based on their content, clusters were named as follows: − Cluster 1, "open sections, a new container to fill" − Cluster 2, "communication difficulties between players" − Cluster 3, "what does re-education mean?" − Cluster 4, "role of the school"  Table A11 in the Appendix A). Ward staff seemed to share the need to consider them in their different aspects, trying to cope with them in the most functional way.
Cluster 1 covers the highest percentage of total variance (38.3%). Another central theme was the proposal of new treatment activities (learning activities, leisure activities and school activities). Based on those proposals, ward staff began a moment of shared reflection on criteria and motivations for the prisoners' participation. Educators initiated the discussion on this theme and the health workers actively responded to the discussion.
Finally, particular attention was paid to the inadequacy of the communication methods between the members of the ward staff. Such methods are not adequate when considering the dynamic and complex communication that characterises the prison context.

3rd Meeting
Attendance corresponds to that of the first meeting. TAEC was carried out on the transcription of the third recording highlighting the occurrence of 3 clusters, respectively covering 38.5%, 17.1% and 43.8% of the total variance (see Figure 3).
Based on their content, clusters were named as follows: − Cluster 1, "dynamism versus precariousness" − Cluster 2, "synthesis requires team" − Cluster 3, "tradition versus innovation" The third meeting was characterised by a dialectical and confrontational nature. Ward staff addressed the issue of change and how it brings with it the conflict between tradition and innovation (e.g., see the quote extracted from the third meeting in Table A11 in the Appendix A). They are well represented by the Eighth Section of the prison, where the study took place. The eighth section houses prisoners in pre-trial detention. Such conditions make the treatment precarious and seem to place a significant burden on the volunteers.
The meeting continued to focus on issues related to the eighth section and on the open sections' potentially negative effects.

4th Meeting
The fourth meeting took place after a holiday break in August. Attendance corresponds to that of the first meeting.
TAEC was carried out on the transcription of the fourth recording highlighting the occurrence of 3 clusters, respectively covering 36.4%, 22.9% and 40.5% of the total variance (see Figure 4).
Based on their content, clusters were named as follows: − Cluster 1, "school versus work" − Cluster 2, "adaptation and innovation of procedures" − Cluster 3, "the impact of bureaucracy in everyday working life" The fourth meeting's debate was mainly characterised by the demonstration of resistance to everyday prison bureaucracy (e.g., see the quote extracted from the fourth meeting in Table A11 in the Appendix A).
Cluster 3 covers the highest percentage of total variance (40.5%). Volunteers declared more difficulties accepting that every single activity must be rigidly codified to be monitored. As a result of their resistance against bureaucracy, their acts and behaviours were considered inappropriate by the rest of the group.
Another important theme is represented by the comparison of work and school activities. The ward staff agreed that most prisoners seemed to prefer work to school. In fact, prisoners frequently drop-out of school in order to apply for paid work. This attitude seemed to greatly disappoint and distress the teachers.
Lastly, ward staff debated the possibility of evaluating the proposal to make schooling compulsory at least until the eighth grade. The group moved towards the definition of a concrete proposal for action during the fourth meeting. This seems to be very different from the first meetings, where schooling appeared in a more marginal position. Now teachers take a more integrated position within the ward staff.

