Pub Date : 2019-05-13DOI: 10.1108/JFP-12-2018-0049
E. Mellor, Simon C. Duff
Purpose The purpose of this paper is to investigate the attitudes of staff members in secure hospitals and the general population towards pornography use and their decision-making regarding access to pornography. Design/methodology/approach A between participants design was used whereby 324 participants, including 162 staff members and 162 people of general population, answered an online questionnaire. Vignettes were presented of six hypothetical patients in a secure hospital, based on gender (male/female) and offence type (sexual/violent/non-offender). Participants were required to decide whether the individual depicted in the vignette should have access to pornography. Finally, participants were given a psychometric assessment of their own attitudes towards pornography. Findings Participants were less likely to decide that the sex offender should have access to pornography than the violent or non-offender, thus the offence type of the patient was a significant predictor. There was a significant relationship between attitudes to pornography and whether the individual in the vignette should be given access to pornography. There was no significant difference between attitudes towards pornography of the general public and staff members or for male and female participants. Gender of the patient described in the vignette was not a significant predictor. Practical implications The research highlights the importance of our own attitudes towards pornography, our possible beliefs about sexual offenders and the effects these may have on decision-making. Originality/value The research determines attitudes towards pornography and explores how attitudes influence decision-making.
{"title":"A quantitative analysis of attitudes toward pornography use in secure hospitals: sexual, violent and non-offenders","authors":"E. Mellor, Simon C. Duff","doi":"10.1108/JFP-12-2018-0049","DOIUrl":"https://doi.org/10.1108/JFP-12-2018-0049","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to investigate the attitudes of staff members in secure hospitals and the general population towards pornography use and their decision-making regarding access to pornography.\u0000\u0000\u0000Design/methodology/approach\u0000A between participants design was used whereby 324 participants, including 162 staff members and 162 people of general population, answered an online questionnaire. Vignettes were presented of six hypothetical patients in a secure hospital, based on gender (male/female) and offence type (sexual/violent/non-offender). Participants were required to decide whether the individual depicted in the vignette should have access to pornography. Finally, participants were given a psychometric assessment of their own attitudes towards pornography.\u0000\u0000\u0000Findings\u0000Participants were less likely to decide that the sex offender should have access to pornography than the violent or non-offender, thus the offence type of the patient was a significant predictor. There was a significant relationship between attitudes to pornography and whether the individual in the vignette should be given access to pornography. There was no significant difference between attitudes towards pornography of the general public and staff members or for male and female participants. Gender of the patient described in the vignette was not a significant predictor.\u0000\u0000\u0000Practical implications\u0000The research highlights the importance of our own attitudes towards pornography, our possible beliefs about sexual offenders and the effects these may have on decision-making.\u0000\u0000\u0000Originality/value\u0000The research determines attitudes towards pornography and explores how attitudes influence decision-making.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-12-2018-0049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48498328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-10DOI: 10.1108/JFP-01-2019-0004
Beth Rimmer, Philip Birch
Purpose Contemporaneously, the crime of rape has experienced an increase in reporting. The majority of rape survivors continue to experience, however, extensive victimisation due to biased attitudes held by many people and organisations within the general population. The paper aims to discuss these issues. Design/methodology/approach In a quantitative study with a sample of 176 participants, this research aimed to explore sexuality and religiosity as factors that affect attitudes towards survivors of rape. Findings Results indicated that negative attitudes towards rape survivors could be predicted by rape myth acceptance. While the sexuality of the victim affected attitudes towards rape survivors and negative attitudes towards survivors were also found to be predicted by high religiosity scores, analyses concluded that both males and females perceived gay male victims with more negative attitudes in comparison to lesbian rape survivors. Male participants demonstrated, overall, more negative attitudes towards rape survivors than their female counterparts. In sum, sexuality and religiosity were concluded to be crucial factors in explaining blame attributions. Practical implications This study indicates: (1) the effect of social correlates other than gender on rape myths; (2) the effect sexuality has on the perception of rape myths; and (3) the effect religiosity has on the perception of rape myths. This study also reveals implications for the reporting, prosecution and conviction of rape cases that may be subject to bias and discrimination due to victim characteristics other than gender. Originality/value Attitudes towards rape survivors based on social correlates other than gender have received little attention within existing literature and research. This paper adds to this discussion by considering the affects of sexuality and religiosity which have implications for the reporting of such a crime.
