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The Good Thinking! course — developing a group-based treatment for people with learning disabilities who are at risk of offending
- Authors:
- GOODMAN Wendy, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(3), 2011, pp.114-121.
- Publisher:
- Emerald
Offender treatment programmes are often inaccessible to those with learning disabilities, which may mean those convicted of offences may receive no offender treatment. This paper describes the development of the “Good Thinking!” course, a group-based offender treatment programme designed to help address this need. It aims to inform and encourage clinicians and commissioners working in this field to increase the availability of specialist community-based treatments for offenders who have learning disabilities. The course comprises 23 two-hour sessions run once a week in a community setting. Based on the premise that people who commit offences are often trying to meet ordinary life goals through anti-social means, it aims to help participants identify and understand their goals, develop the social skills necessary, and teaches a problem-solving strategy for more complex problems. A description of the course and a case study are provided. However, to date, insufficient data have been produced to enable a formal evaluation of the effectiveness of the course.
A therapeutic community for personality disorder in a high secure intellectual disability service: inception and early experiences
- Authors:
- TAYLOR Jon, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(4), 2012, pp.165-170.
- Publisher:
- Emerald
This article explains the reasons for use of a therapeutic community for personality disorder in a high secure intellectual disability service. While no findings are reported, it describes the rationale for, and early experiences of, a therapeutic community intervention for people with mild intellectual disability and personality disorder in a high secure setting. The article describes the allocation of staff and patients to the services, and details staff support and training that has been provided. The article concludes by noting that the ‘whole day’ treatment approach of a therapeutic community enabled the interpersonal style of the offenders with a personality disorder to be explored in depth. The peer pressure and feedback that is a feature of therapeutic communities is an effective intervention for offenders with mild learning disabilities.
The way back: a reasoned and data based approach to increasing community access for sex offenders during and post treatment
- Authors:
- STEVENSON Brandie, et al
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 2(2), 2011, pp.63-71.
- Publisher:
- Emerald
Community-based programmes for people with learning disabilities have to decide the conditions under which those in treatment will be able to enter the community. This paper presents how a Community Trust programme, first described theoretically in 1996, will work in practice. From the moment treatment begins, data will be collected relating to how individuals will be able to access the community. Therapists will be able to make decisions on that access, based on data not opinion. Two case examples demonstrate the principles of the trust programme. Community trust for individuals who have engaged in serious, dangerous, or criminal behaviours is a serious issue and therefore must be a well thought out process, and also needs to be data based. The paper shows how community-based treatment programmes give individuals real life opportunities to practice skills in a safe setting and thus transfer what is learned in therapeutic sessions to community application.
‘It’s intense, to an extent’: a qualitative study of the emotional challenges faced by staff working on a treatment programme for intellectually disabled sex offenders
- Authors:
- SANDU Daljit, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(4), July 2012, pp.308-318.
- Publisher:
- Wiley
Research indicates that working with service users with an intellectual disability is associated with a range of negative effects as is working with sex offenders. However, some recent work suggests that staff working in these areas may not be as negatively affected as is commonly assumed. This study used semi-structured interviews to explore the emotional challenges faced by eight staff members working on a sex offender treatment programme for people with an intellectual disability. The interviews were analysed using interpretative phenomenological analysis. The results suggest that the emotional experiences of the participants were complex, some were shared and some individual. Staff experienced a range of negative emotions that they dealt with in a variety of ways including through the use of humour and various emotional defences. Empathy was a challenging and complex issue with individuals taking a variety of positions. The authors conclude that staff awareness and understanding of the role of emotions in relation to their own well-being and in relation to therapeutic processes varied. Emotional intelligence was associated with greater therapeutic understanding. Working with offenders with intellectual disabilities presents psychological and emotional challenges. Recommendations are made in relation to personal and professional characteristics and need for clinical supervision to support staff well-being as well as the development of therapeutic competence and effectiveness.
Introduction to the Dutch De Borg institutions
- Author:
- ROOS Jacqueline
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 1(1), April 2010, pp.29-32.
- Publisher:
- Emerald
In the Netherlands there are different facilities for the treatment and care of mentally disabled people: ordinary care institutions where people live and work; mental health care institutions that provide treatment; and specialised treatment units for people with learning disabilities and severe challenging behaviour. In this article the author introduces De Borg, a collaboration of five institutions in the Netherlands for adults with mild learning disabilities (intellectual disabilities) and severe problem behaviour. These institutions have different backgrounds: one is a TBS facility (a special forensic psychiatric facility); one a mental health care; and three for mentally disabled people. All five organisations offer temporary treatment, where clients come in from other institutions and prisons, and, after treatment, leave – normally to lower care institutions for the mentally disabled. A total of 224 beds are available for inpatient treatment and 800 places for outpatients. Previously, all facilities were either low or high security, but there are currently plans to build a medium secure unit for patients with learning disabilities. The author presents some results of the research that has taken place in the treatment units about the characteristics of the clients, and concludes with recent developments in De Borg institutions, such as the creation of a common ‘vision on treatment and treatment programmes’ and the improvement of treatment programmes.