5th Meeting
The fifth meeting took place in November, due to staff holidays. Members of the group belonging to the teacher's category were absent.
TAEC was carried out on the transcription of the fifth recording highlighting the occurrence of 4 clusters, respectively covering 21.9%, 20.4%, 30.6% and 27% of the total variance (see Figure 5).
Based on their content, clusters were named as follows: − Cluster 1, "school versus work"; − Cluster 2, "adaptation and innovation of procedures"; − Cluster 3, "the impact of bureaucracy in everyday working life" − Cluster 4, "volunteers versus educators" The fifth meeting was characterised by thematic clusters which highlighted opposing positions.
Cluster 3 was strongly connected to the theme of change. It covered the highest percentage of total variance (30.6%). Participants discussed the proposal to introduce operational tools to manage the change. They proposed the creation of a "pact of responsibility" to be submitted by the Open Sections' inmates in order to guarantee more authentic treatment activities and high levels of participation.
Educators supported the proposal. Prison officers were the most sceptical about the change, because of their direct experience among the sections. They reported that inmates seemed to prefer past practices (e.g., see the quote extracted from the fifth meeting in Table A11 in Appendix A). During this meeting, the group seemed to experience high levels of fatigue trying to find shared lines of thought and action. Many questions concerning volunteers remained open, with participants expressing concern about the management of the volunteer's relationship with the prisoners and their attempts to manipulate volunteers.
Lastly, in order to reduce the chaotic atmosphere of the meeting, the ward staff undertook the job of tidying up and mapping out the various activities proposed. It was the educators and teachers who carried this task out.
The ward staff succeeded in initiating a shared dialogue about the possibility of concrete and immediate action. However, probably due to the presence of so many different professional roles, it remained difficult to reach a compromise and achieve teamwork.

6th Meeting
The Addiction Treatment Service operator was absent. TAEC was carried out on the transcription of the sixth recording highlighting the occurrence of 5 clusters, respectively covering 14.8%, 21.3%, 15.5%, 27% and 21.3% of the total variance (see Figure 6).
Based on their content, clusters were named as follows: − Cluster 1, "the value of a signature: different views" − Cluster 2, "interaction between parties" − Cluster 3, "rethink tasks" − Cluster 4, "need to think about new tools" − Cluster 5, "the impact of current events between the outside and inside" The sixth meeting took on a creative and integrative approach. Ward staff continued to seek concrete solutions to the issues surrounding the introduction of organisational innovations. They proposed, as in the previous meeting, the signing of the 'pact of responsibility' to encourage greater adherence to treatment by the open sections' inmates (e.g., see the quote extracted from the sixth meeting in Table A11 in the Appendix A).
The establishment of a teaching secretariat was also proposed (especially by educators and teachers). Cluster 4 covers the highest percentage of variance (27%).
Clusters 2 and 5 cover the same percentage of variance (21.3%). Cluster 2 refers to the theme of integration between parties. Ward staff highlighted the need to discuss the co-construction (and sharing) of a common language, which would allow parties to structure a shared thought and to attribute a specific meaning to the proposed activities. Volunteers struggled to share the meaning of the proposals. The discussion seemed to be fixed on a priori vision related to the different working approaches.
Cluster 3 (15.5%) includes proposing that volunteers cooperate more. Aside from the necessity to cooperate towards the achievement of the same objectives, the ward staff underlined the impossibility of thinking of the detention activity as a series of disconnected interventions.
Lastly, Cluster 1 focuses on the signing of 'the pact of responsibility' as a concrete commitment by prisoners towards the organization. It was mainly the educators who sustained such a position.

7th Meeting
Psychologist and physicians were absent. TAEC was carried out on the transcription of the seventh recording highlighting the occurrence of 4 clusters, respectively covering 17%, 18%, 32.5% and 32.5% of the total variance (see Figure 7).
Based on their content, clusters were named as follows: − Cluster 1, "urgency of concretising" − Cluster 2, "communication block" − Cluster 3, "face the needs" − Cluster 4, "the impact of top-down logics" The seventh meeting was characterised by the assumption of responsibility by the ward staff. In parallel to this, the group highlighted the presence of a communication block which made it difficult for the management of prisoners' and their daily work. Cluster 3 emphasizes the urgency of addressing the needs expressed by each organisational stakeholder. Participants proposed to uncover each category in order to identify resources and limits for the construction of a shared project (e.g., see the quote extracted from the seventh meeting in Table A11 in the Appendix A).
This step strongly highlights the need to consider the complexity of each role within a process of common work (with a continuous reference to the organisational culture).
Cluster 4 takes up the theme of the signing of 'the pact of responsibility' again, as a tool designed to manage the process of adherence to the open sections' standard.
Cluster 3 and Cluster 4 cover the same and more significant percentage of the total variance (32.5%).
Cluster 2 includes the debate about the communication block, which was mainly in relation to the flow of information between professionals. Often the means of communication between the parties are the prisoners themselves, but the information resulting from this exchange is partial, incorrect, or unfounded. This is mostly an attempt at triangulation and exploitation.
Then, in Cluster 1 the need to achieve greater concreteness between the proposals presented at the meeting and their implementation was expressed.

