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Chapter 15 - Forensic Psychotherapy and Psychological Therapies in Forensic Mental Health Settings

Published online by Cambridge University Press:  aN Invalid Date NaN

By
Gwen Adshead  and
John Marshall
Edited by
Mary Davoren  and
Harry G. Kennedy
Mary Davoren
Affiliation:
Broadmoor Hospital and West London NHS Trust
Harry G. Kennedy
Affiliation:
Trinity College Dublin
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Summary

‘Forensic psychotherapy’ is a shorthand term for the treatment of offenders with psychodynamic psychotherapy. Over the last decade, a range of psychological therapies for offenders have been developed, often based on improved therapies for personality disorder. The author discusses what distinguishes forensic psychotherapy from other psychological therapies offered to offenders; and which offenders might benefit most from psychodynamically focussed therapy. The author describes how psychological treatments broadly fit within the risk needs responsivity construct and the matched stepped care system. Matched stepped care and an appropriate governance framework ensure services deliver evidence-based practices, targeting underlying needs. Clear treatment pathways exist, low- to high-intensity interventions are provided with good fidelity and the right people skills are in place to deliver these interventions. The requirement to step up in intensity and expertise level of treatment is based on a clinical formulation and risk. Having the right service in the right place at the right time delivered by the right professional is critical to reducing risk among people who are violent.

Keywords

Forensic psychotherapyPsychodynamicRisk needs responsivityMatched stepped carePsychotherapy matrix
Type
Chapter
Information
Seminars in Forensic Psychiatry , pp. 343 - 361
Publisher: Cambridge University Press
Print publication year: 2024

