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Article
Publication date: 18 May 2015

Helen Miles

The treatment of substance use amongst mentally disordered offenders (MDOs) remains a challenge for secure forensic mental health services. The purpose of this paper is to…

Abstract

Purpose

The treatment of substance use amongst mentally disordered offenders (MDOs) remains a challenge for secure forensic mental health services. The purpose of this paper is to present an integrated three-stage substance use treatment programme (SUTP) for male and female MDO’s in medium security.

Design/methodology/approach

In total, 45 (72.6 per cent) MDO’s were referred (39 males/6 females). Standardised outcome measures were administered pre-SUTP, post-SUTP and at one year follow-up. Abstinence rates and location was determined via case notes at three year follow-up.

Findings

All MDO’s had a past history of substance use, approximately three-quarters reporting problematic use prior to admission. Over half completed all three SUTP stages, less than 5 per cent dropping out during active treatment. The SUTP supported abstinence throughout the one year follow-up period and significantly improved MDO’s adaptive beliefs about substances and craving by one year follow-up amongst attendees. At three years, most MDO’s were in the community and almost three-quarters were abstinent. There was no significant difference in abstinent rates between community and hospital. There was a non-significant trend suggesting SUTP attendance supported abstinence. Both male and female participants appear to have benefited from treatment and satisfaction was high, reflecting the specific aims and objectives of treatment.

Research limitations/implications

The small non-randomised sample from one area limits the generalisability of findings and statistical power.

Originality/value

Findings indicate further support for the limited evidence base that small but clinically meaningful and maintained changes to problematic substance use are possible following integrated substance use treatment for male and female MDO’s.

Details

Advances in Dual Diagnosis, vol. 8 no. 2
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 9 November 2010

Holly Corlett and Helen Miles

This study examines the implementation of the recovery model or ‘philosophy’ in a secure NHS forensic service. Twenty‐six (86.7%) staff and seventeen (70.8%) mentally…

Abstract

This study examines the implementation of the recovery model or ‘philosophy’ in a secure NHS forensic service. Twenty‐six (86.7%) staff and seventeen (70.8%) mentally disordered offenders (MDOs) were interviewed in Spring 2009 from the rehabilitation and pre‐discharges units in a medium secure forensic service in Kent, UK. Their views on recovery were measured using the Developing Recovery Enhancing Environments Measure (DREEM: Ridgeway & Press, 2001). Staff consistently rated all 24 elements of recovery as more important than the MDOs. Staff also rated the elements of recovery as better implemented, except Intimacy and Sexuality. There was a significant effect of MDOs' forensic history (restriction status and index offence type) on ratings of how well elements of recovery were implemented. Staff and MDOs rated all elements of recovery as at least moderately important (above median value). The implications of the recovery philosophy in forensic mental health services are discussed.

Details

The British Journal of Forensic Practice, vol. 12 no. 4
Type: Research Article
ISSN: 1463-6646

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Book part
Publication date: 11 May 2012

Colin G. Pooley, Dave Horton, Griet Scheldeman, Miles Tight, Helen Harwatt, Ann Jopson, Tim Jones, Alison Chisholm and Caroline Mullen

Purpose – To examine the potential for switching short trips in urban areas from cars to walking and cycling, and the possible contribution, this could make to a reduction…

Abstract

Purpose – To examine the potential for switching short trips in urban areas from cars to walking and cycling, and the possible contribution, this could make to a reduction in transport-related greenhouse gas emissions.

Methods – Case studies in four urban areas combining a questionnaire survey, interviews with households and during journeys and in-depth ethnographies of everyday travel.

Findings – The barriers to an increase in walking and cycling in British urban areas are emphasised. It demonstrates that motivations for walking and cycling are mostly personal (health and local environment) and that the complexities and contingencies of everyday travel for many households, combined with inadequate infrastructure, safety concerns and the fact that walking and cycling are seen by many as abnormal modes of travel, mean that increasing rates of walking and cycling will be hard. Given that the contribution of trips less than 2 miles to transport-related greenhouse gas emissions is relatively small, it is argued that any gains from increased walking and cycling would mostly accrue to personal health and the local environment rather than to the UK's carbon reduction target.

Social implications – Positive attitudes towards walking and cycling are motivated mainly by personal concerns rather than global environmental issues.

Originality – Use of detailed ethnographic material in policy-related transport research.

