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21 – 30 of over 1000
Article
Publication date: 30 November 2012

John Devapriam and Regi T. Alexander

Traditionally, services for people with learning disabilities (LD) and forensic needs are underdeveloped. This paper aims to describe the setting up of a tiered model of LD…

601

Abstract

Purpose

Traditionally, services for people with learning disabilities (LD) and forensic needs are underdeveloped. This paper aims to describe the setting up of a tiered model of LD forensic service provision in Leicester, Leicestershire and Rutland, facilitated and driven by a core team of professionals who have the skills and expertise in this area.

Design/methodology/approach

With no dedicated funding, this team is virtual in nature and provides support for the community and in‐patient teams in the assessment and management of offenders with LD. A care pathway including a process map is included to represent a visual idea of the referral, assessment, intervention and disposal strategies across the four tiers of service delivery. The service has a unique partnership arrangement with the independent sector that allows for staff training in order to deliver quality outcomes. The virtual team can support patients with learning disabilities and forensic needs in the community and in‐patient settings, both by avoiding unnecessary in‐patient admissions and by improving the treatment outcomes of those discharged from in‐patient settings.

Findings

Further research is required to demonstrate the clinical and social outcomes for offenders with LD using the tiered model of care and care‐pathway.

Originality/value

The virtual team and the LD forensic care pathway were developed because of a gap in service that was identified as part of a mapping exercise and stakeholder discussion. In the current economic climate, additional resources to address this gap in service may not be readily available; therefore, an innovative way of addressing this gap in service was by developing a care pathway for use by community LD teams based on lean principles and evidence‐based medicine and the pooling of specialist skills to develop the virtual team to enable and support the implementation of the care pathway.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 3 no. 4
Type: Research Article
ISSN: 2042-0927

Keywords

Article
Publication date: 24 January 2011

Catrin Morrissey and Bridget Ingamells

Dialectical behaviour therapy (DBT) (Linehan, 1993) is a comprehensive psychological treatment that was first developed for suicidal individuals with a diagnosis of borderline…

Abstract

Dialectical behaviour therapy (DBT) (Linehan, 1993) is a comprehensive psychological treatment that was first developed for suicidal individuals with a diagnosis of borderline personality disorder. The model has successfully been used to address violence and aggression in a forensic setting (Evershed et al, 2003). The National High Secure Learning Disability Service (NHSLDS) piloted an adapted DBT programme suitable for men with mild learning/intellectual disabilities in 2004, and the programme has been developed over a period of six years. This paper describes the rationale for development of the programme, how the programme has evolved, the major modifications to mainstream DBT that it incorporates, and the challenges that remain.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 2 no. 1
Type: Research Article
ISSN: 2042-0927

Keywords

Article
Publication date: 24 January 2011

Regi Alexander, Avinash Hiremath, Verity Chester, Fatima Green, Ignatius Gunaratna and Sudeep Hoare

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138…

Abstract

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138 patients, 77 discharged and 61 current inpatients, treated over a six‐year period were included in the audit. Information on demographic and clinical variables was collected on a pre‐designed data collection tool and analysed using appropriate statistical methods. The median length of stay for the discharged group was 2.8 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. There was a ‘difficult to discharge long‐stay’ group which had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not predictive of the length of stay. Clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay, and there is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables. Common datasets and multi‐centre audits are needed to drive this.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 4 March 2014

Laura Willets, Paul Mooney and Nicholas Blagden

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is…

Abstract

Purpose

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services.

Design/methodology/approach

A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate.

Findings

Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety.

Originality/value

The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 5 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 24 January 2011

Verity Chester, Fatima Green and Regi Alexander

This paper briefly reviews the literature on smoking and smoking cessation programmes for people with intellectual disability, and describes the baseline audit of such a programme…

Abstract

This paper briefly reviews the literature on smoking and smoking cessation programmes for people with intellectual disability, and describes the baseline audit of such a programme for patients resident in a forensic service. The audit describes the prevalence of smoking, its significant associations and the effect of an intervention programme. In total, 79 patients participated in the audit, 48 of whom were smokers on admission (60.8%). Roughly a third of smokers gave up during their hospital stay (N = 15). Those who did not give up significantly reduced the number of cigarettes they smoked per day. Female smokers appeared less likely to give up than men. Length of stay and treatment with anti‐psychotic medication were not significantly linked to smoking behaviour. A simple smoking cessation programme with an emphasis on health education and nicotine replacement therapies appeared to be effective in cutting down smoking rates and tobacco consumption in this population. One should be cautious about generalising the conclusions to all forensic hospital services for people with intellectual disability, as the audit was limited by the lack of a control group and conducted in a single service.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 14 November 2016

Morna Browning, Rosemary Gray and Rose Tomlins

The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and…

Abstract

Purpose

The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and interventions delivered. It discusses the clinical implications of these and examines outcomes such as recidivism.

Design/methodology/approach

A retrospective case note review of all 70 service users open to the CFT during June 2013 was carried out, using a structured service evaluation tool.

Findings

The majority of service users (74.3 per cent) had a mild intellectual disability. Multiple mental health and/or physical health diagnoses were common, and 28 per cent had problematic drug or alcohol abuse. Almost half of service users had been victims of physical or sexual abuse, or neglect. Sexual offences were the most common index offence, followed by assault and fire-setting. A wide range of multi-disciplinary interventions were delivered within the Community Forensic Team. Following CFT involvement there was an increase in service users living in supported living in the community and a decrease in people in secure or out of area placements. Over half of service users engaged in no further offending behaviour since their referral, and those who did offend generally showed a decrease in the severity of offending behaviours. There was a large decrease in the number of convictions received.

