In the United Kingdom, Section 27 of the Youth Justice and Criminal Evidence Act permits "Achieving Best Evidence" (ABE) forensic interviews to replace the evidence-in-chief in cases involving children. It is therefore imperative that forensic interviewers elicit complete, reliable, and coherent narratives from children. The goal of the current research study was to assess the coherence of forensic interviews and whether the interviewers' emotional or cognitive support was associated with increases in the coherence of these interviews. Children's narrative coherence was examined in 80 transcripts of ABE investigative interviews with 7- to-15-year-olds who disclosed sexual abuse. Narrative coherence was assessed using the Narrative Coherence Coding Scheme, including three dimensions of narrative coherence: chronology, consistency, and theme (Reese et al., 2011). Findings revealed that first elicited events were more likely to be more coherent compared to subsequently elicited events, and child engagement was positively associated with all dimensions of narrative coherence. Interviewer support was positively associated with chronology, script accounts of abuse were associated with decreased consistency and chronology (but not theme), and cognitive support was not associated with any dimension of narrative coherence.
Forensic mental health services provide care to people in secure psychiatric hospitals and via specialised community teams. Such services are typically low volume and high cost, often highly restrictive and average duration of inpatient care prior to discharge is long. Measuring outcomes of care is important to safeguard patients and the public, monitor progress, inform treatment plans and assist in service evaluation and planning. We describe the development in England of a new outcome measure for forensic mental health services. Patient interviews and multistakeholder focus groups were held to elicit key concepts. Thematic analysis was used to develop an outcomes framework. Fifteen patients participated in the interviews and 48 stakeholders in the focus groups. Six domains were identified in thematic analysis: 'about me, my quality of life, my health, my safety and risk, my life skills and my progress'. Sixty-two stakeholders participated in the first round of the Delphi process, and 49 completed round two. Eight of the top fifteen outcomes were shared between patients/carers and professionals. Based on these results, a new outcome measure, the FORensic oUtcome Measure (FORUM), was developed including both a patient reported and clinician reported measure. Further assessment of the FORUM's use to track patients' progress over time, and facilitate shared decision-making and care planning, is required.
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