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Article
Publication date: 12 March 2014

Clive G. Long, Olga Dolley and Clive R. Hollin

The purpose of this paper is to assess the effectiveness of a gender-specific group treatment programme for personality disordered (PD) women in a medium secure psychiatric…

Abstract

Purpose

The purpose of this paper is to assess the effectiveness of a gender-specific group treatment programme for personality disordered (PD) women in a medium secure psychiatric setting.

Design/methodology/approach

In all, 56 consecutive admissions with a primary diagnosis of personality disorder (mostly borderline type) and co-morbidity were assessed according to their participation in, and benefit from, a core set of five manualised group treatments that focused on social and interpersonal deficits, instability of mood and problematic substance use. A single cohort pre-test post-test comparison design was used with evaluation based on global change over an amalgam of self-report group specific outcome measures.

Findings

In all, 70 per cent of patients attended three or more core groups, with attendance for each group ranging from 85 to 53 per cent. Between 65 and 77 per cent of patients showed a significant improvement on pre-group psychometrics. Patients who achieved a significant positive change in one group tended to do so in others. In all, 85 per cent of patients who completed two or more groups had overall positive direction of change scores. Those who benefited from treatment engaged more quickly, were more likely to have been admitted from hospital, to have previously engaged in therapy and to score lower on measures of impulsivity and personality pathology.

Research limitations/implications

In a clinically representative study the absence of a control group limits the extent to which observed changes can be attributed to described interventions.

Practical implications

Findings reflect the importance of providing a broad clinical approach to changing cognitive behavioural functioning with PD patients in secure settings. They also highlight the need to improve ways of engaging patients at an earlier stage of hospital stay and of increasing the acceptability and uptake of relevant group treatments. Further evidence-informed service developments are needed to meet these challenges.

Originality/value

The study adds to a small literature on the clinical impact of a gender-specific group treatment programme for PD women in secure settings.

Details

Journal of Criminal Psychology, vol. 4 no. 1
Type: Research Article
ISSN: 2009-3829

Keywords

Article
Publication date: 10 December 2009

John Taylor, Raymond Novaco and Lucy Johnson

Anger has been shown to be associated with aggression and violence in adults with learning disabilities in both community and secure settings. Emerging evidence has indicated that…

Abstract

Anger has been shown to be associated with aggression and violence in adults with learning disabilities in both community and secure settings. Emerging evidence has indicated that cognitive behavioural anger treatment can be effective in reducing assessed levels of anger in these patient populations. However, it has been suggested that the effectiveness of these interventions is significantly affected by verbal ability. In this service evaluation study the pre‐ and post‐treatment and 12‐month follow‐up assessment scores of 83 offenders with learning disabilities who received cognitive behavioural anger treatment were examined in order to investigate whether participants' responsiveness to treatment was a function of measured verbal IQ. The results indicate that, overall, the effectiveness of anger treatment was not the result of higher verbal ability as reflected in verbal IQ scores. It is concluded that cognitive behavioural therapy for anger control problems can be effective for people with moderate, mild and borderline levels of intellectual functioning and forensic histories.

Details

Advances in Mental Health and Learning Disabilities, vol. 3 no. 4
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 1 June 2007

Paul Willner

Cognitive behavioural therapy (CBT) is being used increasingly with people with learning disabilities. The evidence base to support these developments comes from uncontrolled…

Abstract

Cognitive behavioural therapy (CBT) is being used increasingly with people with learning disabilities. The evidence base to support these developments comes from uncontrolled trials of CBT in a variety of psychological disorders and eight to nine controlled trials of CBT for anger (plus a single controlled study in depression). This paper reviews the evidence for the effectiveness of group‐based anger management and the acquisition of anger coping skills, and the effectiveness of individual anger treatment, with some discussion of the status of CBT for other indications and the difficulties of conducting outcome research in this area.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 2
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 3 September 2012

Lia Ahonen and Jürgen Degner

This article aims to analyze and discuss the role of moral development in treatment of behavior problems and, further, to describe differences and similarities between two…

Abstract

Purpose

This article aims to analyze and discuss the role of moral development in treatment of behavior problems and, further, to describe differences and similarities between two different methods – milieu therapy (MT) and cognitive behavioral therapy (CBT) – in terms of addressing criminogenic needs and promoting moral development.

Design/methodology/approach

By performing a literature review, the study shows that even though there are both pros and cons using MT and CBT in institutional care, relationships strong enough to restructure a young person's moral reasoning require time, and involves not only the young person's parents and social network members, but also a genuine therapeutic alliance with clinical staff at the institution.