Practical implications

The study shows the benefits of a multi-disciplinary Community Forensic Team for offenders with intellectual disabilities in terms of reduced recidivism and range of interventions delivered. It highlights the importance of clinicians within such a team having the skills to work with people with co-morbid diagnoses (e.g. autism) and people with trauma backgrounds and problematic substance use.

Originality/value

This paper demonstrates the complexity of the service users who are supported by the CFT, as well as the integral role played in supporting individuals to move to less restrictive settings, with positive outcomes.

Article
Publication date: 12 September 2016

Robert J. Chandler, Charlotte Swift and Wendy Goodman

The purpose of this paper is to evaluate the use of cognitive behavioural approaches to treat a gentleman with a learning disability who had been reported to the police for…

Abstract

Purpose

The purpose of this paper is to evaluate the use of cognitive behavioural approaches to treat a gentleman with a learning disability who had been reported to the police for allegedly making contact with children using social media in an attempt to initiate a romantic relationship using a single case design.

Design/methodology/approach

An 11 session cognitive behavioural intervention was employed, comprising of index offence analysis, challenging distorted cognitions related to the offence, developing an internal focus for responsibility and psychoeducation with regards to “staying safe” online.

Findings

Follow up data demonstrated no improvements in victim empathy, nor in agreement ratings in terms of key cognitions associated with responsibility for offending behaviour.

Research limitations/implications

Whilst treatment efficacy was not established, this case study raises important questions that go beyond the single case design. Whilst the gentleman reported becoming “safer” in terms of initiating contact with unknown people via social media, this could not be substantiated, and is indicative of the cardinal difficulty of monitoring online recidivism. Generalisability of findings to the wider learning disability population is limited by a single case design.

Originality/value

This is the first published case study to the authors knowledge to evaluate cognitive behavioural approaches to reduce antisocial internet related behaviour in a forensic learning disability setting. Findings of considered within the context of the concept of minimisation of offending behaviour, the concept of “counterfeit deviance”, and also how best to measure therapeutic change within this population.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 3
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 4 February 2014

Julia Kelly

– The purpose of this paper is to outline and evaluate the development of a thinking skills programme for adults with learning disabilities at risk of offending.

Abstract

Purpose

The purpose of this paper is to outline and evaluate the development of a thinking skills programme for adults with learning disabilities at risk of offending.

Design/methodology/approach

The programme was evaluated over three years using self-report clinical measures related to treatment targets and feedback from participants.

Findings

Results showed a statistically significant improvement in general empathy (t=1.800, df=15, p=<0.05) and perspective taking (t=1.898, df=15, p=<0.05). Improvement in impulsivity and locus of control was not significant. Feedback from service users was positive.

Practical implications

Findings suggest that thinking skills programmes can be of benefit to adults with learning disabilities at risk of offending.

Originality/value

There is a need to provide opportunities for adults with learning disabilities to address generic deficits and factors supporting offending behaviour and to increase readiness for offence-specific treatment.

Details

Journal of Forensic Practice, vol. 16 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 9 September 2013

Glenn Batey and Theresa Comer

Since its inception, the internet has become increasingly dominant in everyday life. Despite its obvious benefits, concerns have been raised as to potential risks of the internet…

Abstract

Purpose

Since its inception, the internet has become increasingly dominant in everyday life. Despite its obvious benefits, concerns have been raised as to potential risks of the internet such as susceptibility to being a victim of crime and bullying. For individuals with a learning or developmental disability this risk is increased given their lack of intellectual functioning and social awareness. For individuals with such a disability and a forensic background, the risks may be even greater given the added possibility of offending online. The purpose of this paper is to describe the development of an internet risk awareness group for such individuals.

Design/methodology/approach

The internet awareness group comprises of ten sessions run on a weekly basis for individuals with a learning/developmental disability and forensic background. The aim of the group is to aid an understanding of the benefits and risks of the internet, including things to be aware of to enable service users to make an informed choice and to minimise their chance of being the victim of any crime or distress. The sessions also have a forensic focus and will outline legal aspects of the internet in relation to behaviours such as stalking and will teach service users about the consequence of this.

Findings

The paper describes the process of developing the course material, providing the course and adapting it in light of feedback from participants.

Originality/value

The paper highlights the emerging nature of problematic internet use amongst learning disabled offenders. It serves to raise awareness among health and social care professionals and instigate the development of further good practice.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 4 no. 3/4
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 1 March 2010

Jon Taylor

People with learning disabilities have traditionally been denied access to a range of psychological therapies. Similarly, offenders with learning disabilities, particularly in…

Abstract

People with learning disabilities have traditionally been denied access to a range of psychological therapies. Similarly, offenders with learning disabilities, particularly in prison settings, have largely been unable to access treatment strategies that are provided for offenders who do not have such disabilities. As a consequence these individuals are denied the opportunity to address their criminogenic needs and/or attend to their psychological welfare. This paper provides a brief exploration of the reasons and evidence for such practice, alongside the evidence that people with learning disabilities can successfully engage in psychotherapy. It is concluded that there is no evidence that would support the exclusion of people with disabilities from treatment options.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 1 no. 3
Type: Research Article
ISSN: 2042-0927

Keywords

21 – 30 of over 1000