The Journal of Forensic Practice
- Emerald Group Publishing Limited
- Publication date:
- Nbr. 22-2, March 2020
- Nbr. 22-1, December 2019
- Nbr. 21-4, November 2019
- Nbr. 21-3, August 2019
- Nbr. 21-2, May 2019
- Nbr. 21-1, January 2019
- Nbr. 20-4, November 2018
- Nbr. 20-3, August 2018
- Nbr. 20-2, May 2018
- Nbr. 20-1, February 2018
- Nbr. 19-4, November 2017
- Nbr. 19-3, August 2017
- Nbr. 19-2, May 2017
- Nbr. 19-1, February 2017
- Nbr. 18-4, November 2016
- Nbr. 18-3, August 2016
- Nbr. 18-2, May 2016
- Nbr. 18-1, February 2016
- Nbr. 17-4, November 2015
- Nbr. 17-3, August 2015
- Using a visually adapted repertory grid technique (VARGT) with people who stalk
Purpose: This paper aims to provide instructions on how to implement an adapted version of the standard repertory grid technique (VARGT). The purpose of which is to provide practitioners with a tool, which enables active engagement by participants in research and clinical practice. This tool has been used effectively with people convicted of stalking offences. Design/methodology/approach: Repertory grids, developed from Kelly’s Personal Construct Theory (1955), had never been used with those who stalk, either clinically or in a research context. Visual and kinaesthetic adaptations were made to standard RGT procedures (Grice, 2002; Tan and Hunter, 2002), for use in a mixed methods research study (Wheatley, 2019, p. 77) due to expected challenges in engaging with this group. This manuscript presents theoretical underpinnings and step-by-step instructions for practical application. Findings: The VARGT is easy to administer and produces rich data, in both qualitative and quantitative formats. This adapted approach encourages active participation and an interpreted therapeutic collaboration (Wheatley et al., 2020). Practical implications: This novel technique has engaged men convicted of stalking offences collaboratively in research activities and showed potential for its use as a clinical tool. This instructional technical paper allows the technique to be replicated. Originality/value: This novel technique has engaged men convicted of stalking offences collaboratively in research activities and showed potential for its use as a clinical tool. This instructional technical paper allows the technique to be replicated.
- Researcher-practitioner reflections: the therapeutic utility of the visually adapted repertory grid technique (VARGT) with stalkers
Purpose: This paper outlines researcher–practitioner reflections on the use of a visually adapted repertory grid technique (VARGT) with men convicted of stalking. It draws on and assimilates participant experiences of the VARGT as a research engagement tool. Further, it extends discussion to propose its value as a generic engagement tool for when personal insights and collaborative case formulations may otherwise be difficult to access. Design/methodology/approach: The repertory grid technique, developed from Kelly’s Personal Construct Theory (1955), was adapted visually for utility in a mixed methods research study with those who commit stalking offences (Wheatley, in preparation). Analytical and reflexivity processes within this original study highlighted rich and recurrent data across the sample pertaining to the positive participant experience of the VARGT, unrelated to its core research question. Findings: This paper presents reflections and psychological discussion for experiences of using the VARGT. Key features clustered around therapeutic alliance and engagement, enlightenment and a motivation for positive change. Practical implications: This paper suggests the VARGT has value in participant–client engagement, particularly where sensitive topics are being investigated and participants have difficulty directly articulating their psychosocial functioning. Originality/value: This novel technique offers potential as an engagement tool for use in research and clinical settings.
- Care quality commission inspections of high-security hospitals
Purpose: Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC) monitors and regulates forensic healthcare provision. The purpose of this study is to identify key concerns highlighted in CQC inspection reports of the three high-secure hospitals in England between 2010 and 2018. Design/methodology/approach: In this qualitative study, 49 CQC inspection reports from three high-secure hospitals were subjected to thematic analysis. Findings: Five central themes emerged: staffing and management; restrictive practice; physical environment and ward atmosphere; patients’ needs and involvement in their care; and legal and statutory matters. There was some variation in the overall quality of care between the hospitals. Positive staff–patient interactions and good practice in assessing and delivering care were consistently observed. However, enduring staff shortages within each hospital were experienced negatively and sometimes co-occurred with concerns over restrictive practices, poor care-plan procedure and inadequate legal documentation. Over time, Rampton and Broadmoor Hospitals appeared to worsen with regard to staffing levels, staff morale and management involvement. While services progressed over time in providing patients with access to advocacy and information concerning their rights, in some recent inspections it remained unclear whether patients were adequately involved in the care-plan process. Practical implications: These findings provide preliminary indicators for areas requiring further attention from policymakers, clinicians and advocates. Originality/value: This study appears to be the first systematic analysis of key concerns expressed in CQC reports of English high-security hospitals.