Findings

These are central factors articulated in both CBT and MT, but are more explicitly expressed in MT. The results presented in this article highlight some important practical implications: in order to redevelop moral self and societal values, an overly narrow focus on criminogenic needs might exclude other components or processes of treatment and behavioral change. Together with a treatment program that views close staff‐resident interactions as of secondary importance, this could impair the possibility to obtain positive and long‐lasting treatment results.

Originality/value

In practice, moral development itself should be considered as an overall treatment goal, integrated into the daily life at the institution, 24 hours a day. Finally, the possibility to work with moral development in institutional settings is discussed.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 33 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 12 March 2018

Chris Patterson

For the 3.8 per cent of people with intellectual disabilities (IDs) who have offended sexually, the main form of treatment is the group-based, cognitive-behavioural, adapted sex…

1175

Abstract

Purpose

For the 3.8 per cent of people with intellectual disabilities (IDs) who have offended sexually, the main form of treatment is the group-based, cognitive-behavioural, adapted sex offender treatment programme (ASOTP) that focusses on challenging cognitive distortions condoning sex offending. The purpose of this paper is to provide an evaluation of how effective the ASOTP is at reducing ID sex offenders’ cognitive distortions.

Design/methodology/approach

Three databases were searched systematically: PsycINFO, MEDLINE and Web of Science. Six studies met the inclusion criteria, yielding 118 participants. Using a random-effects model, effect sizes were calculated using pre- and post-treatment scores on a measure of cognitive distortions. The standardised mean difference (SMD) was 1.77 (95 per cent CI: 1.06, 2.46), which was statistically significant (p<0.001) and “large”. Sensitivity analysis demonstrated that this SMD was robust, and a check for publication bias revealed that it was unlikely that the “file drawer problem” confounded the meta-analysis.

Findings

These results indicated that the ASOTP can significantly reduce ID sex offenders’ cognitive distortions, regardless of treatment length, IQ level, language abilities, or offence type. Consistent with earlier reports, longer treatment resulted in the greatest reductions: the optimum treatment length was 24 months.

Research limitations/implications

The ASOTP’s current evidence is comprised wholly of case and quasi-experimental studies, none of which employed control groups. This paper highlights how there is a dire need for high-quality experimental evaluation of the ASOTP.

Practical implications

Clinicians are advised to continue using the ASOTP as the main treatment for ID sex offenders until the effectiveness of the ASOTP is further examined using randomised controlled trials.

Originality/value

This is the first meta-analytic review of the effectiveness of the ASOTP.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 9 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 2 July 2016

Laura MacPherson, Anahi Collado, Carl W. Lejuez, Richard A. Brown and Matthew T. Tull

Cigarette smoking remains the primary preventable cause of mortality and morbidity globally. The overarching goal of the paper is to disseminate the Behavioral Activation Treatment

Abstract

Purpose

Cigarette smoking remains the primary preventable cause of mortality and morbidity globally. The overarching goal of the paper is to disseminate the Behavioral Activation Treatment for Smoking (BATS), which integrates behavioral activation principles with standard treatment guidelines to assist individuals in achieving short- and long-term smoking cessation. Through a series of sequential steps, BATS guides individuals who wish to quit smoking to increase their engagement in healthy, pleasurable, and value-consistent activities.

Design/methodology/approach

The document provides the BATS rationale and contains an abridged manual for use by clinicians and/or researchers in the context of clinical trials. Findings: BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

Findings

BATS is accruing empirical evidence that suggests its ability to promote successful smoking cessation outcomes while decreasing any associated depressive symptoms.

Practical implications

A description of key components, forms, and strategies to address common treatment barriers are included.

Originality/value

BATS’s strong roots in learning theories and its idiographic nature allow for the intervention to be implemented flexibly across a wide range of settings and smoking populations. The treatment may also be combined seamlessly with pharmacotherapies. BATS targets both cigarette smoking and depressive symptoms, which constitute a significant barrier to cessation, through a common pathway: increasing rewarding activities. The treatment offers a parsimonious complement to standard smoking cessation treatments.

Details

Advances in Dual Diagnosis, vol. 9 no. 2/3
Type: Research Article
ISSN: 1757-0972

Article
Publication date: 1 September 2007

Joe Curran, Paul Lawson, Simon Houghton and Kevin Gournay

Behavioural activation is a contemporary behavioural treatment for depression that has the potential advantages of being more readily adopted in psychiatric inpatient environments…

317

Abstract

Behavioural activation is a contemporary behavioural treatment for depression that has the potential advantages of being more readily adopted in psychiatric inpatient environments than more complex psychological treatment approaches and requiring less intensive training than these approaches. In this article the theoretical and empirical foundations of behavioural activation are described along with an outline of the therapeutic process and key interventions used. Consideration is then given to factors influencing the implementation of BA in psychiatric inpatient environments.