Details

Transport and Climate Change
Type: Book
ISBN: 978-1-78052-440-5

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Article
Publication date: 1 November 2008

Jenni Bacon, Helen Lockett and Miles Rinaldi

What does it mean to say there's an evidence base for supported employment? One approach, known as Individual placement and support or IPS for short, has been extensively…

Abstract

What does it mean to say there's an evidence base for supported employment? One approach, known as Individual placement and support or IPS for short, has been extensively evaluated and proven to help high numbers of people with severe mental health problems into work. But there is still little evidence of this approach being put into practice here in the UK. This article recalls a visit this year to the UK by Professor Bob Drake and colleagues from Dartmouth, New Hampshire, USA where the approach was developed, and explains the principles of supported employment and what it can mean for service users, staff, families and employers.

Details

A Life in the Day, vol. 12 no. 4
Type: Research Article
ISSN: 1366-6282

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Article
Publication date: 18 November 2013

Calem De Burca, Helen Louise Miles and Eduardo Antonio Vasquez

Substance use contributes to the development of criminogenic behaviour and mental health problems. However, the extent and severity of substance use and the relationship…

Abstract

Purpose

Substance use contributes to the development of criminogenic behaviour and mental health problems. However, the extent and severity of substance use and the relationship to offending in mentally disordered offenders (MDOs) admitted to regional medium secure units has received relatively limited research attention.

Design/methodology/approach

Case note reviews (n=57) and semi-structured interviews (n=21) of past substance use levels, substance use problems and forensic history were conducted at a medium secure unit in South East England.

Findings

Results highlighted the high prevalence of substance use among MDOs, especially when determined by self-report. At least one-third (case note review) or almost half (self-report) used alcohol at the time of their index offence, although many failed to recognise use as problematic. Significant correlations were found between heavy past use of alcohol and use of alcohol at time of offending. Past heavy use of alcohol significantly predicted whether or not the individual was convicted of a violent offence.

Research limitations/implications

The small sample from one area limits the generalisability of findings as substance use demographics vary. Methodological shortcomings were noted when comparing data from self-report and case note information. Retrospective recall bias may influence past perceptions of substance use.

Practical implications

These preliminary findings indicate the importance of assessing substance use in MDOs and considering its relationship to offending behaviour in treatment and risk management.

Originality/value

Although anecdotally substance use is known to be high and likely to be related to offending behaviour amongst MDOs, there is little previous research highlighting this.

Details

Journal of Forensic Practice, vol. 15 no. 4
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 16 August 2011

Theresa A. Gannon, Tracy King, Helen Miles, Lona Lockerbie and Gwenda M. Willis

The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally…

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Abstract

Purpose

The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally disordered offenders.

Design/methodology/approach

As evaluation and work on the SOTG is necessarily ongoing, case study descriptions of each patient who attended the SOTG and of their progress throughout SOTG are described.

Findings

Overall, the case study progress reports suggest that mentally disordered male patients made some notable progress on SOTG despite their differential and complex needs. In particular, attention to each patient's life goals and motivators appeared to play a key role in promoting treatment engagement. Furthermore, patients with lower intelligence quotient and/or indirect pathways required additional support to understand the links between the Good Lives Model (GLM) and their own risk for sexual offending.

Research limitations/implications

Further evaluations of SOTG groups, that incorporate higher numbers of participants and adequate control groups, are required before solid conclusions and generalisations can be made.

Practical implications

Practitioners should consider providing additional support to clients when implementing any future SOTGs for mentally disordered patients.

Originality/value

This is the first paper to outline and describe implementation of the GLM in the sexual offender treatment of mentally disordered male patients group format. As such, it will be of interest to any professionals involved in the facilitation of sexual offender treatment within this population.

Details

The British Journal of Forensic Practice, vol. 13 no. 3
Type: Research Article
ISSN: 1463-6646

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Abstract

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An International Feminist Challenge to Theory
Type: Book
ISBN: 978-0-76230-720-3

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Article
Publication date: 18 November 2013

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161

Abstract

Details

Journal of Forensic Practice, vol. 15 no. 4
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 1 November 2008

Adam Pozner

Abstract

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A Life in the Day, vol. 12 no. 4
Type: Research Article
ISSN: 1366-6282

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Article
Publication date: 9 November 2010

Carol Ireland and Neil Gredecki

Abstract

Details

The British Journal of Forensic Practice, vol. 12 no. 4
Type: Research Article
ISSN: 1463-6646

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