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Offenders referred to a learning disability service: a retrospective study from one county
- Authors:
- THOMAS D.H., SINGH T.H.
- Journal article citation:
- British Journal of Learning Disabilities, 23(1), 1995, pp.24-27.
- Publisher:
- Wiley
A retrospective study of all offenders with learning disabilities referred to a community based out-patient clinic serving one county over a seven-year period was performed. Information was collected regarding degree of learning disability, presence of additional mental disorder, type of offence committed and living conditions at the time of referral. Follow up over a subsequent three-year period was also performed retrospectively and covered areas such as treatment, reoffending, hospitalisation and present accommodation. Some of the implications of the findings are discussed and it is argued that a community based out-patient clinic supported by a small in-patient unit cannot cope with all offenders with learning disabilities.
The development and preliminary evaluation of a thinking skills programme for adults with learning disabilities at risk of offending
- Author:
- KELLY Julia
- Journal article citation:
- Journal of Forensic Practice, 16(1), 2014, pp.32-45.
- Publisher:
- Emerald
Outlines and evaluates the development of a thinking skills programme for adults with learning disabilities at risk of offending. The programme was evaluated over three years using self-report clinical measures related to treatment targets and feedback from participants. Results showed a statistically significant improvement in general empathy and perspective taking. Improvement in impulsivity and locus of control was not significant. Feedback from service users was positive. The findings suggest that thinking skills programmes can be of benefit to adults with learning disabilities at risk of offending. There is a need to provide opportunities for adults with learning disabilities to address generic deficits and factors supporting offending behaviour and to increase readiness for offence-specific treatment. (Edited publisher abstract)
Evaluation of treatment outcomes from a medium secure unit for people with intellectual disability
- Authors:
- ALEXANDER Regi T., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.22-32.
- Publisher:
- Emerald
Short-term treatment outcomes were evaluated in 138 individuals (109 male) admitted over a six-year period to a 64-bedded medium secure inpatient service for offenders with mild intellectual disabilities. The aim was to audit successful treatment outcome, defined by a move to a lower level of therapeutic security, and to establish the length of hospital stay and the socio-demographic, clinical and forensic variables associated with it. Seventy seven discharged and 61 current in-patients, were included. The median length of stay for the discharged group was 2.8 years, with 75% staying for less than 5 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. Of the 61 inpatients, 36 were considered ‘difficult to discharge long stay’ patients. However, a third of this group had moved to low secure rehabilitation settings within the service. The ‘difficult to discharge’ group had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not found to be predictive of length of stay. The author concludes that clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay. There is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables.
An evaluation of the PCL-R in assessing prisoners with low intellectual functioning
- Authors:
- FITZGIBBON Diana Wendy, CAMERON Angus
- Journal article citation:
- British Journal of Forensic Practice, 9(1), April 2007, pp.10-15.
- Publisher:
- Emerald
The Psychopathy Checklist-Revised is used for forensic and clinical settings to give an indication of the level of psychopathy and individual presents. The use of the PCL-R with offenders with a learning disability (LD) is under-studied. This current study aims to replicate an earlier study which focused on the problems arising from assessing an LD service sample from Rampton Hospital. The results may suggest that the PCL-R may be used reliability with offenders with low intellectual functioning.
Sixteen years of the Brooklands Thinking Skills Offender Programme
- Authors:
- HICKMAN Gareth, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(3), 2017, pp.132-143.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to report on the Brooklands Thinking Skills Offender Programme (BTSOP), a social problem-solving skills group programme developed and provided to people with intellectual disabilities (IDs) detained in conditions of medium and low security. The programme has been running and evolving since 2001 and has undergone consistent development over this time. Within the past five years, there have been significant developments of the Secure Service Treatment Pathway and the current paper describes the integration of the BTSOP within this new pathway model. Design/methodology/approach: The programme was evaluated over five years using self-report psychometric measures related to treatment targets. Evaluation data in relation to attrition rates, discharges, transfers, treatment engagement and recidivism are also provided from a 16-year period. The updated treatment pathway and a description of the programme are provided. Findings: Results showed statistically significant improvements in Rational Problem Solving, increased internal locus of control and decreased external locus of control. Reflection on the limitations and challenges to outcome assessment in this area is offered. Originality/value: This paper builds on the existing evidence base of interventions focused on developing social problem-solving skills in offenders and presents evidence of the effectiveness of such programmes with offenders with IDs. (Publisher abstract)
Development and implementation of a discharge pathway protocol for detained offenders with intellectual disabilities
- Authors:
- TAYLOR John L., et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(3), 2017, pp.144-154.
