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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.

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.

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 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 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.

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.

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.

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.

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.

Interpretative phenomenological analysis was utilised to explore interviews of seven service users' experiences of the VOTP, within a high secure psychiatric hospital.

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.

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.

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.

The purpose of this paper is to outline the development, structure and implementation of the Choices, Actions, Relationships and Emotions (CARE) programme.

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.

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.

CARE is a relatively new programme and this is the first paper to outline its structure and content.

Within controlled environments such as prisons or forensic facilities, strong sanctions and other factors can inhibit the expression of offence-linked behaviours otherwise observable in community settings. For example, institutional restrictions may distort the offender’s habitual expression of aggressive behaviours such that the individual’s aggressive characteristics are less intense or observable. Thus, the influences of controlled settings can make it difficult for staff to capture idiosyncratic evidence of change or lack thereof over time or with treatment. The purpose of this paper is to describe an assessment and measurement framework that can be used to assist treatment and correctional staff collectively focus attention on relevant characteristics and behaviours idiosyncratically linked to offending.

The authors use the terms “offence analogue behaviours (OAB)” to describe proxies of offence behaviours observable in controlled settings and “offence replacement behaviours (ORB)” as the contrasting positive, pro-social skills and strategies that the individual implements to change and manage problem areas linked to aggression and criminality. This paper discusses the application and practical utility of the framework and an associated assessment and measurement tool; the Offence Analogue and Offence Replacement Behaviour Guide (Gordon and Wong, 2009-2013).

The OAB and ORB Guide has shown to be useful by directing the attention of treatment personnel to the here-and-now offence related behaviours displayed by offenders in custodial settings. In the absence of such focused attention, relevant proxy behaviours can often be masked in these highly controlled environments. The Guide is therefore a useful adjunct to identify such behaviours for treatment and for assessing treatment-related changes.

The OAB/ORB Guide was developed based on a conceptual framework derived from the empirical literature on correctional treatment, risk assessment, psychological theories and clinical practice. While there has been some positive pilot use of the Guide’s utility and preliminary research, at this point, empirical evidence is still lacking.

The OAB/ORB Guide provides quantified and structured guidelines to assess offence proxy and offence replacement behaviours observable day-to-day within controlled environments, such as during custody or supervised release to the community.

This guide was developed to assist staff with the identification, documentation and measurement of idiosyncratic negative and positive offence-related proxy behaviours observable across custodial or supervised contexts. Accordingly, the authors suggest that OAB/ORB guide information can be used to evaluate changes in risk over treatment and/or time. Further, the authors describe how this framework may enhance the efficacy of multi-disciplinary treatment and management teams. Two cases are used to illustrate the application of the Guide.

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.