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Do sexual offenders with learning disabilities benefit from sex offender treatment programmes?
- Author:
- HENSON Teresa
- Journal article citation:
- British Journal of Learning Disabilities, 37(2), June 2009, pp.98-102.
- Publisher:
- Wiley
This article discusses some of the clinical and practical issues in relation to sex offender treatment in prisons and compares, through the experience of one offender who has been called Sam, how the experiences may differ between offenders with and without learning disabilities. It gives a brief overview of how programmes have developed in prisons and describes differences between the Sex Offender Treatment Programme and the Adapted Programme. It highlights how offenders with learning disabilities are severely disadvantaged by the programmes and how current sentencing practice will discriminate against this group in terms of not being able to demonstrate reduction of risk, resulting in offenders with learning disability remaining in prison for ever extending periods.
Characteristics of referrals and admissions to a medium secure ASD unit
- Authors:
- O'DONOGHUE Therese, SHINE John, ORIMALADE Olufunto
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(3), 2014, pp.138-146.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present preliminary data on a cohort of patients referred to a specialist forensic medium-secure autism spectrum disorder (ASD) service during its first two years of opening and to identify variables associated with admission to the service. Design/methodology/approach: Data on all referrals to the service (n=40) was obtained from clinical files on demographics, offending history, psychiatric history and levels of therapeutic engagement. The sample was divided into two groups: referred and admitted (n=23) and referred and not admitted (n=17). Statistical analysis compared the two groups on all variables. Findings: Totally, 94 per cent of all individuals assessed had a diagnosis of autism, however, structured diagnostic tools for ASD were used in a small minority of cases. About half the sample had a learning disability, almost four-fifths had at least one additional mental disorder and almost three-quarters had a history of prior supervision failure or non-compliance with treatment. The sample had a wide range of previous offences. No significant differences were found between the groups on any of the variables included in the study. Research limitations/implications: The present study presents a starting point to follow up in terms of response to treatment and characteristics associated with treatment outcome. Practical implications – The sample had a wide range of clinical and risk-related needs. Both groups shared many similarities. Originality/value: This highlights the need for comprehensive assessment looking at risk-related needs so that individuals are referred to an optimal treatment pathway. (Publisher abstract)
Intellectual disability and mental health: is psychology prepared?
- Authors:
- RAZZA Nancy J., et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(6), 2014, pp.381-389.
- Publisher:
- Emerald
Purpose: The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach: The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings: The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications: This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programmes. (Edited publisher abstract)
Alcohol and illicit drug misuse in people with learning disabilities: implications for research and service development
- Authors:
- TAGGART Laurence, HUXLEY Adam, BAKER Gill
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 2(1), March 2008, pp.11-21.
- Publisher:
- Emerald
This paper offers readers a review of the literature on alcohol and illicit drug misuse in people with learning disabilities, focusing on six key areas. First, clarity is provided on the definition of ‘misuse’. Second, prevalence rates are examined along with the methodological difficulties involved in such studies, the authors arguing that prevalence rates are higher than current estimates. Third, the authors explore the relationship between the intra- and inter-personal risk factors. Fourth, the nature of substance misuse is explored, with a focus on offending behaviour. Fifth, a range of treatment modalities are described with a series of recommendations for more robust evidence-based interventions. Last, the authors explore the gaps in policy that lead to a dearth in service provision as well the barriers which people with learning disabilities face on entering treatment services. The paper cites four more innovative projects that address this population’s needs in England, and illustrates how Northern Ireland has positioned the needs of this hidden population within the Department of Health, Social Services and Public Safety (Northern Ireland).
Good practice in physical interventions: a guide for staff and managers
- Editors:
- PALEY Sharon, BROOKE John, (eds.)
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2006
- Pagination:
- 157p.
- Place of publication:
- Kidderminster
The first handbook for staff and managers on good practice in physical interventions draws together practical guidance from some of the UK’s leading physical interventions trainers and experts. Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). This study aims to investigate the extent to which staff in intellectual disability services need training in the use of physical interventions or restraint.
Physical interventions with people with intellectual disabilities: staff training and policy frameworks
- Authors:
- MURPHY Glynis, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 16(2), June 2003, pp.115-125.
