Search results

This paper aims to provide practitioners with a brief but comprehensive review of the current evidence base for psychological treatment approaches used in the UK that may be useful for stalking therapies.

A rapid evidence assessment was conducted on papers (post the UK Protection from Harassment Act, 1997) that discuss treatments of stalking (with or without a conviction) and associated offences/disorders. Therapies reviewed were Acceptance and Commitment Therapy, Cognitive Analytic Therapy, Cognitive Behavioural Therapy, Dialectical Behaviour Therapy and Schema Therapy. Searches for Mentalization-Based Therapy and Psychodynamic Therapy in relation to stalking were also performed but yielded no results that met inclusion criteria.

There is currently a severely limited evidence base for the efficacy of the psychological treatment of stalking behaviours. Some interventions show promise although a multifaceted, formulation-based approach is likely to be required.

Future research would benefit from robust studies focused on stalking with long-term efficacy follow-ups.

To the best of the authors’ knowledge, this is the first rapid evidence review of psychological treatments that directly address stalking behaviour.

This paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their “accommodation journey”.

A rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis.

The quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status.

Current policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents’ health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements.

This evidence assessment is the first to consider the accommodation journey of older people residing in SIH.

Adolescent violence towards parents (AVTP) has damaging impacts on family relationships, however, little is known about the characteristics of the families in which it occurs. The purpose of this paper is to synthesize current knowledge of the AVTP characteristics to help to inform the development of more effective community responses.

The paper opted for a Rapid Evidence Assessment taking an ecological approach to organize current knowledge about the characteristics of both victims and perpetrators of AVTP. It synthesized 20 empirical studies identified from a systemic review of published literature.

The assessment concludes that adolescents who perpetrate AVTP typically experience high levels of comorbid mental health concerns, drug and alcohol use, anger difficulties and trauma. The victims (parents) are characterized as having strained relationships with other family members and trauma profiles.

Policy and practice responses should be tailored to systemically address needs in the identified areas. This review further illustrates the limitations of current knowledge, highlighting inconsistencies in both definitions and findings, particularly related to key characteristics.

This paper is the first of its kind to systemically search this literature and only include the most rigorously designed studies. It adds value to the developing field of AVTP by providing the scaffolding of the characteristics of families who have been impacted.

Different pathways of frailty care to prevent or delay progression of frailty and enable people to live well with frailty are emerging in primary and community care in the UK. The purpose of the study is to understand effective frailty care pathways and their components to inform future service development and pathway evaluation in primary- and community-care services.

A rapid evidence review was conducted: 11 research publications met the inclusion criteria and were analysed using narrative thematic synthesis.

There is strong evidence that resistance-based exercise, self-management support, community geriatric services and hospital at home (HAH) improve patient health and function. In general, evaluation and comparison of frailty care pathways, components and pathway operations is challenging due to weaknesses, inconsistencies and differences in evaluation, but it is essential to include consideration of process, determinant and implementation of pathways in evaluations.

To achieve meaningful evaluations and facilitate comparisons of frailty pathways, a standardised evaluation toolkit that incorporates evaluation of how pathways are operated is required for evaluating the impact of frailty pathways of care.

The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry.

A rapid evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches.

The review found that English prison healthcare has undergone “transformation” during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources.

Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered a small number of countries, which may limit the transferability of findings. The lack of quantitative data necessitated the use of qualitative data gathered from key informants. However, this enabled a good understanding of current practice.

The review findings support the World Health Organisation position on the value of integrated prison and public health systems in improving quality of healthcare. It also recommends future policy needs to take account of the “whole prison approach” recognising that healthcare in prisons cannot operate in isolation from the prison regime or the community.

This is unique research which has great value in supporting prison reform in England. It will also be of interest internationally due to the paucity of data in the published peer-reviewed literature on the impact of commissioning models on healthcare or health outcomes.

A Rapid Evidence Assessment (REA) determined the effectiveness of correctional programmes for women offenders and examined features of programmes providing the strongest outcomes. The paper aims to discuss these issues.

Electronic databases and web sites were reviewed to identify literature focused on interventions with female offenders published since 2006, the end point of the last REA conducted in the area. The following retention criteria were applied: participants were over age 18; sample included women and results are reported separately for women; study included an appropriate comparison group; study included recidivism as an outcome measure. Studies’ methodological design quality was assessed using the Maryland Scientific Methods Scale.

In total, one meta-analysis and 22 studies reflecting 17 unique samples, published from 2006 to December 2014, were identified. Overall, the best evidence suggests that the following programmes and approaches have an evidence base: first, substance abuse treatment, in particular in-custody or hierarchical therapeutic community programmes; second, gender-responsive programmes that emphasize existing strengths and competencies, as well as skills acquisition; and third, following in-custody programme treatment with participation in community follow-up sessions. There is also promising evidence for the use of community opioid maintenance among heroin addicted women.

This review demonstrated that since 2006 the number of high-quality research studies assessing women’s correctional outcomes has grown considerably. The results provide guidance to programme designers and administrators on programmes for women offenders likely to be effective in promoting public safety goals and offender reintegration.

The purpose of this paper is to report on the findings from a study commissioned by the Office of the Children’s Commissioner (OCC) in England, concerning intrafamilial child sexual abuse (IFCSA)/incest. Specifically, it aims to explore what is known about the prevalence, nature, and impact of IFCSA and where the gaps in knowledge lie.