8th Meeting
As per the previous meeting, psychologist and physicians were absent. TAEC was carried out on the transcription of the eighth recording highlighting the occurrence of 5 clusters, respectively covering 14.5%, 19.8%, 18.1%, 30.5% and 17.3% of the total variance (see Figure 8).
Based on their content, clusters were named as follows: − Cluster 1, "from need to project" − Cluster 2, "unity is the strength" − Cluster 3, "tasks' division" − Cluster 4, "a puzzle to be reassembled" − Cluster 5, "School crisis" The eighth meeting followed the meeting in which the presence of a communication block between the prison workers was made explicit. Consequently, it was characterised by discussions relating to a theme of 'fitting together' and 'uniting'. Participants expressed the need to restructure themselves, like a jigsaw puzzle, which implies adaptation between its various components.
Cluster 4 points out a fragmentation between parties, especially between the volunteers and educators. The volunteers strongly underlined the need to be considered as an independent organisation. They complained about poor consideration of their needs by the prison organisation which seems unable to recognise them in their identity and individuality (e.g., see the quote extracted from the eighth meeting in Table A11 in the Appendix A).
The difference between the parties was strongly underlined by the educators, as if the integration required by the ward staff meetings could not be applied due to different organisational time management.
Cluster 4 covers the highest percentage of total variance (30.5%).
The other clusters show that participants (prison officers, physicians, teachers, and educators) had an urgent need to set up a common task to coordinate their efforts in order to guide inmates along a concrete and effective re-educational pathway, in response to the thematic core of cluster 4.
As in the previous meetings, schooling was indicated as an activity difficult to achieve when the alignment between the parties was absent.
Lack of cohesion has repercussions on the participation of prisoners in school activities. The engagement of prison workers seems to be closely linked to the involvement of prisoners themselves, as if integrity and accountability cannot be expected from them if the same dimensions are not first evoked in the ward staff. The establishment of a school secretariat was proposed again.

9th Meeting
As per the previous meetings, psychologist and physicians were absent. TAEC was carried out on the transcription of the ninth recording highlighting the occurrence of 5 clusters, respectively covering 14.7%, 27.9%, 17%, 24% and 16.2% of the total variance (see Figure 9). Based on their content, clusters were named as follows: − Cluster 1, "critical case 1" − Cluster 2, "encouraging dialogue" − Cluster 3, "the importance of work in prison" − Cluster 4, "critical case 2" − Cluster 5, "the role of time in prison" During the ninth meeting, most of the time was devoted to dialogue and the discussion of critical cases. Focus was shifted from the sections and prison organization to people, indicating that the ward staff needed to refocus on the users (i.e., the prisoners).
The need for dialogue was stressed and the educators asked the prison officers to try to consider not only the custody perspective but also a re-educational one. There was a clear difficulty in reconciling these two aspects (e.g., see the quote extracted from the nineth meeting in Table A11 in Appendix A).
Another important theme that emerged from the ninth meeting was that of "time", which is linked to that of "waiting". Waiting for something to happen concerns both the prison workers, who perceive themselves as part of a slow and excessively complex mechanism, and the inmates, whose lives seem to be "suspended" while waiting to serve their sentences.