- “Swimming against the tide”: conditional discharge from medium secure care
Purpose: The purpose of this paper is to explore the experiences of mentally disordered offenders (MDOs) conditionally discharged from secure hospitals on a restrictive Section of the Mental Health Act (Section 37/41). Design/methodology/approach: Data were derived from seven semi-structured interviews from three forensic community teams. Findings: Thematic analysis identified seven predominant themes: (1) the uncertainty of the discharge timeframe; (2) fear of jeopardising discharge; (3) progress; (4) engagement with community life; (5) barriers to social engagement; (6) evolving identity and (7) someone to turn to. Findings are discussed in relation to the recovery model and the good lives model. Practical implications: The findings highlight the importance of fostering trust between MDOs and their care teams to encourage help-seeking. They also suggest that resources should be sequenced appropriately throughout the discharge process, to match the “window of engagement” and maximize impact and effectiveness. Originality/value: This research gained rarely obtained first-hand perspectives from MDOs, with the findings contributing to a more effective evaluation of the discharge pathway.
- Understanding the lived experience of British non-offending paedophiles
Purpose: Research into paedophilia mainly uses offender samples; thus, little is understood about non-offending paedophiles. The limited body of research has been conducted in North America or Europe whose health and legal systems differ from those in the UK. Using semi-structured interviews, the purpose of this study is to explore the experience of three non-offending British paedophilic males. Design/methodology/approach: The interview discussed their paedophilia, refraining from offending and perspectives on treatment initiatives. Data were analysed using interpretative phenomenological analysis. Findings: Three superordinate themes emerged: “paedophilia as more than a sexuality,” “acceptance leads to management” and “barriers to support.” These encapsulated how paedophilia was understood, how accepting one’s sexual attraction is tantamount to well-being and the various obstacles to providing support were discussed. Research limitations/implications: Acknowledging the sampling considerations (size and recruitment), the results implicate research into paedophilia. The onset of paedophilia was chronologically associated with typical sexual attraction, and not the result of sexual abuse as some theories suggest. Furthermore, the tenets of attraction to children extending beyond sexual desire were highlighted. Practically, the results influence future research into the area and highlight the dearth in our understanding of diverse behavioural management techniques (i.e. computerised images of children or human-like dolls). Originality/value: This paper presents novel insight into the aspects of paedophilia, excluding offensive behaviour and highlights the need for affordable, UK-based services targeted towards people with a paedophilic attraction to manage child sexual abuse preventatively and not reactively.
- Implementation of a schema therapy awareness group for adult male low secure patients with comorbid personality difficulties: reflections and challenges
Purpose: The purpose of this study/paper is to describe the implementation of a six-month schema therapy awareness (STA) group. Research supporting individual schema therapy (ST) as an effective intervention for personality disorder is growing steadily within a number of settings including with forensic patients. Alongside individual ST, positive results have been reported for group ST. However, to the best of the authors’ knowledge, no current published research exists with regard to the use of group ST within forensic populations and more specifically within a low secure environment. Design/methodology/approach: This paper describes the implementation of a six-month schema therapy awareness (STA) group with individuals situated within a low secure environment. Findings: For individuals transitioning into the community from a secure setting, the focus of risk management should attempt to move away from external controls towards more of a reliance on internal factors. In ST, this is achieved by understanding the role of schema modes (and underlying schemas) that are linked to an individual’s offences/risk and developing this understanding into a coherent and accessible formulation for the individual to make changes. Research limitations/implications: Further robust research evaluating clinical change is recommended as the next step. Practical implications: The group protocol is described along with the challenges and potential solutions experienced during the implementation. This provides an opportunity for other professionals to replicate this approach in the future. Originality/value: With regard to group ST within forensic populations, the research is sparse at present and this study focusses on practical application of theory and the challenges of operationalising a STA group.