- Publisher:
- Emerald
Purpose: Building the Right Support, a national plan for people with intellectual disabilities (ID) in England aims to avoid lengthy stays in hospital for such people. Discharge planning is understood to be helpful in facilitating successful transition from hospital to community services, however, there is little guidance available to help those working with detained patients with ID and offending histories to consider how to affect safe and effective discharges. The paper aims to discuss these issues. Design/methodology/approach: In this paper, the development and implementation of a multi-faceted and systemic approach to discharge preparation and planning is described. The impact of this intervention on a range of outcomes was assessed and the views of stakeholders on the process were sought. Findings: Initial outcome data provide support for the effectiveness of this intervention in terms of increased rates of discharge, reduced lengths of stay and low readmission rates. Stakeholders viewed the intervention as positive and beneficial in achieving timely discharge and effective post-discharge support. Practical implications: People with ID are more likely to be detained in hospital and spend more time in hospital following admission. A planned, coordinated and well managed approach to discharge planning can be helpful in facilitating timely and successful discharges with low risks of readmission. Originality/value: This is the first attempt to describe and evaluate a discharge planning intervention for detained offenders with ID. The intervention described appears to be a promising approach but further evaluation across a range of service settings is required. (Publisher abstract)
Users' views of a dynamic risk assessment system
- Author:
- MURPHY Lesley
- Journal article citation:
- Nursing Times, 16.08.05, 2005, pp.35-37.
- Publisher:
- Nursing Times
The assessment and management of risk plays a significant role in the ongoing care and future management of patients with learning disabilities. This article describes the use of the dynamic risk assessment and management system for individuals with learning disabilities and offending behaviour.
Towards an environmental perspective on intervention for problem sexual behaviour in people with an intellectual disability
- Author:
- O'CONNOR Wendy
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 10(2), 1997, pp.159-175.
- Publisher:
- Wiley
Describes the evolution of intervention for people with an intellectual disability who have problem sexual behaviour in Australia. Accepted treatments for non-disabled sexual offenders are now being applied to offenders with a disability. Finds that intervention should be broad-based and individualised and attend to deviant sexual preference, patterns of offending behaviour and the environmental context of the behaviour. There is a need for controlled studies to isolate the effects of individual components in multi-component interventions.
A community EQUIP treatment group
- Authors:
- TEARLE Shaw, HOLT Rachel R.
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 9(2), 2018, pp.69-80.
- Publisher:
- Emerald
Purpose: There is a pressing need to develop community forensic support for adults with intellectual disabilities and a high risk to others. Equipping youth to help one another (EQUIP) was developed for juvenile offenders in the USA and is used across Europe and North America. The purpose of this paper is to evaluate an adapted community model of EQUIP for men with intellectual disabilities and a history of sexual offending. Design/methodology/approach: A case series design was used. The adapted EQUIP group ran for one session per week over ten months, with each participant accompanied by a support worker. Six men living in the community with intellectual disabilities and a history of sexual offending completed the programme. Findings: Analysis of the results suggests that this adapted version of EQUIP produced similar results to the programme delivered in an inpatient setting. Participants’ reasoning and problem-solving abilities were improved post-intervention. Satisfaction levels from participant and their support workers were high. There was no evidence of recidivism during the ten months the group ran. Research limitations/implications: The case series design utilised only allows the conclusion that the changes above occurred at the same time as the group. Further research is needed to ascertain whether it is likely that the intervention resulted in the changes. Practical implications: There is a pressing need to develop the evidence base for interventions offered in the community to people with intellectual disabilities and a history of offending. This study provides some evidence that EQUIP can be adapted to suit this population. Social implications: The availability of community interventions may, over time, decrease the need for detention in inpatient settings. This is in line with the transforming care agenda. Originality/value: This is the first published research into use of EQUIP in the community with adult participants with intellectual disabilities. (Edited publisher abstract)
Effects of intellectual functioning on cognitive behavioural anger treatment for adults with learning disabilities in secure settings
- Authors:
- TAYLOR John, NOVACO Raymond W., JOHNSON Lucy
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(4), December 2009, pp.51-56.
- Publisher:
- Emerald
In both community and secure settings, anger has been shown to be associated with aggression and violence in adults with learning disabilities. Although evidence has shown that cognitive behavioural anger treatment can be effective in reducing the assessed levels of anger in these patients, it has been suggested that the effectiveness of these interventions is significantly affected by an individual’s verbal ability. This service evaluation study of 83 offenders with learning disabilities who received cognitive behavioural anger treatment, examines the pre-treatment, post-treatment and 12 month follow-up assessment in order to investigate whether participants responsiveness to a treatment was a function of measured verbal IQ. Overall, the results indicated that the effectiveness of anger treatment was not the result of higher verbal ability, as reflected in verbal IQ scores. The authors conclude that cognitive behavioural therapy for anger control problems can be effective for both men and women with moderate, mild and borderline levels of intellectual functioning and forensic histories, and that the positive outcomes are maintained, and even increase, at the 12 month follow-up.