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1 – 10 of over 2000Amy Izycky, Louise Braham, Lisa Williams and Todd Hogue
Measures of risk employed in mental health settings in the last 20 years have consisted of clinical scales that comprise both historical and clinical factors. Examples of such…
Abstract
Measures of risk employed in mental health settings in the last 20 years have consisted of clinical scales that comprise both historical and clinical factors. Examples of such tools include the widely used HCR‐20 (Webster et al, 1997), SVR‐20 (Boer et al, 1997) and VRS (Wong & Gordon, 2000). Such tools are time‐intensive and, in the main, completed by an independent rater. At present there is a lack of systems to guide teams to investigate salient risk factors related to mental state and violent offending that inform treatment effectiveness, change and, ultimately, risk assessment decisions. This paper describes the application of such a system. The Standard Goal Attainment Scaling for Sex Offenders (GAS‐S) (Hogue, 1994) has been modified for use with violent offenders and is presented herewith. Application of the tool to the Violent Offender Treatment Programme (VOTP) is discussed, alongside its potential usefulness in informing risk assessment and the effectiveness of treatment intervention.
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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…
Abstract
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.
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Rachel Connell and Darren Johnson
Whilst a great deal of research exists on the effectiveness of treatment with violent offenders comparatively little is known about the experience of treatment providers. The…
Abstract
Purpose
Whilst a great deal of research exists on the effectiveness of treatment with violent offenders comparatively little is known about the experience of treatment providers. The purpose of this paper is to explore the experiences of four prison officers delivering a high-intensity intervention, with violent offenders.
Design/methodology/approach
A qualitative approach was used to gain a rich, individualised account of treatment providers’ experiences, with interpretative phenomenological analysis applied by the lead researcher (first author). External auditing analysis was conducted by the second author.
Findings
The analysis generated two superordinate themes: “Impact on Self-Coping” and “With Great Challenge Comes Great Reward” with pertinent sub-themes. The findings support the existing evidence regarding the relevance of individual characteristics and coping style on well-being, regardless of the nature of the offences being discussed. Working with violent offenders could be challenging yet rewarding with adequate support in place.
Practical implications
It is imperative that treatment providers are offered support and encouragement in undertaking their role and that a rehabilitative culture is promoted and reinforced within custodial environments. Additional training for facilitators to develop effective self-coping strategies was recommended in addition to careful management of delivery periods.
Originality/value
These findings add to the evidence base in relation to the impact of high-intensity treatment provision on individual well-being; suggestions are made to support clinical and organisational good practice.
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Sharon Howden, Jayde Midgley and Rebecca Hargate
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…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
There was evidence of improved outcomes for some participants in some areas related to risk of violence.
Research limitations/implications
Consideration is given to using varied risk assessments to evaluate outcomes of an adapted VOTP for a MSU.
Originality/value
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.
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Annette McKeown and Sarah McCrory
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Practical implications
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.
Originality/value
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.
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Katie Dhingra and Daniel Boduszek
This paper aims to provide a critical review of the psychopathy literature, with a particular focus on recent research examining the relationship between psychopathy and various…
Abstract
Purpose
This paper aims to provide a critical review of the psychopathy literature, with a particular focus on recent research examining the relationship between psychopathy and various forms of criminal behaviour.
Design/methodology/approach
The authors provide an overview of the studies conducted to date. To identify relevant published studies for this review, literature searches were completed using Web of Science, Scopus, PsychINFO, and PubMed.
Findings
Substantial empirical research exists to suggest that psychopathy is a robust predictor of criminal behaviour and recidivism. Furthermore, considerable support for the assertion that the violence perpetrated by psychopathic offenders is more instrumental than the violence committed by other offenders was found. In addition, some research suggests that the greater use of instrumental violence among psychopathic offenders may be due to the interpersonal/affective traits of psychopathy, and not the impulsive/antisocial traits.
Originality/value
The current paper is the first to provide an in‐depth review of the literature examining the association between psychopathy and criminal offending with a particular focus on violent and homicidal behaviour.
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Sally Stewart, Abigail Oldfield and Louise Braham
The Violent Offender Treatment Programme (VOTP) is a cognitive programme which aims to reduce risk of recidivism of mentally disordered offenders. Research has examined the use of…
Abstract
Purpose
The Violent Offender Treatment Programme (VOTP) is a cognitive programme which aims to reduce risk of recidivism of mentally disordered offenders. Research has examined the use of various assessment tools to explore the effectiveness of the programme. Examination of service user feedback in relation to mental health service provision and violence risk has not been conducted. This study aims to explore service users' experiences of the VOTP.
Design/methodology/approach
Interpretative phenomenological analysis was utilised to explore interviews of seven service users' experiences of the VOTP, within a high secure psychiatric hospital.
Findings
Four broad themes were found: consistency, learning and application, the group experience, and programme structure. Findings indicate participants held positive views of the VOTP. They could relate to the material covered and felt this had enhanced their ability to manage violence and aggression. Recommendations to improve the programme included simplifying programme material, maintaining patient motivation, and ensuring effective communication.
Research limitations/implications
The service users whose risk had substantially reduced and thus left the hospital were not included in this study. In addition, there were restrictions on the patients available as current mental health had to be taken into account. Implications include the importance service users place on group process.
Originality/value
Examining service user feedback in relation to mental health service provision had not previously been completed. Findings may be beneficial to other treatment programmes for violence and other group based psychological treatments in similar settings.
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Natalie Smith, Jenny Tew and Prina Patel
– The purpose of this paper is to outline the development, structure and implementation of the Choices, Actions, Relationships and Emotions (CARE) programme.
Abstract
Purpose
The purpose of this paper is to outline the development, structure and implementation of the Choices, Actions, Relationships and Emotions (CARE) programme.
Design/methodology/approach
This paper will present some of the background to the programme, its aims, structure and delivery methods and the nature of the treatment population to date. It will also reflect on some of the lessons learnt through the development and implementation of the programme and the challenges faced in evaluating its impact. Plans for its future evaluation and development are discussed.
Findings
Female offenders represent a distinct group with particular treatment and responsivity needs. These have traditionally been accommodated in programmes developed for male offenders, adapted slightly to meet their needs. CARE represents a distinct approach, designed specifically for the needs of female offenders with a history of violence and complex presentations.
Originality/value
CARE is a relatively new programme and this is the first paper to outline its structure and content.
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Thomas Nally, Jane L. Ireland, Leah Greenwood, Carol A. Ireland and Philip Birch
This study aims to explore the impact of inclusion of victim empathy-based content in offender treatment.
Abstract
Purpose
This study aims to explore the impact of inclusion of victim empathy-based content in offender treatment.
Design/methodology/approach
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
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.
Practical implications
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.
Originality/value
The study represents the first to apply detailed analysis to this topic area and with a complex group.
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