Search results

The Good Lives Model (GLM) is a new approach to offender rehabilitation that provides an integrative framework for assisting individuals to achieve their goals while reducing their risk for reoffending. Recently it has been proposed that an augmented form of the GLM could provide a comprehensive conceptual, ethical and practice framework for rehabilitation within the specialty of forensic mental health. However, there is a paucity of published literature to guide practitioners on how to integrate the GLM into their practice with mentally disordered offenders. The aim of this article is to present a set of resources (the GLM tool kit) tailored for use with offenders with mental disorder.

Each of the five resources that comprise the tool kit will be described, the theoretical, methodological and practical considerations that influenced their development will be reviewed, and a case example demonstrating their clinical application, presented.

The tool kit can guide forensic mental health practitioners in assessment, case conceptualization and rehabilitation planning according to the Good Lives Model. It includes some practical resources that practitioners can use to help mentally disordered offenders understand themselves better, including the reasons why they came to offend, and to highlight what they need to change to live better lives.

The paper provides clinicians with some structure in applying the Good Lives Model within a forensic mental health team context.

Much of the GLM practice literature relates to non‐mentally disordered offenders. The paper builds on this literature by presenting a set of tools that have been designed specifically with mentally disordered offenders in mind.

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.

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.

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.

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.

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

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.

Housing‐related support funded by Supporting People has developed in line with traditional service areas relating to criminal justice, health and social care. This means that opportunities for developing integrated services geared to meeting the needs of mentally disordered offenders have been limited. Using a case study to explore service needs, a rethink of commissioning and support roles is recommended for forensic mental health services.

This article seeks to explore the historical context of government policy in relation to mentally disordered offenders. The article will relate this context to the work of the Probation Service, in particular the development of the Offender Management System (OASys), risk assessment and the implications and challenges that face the National Offender Management Service (NOMS). The key question to be assessed is whether NOMS and OASys can lead to a better service for those with mental disorder, and therefore reduce their risk.

The purpose of this paper is to increase our understanding of the role of mental disorder in sexual offending as well as identifying innovations in assessment and treatment with offenders who present with these typically complex risks and needs.

The converging literatures on “good lives” and other developments in sexual offender treatment are compared with recovery from mental disorder and what is known about the particular needs and characteristics of sexual offenders with mental illness and severe personality disorder (PD).

A key outcome of this review is that many mentally disordered sexual offenders have similar needs to those in prison and the community but there are particular challenges posed by severe PD, paraphilias and the relatively rare individuals whose offending is functionally linked to psychotic symptoms.

Practical implications include the need for case formulation of complex needs related to mental disorder using direct and indirect measures of attitudes and interests. Treatment needs to be responsive to very different personality and mental health presentations as well as problems with offending and cognitive schemas. Direct functional links between mental health symptoms such as delusions and hallucinations are very rare in practice and are usually secondary to PD and sexual offending issues. In practice, treatment promoting recovery from mental disorder is highly compatible with the “good lives” approach to sexual offender treatment. Staff development, supervision and support are particularly important for staff treating mentally disordered sexual offenders.

It is argued that mentally disordered sexual offenders are an under-researched sub-group within the wider sexual offender population. This paper brings together the relatively limited literature on treatment with examples of recent treatment innovations, multi-modal assessment approaches and reviews of research on the needs of this relatively uncommon but highly risky group.

The supervision of mentally disordered offenders at risk of harm to themselves or others is universally practised, but there is little research evidence in the literature as to how, in what circumstances, with which patients, to what end and with what results for the patient and/or staff. This article reviews the available evidence on the practice and calls for evidence based guidelines for the role inherited by nurses to inform effective practice. It concludes:• empirical evidence is lacking on the supervision of mentally disordered offenders as an effective nursing intervention• there is evidence of ambiguity as regards psychiatric nursing interventions• supervision of mentally disordered offenders is subject to covert and inconsistent practice• there is a need for research on which to base training, skill mix decisions and the general management of supervision.

There is increasing recognition that, wherever clinically appropriate, the needs of mentally disordered offenders should be met by health and social services rather than the criminal justice system (Cohen & Eastman, 1997). Many trusts now make separate service provision for this client group, but there has been little research into the role of applied psychology in these services. This study consists of an exploratory audit of the referrals to applied psychology in a multidisciplinary mentally disordered offenders team. Client characteristics as well as referral characteristics were explored. One of the main results of the audit was that clients referred for outpatient groups (who were not normally known to the team prior to referral) had significantly higher rates of non‐attendance and drop‐out than clients referred for other reasons. Outpatients in general also had higher rates of non‐attendance and dropout than inpatients. The main conclusion of this study is that applied psychology resources may be best used in the provision of services to clients known to the team and that, as inpatient work may be more productive, it should perhaps be the priority for psychologists working with this client group.

Recent changes in UK immigration policy have led to increasing deportation of foreign national offenders and more than 5000 were deported in 2008. This rise follows a review in 2006 which found that some foreign national offenders were being lost due to disposal or transfer through mental health services. As a result, a department was set up within the United Kingdom Border Agency (UKBA) to identify and review those detained under Restrictions Orders who were due to be conditionally released from hospital, so that they could be considered for deportation. As a result of these changes, forensic clinicians are more frequently presented with detained patients who have immigration problems that can lead to problems in the care pathway through secure services. A local audit was carried out in an inner‐London medium secure service to quantify the number of detained patients who are born abroad, and to review their care pathways to determine whether they are affected by immigration difficulties. It is hoped that the discussion of the issues identified by this audit can support service improvement and provide better care for patients in medium secure services.

Mentally disordered offenders (MDO), contary to general belief, are not the sole concern of specialist and secure services. Their numbers are far greater in the community. Instead of denying involvement with and responsibility for this group, mainstream mental health services need to recognise the reality of their presence on their caseloads and take steps to provide services to them. However this client group often has complex needs that may transcend the capacity of individual key workers or single agencies to meet. This has important implications for the training, supervision and support of individual staff, and for improved liaison and inter‐agency working, particularly with forensic practitioners in prisons and secure mental health services.

Provision of comprehensive diversion services for the mentally disordered who come into conflict with the law offers benefits for patients and all those involved in the process, including the police, crown prosecution service and other agencies. It gives access to the most appropriate disposal for this vulnerable group. This case study of a man who had multiple contacts with the diversion services in Birmingham illustrates the particular difficulties associated with diversion from custody for mentally disordered individuals, particularly where there are multiple problem areas. Examination of the case suggests that in spite of inter‐agency commitment to the philosophy of diversion, in some instances a period spent in custody is unavoidable.