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The purpose of this paper is to examine music as a therapy for complex needs and offending behaviour.

This study utilised the rapid evidence assessment (REA) approach to collect and assess the current data pertaining to music as a therapy for complex needs and offending behaviour. Within the REA this study used a thematic analysis as the analytical framework to manage and explore the wealth of data collected during the REA.

The results of this study are presented in two parts – first, the application of music as a therapy for complex needs and second, music as a therapy for offending behaviour. These two sections explore music therapy as an effective intervention method for offending behaviour and/or complex needs. Psychopathy as a complex need is a subsidiary theme that is also investigated within this section.

To present music as a therapy as an effective method of therapy and intervention for those with offending behaviour and/or complex needs, thus, leading to further research in the field.

To incorporate music therapy into working with offending behaviour; to incorporate music therapy into interventions for those with complex needs, such as psychopaths; to recognise a need for developing innovative approaches/methods to address gaps in treatment; and to recognise music therapy’s potential as a programme utilised alongside cognitive-behavioural therapy.

There has been a significant amount of academic attention given to researching music as an effective therapy for select groups such as those with autism, anxiety, dementia and depression. The scope of this attention has extended to examine the link between music, cognition and emotion. The limitation of this work is the lack of research that has focussed on music as a therapy as an intervention for complex needs and offending behaviour, to which this study will begin to redress.

The purpose of this paper is to provide an overview of the clinical governance issues involved in the provision of psychological therapies within a context of massive demand and expansion underpinned by recent policy developments at the Department of Health. Raises awareness of the potential risks to Trusts involved in inadequate governance of therapy provision.

The paper shows an informed review of the recent policies and influences affecting the development of psychological therapies and the clinical governance issues arising from them.

The paper compares the realities of service provision with the ideal model of service delivery recommended by the Department of Health. Raises concerns for all those Trusts providing psychological therapies about their governance and risk management arrangements.

The paper shows the key summary and opinion for all Trusts responsible for provision of psychological therapies.

This article sets out to provide information regarding the evidence base for psychological treatments and to demonstrate that the number of mental health professionals who are available and competent to deliver these treatments is very small compared with the numbers of people who might benefit. The article also considers the prevalence of conditions that are amenable to psychological treatment and then explores how ‘stepped care’ may be one solution for providing available treatment resources in a way that is fairest and most effective for the population at large.

Organisations are increasingly understanding the need to be trauma informed. However, how trauma therapies in such organisations apply the principles of choice and collaboration is less understood. The present paper applies two trans-theoretical methods for involving clients in their therapy through preference accommodation and feedback-informed treatment (FIT). A case vignette is provided demonstrating how to involve clients in trauma therapy by listening to their preferences, needs and by providing them with a voice on their experience of the process and outcome of care.

A focused review of the literature was conducted, with relevant randomised control trials, systematic reviews and meta-analyses sourced. The resulting information informed the design and this model for working with those in trauma therapy.

The research regarding trauma-specific therapies being more effective is far from conclusive. At the same time, early attrition and negative outcomes make up a large percentage of those seeking therapy. Using preference accommodation and FIT is one possibly way to mitigate against these experiences in therapy and to provide choice, preference and collaboration consisting with the principles of trauma-informed approaches.

Methods to improve the experiences of those seeking trauma therapy have been identified and discussed. According to the author’s knowledge, this is the first known paper aligning trauma therapy and trauma-informed approaches with preference accommodation and FIT. Future empirical studies may wish to examine the relative effectiveness of this approach.

Methods to improve outcomes for those seeking trauma therapy are at the disposal of practitioners. Improving outcomes, while also providing choice, voice and collaboration is a clinical setting.

This is a novel paper adding to value and extending how practitioners can use principles of trauma-informed approaches within trauma therapy.

In the previous chapter, the reader will have become familiar with the idea of screening for traumatic experiences within organisations as a way to identify those who may benefit most from interventions and support. In this chapter, I present an overview of the trauma therapy literature in the first instance and then explore some of the debates regarding specific trauma-informed treatments versus general therapeutic approaches. The multicultural competency literature is discussed, and the multicultural orientation approach of cultural humility, cultural opportunity and cultural comfort is highlighted in a practice context. This chapter concludes with a case study vignette that brings it all together with a clinical example of what trauma-informed therapy through a multicultural lens might look like. As such I operationalise choice, collaboration , trust and transparency, and cultural principles from the trauma-informed care literature. Although applied here to specific trauma-informed organisations, some of the methods and processes that I unpack can be used in non-specific organisations where social/case managers are employed and wish to operationalise choice and collaboration in a structured way.