{"title":"Exploring factors affecting attitudes towards rape survivors: the role of sexuality and religiosity","authors":"Beth Rimmer, Philip Birch","doi":"10.1108/JFP-01-2019-0004","DOIUrl":"https://doi.org/10.1108/JFP-01-2019-0004","url":null,"abstract":"\u0000Purpose\u0000Contemporaneously, the crime of rape has experienced an increase in reporting. The majority of rape survivors continue to experience, however, extensive victimisation due to biased attitudes held by many people and organisations within the general population. The paper aims to discuss these issues.\u0000\u0000\u0000Design/methodology/approach\u0000In a quantitative study with a sample of 176 participants, this research aimed to explore sexuality and religiosity as factors that affect attitudes towards survivors of rape.\u0000\u0000\u0000Findings\u0000Results indicated that negative attitudes towards rape survivors could be predicted by rape myth acceptance. While the sexuality of the victim affected attitudes towards rape survivors and negative attitudes towards survivors were also found to be predicted by high religiosity scores, analyses concluded that both males and females perceived gay male victims with more negative attitudes in comparison to lesbian rape survivors. Male participants demonstrated, overall, more negative attitudes towards rape survivors than their female counterparts. In sum, sexuality and religiosity were concluded to be crucial factors in explaining blame attributions.\u0000\u0000\u0000Practical implications\u0000This study indicates: (1) the effect of social correlates other than gender on rape myths; (2) the effect sexuality has on the perception of rape myths; and (3) the effect religiosity has on the perception of rape myths. This study also reveals implications for the reporting, prosecution and conviction of rape cases that may be subject to bias and discrimination due to victim characteristics other than gender.\u0000\u0000\u0000Originality/value\u0000Attitudes towards rape survivors based on social correlates other than gender have received little attention within existing literature and research. This paper adds to this discussion by considering the affects of sexuality and religiosity which have implications for the reporting of such a crime.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-01-2019-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46992379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-07-2018-0031
Petra Scicluna, M. Clark
Purpose The purpose of this paper is to provide a theoretical analysis of the pathways of female addicts within the Maltese context by highlighting the complex interrelatedness between substance abuse and victimisation. This paper proposes that female addiction and victimisation trajectories unfold in a non-linear fashion, heavily influenced by particular socio-psychological processes. Design/methodology/approach Guided by a career approach conceptual framework, this study was carried out through an in-depth exploration of the victimisation and addictive career trajectories of 12 women, who are either incarcerated or in a residential drug treatment facility. Data were gathered qualitatively through in-depth interviews and analysed using a grounded theory methodology. Findings The paper highlights how the victimisation and substance abuse trajectories of women initially unfold and develop over time. This includes an exploration of the strategies employed in order to negotiate gender-based victimisation experiences throughout their lifetime, such as through the development of a victim identity and the self-medication of trauma symptoms, a process that is facilitated by the influence of older, male peers. As the women’s addiction trajectories progress rapidly towards commitment, sex work and IPV feature and the victim identity is reinforced, motivating continued and increased drug use. Practical implications The paper includes implications for the development of a gender-responsive framework of intervention when working with women who were present for the treatment. Originality/value With a focus on women’s experiences, this study fills a lacuna within the literature by complementing and expanding upon quantitative analyses that examine these phenomena as distinct entities.
