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This paper aims to describe the process and outcomes of restorative justice (RJ) between a detained patient with autism and a person he harmed.

A single case study design was used to provide an in-depth description of a RJ referral.

Restorative outcomes that align with the theories of RJ, in particular trauma processing and emotional reconnection, were observed by RJ practitioners and reported by participants. The person harmed reported a “safer” memory of the offence.

The absence of outcome assessments limits the findings to observational data and self-reported experiences from participants. A triangulated outcome approach is recommended.

RJ practices can safely be applied within a secure hospital environment. The RJ process can also be followed by a person with difficulties in social and emotional processing.

The RJ process provides a safe framework within which forensic mental health services can respond to the needs of victims, which are not routinely addressed in standard clinical practice, and in worst case scenarios, may even be overlooked.

The evidence base for what works with forensic patients in high-security inpatient settings has typically focused on outcome research and not included clinical expertise from practice-based experience, which is an important facet of evidence-based practice. The purpose of this paper is to establish whether experts with clinical and/or research experience in this setting could reach consensus on elements of high-security hospital services that would be essential to the rehabilitation of forensic patients.

A three-round Delphi survey was conducted to achieve this aim. Experts were invited to rate agreement with elements of practice and interventions derived from existing research evidence and patient perspectives on what worked. Experts were also invited to propose elements of hospital treatment based on their individual knowledge and experience.

In the first round 54 experts reached consensus on 27 (out of 39) elements that included physical (e.g. use of CCTV), procedural (e.g. managing restricted items) and relational practices (e.g. promoting therapeutic alliances), and to a lesser extent-specific medical, psychological and social interventions. In total, 16 additional elements were also proposed by experts. In round 2 experts (n=45) were unable to reach a consensus on how essential each of the described practices were. In round 3 (n=35), where group consensus feedback from round 2 was provided, consensus was still not reached.

Patient case complexity, interventions with overlapping outcomes and a chequered evidence base history for this population are offered as explanations for this finding alongside limitations with the Delphi method.

Based on the consensus for essential elements derived from research evidence and patient experience, high-secure hospital services might consider those practices and interventions that experts agreed were therapeutic options for reducing risk of offending, improving interpersonal skills and therapeutic interactions with patients, and mental health restoration.

The study triangulates what works research evidence from this type of forensic setting and is the first to use a Delphi survey in an attempt to collate this information.

The purpose of this paper is to document reflections on experiences of stigma and discrimination as described by predominantly black and ethnic minority (BME) service users in a high security hospital via a slow‐open therapy group. Service users from BME are known to have higher drop‐out rates and poorer treatment outcomes in non‐forensic therapy settings (Rathod et al.). Further, they are over‐represented in forensic services and often disengage, because their views and feelings are poorly understood (Ndegwa).

Thematic analysis was applied to a sample of electronically stored running records of group sessions, in which experiences of care, discrimination, hope, despair, and recovery were shared.

Over a three‐year period, 18 forensic patients participated in the group. Group members' reflections on detention, offending and illness were collected. Themes relating to isolation and distance, other barriers to recovery and strategies for coping “against the odds”, are illustrated via anonymised material from the sessions.

Stigma and discrimination are difficult concepts to hold in mind, and are therefore difficult to access. Nevertheless, their effects can be so all encompassing for patients in high security that hope is hard to sustain. The extent to which the themes generated by this sample are representative of those pertinent to others in similar secure settings is inevitably beyond the scope of this paper.

Service users can, and do, share ideas about possibilities for surviving despite their past. Their comments shed light on barriers to engagement for this potentially marginalized population, and possibilities for improving the capacity of the clinical service to hear their voices on an issue of such importance to their potential for recovery.

Specific attention to the perspectives of all service recipients on the impact of illness and their recovery is required in a modern health service, where inclusion is a guiding principle.

Interventions for addressing stigma for the most marginalized are infrequently described, but are potentially relevant for all.

The efficacy of cognitive-behavioural therapy (CBT) for schizophrenia in community and general psychiatric settings has been widely investigated and its practice recommended in primary and secondary care. In secure forensic mental health services the evidence is less established. The purpose of this paper is to evaluate the effectiveness of group CBT for schizophrenia in a high secure hospital.

In all, 27 male forensic patients completed a manualised CBT group and were compared on primary and secondary outcomes to patients receiving treatment as usual (TAU). Primary outcomes were positive and negative symptoms as measured by the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and the Psychotic Symptom Rating Scales (PSYRATS). A secondary outcome was interpersonal functioning as measured by the Inventory of Interpersonal Problems (IIP-64).

CBT participants showed improvement on negative symptoms; affective flattening, alogia, anhedonia and avolition; in comparison to participants in TAU. CBT participants also showed reductions in delusions and hallucinations on the SAPS but not the PSYRATS. TAU participants improved on positive symptoms as measured by the PSYRATS. CBT participants showed reductions in overall interpersonal problems, and most notably in being socially inhibited and self-sacrificing. No iatrogenic effects of treatment were found; improvements in depression anxiety and stress were reported by group completers, which contrasted to experiences of the TAU group.

Absence of random allocation to CBP or TAU groups retains the risk of recruitment bias. Findings are preliminary given the sample size. Multiple outcome assessments increase risk of a type I error.

CBT for schizophrenia can be effective with clients in secure forensic mental health settings. Improvements in negative symptoms and interpersonal functioning appear to be particular gains. Self-report measures might be subject to specific demand characteristics in such settings.

The evaluation includes a comparator group in a high secure setting, which is typically absent in reported evidence for this population (Blackburn, 2004). The study also investigated changes in interpersonal functioning, which has previously been noted as an important but absent outcome in CBT for psychosis (Haddock et al., 2009). Iatrogenic outcomes were also considered in the evaluation to ensure no adverse effects were experienced from treatment.

Life studies are a rich source for further research on the role of the Afro‐American woman in society. They are especially useful to gain a better understanding of the Afro‐American experience and to show the joys, sorrows, needs, and ideals of the Afro‐American woman as she struggles from day to day.

We issue a double Souvenir number of The Library World in connection with the Library Association Conference at Birmingham, in which we have pleasure in including a special article, “Libraries in Birmingham,” by Mr. Walter Powell, Chief Librarian of Birmingham Public Libraries. He has endeavoured to combine in it the subject of Special Library collections, and libraries other than the Municipal Libraries in the City. Another article entitled “Some Memories of Birmingham” is by Mr. Richard W. Mould, Chief Librarian and Curator of Southwark Public Libraries and Cuming Museum. We understand that a very full programme has been arranged for the Conference, and we have already published such details as are now available in our July number.

Compassionate release is a process that allows for the early release or parole of some incarcerated people of advanced age, with life-limiting illness, complex medical care needs or significant functional decline. Despite the expansion of State and Federal compassionate release programs, this mechanism for release remains underutilized. Health-care professionals are central to the process of recommending compassionate release, but few resources exist to support these efforts. The purpose of this paper is to provide a guide for health-care professionals requesting compassionate release for patients who are incarcerated.

This study is stepwise guide for health-care professionals requesting compassionate release for patients who are incarcerated.

This study describes the role of the health-care professional in requesting compassionate release and offers guidance to help them navigate the process of preparing a medical declaration or request for compassionate release.

No prior publications have created a step-wise guide of this nature to aid health-care professionals through the compassionate release process.