This paper reviews the current evidence base for human givens therapy in the context of mental health. A systematic literature search was conducted from which it is concluded that the evidence base for human givens therapy is currently limited: most evidence proffered is expert opinion supported with brief case studies or anecdotal evidence, with the exception of two descriptive studies both concerning trauma and the rewind technique. This paper calls for further research to be undertaken to examine the effectiveness of human givens therapy and for mainstream mental health, counselling and psychotherapy journals to provide space for healthy debate.

This study aims to examine what patients say is helpful in psychodynamic psychotherapy by analyzing responses to an open-ended question at two time points: three months into treatment and termination.

Participants in this naturalistic study were a diverse group of patients seeking treatment at a psychodynamic psychotherapy training clinic (within a public hospital system). The authors used thematic analysis to categorize patient responses to an open-ended question about what is helpful in their treatment.

The authors found that a majority of patients found their psychotherapy helpful, and patient responses broke down into 16 categories. Themes that emerged from categories were what patients experience or feel, what therapists/therapy provides and what patients do in therapy. The most frequently endorsed category at both three months and termination was embedded within other categories, “mention of an other,” which captured when patients specifically mentioned another person (i.e. the therapist) in their response. The next most frequently endorsed categories were “talking/someone to talk with,” “feeling better/experiencing well-being/improved functioning” and “having regularity/structure” (at three months) and “having attention directed at experience,” “having regularity/structure” and “experiencing the professional role of the therapist” (at termination).

Findings shed light on factors contributing to helpful psychotherapy from patients’ perspectives in their own words. While previous research has shown that the therapy relationship is an important factor in effective therapy, the findings of this study highlight this ingredient in a personal, spontaneous way.

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

People in prisons have a high prevalence of poly-traumatisation throughout their life span. The behavioural and emotional sequalae of trauma are likely to be managed across the whole organisation. However, there is still a lack of clarity about the key components of a trauma-informed approach within the custodial context. This study aimed to gather in-depth knowledge of staff views on the components of an optimal trauma pathway in a prison and the organisational factors that influence its implementation.

The authors’ research design is qualitative, involving in-depth, semi-structured interviews with eight members of staff from different professional backgrounds at a single prison in the UK that houses sentenced and remand prisoners. Data was analysed using reflexive thematic analysis.

Three super-ordinate themes were identified within the data. Firstly, components of a trauma-informed pathway included sub-themes of asking about what has happened and knowing how to respond; providing specialist approaches; enabling residents to cope; screening and detection; and a compassionate relational approach. Secondly, organisational factors were associated with sub-themes of culture and leadership, resources and systems and processes. Thirdly, staff factors were associated with sub-themes of skills development and training, staff well-being and support and staff attitudes.

Post-traumatic stress disorder (PTSD) and complex PTSD in prisons are under-detected, and there are complex psychosocial factors within prisons that mediate the effectiveness of psychological therapies.

To the best of the authors’ knowledge, this study represents the first exploration of staff perspectives on the components of a trauma-informed pathway within custodial settings. Future directions should involve the piloting and evaluation of the components of the trauma-informed pathway, with a focus on longer-term outcomes and exploration of the organisational factors that impact on effectiveness.

Young people receiving services for substance use problems often experience high rates of other psychosocial problems in addition to mental disorders. This has implications for design of effective interventions. There is a lack of concisely organised practical information to help organisations serving this population establish contextually relevant and rigorous approaches to the design of evidence‐based interventions. This paper aims to focus on these issues.

Drawing on literature from clinical and implementation science, this paper describes a new approach to the development and implementation of evidence‐based practice (EBP). Contributions of innovators, early adopters, evaluators, and other scholars are reviewed and synthesized.

Traditional approaches to EBP relying on manualised programs targeting discrete diagnoses have not yielded meaningful progress in the dissemination of EBP to services that specialise in treatment and support for young people experiencing complex psychosocial needs. Recent initiatives are moving away from reliance on manualised programs and adopting a modular practice elements approach that enables maximum flexibility in responding to the unique needs of individual clients. This approach has potential to mitigate barriers to implementation of EBP in resource poor environments.

The complexity of needs presented by young people with dual mental health and substance use problems is increasingly recognised, but there is little information available that supports the formulation evidence‐based interventions that directly address this complexity. This paper applies knowledge from research to the practical challenges faced by practice leaders in real‐world services.