{"title":"Victimisation and addictive careers amongst women in Malta","authors":"Petra Scicluna, M. Clark","doi":"10.1108/JFP-07-2018-0031","DOIUrl":"https://doi.org/10.1108/JFP-07-2018-0031","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to provide a theoretical analysis of the pathways of female addicts within the Maltese context by highlighting the complex interrelatedness between substance abuse and victimisation. This paper proposes that female addiction and victimisation trajectories unfold in a non-linear fashion, heavily influenced by particular socio-psychological processes.\u0000\u0000\u0000Design/methodology/approach\u0000Guided by a career approach conceptual framework, this study was carried out through an in-depth exploration of the victimisation and addictive career trajectories of 12 women, who are either incarcerated or in a residential drug treatment facility. Data were gathered qualitatively through in-depth interviews and analysed using a grounded theory methodology.\u0000\u0000\u0000Findings\u0000The paper highlights how the victimisation and substance abuse trajectories of women initially unfold and develop over time. This includes an exploration of the strategies employed in order to negotiate gender-based victimisation experiences throughout their lifetime, such as through the development of a victim identity and the self-medication of trauma symptoms, a process that is facilitated by the influence of older, male peers. As the women’s addiction trajectories progress rapidly towards commitment, sex work and IPV feature and the victim identity is reinforced, motivating continued and increased drug use.\u0000\u0000\u0000Practical implications\u0000The paper includes implications for the development of a gender-responsive framework of intervention when working with women who were present for the treatment.\u0000\u0000\u0000Originality/value\u0000With a focus on women’s experiences, this study fills a lacuna within the literature by complementing and expanding upon quantitative analyses that examine these phenomena as distinct entities.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-07-2018-0031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44040118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-11-2018-0047
Kim Liddiard, S. Morgan, Charlotte Hill, A. Simmonds
Purpose The purpose of this paper is to explore whether the current forensic mental health inpatient population within a medium secure unit is more or less complex (i.e. clinical and risk presentations) than former years using the Health of the Nation Outcome Scale (HoNOS) secure. Additionally, the use of the HoNOS secure as a service-wide measure is discussed in terms of its usefulness. Clinical implications and recommendations are offered for the continued use of the HoNOS secure in services more widely. Design/methodology/approach A retrospective case review of completed HoNOS secure assessments for 130 patients over three time intervals 2012, 2015 and 2018 was used. A multivariate analysis was performed on the data using SPSS version 25. Findings The findings revealed that contrary to clinical opinion, inpatients’ clinical and risk presentations had not changed significantly overtime. Research limitations/implications The study shows the benefits of using the HoNOS secure at a service-wide level to explore and understand similarities and differences in inpatient admissions over time. It also highlights the usefulness of the HoNOS secure for considering different ward characteristics and the needs of patients residing in these environments. Originality/value Although much research exists surrounding the individual use of the HoNOS secure in relation to outcomes, there is limited research focusing on use of the HoNOS secure at the service level. The paper therefore provides evidence of the utility and value of the HoNOS secure as a service-level outcome measure.
目的:本论文的目的是利用国家健康结果量表(HoNOS)来探讨目前中等安全单位内的法医精神卫生住院人口是否比前几年更复杂(即临床和风险表现)。此外，还讨论了HoNOS安全作为服务范围措施的用途。为继续在服务中更广泛地使用HoNOS安全提供了临床意义和建议。设计/方法/方法对2012年、2015年和2018年三个时间间隔内130例患者完成的HoNOS安全评估进行回顾性病例回顾。使用SPSS version 25对数据进行多变量分析。研究结果显示，与临床观点相反，住院患者的临床和风险表现并没有随着时间的推移而发生显著变化。研究局限/启示研究显示了在服务范围内使用HoNOS安全的好处，以探索和了解住院患者住院时间的异同。它还强调了HoNOS安全在考虑不同病房特征和居住在这些环境中的患者需求方面的有用性。原创性/价值虽然有很多关于个人使用HoNOS安全与结果相关的研究，但关注HoNOS安全在服务级别使用的研究有限。因此，本文提供了HoNOS安全作为服务级别结果度量的效用和价值的证据。
{"title":"Service evaluation of the need for care and clinical risk management procedures using the Health of the Nation Outcome Scale (HoNOS) secure","authors":"Kim Liddiard, S. Morgan, Charlotte Hill, A. Simmonds","doi":"10.1108/JFP-11-2018-0047","DOIUrl":"https://doi.org/10.1108/JFP-11-2018-0047","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to explore whether the current forensic mental health inpatient population within a medium secure unit is more or less complex (i.e. clinical and risk presentations) than former years using the Health of the Nation Outcome Scale (HoNOS) secure. Additionally, the use of the HoNOS secure as a service-wide measure is discussed in terms of its usefulness. Clinical implications and recommendations are offered for the continued use of the HoNOS secure in services more widely.\u0000\u0000\u0000Design/methodology/approach\u0000A retrospective case review of completed HoNOS secure assessments for 130 patients over three time intervals 2012, 2015 and 2018 was used. A multivariate analysis was performed on the data using SPSS version 25.\u0000\u0000\u0000Findings\u0000The findings revealed that contrary to clinical opinion, inpatients’ clinical and risk presentations had not changed significantly overtime.\u0000\u0000\u0000Research limitations/implications\u0000The study shows the benefits of using the HoNOS secure at a service-wide level to explore and understand similarities and differences in inpatient admissions over time. It also highlights the usefulness of the HoNOS secure for considering different ward characteristics and the needs of patients residing in these environments.\u0000\u0000\u0000Originality/value\u0000Although much research exists surrounding the individual use of the HoNOS secure in relation to outcomes, there is limited research focusing on use of the HoNOS secure at the service level. The paper therefore provides evidence of the utility and value of the HoNOS secure as a service-level outcome measure.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-11-2018-0047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44341232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-10-2018-0042
