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Life Skills Group: increasing foundation knowledge and motivation in offenders with a learning disability
- Authors:
- PATTERSON Christy, THOMAS Cathy
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(1), 2014, pp.4-13.
- Publisher:
- Emerald
Purpose: Offenders with a learning disability present with greater clinical need than those without a learning disability. However, for this client group, access to and engagement with psychological and criminogenic interventions are often limited. The purpose of this paper is to discuss a potentially useful approach to this issue. Design/methodology/approach: A single case study design was used to evaluate an introductory group programme, delivered over 12 weekly sessions, in a forensic learning disability service. Semi-structured interviews were used alongside psychometric measures, which were completed prior to, and following completion of, the group, in order to assess the individual's experience of the group, their emotional understanding and difficulties, and readiness to change. Findings: Readiness to change and emotional understanding improved following completion of the programme. Self-reported emotional difficulties showed improvement, although not all staff reports corroborated this. Notably, the service user reported a positive experience, with increased confidence and motivation to attend further groups. Research limitations/implications: Generalisation from the results of single case studies is limited. Although results suggest that motivation to engage further has increased, more research is required to assess whether this impacts on actual ability to engage. Practical implications: Offering an introductory programme prior to further, more criminogenically focused intervention may be more effective than offering these interventions as the first stage of treatment. Originality/value: An introductory group programme may be potentially helpful in providing the foundation knowledge, confidence and motivation necessary to attend further intervention focusing on criminogenic need for offenders with a learning disability. (Publisher abstract)
Redesigning and evaluating an adapted sex offender treatment programme for offenders with an intellectual disability in a secure setting: preliminary findings
- Authors:
- LARGE Julia, THOMAS Cathy
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(2), 2011, pp.72-83.
- Publisher:
- Emerald
This study examined the needs of multiple stakeholders in an adapted sex offender treatment programme (ASOTP), and evaluated a pilot programme set up to respond to the identified needs. Stakeholders included purchasers of Partnerships in Care Learning Disability Services, referred clients, internal and external clinicians involved in their care and group facilitators. Data was gathered from questionnaires and semi-structured interviews in order to determine the key issues necessitating change. An ASOTP was designed and piloted to address highlighted needs, including time frames for the commencement and completion of treatment. Feedback was positive, with participants showing an increase in motivation, knowledge, and, unexpectedly, enhanced levels of risk disclosure. Facilitators reported increased satisfaction and decreased stress levels. The programme was tailored to respond to individual treatment needs within a group setting whilst ensuring programme integrity and effective risk management within a forensic learning disability service. Implications for future research in terms of improving treatment effectiveness are discussed.
Do male and female forensic patients with learning disabilities differ on subscales of the Novaco Anger Scale and Provocation Inventory (NAS-PI)?
- Authors:
- CHILVERS Jane, THOMAS Cathy
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(2), 2011, pp.84-97.
- Publisher:
- Emerald
While anger is associated with learning disabled populations, the role of gender is not clear. This study examined the experience of anger in females within a forensic psychiatric service. The Novaco Anger Scale and Provocation Inventory was applied. Scores obtained by 12 females were compared with those of 23 males. Findings revealed significant differences between gender scores, suggesting female forensic patients with learning disabilities experience higher levels of anger than do males, particularly in the arousal domain, and demonstrated difficulties in regulating anger. Gender specific differences, and the potential influence of learning disabilities should be considered when assessing and treating anger difficulties. Female forensic patients with learning disabilities may benefit from a greater emphasis on anger arousal reduction work. The authors recommend further research using more measures to further understand how the impact of gender and learning disabilities on the experience of anger is related.
Management of aggression care plans in a forensic intellectual disability service: a ten-year progress update
- Authors:
- KITCHEN David, THOMAS Cathy, CHESTER Verity
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(2), 2014, pp.88-96.