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References

King, S. Transformative agency and desistance from crime. Criminology & Criminal Justice 2013; 13 (3): 317–35.Google Scholar
Bowlby, J. Forty-four juvenile thieves: their characters and home-life. International Journal of Psycho-Analysis 1944; 25: 19–53.Google Scholar
Bowlby, J. A Secure Base: Parent-Child Attachment and Healthy Human Development. London, Routledge, 1988 (3rd ed., 2012).Google Scholar
Ogilvie, CA, Newman, E, Todd, L, Peck, D. Attachment and violent offending: a meta-analysis. Aggression and Violent Behaviour 2014; 19 (4): 322–39.CrossRefGoogle Scholar
Fox, BH, Perez, N, Cass, E, Baglivio, MT, Epps, N. Trauma changes everything: examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child Abuse & Neglect 2015; 46: 163–73.CrossRefGoogle ScholarPubMed
Hughes, K, Bellis, MA, Hardcastle, KA et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health 2017; 2 (8): e356–66.CrossRefGoogle Scholar
Vaillant, GE. Ego Mechanisms of Defense: A Guide for Clinicians and Researchers. Washington, DC, American Psychiatric Press, 1992.Google Scholar
Perry, JC, Bond, M. Change in defense mechanisms during long-term dynamic psychotherapy and five-year outcome. American Journal of Psychiatry 2012; 169 (9): 916–25.CrossRefGoogle ScholarPubMed
Cramer, P. Psychological maturity and change in adult defense mechanisms. Journal of Research in Personality 2012; 46 (3): 306–16.CrossRefGoogle Scholar
Yakeley, J, Adshead, G. Locks, keys, and security of mind: psychodynamic approaches to forensic psychiatry. The Journal of the American Academy of Psychiatry and the Law 2013 41 (1): 38–45.Google ScholarPubMed
Huband, N, Duggan, C, McCarthy, L, Mason, L, Rathbone, G. Defence styles in a sample of forensic patients with personality disorder. Personality and Mental Health 2014; 8 (3): 238–49.CrossRefGoogle Scholar
Tapp, J, Cottle, L, Christmas, M et al. A psychometric evaluation of the Defence Style Questionnaire-40 in a UK forensic patient population. The Journal of Forensic Psychiatry & Psychology 2018; 29 (2): 288–307.CrossRefGoogle Scholar
Steinert, C, Munder, T, Rabung, S, Hoyer, J, Leichsenring, F. Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. American Journal of Psychiatry 2017; 174 (10): 943–53.CrossRefGoogle ScholarPubMed
Buchheim, A, Viviani, R, Kessler, H et al. Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy. PloS One 2012; 7 (3): e33745.CrossRefGoogle ScholarPubMed
Fonagy, P, Levinson, A. Offending and attachment: the relationship between interpersonal awareness and offending in a prison population with psychiatric disorder. Canadian Journal of Psychoanalysis 2004; 12 (2): 225–51.Google Scholar
Bateman, AW, Fonagy, PE. Handbook of Mentalizing in Mental Health Practice. Washington, DC, American Psychiatric Publishing, Inc., 2012.Google Scholar
Benefield, N, Joseph, N, Skett, S et al. The offender personality disorder strategy jointly delivered by NOMS and NHS England. Prison Service Journal 2015; 218: 4–9.Google Scholar
Marshall, WL, Burton, DL. The importance of group processes in offender treatment. Aggression and Violent Behavior 2010; 15 (2): 141–9.CrossRefGoogle Scholar
Lyth, IM. Containing Anxiety in Institutions: Selected Essays, Vol. 1. London, Free Association Books, 1988.Google Scholar
Kahneman, D. Thinking, Fast and Slow. London, Macmillan, 2011.Google Scholar
Daffern, M, Jones, L, Shine, J (eds) Offence Paralleling Behaviour: A Case Formulation Approach to Offender Assessment and Intervention (Vol. 48). Chichester, John Wiley & Sons, 2010.CrossRefGoogle Scholar
Ireland, J, Ireland, C. Therapeutic treatment approaches for violence: some essential components. In Ireland, JL, Ireland, CA, Birch, P (eds) Violent and Sexual Offenders: Assessment, Treatment and Management (2nd ed.). New York, Routledge, 2019, pp. 319–41.Google Scholar
Hacker, H. Trauma and its treatment in forensic settings. In Ireland, JL, Birch, P, Ireland, CA (eds) Routledge International Handbook on Aggression. London, Taylor and Francis, 2017.Google Scholar
Ogloff, JTP, Davis, MR. Advances in offender assessment and rehabilitation: contributions of the risk-need-responsivity approach. Psychology Crime & Law 2004; 10: 229–42.Google Scholar
Andrews, DA, Bonta, J. The Psychology of Criminal Conduct (5th ed.). New Providence, NJ, LexisNexis Matthew Bender, 2010.Google Scholar
Witt, K, van Dorn, R, Fazel, S. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PloS One 2013; 8 (2).CrossRefGoogle ScholarPubMed
Andrews, D, Bonta, J, Hoge, R. Classification for effective rehabilitation. Criminal Justice and Behaviour 1990; 17: 19–52.CrossRefGoogle Scholar
Mental Health in Scotland: A Guide to Delivering Evidence-Based Psychological Therapies in Scotland – The Matrix, 2011 (NHS Education for Scotland and The Scottish Government, 2011 and 2015).Google Scholar
The Matrix, A Guide to Delivering Evidence-Based Psychological Therapies in Scotland, 2015.Google Scholar
Vatnar, SKV, Bjørkly, S. Lethal intimate partner violence: an interactional perspective on women’s perceptions of lethal incidents. Violence and Victims 2013; 28 (5): 772–89.CrossRefGoogle ScholarPubMed
Hurless, N, Cottone, RR. Considerations of conjoint couples therapy in cases of intimate partner violence. The Family Journal; 2018, 26 (3): 324–9.CrossRefGoogle Scholar
Armenti, NA, Babcock, JC. Conjoint treatment for intimate partner violence: a systematic review and implications. Couple and Family Psychology: Research and Practice 2016; 5 (2): 109–23.Google Scholar
Nesset, MB, Lara-Cabrera, ML, Dalsbø, TK et al. Cognitive behavioural group therapy for male perpetrators of intimate partner violence: a systematic review. BMC Psychiatry 2019; 19 (1): 11.CrossRefGoogle ScholarPubMed