- Publisher:
- Wiley
Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). This study aims to investigate the extent to which staff in intellectual disability services were trained in the use of physical interventions or restraint. Their views of a recent policy framework on physical interventions were also sought. There were three groups of participants: (i) group 1 included staff who had attended conferences on the Policy Framework (the conference sample); (ii) group 2 included staff from two geographical areas (the geographical sample); (iii) group 3 included staff in specialist assessment and treatment services (the SpAT sample). All participants were sent a questionnaire asking them about their training in (and use of) physical intervention methods and their opinions on the policy document. There were at least 12 different types of training recorded, including a number of varieties of Control and Restraint (C&R). By no means did all the senior staff did have training in physical intervention methods. The degree of training varied with the sample and the type of training varied with the employing organization. Most participants in group 1 were very positive about the BILD & NAS Policy Framework but few staff in groups 2 and 3 had read the document. About two-thirds of the participants said their services had (or were developing) a written policy on physical interventions. There remained a clear need for further training in physical interventions and evidence on which the effectiveness of different methods of physical interventions could be judged.
Clozapine use in personality disorder and intellectual disabilities
- Authors:
- KIANI Reza, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(6), 2015, pp.364-370.
- Publisher:
- Emerald
Purpose: Clozapine is a well-known antipsychotic medication licensed for treatment-resistant schizophrenia, but there is limited research available to suggest its efficacy in the context of personality disorder and intellectual disabilities presenting with high-risk behaviour with or without psychotic symptoms. The purpose of this paper is to raise awareness of the benefits of using clozapine in patients with intellectual disabilities and personality disorder that present with a complex picture of serious risk of harm to both their life and the lives of others. Design/methodology/approach: The authors present five patients with intellectual disabilities and serious life-threatening challenging behaviour whom were started on clozapine as part of their multidisciplinary treatment plan to manage their presentation. The authors completed baseline assessment of five main symptom domains and then repeated this assessment following treatment with clozapine. Findings: In all five cases use of clozapine was objectively associated with an improvement in symptomatology, quality of life and a safe transfer to the community. Originality/value: The findings suggest that judicious use of clozapine could be considered as one of the effective pharmacological strategies in the management of patients with intellectual disabilities and personality disorder who present with serious life-threatening challenging behaviours. (Publisher abstract)
Should actuarial risk assessments be used with sex offenders who are intellectually disabled?
- Authors:
- HAMS Andrew J. R., TOUGH Susan
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 17(4), December 2004, pp.235-241.
- Publisher:
- Wiley
Objective actuarial assessments are critical for making risk decisions, determining the necessary level of supervision and intensity of treatment. This paper reviews the history of organized risk assessment and discusses some issues in current attitudes towards sexual offenders with intellectual disabilities. The authors present two risk assessment tools (RRASOR and STABLE-2000) that appear to have practical utility with this population. Data are presented from a community sample of 81 sexual offenders who are intellectually disabled suggesting that the RRASOR may provide a useful metric of risk for this population. Dynamic risk is assessed using the STABLE-2000. This tool, based on 16 areas empirically associated with sexual recidivism, samples the individuals’ current behaviour, skill deficits and personality factors. Change in these factors serves to flag the supervisor to changing risk levels. In addressing the question of whether we should seek special risk measures normed on people with intellectually disabilities, given the current lack of alternative tools, the authors conclude that it is reasonable to make use of the risk assessments that have been validated on the general sex offender population.
Sterilisation
- Author:
- HARRIS Peter
- Journal article citation:
- Mental Health and Learning Disabilities Care, 3(9), May 2000, p.315.
- Publisher:
- Pavilion
A man with learning disabilities cannot be sterilised; a women can. The decision rests on the balance of risk to their physical and mental health. Discusses the law using a case example.
The mentally retarded person as a victim of maltreatment
- Authors:
- VERDUGO M.A., BERMEJO B.G.
- Journal article citation:
- Aggression and Violent Behavior, 2(2), Summer 1997, pp.143-165.
- Publisher:
- Elsevier
Throughout history, disabled people have been an especially vulnerable group to maltreatment practices. This article reviews the main conclusions drawn from recent publications on the maltreatment of people with learning difficulties. Goes on to consider whether learning difficulties are the cause or the consequence of maltreatment, the vulnerability factors related to disability, and the main risk situations. Presents reflections from more specific studies, such as the relationship between sexual abuse and learning difficulties; and proposes some current prevention and treatment strategies.