A rapid evidence assessment (REA) was used, the function of which is to: search the literature as comprehensively as possible within given time constraints; collate descriptive outlines of the available evidence on a topic and critically appraise it; sift out studies of poor quality; and provide an overview of the evidence. Over 57,000 documents were scanned, and 296 ultimately systematically analysed.

It was found that: there is wide variation in prevalence rates between studies; girls are more likely to be victims than boys; the onset of abuse is typically school age; abuse in minority groups is under-reported; sibling abuse may be more common than that by fathers; female perpetrated abuse may be under-reported; families where abuse occurs are often dysfunctional; and IFCSA has significant adverse effects on victims.

A REA is not a full systematic review, differing in the scope and depth of the searches and depending almost exclusively on electronic databases, not accompanied by searching journals by hand.

This work found numerous gaps in current knowledge about IFCSA, which the authors recommend be addressed by further research, including: the scale and nature of IFCSA in disabled victims, research on BME children’s experiences; the prevalence of abuse by stepfathers as compared to biological fathers; the experiences of male victims; the experiences of lesbian, gay, bisexual, and transgendered child victims; the short-term impact of IFCSA based on child victims’ experiences; and more widely, further research on the prevalence of abuse in clinical populations and the relationship between that and prevalence in wider society. In addition to such questions, the OCC inquiry will also investigate issues surrounding child protection and criminal justice responses to (IF)CSA and how these might be improved. The evidence base for this section of the inquiry is reported in Gekoski et al. (2016).

The findings of this research provide the evidence base for a new two-year inquiry into the subject of IFCSA by the OCC.

The purpose of this paper is to review the literature on the factors related to women’s ability to achieve and maintain abstinence from alcohol.

A rapid evidence assessment was carried out in four stages: definitions and research questions were agreed, search and selection were completed, data were extracted, quality of studies was assessed, and findings were synthesised and presented.

Medline, PsycINFO, CINAHL and ASSIA were searched for cohort studies published in English during January 2000–February 2015. Expanded search terms for Women, Alcohol and Abstinence, and Cohort were used to identify relevant studies for inclusion, resulting in 1,040 records. Of these, 32 manuscripts from 31 studies were eligible for inclusion in the review. Alcohol-related factors such as increased quantity and frequency of alcohol consumption were related to lower likelihood of achieving and maintaining abstinence; treatment factors such as type of treatment and number of treatment episodes were related to higher and lower likelihood; demographic factors such as financial problems and poor housing status were related to lower likelihood; and psychological factors such as craving, other drug use and comorbid health problems were linked to lower likelihood.

To the authors’ knowledge, this is the first time the factors related to the specific outcome of abstinence in women have been synthesised. Many of the factors found are also known to contribute to vulnerability for developing alcohol problems. The review revealed the paucity of studies with female only samples, or where results for women were reported separately.

The purpose of this paper is to identify factors associated with drinking patterns during pregnancy.

A rapid evidence assessment was undertaken, scanning multiple databases for studies examining factors associated with alcohol consumption in pregnancy. Studies were included if they stratified data according to quantity of alcohol consumed and identified relevant associated factors. Drinking patterns were classified as light/moderate and heavy/binge.

In total, 15 studies were included (N=7 light/moderate; N=15 heavy/binge drinking). Factors associated with alcohol consumption during pregnancy included: smoking, age, SES, marital status, pre-pregnancy substance use and parity. While few studies reported an association between heavy/binge drinking and maternal mental health, none of the studies included explored the association between mental health and light/moderate drinking.

Relatively few studies have looked at the association between psychological characteristics of women and their drinking patterns. There is a lack of articles examining light/moderate drinking in pregnancy compared to heavy/binge drinking. Moreover, there is marked variation in how alcohol use is measured. Further studies are needed to increase understanding of the association between psychological factors and patterns of drinking during pregnancy, and how health professionals might support women in this context.

The authors expand on previous work by examining two different patterns of alcohol consumption in pregnancy, rather than alcohol use simply as an isolated concept. The two groups were found to differ in a number of demographic and social factors. This information could be used to aid healthcare professionals in targeting specific interventions to those women most at risk.

This rapid evidence assessment (REA) study aims to synthesise what is known about food refusal within male prison populations to aid a better understanding of why this occurs. By looking at the various functions of food refusal for this population, it is hoped that professionals can better support prisoners’ needs in this area.

A rapid review of available data within the published literature was completed. Searches were conducted on two databases (PsychInfo and MedLine), and a total of 328 articles were screened using a three-stage process. This resulted in 13 articles being identified for the final sample, which were reviewed and synthesised into themes by looking for commonalities.

Five themes were identified: “to protest”, “to achieve goals or demands”, “to manage interpersonal difficulties with prison/custodial staff”, “to end life” and “mental health and personality disorder”. The findings appear to suggest that food refusal in this context may be predominantly driven by a need to communicate or gain control.

To help prevent and cease food refusal, it will be beneficial for prison staff to use approaches that support prisoners feeling a sense of fairness, transparency, control and autonomy, as well as problem-solving skills and establishing a sense of purpose and motivation.

This REA confirmed there is a lack of good-quality research into the functions of food refusal among prisoners in the UK. Future research should involve contact with prisoners who have engaged in food refusal to understand motivations firsthand.