Details

The Journal of Mental Health Training, Education and Practice, vol. 2 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 18 May 2012

Caroline J. Easton

This study aims to evaluate differences between substance dependent men who were arrested for intimate partner violence (IPV) with and without concurrent psychiatric problems.

330

Abstract

Purpose

This study aims to evaluate differences between substance dependent men who were arrested for intimate partner violence (IPV) with and without concurrent psychiatric problems.

Design/methodology/approach

In total, 63 participants were randomly assigned to manual‐guided group behavioral therapies (cognitive behavioral therapy for substance dependent domestic violence offenders (SADV) or drug counseling (DC)) and assessed across 12 weeks of treatment.

Findings

Despite excluding psychotic disorders and bipolar disorders at baseline, 23 percent of clients reported prior mental health treatment. SADV participants with co‐occurring mental health were different than SADV participants without co‐occurring mental health symptoms on both baseline and post‐treatment time periods. SADV participants with co‐occurring mental health symptoms had more pre‐treatment impairments, more drug use during treatment, a trend for more problems with aggressive behaviors throughout treatment and significantly more impairments in anger control subscales at post treatment compared to SADV participants without co‐occurring mental health symptoms.

Practical implications

The findings suggest the need to target and treat co‐occurring psychiatric symptoms and distress among SADV offenders. Perhaps offering clients targeted behavioral or pharmacotherapy adjunctive treatments can help improve treatment outcomes among substance dependent offenders of IPV when mental health problems are present.

Originality/value

This study is one of the first to evaluate differences between substance dependent men arrested for IPV with and without concurrent psychiatric problems. It shows that men who are violent toward their partners tend to have a co‐occurring problem with addiction, yet little is known about differences between substance dependent male offenders who have dual mental health problems.

Article
Publication date: 10 February 2012

Leam A. Craig, Ian Stringer and Cheryl E. Sanders

This study summarises the results of a cognitivebehavioural treatment group for sexual offenders (n=14) with intellectual limitations in the community.

1157

Abstract

Purpose

This study summarises the results of a cognitivebehavioural treatment group for sexual offenders (n=14) with intellectual limitations in the community.

Design/methodology/approach

All participants were convicted sex offenders serving probation orders or prison licences who attended a 14‐month treatment programme designed for sex offenders with intellectual limitations. The programme comprised of five main components: sex education; cognitive distortions; offending cycle; victim empathy; and relapse prevention. All participants completed psychometric measures specifically designed for people with intellectual limitations before and immediately after completing the treatment programme. The four core measures include: Victim Empathy; Sexual Attitudes and Knowledge Assessment (SAK); Questionnaire on Attitudes Consistent with Sexual Offenders (QACSO); and Sex Offences Self‐Appraisal Scale (SOSAS).

Findings

Post assessment results reveal significant improvements in sexual offence related attitudes; reductions in attitudes relating to cognitive distortions and pro‐sexual assault beliefs; and significant improvements in victim empathy.

Research limitations/implications

Although none of the participants have been reconvicted for committing new sexual offences during the follow‐up period, given that the follow‐up was restricted to 12 months post‐treatment, it is not possible to conclude this intervention was successful in reducing risk of sexual recidivism.

Originality/value

The results from this study support the use of cognitivebehavioural approaches in demonstrating positive cognitive shift (reconstructing cognitive distortions and attitudes to victim empathy) for sexual offenders with intellectual limitations.

Details

The British Journal of Forensic Practice, vol. 14 no. 1
Type: Research Article
ISSN: 1463-6646

Keywords

Article
Publication date: 1 July 2007

S Hearne, K Garner, B O'Mahony, C Thomas and R Alexander

This paper describes an innovative, multi‐modular group therapy programme based on cognitivebehavioural principles and psycho‐education. It introduces participants to strategies…

Abstract

This paper describes an innovative, multi‐modular group therapy programme based on cognitivebehavioural principles and psycho‐education. It introduces participants to strategies and skills to assist with deficits such as poor social skills, low self‐esteem, poor emotional regulation and problematic inter‐personal relationships. The manual‐based format of this programme enables members to be introduced to working in a group, and enables facilitators to obtain qualitative information about group members to promote existing skills in future treatment programmes. The core deficit areas targeted by the programme are not by any means exclusive to individuals in in‐patient forensic learning disability settings, so the programme can be useful for clients with learning disability and offending behaviours who are resident in the community.

Details

The British Journal of Forensic Practice, vol. 9 no. 2
Type: Research Article
ISSN: 1463-6646

Keywords

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