10th Meeting
Psychologist, physicians, and prison officers were absent. TAEC was carried out on the transcription of the tenth recording highlighting the occurrence of 4 clusters, respectively covering 25%, 33.1%, 14.3% and 27.5% of the total variance (see Figure 10).
Based on their content, clusters were named as follows: − Cluster 1, "school versus work" − Cluster 2, "adaptation and innovation of procedures" − Cluster 3, "the impact of bureaucracy in everyday working life" − Cluster 4, "importance of volunteers" During the last meeting, teachers reported on the performance of the school during the past year, complaining about the high drop-out rate of prisoners (e.g., see the quote extracted from the tenth meeting in Table A11 in the Appendix A).
Cluster 2 covers the highest percentage of total variance (33.1%). Contrary to the previous meetings, a lot of time was also dedicated to the recognition of the role of the volunteers. Even though they are "outsiders", the rest of the ward staff indicated that volunteers are indispensable in the work with the prisoners. On the other hand, the volunteers as outsiders, valued the ward staff's arrangement which allowed them to compare and share their work with other professionals during the year.
Lastly, the tenth meeting was characterised by a sort of paralysis due to the absence of the educator, who had assumed the leadership of the group from the beginning.
While the ward staff stressed the need to take up some of the issues discussed in the previous meetings, they were not able to do so due to the absence of the educator.

Interaction Process Analysis
Interactions between the ward staff were analysed through the Interaction Process Analysis (IPA) grid by Bales [25][26][27][28]. The charts in the Appendix A show the occurrence of the interaction modes of each meeting. Occurrences are the number of times in which participants express themselves during the meeting according to the 12 categories of the IPA grid (12-factor model).
First meeting. It was characterised by a strong predominance of category 6 (n = 230) followed by category 5 (183) and 7 (115). This highlights the group's tendency (especially educators and prison officers) to focus on the task, in an exchange of questions and answers aimed at sharing information. The interactions falling within the socio-emotional area (cat. 1, 2, 3, 10, 11, 12) were much lower. Moreover, they tended towards the area of positive reactions (cat. 1, 2, 3) Second meeting. It was also characterised by a predominance of category 6 (n = 289) followed by category 7 (139) and 5 (96). This is indicative of the tendency to focus on the task. The educators played the role of the main stakeholders and posed many questions to the prison officers. The interactions in the social-emotional area were much lower, highlighting the tendency to move towards the area of positive reactions.
Third meeting. It was characterised by a predominance of category 6 (n = 186), followed by 5 (93) and 7 (84). The group remained task focused. The interactions in the socioemotional area were much lower, tending towards the area of positive reactions.
Fourth meeting. As with the previous meetings, it was characterised by a clear predominance of category 6 (n = 194) followed by 5 (117). The fourth meeting was mostly aimed at the exchange of information among participants (task area). The interactions in the socio-emotional area were much fewer, tending more towards the area of positive reactions. Unlike the previous meetings, there was an episode of tension by a volunteer, falling within the negative reactions (category 11).
Fifth meeting. It was characterised by the predominance of category 6 (n = 339) followed by 5 (144) and 7 (126). The group still focused on the task and discussing several questions and answers aimed at sharing information. Unlike the previous meetings, the number of interactions in category 3 (104), referring to the area of positive reactions increased, as did those in category 10 (18), referring to the area of negative reactions. It was predominantly the educators, prison officers and volunteers who showed tension.
Sixth meeting. It was characterised by a predominance of category 6 (n = 407) followed by 5 (130). There were also numerous interactions in category 3 (111) corresponding to the socio-emotional area of positive reactions, but there was also an increase in interactions in categories 10 (32), 11 (7) and 12 (10) promoted by educators and prison officers.
Seventh meeting. Participants still focused on the task and showed a predominance of category 6 (n = 157) supported, unlike before, by the teachers. Even the volunteers were involved, almost equating themselves to the educators, who were up until that moment the main informants. Compared to the past trend, both positive and negative interactions decreased.
Eighth meeting. Category 6 was predominantly (n = 157). Participants were still in the task area. An interesting finding came from the analysis of categories 10, 11 and 12 where it is evident that there was a tightening of the relationships between volunteers and educators. In the socio-emotional area of negative reactions, it shows an escalation of tension between the roles.
Ninth meeting. There was a predominance of category 6 (n = 268). The trend of categories 5 (108) and 7 (85) was also high. The number of interactions falling within the socio-emotional area of negative reactions fell sharply, while those in the socio-emotional area of positive reactions rose.
Tenth meeting. The last meeting was still characterised by a clear predominance of category 6 (n = 354) compared to all the other categories. Sub-frequencies confirm a particular activation of the educators compared to the other participants. Negative interactions were almost completely absent, while positive interactions were significant, especially between educators, teachers, and the volunteers.
The general chart trend (see Figure 11) shows how the ward staff maintained a constant focus on the task area during the 10 meetings. Participants expressed a rich communication flow, mostly based on interactions of questions and answers aimed at sharing information. Within this area, there are more interactions labelled as "attempts to respond" (category 4, 5, 6) than those labelled as "questions" (category 7,8,9).
As shown above in Figure 12, the educators were the most active members within the interactions (with a total of 2104 interactions), followed by prison officers (950 total interactions), volunteers (896 total interactions), teachers (713 total interactions), physicians (509 total interactions), members of the Addiction Treatment Service (433 total interactions) and psychologists (240 total interactions). Psychologists were the least numerous category, and therefore also the least active actors in the group.  As mentioned before, the interaction mode related to category 6 (i.e., gives orientations) is the one most frequently used amongst all ward staff professionals. Specifically, it is the interaction mode most used by the educators, volunteers, and teachers (see Figure 13).
The interactions related to the social-emotional area are much lower than those focused on the tasks. Nevertheless, from the fourth meeting onwards there was an escalation of tension, which took the form of a clash of views highlighted during the sixth meeting between the educators and prison officers. Another clash took place in the eighth meeting between volunteers and educators. Despite these moments, the group managed to rebalance itself and decrease the intensity of the conflict. During the tenth and last meeting, negative interactions were almost completely absent, while positive ones remained significant, especially between educators, teachers, and volunteers.