Babcock, J, LaTaillade, J. Evaluating interventions for men who batter. In Vincent, J, Jouriles, E (eds) Domestic Violence: Guidelines for Research-Informed Practice. Philadelphia, PA, Jessica Kingsley Publishers, 2000, pp. 37–77.Google Scholar
Karakurt, G, Whiting, K, van Esch C, et al. Couples therapy for intimate partner violence: a systematic review and meta-analysis.Journal of Marital Family Therapy 2016; 42 (4): 567–83.CrossRefGoogle ScholarPubMed
Zahl-Olsen, R, Gausel, N, Zahl-Olsen, A et al. Physical couple and family violence among clients seeking therapy: identifiers and predictors. Frontiers in Psychology 2019; 10: 2847.CrossRefGoogle ScholarPubMed
Hanson, RK, Bourgon, G, Helmus, G et al. The principles of effective correctional treatment also apply to sexual offenders: a meta-analysis. Criminal Justice and Behavior 2009; 36: 865–91.CrossRefGoogle Scholar
Laws, DR, Ward, T. Desistance from Sex Offending: Alternatives to Throwing Away the Key. New York, The Guilford Press, 2011.Google Scholar
Looman, J, Abracen, J. The risk need responsivity model of offender rehabilitation: is there really a need for a paradigm shift? International Journal of Behavioural Consultation and Therapy 2013; 8 (3–4): 30–6.CrossRefGoogle Scholar
Mews, A, Di Bella, L, Purver, M. Impact Evaluation of the Prison-Based Core Sex Offender Treatment Programme (Ministry of Justice Analytical Series). London, Ministry of Justice, 2017.Google Scholar
Walker, SC, Bishop, AS. Length of stay, therapeutic change, and recidivism for incarcerated juvenile offenders. Journal of Offender Rehabilitation 2016; 55 (6): 355–76.CrossRefGoogle Scholar
Nagayama Hall, GC. Sexual offender recidivism revisited: a meta-analysis of recent treatment studies. In Database of Abstracts of Reviews of Effects (DARE): Quality-Assessed Reviews. York, Centre for Reviews and Dissemination (UK), 1995.Google Scholar
Lösel, F, Link, E, Schmucker, M et al. On the effectiveness of sexual offender treatment in prisons: a comparison of two different evaluation designs in routine practice. Sex Abuse 2020; 32(4): 452–75.CrossRefGoogle ScholarPubMed
Clarke, C, Tapp, J, Lord, A, Moore, E. Group-work for offender patients on sex offending in a high security hospital: investigating aspects of impact via qualitative analysis. Journal of Sexual Aggression 2013; 19 (1): 50–65.CrossRefGoogle Scholar
Willner, P, Rose, J, Jahoda, A et al. Group‐based cognitive‐behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomised controlled trial. The British Journal of Psychiatry 2013; 203: 288–96.CrossRefGoogle ScholarPubMed
Bellemans, T, Didden, R, Van Busschbach, J et al. Psychomotor therapy targeting anger and aggressive behavior in individuals with mild or borderline intellectual disabilities: a systematic review. Journal of Intellectual and Developmental Disabilities 2019; 44: 121–30.CrossRefGoogle Scholar
Lindsay, W. Adaptations and developments in treatment programmes for offenders with developmental disabilities. Psychiatry, Psychology and Law 2009; 16: S18–S35.CrossRefGoogle Scholar
Hawkins, S, Allen, D, Jenkins, R. The use of physical interventions with people with intellectual disabilities and challenging behaviour: the experiences of service users and staff members. Journal of Applied Research in Intellectual Disabilities 2005; 18: 19–34.CrossRefGoogle Scholar
Davies, B, Griffiths, J, Liddiard, K et al. Changes in staff confidence and attributions for challenging behaviours after training in positive behavioural support within a forensic medium secure service. The Journal of Forensic Psychiatry & Psychology 2015; 26: 847–61.CrossRefGoogle Scholar
Knotter, M, Spruit, A, De Swart, J et al. Training direct care staff working with persons with intellectual disabilities and challenging behaviour: a meta‐analytic review study. Aggression and Violent Behaviour 2018; 40: 60–72.CrossRefGoogle Scholar
Trip, S, Bora, CH, Marian, M et al. Psychological mechanisms involved in radicalization and extremism: a rational emotive behavioral conceptualization. Frontiers in Psychology. 2019; 10: 437.CrossRefGoogle ScholarPubMed
Wiktorowicz, Q. Radical Islam Rising: Muslim Extremism in the West. Lanham, MD, Rowman and Littlefield Publishers, 2005.Google Scholar
Gøtzsche‐Astrup, O, Lindekilde, L. Either or? Reconciling findings on mental health and extremism using a dimensional rather than categorical paradigm. Journal of Forensic Science 2019; 64: 982–8.CrossRefGoogle ScholarPubMed
Bhui K, Otis M, Silva MJ, Halvorsrud K, Freestone M, Jones E. Extremism and common mental illness: cross-sectional community survey of White British and Pakistani men and women living in England. Br J Psychiatry. 2019: 1–8.CrossRefGoogle Scholar
Gannon, TA, Ciardha, CÓ, Doley, RM, Alleyne, E. The Multi-Trajectory Theory of Adult Firesetting (M-TTAF). Aggression and Violent Behaviour 2012; 17 (2): 107–21.CrossRefGoogle Scholar
Gannon, TA, Alleyne, E, Butler, H et al. Specialist group therapy for psychological factors associated with fire setting: evidence of a treatment effect from a non-randomized trial with male prisoners. Behaviour Research and Therapy 2015; 73: 42–51.CrossRefGoogle ScholarPubMed
MacKenzie, RD, James, DV. Management and treatment of stalkers: problems, options, and solutions. Behavior Science & Law 2011; 29: 220–39.Google ScholarPubMed
Rosenfeld, B, Galietta, M, Foellmi, M et al. Dialectical behavior therapy (DBT) for the treatment of stalking offenders: a randomized controlled study. Law and Human Behavior 2019; 43 (4): 319–28.CrossRefGoogle ScholarPubMed
Gannon, TA, Olver, ME, Mallion, JS, James, M. Does specialized psychological treatment for offending reduce recidivism? A meta-analysis examining staff and program variables as predictors of treatment effectiveness. Clinical Psychology Review 2019; 73: 101752.CrossRefGoogle ScholarPubMed

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