O. Rye, K. Canvin, S. Harrison, Charlotte Couldrey, C. Churchman
Purpose A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital. Design/methodology/approach A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe. Findings A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services. Research limitations/implications The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall. Practical implications Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services. Originality/value This is the first research study to construct a theoretical model of recall.
{"title":"Making sense of being recalled: a grounded theory","authors":"O. Rye, K. Canvin, S. Harrison, Charlotte Couldrey, C. Churchman","doi":"10.1108/JFP-10-2018-0042","DOIUrl":"https://doi.org/10.1108/JFP-10-2018-0042","url":null,"abstract":"\u0000Purpose\u0000A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital.\u0000\u0000\u0000Design/methodology/approach\u0000A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe.\u0000\u0000\u0000Findings\u0000A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services.\u0000\u0000\u0000Research limitations/implications\u0000The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall.\u0000\u0000\u0000Practical implications\u0000Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services.\u0000\u0000\u0000Originality/value\u0000This is the first research study to construct a theoretical model of recall.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-10-2018-0042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42444230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-11-2018-0043
P. Habets, I. Jeandarme, Harry G. Kennedy
Purpose Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders. Design/methodology/approach The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements. Findings Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability. Practical implications The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts. Originality/value This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.
{"title":"Applicability of the DUNDRUM-1 in a forensic Belgium setting","authors":"P. Habets, I. Jeandarme, Harry G. Kennedy","doi":"10.1108/JFP-11-2018-0043","DOIUrl":"https://doi.org/10.1108/JFP-11-2018-0043","url":null,"abstract":"\u0000Purpose\u0000Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders.\u0000\u0000\u0000Design/methodology/approach\u0000The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements.\u0000\u0000\u0000Findings\u0000Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability.\u0000\u0000\u0000Practical implications\u0000The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts.\u0000\u0000\u0000Originality/value\u0000This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-11-2018-0043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46950116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-07-2017-0027
R. Worthington
PurposeThe purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced.Design/methodology/approachThe revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing.FindingsThe revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation.Research limitations/implicationsRecommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group.Practical implicationsThe paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena.Social implicationsEnhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group.Originality/valueMuch of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group.
{"title":"The multi-component model of harmful sexual behaviour for people with autism and co-morbid intellectual disabilities – a theory and practice guide","authors":"R. Worthington","doi":"10.1108/JFP-07-2017-0027","DOIUrl":"https://doi.org/10.1108/JFP-07-2017-0027","url":null,"abstract":"PurposeThe purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced.Design/methodology/approachThe revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing.FindingsThe revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation.Research limitations/implicationsRecommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group.Practical implicationsThe paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena.Social implicationsEnhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group.Originality/valueMuch of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group.","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-07-2017-0027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49535845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-09-2018-0037
Kerri Eagle, Trevor Ma, Barbara L. Sinclair
Purpose The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems. Design/methodology/approach A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility. Findings The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme. Practical implications The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings. Originality/value Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.
