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The purpose of this single-case experimental design paper is to examine the efficacy of the high-dosage Life Minus Violence – Enhanced (LMV-E) programme with a small sample of four violent women in custody. All participants were undertaking LMV-E as one component of their treatment pathway in an Offender Personality Disorder (OPD) treatment service for women with personality disorder. The methodology employed an AB baseline design with a six-month baseline period, nine-month treatment period and six-month follow-up. Levels of direct and indirect aggression were recorded throughout the baseline, intervention, and follow-up period. In the follow-up period, women were engaging in further treatment. Psychometric measures linked to treatment domains were used to explore clinically significant and reliable change following the intervention. Clinical and reliable change was indicated in some treatment domains for each participant following the intervention. The pattern of these reductions varied between the women. The patterns of findings are discussed and recommendations presented.

The methodology employed an AB baseline design with a six-month baseline period, nine-month treatment period and six-month follow-up. Levels of direct and indirect aggression were recorded throughout the baseline, intervention and follow-up period. In the follow-up period, women were engaging in further treatment. Psychometric measures linked to treatment domains were used to explore clinically significant and reliable change following the intervention.

Clinical and reliable change was indicated in some treatment domains for each participant following the intervention. The pattern of these reductions varied between the female offenders. The patterns of findings are discussed and recommendations presented.

The LMV-E programme was associated with some positive improvements in treatment domains measured in a small sample of female violent offenders. Improvements to some degree were most commonly found in the domains of anger, emotional control and components of criminal thinking. It would be clinically useful to examine characteristics of individuals that appear to benefit most from particular interventions.

There are no existing published findings related to the implementation of LMV-E with females. Therefore, this paper provides preliminary contribution to the evidence base in this area.

This preliminary study aims to investigate and describe aggression-supportive normative beliefs among patients of a high-secure hospital.

Therapy data from a sample of high-secure forensic hospital patients (N = 11) who had participated in Life Minus Violence-Enhanced, a long-term violence therapy, was examined using interpretative phenomenological analysis (IPA). During therapy, cognitions linked to past incidences of aggression were explored using aggression choice chains.

IPA was applied to data generated through this process to examine the presence and nature of normative beliefs reported, identifying seven themes: rules for aggressive behaviour; use of violence to obtain revenge; processing emotions with violence; surviving in a threatening world; do not become a victim; using violence to maintain status; and prosocial beliefs.

Findings demonstrate that forensic patients have specific aggression-supportive normative beliefs, which may be malleable. Limitations and implications are discussed.

This study aims to explore the impact of inclusion of victim empathy-based content in offender treatment.

This study first presents a systematic review of 20 papers before proceeding to consider qualitative interviews with therapists (n = 7) and forensic patients (n = 5), who had completed a long-term violence therapy (Life Minus Violence – Enhanced, LMV-E©). The research explored perceptions of forensic patients and treatment facilitators when completing victim empathy work and explored any negative effects this may have.

Findings from the systematic review indicated five themes: interventions incorporating victim empathy can be effective; there are positive risk-understanding consequences from completing victim empathy work; offenders perceive victim empathy positively; the emotional impact of victim empathy work on offenders’ is poorly explored; and completing victim empathy in treatment groups receives mixed evaluations from offenders. The systematic review was used to inform the interview themes for the resulting qualitative study with facilitators and forensic patients. This study indicated six themes: victim empathy content facilitates change; victim empathy content can be difficult for patients; victim empathy content can lead to an emotional response; victim empathy content can be beneficial, with the process important; victim empathy content can help understand risk, and patients’ experience of treatment begins before attending sessions.

The potential impact of victim empathy content needs to be evaluated before sessions are completed, accounting for client expectations and treatment readiness. This should include ensuring that appropriate support is in place. Any support provided to patients should be regularly reviewed.

The study represents the first to apply detailed analysis to this topic area and with a complex group.

The purpose of this paper is to inform understanding of female offenders who commit domestic violence. This contentious area of research is growing and there are strong indications that men and women perpetrate similar levels of domestic violence. This has resulted in increasing interest in understanding the characteristics of such offenders as well as considering treatment pathways.

In this study, female prisoners (n=92) completed a measure of psychological and physical aggression (Revised Conflict Tactics Scales, Straus et al., 1996) to explore the types of domestic violence experienced and perpetrated in most recent and previous relationships.

Results indicated high levels of psychological aggression and physical assaults both experienced and perpetrated by female offenders in current and previous relationships. Physical assaults tended to be severe and high levels of mutual violence were reported both in most recent and previous relationships.

The findings suggest the importance of service provision and treatment pathways for female domestic violence perpetrators. On the basis of the findings, treatment needs of such offenders are considered and potential treatment pathways are reflected upon.