Discussion
The present study aimed to understand the impact of the organisational changes introduced by local prison administration and the sustainability of the ward staff tool for prison workers.
We observed across one year the development of 10 meetings carried out by the ward staff involved in the open sections of a Lombardic prison, with the absence of an ideal model for guidance in handling the meetings.
The ward staff 's longitudinal observation made it possible to obtain and analyse information, both related to the impact of organizational changes (i.e., open sections and dynamic supervision) on the prison employees' tasks and to the development of relationships within the group.
The organisational changes of the prison administration promoted a multidisciplinary approach aimed to improve the wellbeing of both the prisoners and prison workers. It has produced new areas of need by the prison employees: the redefinition of their tasks and the adherence to new ways of meeting other members of the ward staff.
The change took place through a strong top-down approach. The prison administration promoted a teamworking attitude-as a result of the introduction of the Open Sections and Dynamic Supervision-through ministerial orders and guidelines.
However, to set up a working group, does not suffice to assign a common objective that could not have been achieved individually [34]. The construction of a group culture implies the transition from thinking in groups to groupthink [35]. According to the psychoanalytic tradition, it refers to the experience of "thinking together" [36], i.e., an ensemble of operations, including their product, deriving from the relational exchanges between group members [37]. As conceptualized by Bion [38] and Foulkes [39,40], the group is not a mere sum of individuals, but a specific psychological entity where lived experience of everyone converges in a sort of "common medium, which is autonomous from the single individuals" [41] (p. 75).
It is necessary for the parts and the whole to interact and influence each other, for the transition to take place. Achieving a balance involves forces, tensions and conflicts caused by the difficulty of bringing together dissimilar, or even divergent points of view and ways of working [42]. If stabilization-a condition of balance among the members-is not reached, the team may experience disorganization-a general lack of balance and chaos. Such a condition could be a prerequisite for the development of syndromes such as burnout, which has been associated with working in a challenging prison environment [6].
Creating a working group necessarily implies considering two dimensions: the task orientation and the relational dimension [43]. Those dimensions are related to the achievement of common objectives and the satisfaction in social relationships.
We hypothesised that we would observe a progressive focus by staff members on new operational practices resulting from organisational changes. In order to test this hypothesis, we conducted the content analysis of the ten meetings using T-LAB software.
According to our results, themes addressed by ward staff can be divided into three phases. The first phase is characterized by the need for knowledge and alignment to common objectives and specific roles (meeting 1.). During this phase, a working method (a way of sharing and integrating different perspectives)-constituted by circularity and reflexivity-emerged.
In the second phase (meetings 2, 3, 4, 5, 6, 7), concrete themes/problems were discussed (e.g., definition of new procedures and tools, reorganisation of school activities, facing bureaucracy etc.) producing wide debates. This phase can be considered a necessary interaction that allows the achievement of concrete and shared working results starting from different points of view [35].
The third phase (meetings 8, 9, 10) ended the productive phase (phase 2) highlighting the difficulty of integration (puzzle to be reassembled), both between those "inside" and "outside" (e.g., the volunteers, considered as the most external members of the group) and among the working positions held by the members. Third phase indicates the need for further reflection in order to integrate values, sub-objectives and sub-cultures, limits, resources and to minimise the loss of energy aimed at the achievement of real, shared goals.
As shown by the IPA analysis, communication within the ward staff moved mainly within the area of the task, leaving the socio-emotional aspects more in the background, in general belonging to positive interactions.
With regard to the engagement of the staff members, contrary to our initial assumption, we observed an important imbalance towards the figure of the educators, who assumed leadership from the beginning, often deciding on the topics to be discussed and covering most of the discussion time. This was particularly evident at the end of the observation period when the educator was absent. His absence created a lack of discussion and ideational confrontation and seemed to put the group's development process in crisis, merely increasing the information level.
According to Tuckman's theoretical model [30] our ward staff did not adhere to the normative and functional steps for the development of teambuilding. Little space was given to mutual knowledge and normal conflicts to avoid the anxiety resulting from being involved in a network of interpersonal relationships. In this sense, the literature underlines that problem-focused coping strategies are a protective factor from stress [44].
In our experience we can say that the ward staff tool has only been partially effective enhancing multidisciplinary approach and improving prison employees means.
Despite the integration of different professionals in the handling of people to support improves the outcomes and promotes sustainability [45], the process of building a multidisciplinary team in the prison context seems to present more difficulties of implementation.
Our results seem to confirm previous findings. Functional adaptation of staff to organisational change is unlikely to occur if it is characterized by ideologically driven initiatives, bureaucratic and unresponsive processes, and a climate of uncertainty [46].
In our case, this seems to be linked to the coexistence of two different organisational models, one oriented to the re-education and social reintegration of the offender, the other more control and security oriented.
As stated by Carlson, corrections' primary business is control of those in its custody. Prisons realized and kept control through the adoption of military-style expectations for its staff and highly bureaucratized methods for its operations [47].
Even if from a theoretical point of view, the prison administration attributes these two organisational models to the present and to the past, respectively, from a practical point of view these two models still seem to coexist in the everyday working practice. Prison workers must provide care, custody, and control for those housed within correctional institutions.
This inevitably also produces a conflict of work requirements, which often emerged during the ten meetings. Different definitions and operationalizations of norms lead to a lack of consensus when and to what extent norms may influence behaviour [48].
Therefore, it is desirable that the administration makes a greater effort to facilitate the assimilation of the new organisational model by all the professionals involved. This could support the growth of the multidisciplinary team and its leadership, for the achievement of long-term goals, considered as value co-creation [49,50]. Value co-creation is based on an interactive and dynamic relationship which may create a common perspective, and everyone can act in a coherent way. As pointed out by Cosimato and colleagues, an ongoing value co-creation can add wellbeing to individuals and groups [51].
Anyway, the ward staff seems to have sustainable behaviour that allows for the consideration not only of each organisational role, but also the mental growth of the workers during the tenure of their work life, in accordance with the organisational purposes. This in turn, builds a sustainable organisation [52].