{"title":"Integrated substance use rehabilitation in a secure forensic facility","authors":"Kerri Eagle, Trevor Ma, Barbara L. Sinclair","doi":"10.1108/JFP-09-2018-0037","DOIUrl":"https://doi.org/10.1108/JFP-09-2018-0037","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems.\u0000\u0000\u0000Design/methodology/approach\u0000A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility.\u0000\u0000\u0000Findings\u0000The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme.\u0000\u0000\u0000Practical implications\u0000The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings.\u0000\u0000\u0000Originality/value\u0000Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-09-2018-0037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49346084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-31DOI: 10.1108/JFP-10-2018-0039
Zulaikha Khan, Arunraj Chidambaram, M. Thomson, C. Hurst
Purpose The purpose of this paper is to identify what key factors multi-disciplinary teams (MDT) deem as most important when making the decision to move service users from one level of security (including low, medium and high secure services) to another. The researchers used the findings from this study to further develop a tool; the assessment for level of security tool (ALS), which aims to structure and streamline this decision-making process. Design/methodology/approach Data from 18 interviews (MDT staff) were analysed using the Delphi technique (Dalkey and Helmer, 1963). This revealed a range of factors discussed when considering service users moves. Participants were asked to rate these factors in accordance with the Delphi which resulted in the removal of certain less important factors based on their scores. The researchers then compared these factors of relevance with a checklist of 16 items previously proposed by a consultant psychiatrist within the trust. This comparison allowed the researchers to highlight any similarities and differences present. Findings Findings from staff interviews revealed a range of 20 clinical factors perceived as essential to this process including procedural, relational and physical security aspects. However, variations were evident between the MDT priorities (20 items) and the originally proposed list. This emphasised the need for a tool which facilitates a holistic and streamlined approach. Practical implications The findings from this research have resulted in the development of the ALS tool comprising of 18 key factors. Originality/value It is envisaged the development of the ALS tool will not only facilitate and structure the decision-making process but also ensure a person-centred approach. This is because the ALS allows for a holistic approach based on an array of factors deemed important to that particular service user. Furthermore, the ALS tool contributes towards the paucity of published structured professional judgement tools needed to make such decisions.
本文的目的是确定在决定将服务用户从一个安全级别(包括低、中、高安全服务)转移到另一个安全级别时，多学科团队(MDT)认为最重要的关键因素是什么。研究人员利用这项研究的发现进一步开发了一种工具;安全水平评估工具(ALS)，旨在构建和简化这一决策过程。设计/方法学/方法使用德尔菲技术(Dalkey and Helmer, 1963)分析了18个访谈(MDT员工)的数据。这揭示了在考虑服务用户移动时讨论的一系列因素。参与者被要求根据德尔菲对这些因素进行评分，从而根据他们的分数去除某些不太重要的因素。然后，研究人员将这些相关因素与之前由信托内的一位精神病顾问提出的16项清单进行了比较。这种比较使研究人员能够突出存在的相似性和差异性。调查结果工作人员访谈的结果揭示了被认为对这一过程至关重要的20个临床因素，包括程序、关系和人身安全方面。然而，MDT的优先事项(20个项目)与最初提议的清单之间存在明显的差异。这强调需要一种工具，以促进整体和精简的办法。实际意义这项研究的结果导致了ALS工具的发展，包括18个关键因素。原创性/价值根据设想，ALS工具的开发不仅将促进和组织决策过程，而且还将确保以人为本的方法。这是因为ALS允许基于一系列被认为对特定服务用户重要的因素的整体方法。此外，肌萎缩侧索硬化症工具导致了做出此类决定所需的已发表的结构化专业判断工具的缺乏。
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Pub Date : 2019-01-31DOI: 10.1108/JFP-07-2018-0026
S. Hunter, Eleanore Craig, J. Shaw
Purpose Within the current offender personality disorder (OPD) pathway in the UK, black, Asian and minority ethnic (BAME) populations are underrepresented. Fewer BAME offenders are engaging with services despite being proportionately identified for inclusion and referred on to the pathway. The paper aims to discuss this issue. Design/methodology/approach This qualitative study explored the experiences of 11 BAME men engaged in a prison-based OPD service for young offenders to identify the highlights and challenges of engagement within the service and to what extent they experienced a sense of inclusion/belonging. Findings Thematic analysis was used to identify three overarching themes and sub-themes. Why am I going to be an Outcast? describes the barriers to engagement encountered by the participants; and Give it a Try and Nothing but Respect describe the process of overcoming these barriers. Barriers revolved around the experiences of judgement, alienation and hopelessness. These were overcome through peer encouragement, developing relationships with staff and freedom to regulate levels of engagement. Practical implications Practice and policy implications are considered to support similar services in addressing the barriers to engagement faced by BAME individuals. Areas for future research are also recommended. Originality/value Currently, no research has directly explored the under-representation of young BAME offenders with emerging personality disorder in the OPD pathway. The findings provided an insight into some of the difficulties these young BAME offenders faced when accessing this service, alongside aspects which maintained their engagement.