- Publisher:
- Emerald
Purpose: Standardised approaches to the management of aggression and violence are critical for all stakeholders of intellectual disability services. The purpose of this paper is to describe the Management of Aggression Care Plan (MoACP). The care plan aims to reduce levels of restrictive interventions, to ensure any interventions relative to aggression and violence are the least restrictive possible, and to promote adaptive behaviours and support life enriching opportunities, in a manner which is personalised to the unique profiles of every patient. Design/methodology/approach: The MoACP was first described by Thomas et al. (2005). This paper describes the rationale, theoretical basis, structure and benefits of the care plan, and provides details of revisions made to the plan in response to evidence-based practice recommendations. Findings: The value of implementing a structured approach to the care planning of management of aggression and violence, in reducing the frequency and impact of restrictive practices, and promoting life enriching opportunities is described. Practical implications: The paper describes a number of practical features of the care plan which most support its continued effectiveness, including patient involvement, individual patient focused training, and audit. Originality/value: Although many services undertake localised approaches to the care planning of management of violence and aggression in forensic intellectual disability services, few have been described in the published literature. (Publisher abstract)
The Essen Climate Evaluation Schema measure of social climate in a secure service for people with intellectual disabilities
- Authors:
- QUINN Marian, THOMAS Cathy, CHESTER Verity
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(4), 2012, pp.171-178.
- Publisher:
- Emerald
This study investigated the psychometric properties of the EssenCES measure of social climate in a secure service for people with intellectual disabilities. Fifty one patients, aged 18 to 71 years, residing in a secure intellectual disabilities service completed the EssenCES as part of routine clinical practice. Analysis revealed acceptable reliability for all three subscales. In order to consider one aspect of the construct validity of this measure, a predicted group difference regarding the impact of security level on ratings of social climate was investigated. Analysis revealed that social climate ratings were more positive on low secure wards than medium secure wards as measured by the combined EssenCES subscales, and the Experienced Safety subscale. The authors concluded that the results provide preliminary evidence to suggest that the EssenCES subscales were reliable in this previously unconsidered population. However the validity of the measure is still unclear and requires further investigation.
The impact of a ward-based mindfulness programme on recorded aggression in a medium secure facility for women with learning disabilities
- Authors:
- CHILVERS Jane, THOMAS Cathy, STANBURY Alex
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(1), January 2011, pp.27-41.
- Publisher:
- Emerald
Mindfulness is the practice of focusing attention effectively and purposefully, in a non-judgmental manner, on current circumstances. It has been increasingly used as a tool for managing a range of difficulties associated with personal suffering, including stress and chronic pain, as well as some aspects of mental disorder. This study aimed to investigate whether the introduction of mindfulness open group sessions would reduce the overall number of aggressive incidents recorded by female patients with learning disabilities in a forensic medium secure psychiatric unit. The participants were all of the 15 patients resident on the ward from October to April 2010. Twice-weekly, 30-minute group sessions were held, and the participants had the option of opting in or out of each session. Proxy measures of institutional aggression, namely the number of observations, physical interventions, and seclusions, were recorded at baseline and at 2 months and 6 months following the introduction of the sessions. Friedman's Analysis of Variance and post-hoc analyses using Wilcoxon's Signed Ranks showed a significant reduction of the 3 measures at 6 months. The potential influence of basic mindfulness practice sessions in reducing aggression is discussed.
The management of aggression care plans: implementation and efficacy in a forensic learning disability service
- Authors:
- THOMAS Cathy, KITCHEN Dave, SMITH Adam
- Journal article citation:
- British Journal of Forensic Practice, 7(2), May 2005, pp.3-9.
- Publisher:
- Emerald
This article describes the design and implementation of the management of aggression care plans (MOACAP) in a secure service for people with learning disability and severe challenging behaviour. The MOACAP is a five-part document, which has sections for descriptions of challenging behaviour, escalation patterns of the behaviour, non-physical interventions, physical interventions and post-incident briefing.