Predictive validity of the PCL-R for offenders with intellectual disability in a high security hospital: treatment progress
- Authors:
- MORRISSEY Catrin, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(2), June 2007, pp.125-133.
- Publisher:
- Taylor and Francis
Among mainstream offenders, the severe personality disorder of psychopathy has considerable importance as a construct. The disorder has long been associated with failure to make treatment progress. The present study aimed to compare the predictive power of the Psychopathy Checklist - Revised (PCL-R) in relation to treatment progress with a more general assessment of violence risk, the HCR-20. A sample of 73 residents in a high security intellectual disability service, who had previously been assessed using the PCL-R and the HCR-20, were followed up at 2 years post-assessment, and their outcome determined in terms of two distinct dichotomous variables reflecting definite positive treatment progress and definite negative treatment progress respectively. In line with predictions, the PCL-R Total score and Factor 1 score (Interpersonal and Affective aspects of psychopathy) and the HCR-20 Total score were significantly inversely associated with a positive move from high to medium security hospital conditions within 2 years of assessment. However against prediction, the PCL-R Total score had incremental validity over the HCR-20. The PCL-R Total and Factor 1, but not the HCR-20 Total score, were also significantly associated with negative treatment progress in terms of a move to more restricted treatment conditions. Psychopathy, and in particular its interpersonal and affective manifestations, is a construct which appears to be associated with indirect measures of treatment progress in this high security ID group. However, caution should be applied in the use of a construct with potentially negative connotations in an already devalued population.
The diagnosis of schizophrenia in the borderline learning-disabled forensic population: six case-reports
- Authors:
- GRALTON Ernest, JAMES Adrian, CROCOMBE Juli
- Journal article citation:
- Journal of Forensic Psychiatry, 11(1), April 2000, pp.185-197.
- Publisher:
- Routledge
Presents six case reports of male patients admitted to an open forensic psychiatric unit for people with mild and borderline learning disability, whose schizophrenia was previously unrecognised. Treatment led to a marked clinical improvement. Highlights the need to be particularly aware of the possibility of schizophrenia in this population.
Assessment and treatment of sexual offenders with intellectual disabilities: a handbook
- Editors:
- CRAIG Leam A., LINDSAY William R., BROWNE Kevin D., (eds.)
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2010
- Pagination:
- 375p.
- Place of publication:
- Chichester
Contributors from the field of forensic psychology contribute to cover theory, research and practical intervention for those working with intellectually disabled sex offenders. Latest research findings on the characteristics and prevalence of sexual offenders with intellectual disabilities are summarised. Key topics covered include: theories of sexual offending, developmental pathways, risk assessment, personality disorders and psychopathy, community and prison based treatment programmes, and legal and mental health services. The available literature on sexual offenders with intellectual disabilities is reviewed along with the latest treatment approaches and legislative developments.
Working with people with learning disabilities and offending behaviour: a handbook
- Authors:
- CHAPLIN Eddie, HENRY Jayne, HARDY Steve
- Publisher:
- Pavilion
- Publication year:
- 2009
- Pagination:
- 162p.
- Place of publication:
- Brighton
This handbook aims to provide up-to-date information on forensic issues in people with learning disabilities. It offers an introduction to working with people who have leaning disabilities and offending behaviour, or those who are at risk of offending behaviour, and looks at recent developments in services, treatment and legislation. Topics covered include an overview of offending, services and partnerships, legal and ethical considerations in the criminal justice system and the Mental Health Act, and psychopathology and offending. The chapter on clinical work discusses approaches to the management of various types of offenders including sexual offenders, fire setters, and violent offenders as well as considering issues around risk assessment. A glossary and extensive list of weblinks are provided. The Handbook covers the same ground as a companion training resource. It can be read independently or used to support the training course materials. Both publications are expected to be of value to forensic nurses, senior carers, behavioural and occupational therapists, trainers, probation services and other frontline staff.
Treatment of offenders with mental disorders
- Editor:
- WETTSTEIN Robert M.
- Publisher:
- Guilford Press
- Publication year:
- 1998
- Pagination:
- 447p.,bibliog.
- Place of publication:
- London
Looks at the treatment of offenders with mental health problems in the United States. Includes chapters on: administration of treatment programmes; legal aspects; inpatient treatment; community based forensic treatment; treatment in prison; treatment of sex offenders; treatment of offenders with learning difficulties; and treatment of juvenile offenders.