There are little known publications exploring the prevalence and characteristics of female domestic violence perpetrators in prison. Research has also tended to focus on current relationships as opposed to considering both current and previous relationships. This paper explores these areas and will be of interest to practitioners working with this client group.

Some psychodynamic approaches conceptualise female violence as a communication of experiences too difficult to think about. As practitioners, understanding what may be too painful to be thought about is incredibly important in assessment and treatment of forensic populations. Incorporating psychodynamic concepts such as splitting, transference, projection and counter-transference into formulation can be extremely helpful in understanding and formulating women’s risk of violence. The purpose of this paper is to introduce how psychodynamic concepts can be incorporated into understanding, assessment, formulation and treatment with this complex client group. This paper will also outline treatment approaches with this population.

This paper will review existing psychodynamic literature and apply this knowledge to working with violent female offenders. Translating theory into reflective practice will be presented.

This paper presents the value of incorporating psychodynamic considerations into existing strategies of understanding and working with violent female offenders. Ways forwards and research directions are proposed.

This paper is focussed primarily on psychodynamic approaches to understanding this population

Psychodynamic concepts can add an additional dimension to formulation, supervision and treatment approaches with this population. Examining the meaning of violence perpetrated by women as well as enactments can improve practitioner’s depth of understanding. Empirical research examining the benefits of psychoanalytic supervision would be extremely useful to explore the impact on formulation, treatment approaches, treatment effectiveness, staff well-being and staff retention.

There is a lack of literature considering the application of psychodynamic constructs to help formulation of complex female offenders in the Offender Personality Disorder Pathway for women.

The topic of offender rehabilitation has been subject to much research over the past decade. Numerous meta‐analytic reviews of offender treatment, particularly group treatment based on cognitive behavioural principles, have been reported. Together with the ‘triad of principles’ — risk, need and responsivity — they have formed the foundation upon which most offending behaviour interventions have developed. However, outcome data from existing programmes provides mixed evidence, and evidence for interventions for those in forensic mental health settings are still in their infancy. This paper critically considers the current evidence for the treatment of offending behaviour, and its application in forensic mental health settings, in order to inform development of such treatments in low secure mental health care. Most of the research focuses on non‐mental health settings, and is largely what will be considered here. The paper concludes that low secure interventions need to capitalise on the evidence of ‘what works’ while revisiting key concepts such as ‘dose’ and responsivity in order to design appropriate treatments. Individual outcome evaluation needs to form part of development in this area.

Individuals being treated in medium secure hospitals have typically engaged in some form of offending in other service settings or while in the community. Although psychological treatment for addressing such behaviour in medium secure hospitals is beginning to be developed, at present there is a lack of evidence of ‘what works’. This paper reports a review of the type and level of offending behaviour engaged in by those in a single medium secure service, including the conviction histories for such behaviours and the psychological approaches to risk reduction and offending behaviour taken in medium secure hospitals in England and Wales. The need to develop an evidence base for psychological treatment in medium secure services including at the individual level is clearly indicated.

The purpose of this paper is to conduct a preliminary evaluation of a Violent Offender Treatment Program (VOTP) adapted for use in a medium secure unit (MSU). The patient population is adult male mentally disordered offenders.

Patient outcomes are explored using the Reliable Change Index and Clinical Significance Criterion. Outcomes are assessed using VOTP facilitators violence risk assessment (VRS), multi-disciplinary team violence risk assessment (HCR-20 and GAS-V), and patient self-report using two measures (FAVT and STAXI-2).

There was evidence of improved outcomes for some participants in some areas related to risk of violence.

Consideration is given to using varied risk assessments to evaluate outcomes of an adapted VOTP for a MSU.

There is limited development and evaluation of psychological treatment programmes that aim to reduce risk of violence for male offenders within MSUs. Outcomes of this evaluation could influence treatment delivery and evaluation in other services.

The case of a woman with a history of offending and prolonged imprisonment is given. The purpose of this paper is to explore the complex interplay between diagnoses of autistic spectrum disorder (ASD), personality disorder and gender dysphoria. A discussion on useful and less useful treatment approaches follows, given the unusual and complex clinical presentation.

This is a case report with a summary of the background to this under-researched area.

The way in which the diagnostic picture clarified over time is explained. The difficulties in accurately diagnosing are put forward and strategies to address this are suggested. Successful treatment of unusual clinical problems may require highly individualised care within generic services.

The authors know of no similar case reports in the published literature. The clinical associations between ASDs, personality disorders and gender dysphoria, in forensic mental health populations, appears to be unexplored in the literature.

This paper provides a clinical practice overview of the challenges that can arise when working with dangerous and severe personality‐disordered patients in a high secure hospital. Poor engagement and treatment readiness, mistrust, paranoia and dominant interpersonal styles are all clinical features that affect treatment delivery. The paper discusses the impact of these features, and suggests how clinicians can engage effectively with individuals who have personality disorders in regard to therapy in general.