Conclusions
From our standpoint, the results here presented suggest that to be sustainable, the ward staff tool needs the organisation's support in terms of training prison employees to the new organizational model. Only after a concrete internalisation of the new organisational model will the ward staff tool be effective.
Another important issue that emerged is the need for a clear setting for ward staff meetings. In our experience, deciding where to hold meetings was a source of tension among the staff members, who experienced a phase of impasse in the absence of the leader. Although there is little space for prison staff in our prisons, it should be considered that setting is particularly important during an organisational change.
In the literature, it is well known that organisational change processes frequently generate feelings of fear, inadequacy, and resistance by employees due to both organizational issues and individual psychological factors [53]. Changing known actions and methodologies generates uncertainty and insecurity, taking employees out of their safe zone [54]. This seems to find total adherence within the prison context, where almost 40 years after the last law reform, employees are asked to rethink some basic elements of detention and penitentiary treatment.
As conceived by the Prison Administration, the application of a multidisciplinary approach to the prisoners' treatment represents the main point of the organisational change, to be achieved through a real integration between the parties. It requires the activation of cognitive and relational resources and higher operational skills than in the past [55].
The picture that has emerged from our study described an experience characterised by a degree of suffering for a lack of shared process of change. Ministerial orders do not seem sufficient to activate a real process of understanding, criticism, and adherence to what is required. Longitudinal observation of the ward staff revealed that it is a necessary, but not sufficient tool to facilitate the implementation of organisational change in the prison context. The group's tendency to act rather than to reflect, especially in the absence of a leader (even if informal leader), highlights the lack of sharing between the administration and prison workers about the purpose of ward staff introduction. It was supposed to be a space where to discuss their role, practices and reflect on the difficulty of implementing organizational change.
Our findings could produce insights into how to develop, implement and evaluate new tools aimed at improving the wellbeing of prison workers and facilitating organizational change.