在英国目前的罪犯人格障碍(OPD)途径中，黑人、亚洲人和少数民族(BAME)人口的代表性不足。尽管按比例确定纳入并转介到途径，但较少的BAME罪犯参与服务。本文旨在对这一问题进行探讨。设计/方法/方法这项定性研究探讨了11名BAME男子在监狱为少年犯提供的OPD服务中的经历，以确定参与服务的亮点和挑战，以及他们在多大程度上感受到包容/归属感。主题分析用于确定三个总体主题和副主题。为什么我要成为一个弃儿?描述参与者参与过程中遇到的障碍;Give it a Try和Nothing but Respect描述了克服这些障碍的过程。障碍围绕着评判、疏远和绝望的经历。这些都是通过同伴鼓励、发展与员工的关系以及自由调节参与程度来克服的。实践意义实践和政策意义被认为支持类似的服务，以解决BAME个人面临的参与障碍。并提出了今后的研究方向。原创性/价值目前，还没有研究直接探讨了年轻的BAME罪犯在OPD途径中出现的新兴人格障碍的代表性不足。调查结果揭示了这些年轻的BAME罪犯在使用这项服务时面临的一些困难，以及保持他们参与的方面。
{"title":"“Give it a Try”: experiences of black, Asian and minority ethnic young men in a prison-based offender personality disorder service","authors":"S. Hunter, Eleanore Craig, J. Shaw","doi":"10.1108/JFP-07-2018-0026","DOIUrl":"https://doi.org/10.1108/JFP-07-2018-0026","url":null,"abstract":"\u0000Purpose\u0000Within the current offender personality disorder (OPD) pathway in the UK, black, Asian and minority ethnic (BAME) populations are underrepresented. Fewer BAME offenders are engaging with services despite being proportionately identified for inclusion and referred on to the pathway. The paper aims to discuss this issue.\u0000\u0000\u0000Design/methodology/approach\u0000This qualitative study explored the experiences of 11 BAME men engaged in a prison-based OPD service for young offenders to identify the highlights and challenges of engagement within the service and to what extent they experienced a sense of inclusion/belonging.\u0000\u0000\u0000Findings\u0000Thematic analysis was used to identify three overarching themes and sub-themes. Why am I going to be an Outcast? describes the barriers to engagement encountered by the participants; and Give it a Try and Nothing but Respect describe the process of overcoming these barriers. Barriers revolved around the experiences of judgement, alienation and hopelessness. These were overcome through peer encouragement, developing relationships with staff and freedom to regulate levels of engagement.\u0000\u0000\u0000Practical implications\u0000Practice and policy implications are considered to support similar services in addressing the barriers to engagement faced by BAME individuals. Areas for future research are also recommended.\u0000\u0000\u0000Originality/value\u0000Currently, no research has directly explored the under-representation of young BAME offenders with emerging personality disorder in the OPD pathway. The findings provided an insight into some of the difficulties these young BAME offenders faced when accessing this service, alongside aspects which maintained their engagement.\u0000","PeriodicalId":44049,"journal":{"name":"Journal of Forensic Practice","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/JFP-07-2018-0026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45373135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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