Limitations and Implications
The present study is not without limitations. Firstly, sampling and data collection was limited by the local prison administration. Only one ward staff was observed, therefore our results cannot be generalised.
Secondly, employees missed some of the monthly meetings alternately. Future research could plan longitudinal design, observing multiple ward staff groups for a longer period than 12 months. This would allow investigation of further elements of the work groups' process and to observe the groups during organisational events (i.e., cultural changes, management transitions etc.).
Thirdly, we conducted a qualitative study, but future research could also include quantitative measures to assess objective constructs such as work wellbeing and job satisfaction.
Despite the limitations, this study has tried to fill the gap in the literature within the context of prison organisation.
Our results highlighted that a clear organizational model, shared leadership, and ward staff training are necessary to ensure employees work productively and feel good. A good employment environment in a prison context allows for the concrete rehabilitation of offenders and improves the levels of public health, which include prison staff, prisoners, their families, and the wider community.  Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and it was approved by the Ethics Committee of Catholic University of the Sacred Heart of Milan (protocol code [10][11][12][13][14][15][16][17][18][19].
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.

Data Availability Statement:
The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy restrictions.

Conflicts of Interest:
The authors declare no conflict of interest.

Meeting
Cluster Theme Role's Member Quotes 1 3 Ways of sharing in the decisionmaking processes Volunteer "Yes, but prison officers told me that they would prefer to finish ten minutes earlier in order to be able to do... so actually finish at ten to three. In this way I would only have 10 min for the discussion, which is practically impossible. Suppose there's even the slightest interruption during the film, the discussion won't be able to take place." The impact of bureaucracy in everyday working life Educator "Sometimes, the decision-making process is blocked because the magistrate or the public prosecutor have to wait for the behavioural reports from all the prisons where the prisoner has been during the period of early release request. That is the reason why early release does not arrive. If the public prosecutor or the magistrate do not also have the behavioural reports from the other prisons-including those in southern Italy-they do not proceed".

3
The impact of bureaucracy in everyday working life  "This meeting took place because of the need to get two institutions (i.e., prison and voluntary association) talking. After the previous meeting-where our director expressed a specific need-I had imagined that this could be an operational moment. A request was made, it was passed from institution to institution, and now we have to start working". 9 2 Encouraging dialogue Educator "I ask a courtesy. I saw that inmate XXX went back to ward 4. He moved from ward 4 to ward 6 and from ward 6 back to ward 4. I really can't do that".