- Adolescent inpatient completers of dialectical behaviour therapy
Purpose: Dialectical behaviour therapy (DBT) aims to reduce emotional dysregulation and engagement in less adaptive behaviours for adults with mixed disorders of conduct and emotions (MDCE). However, there is limited evidence available for the effectiveness of DBT skills training for adolescents with MDCE who are resident within a secure impatient setting. The paper aims to discuss these issues. Design/methodology/approach: A retrospective study investigated changes in aggressive and self-injurious behaviours in 22 adolescents within a secure inpatient mental health setting with MDCE who had completed one cycle of DBT skills training. Changes in symptomatic problems, behavioural and social impairment were also investigated in 17 of the 22 participants who completed the DBT skills training cycle. Findings: There were statistically significant decreases in the frequencies of engagement in total aggressive and deliberate self-harm behaviours after the DBT skills training cycle. There was a significant improvement in symptomatic and behavioural impairment, but not in social impairment. Practical implications: The findings of this study suggest that DBT skills training may be beneficial for behavioural and symptomatic outcomes in adolescent inpatients with MDCE. Originality/value: This study provides preliminary evidence for the effectiveness of DBT skills training for adolescents with MDCE within a secure inpatient setting. Additional studies are required to investigate the clinical benefits of specific aspects of DBT for individual patients.
- The importance of considering trauma in individuals with autism spectrum disorder: considerations and clinical recommendations
Purpose: The area of trauma in autism spectrum disorders (ASDs) is an important area given the substantial rates of abuse endured by these individuals. However, there are issues with the identification of trauma, understanding how it is perceived, and manifested. The paper aims to discuss this issue. Design/methodology/approach: The limited research regarding trauma in ASD is reviewed and gaps are identified. Findings: The key findings from the relevant literature are discussed. Practical implications: Practical suggestions are outlined for more effective identification of trauma in individuals with ASD. Originality/value: To date, there has been relatively little research on trauma and ASD. This paper emphasises the urgent need for attention in this area.
- The perceived challenges of working with patients who use new psychoactive substances: a qualitative study in a medium secure unit
Purpose: New psychoactive substances (NPS) are increasingly being used in secure mental health settings. Within these settings, NPS use presents a range of challenges and staff currently lack adequate training to manage these challenges. The purpose of this paper is to explore nursing staffs’ perception of the challenges of working with patients who use NPS and to explore nursing staffs’ perception of their training needs in relation to NPS. Design/methodology/approach: A cross-sectional qualitative design was employed. Semi-structured interviews were conducted with eight nursing staff from a medium secure unit (MSU). Findings: A thematic analysis identified three overarching themes: “There Will Always Be Something”, “We Are Doing Our Best” and “If We Know More, We Can Do More”. The findings describe how nursing staff manage NPS use at present, and their perceptions of how training could improve their management of NPS use in the future. Practical implications: The findings suggest that MSUs require a local policy for managing NPS use. The research implies that staff training programmes should recognise the existing methods staff use to manage NPS use. The findings also suggest that NPS interventions should target the whole peer group and not just the individual using NPS. Originality/value: This paper contributes to the limited literature on NPS. The findings demonstrate the importance of developing evidence-based mechanisms for managing NPS use. Changes to practice are suggested, with the view of developing ways in which staff currently manage NPS use by complementing this with specific training on NPS.
- WARRN – a formulation-based risk assessment procedure for Child and Adolescent Mental Health Services (CAMHS): the view of clinicians
Purpose: Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services which has been adopted across most Child and Adolescent Mental Health Services (CAMHS) across Wales. The paper aims to discuss this issue. Design/methodology/approach: An online survey was disseminated to National Health Service clinicians in CAMHS to evaluate their perceptions of the use and effectiveness of WARRN. Data from 88 clinicians were analysed with both quantitative and qualitative methods. Findings: Clinicians reported increased clinical skills, increased confidence in their assessment and management of risk and in safety planning, the increased safety of service users and the general public, and a belief that WARRN had saved lives. The qualitative data showed that clinicians thought a common risk evaluation instrument across Wales and different agencies had created a common language and understanding that improved communication. Practical implications: WARRN appears well accepted in CAMHS services with the view that it is having a very positive effect on service user well-being and safety and could be implemented in other services. Originality/value: This is the first report of a formulation-based approach to the management of serious problem behaviours in CAMHS services.
- A multi-site survey of forensic nursing assessment
Purpose: A major difficulty identified many years ago in psychiatric care is the shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments which are behaviourally based and therefore appropriate for use in a variety of contexts. The aim of this project...
- An exploration of staff and prisoner experiences of a newly commissioned personality disorder service within a category B male establishment
Purpose: – The purpose of this paper is to explore staff and prisoner experiences of a newly implemented Personality Disorder Service (PDS) within a category B male establishment. Design/methodology/approach: – A semi-structured interview was used to explore the experiences of seven male category...
- Child sexual exploitation
Purpose: The purpose of this paper is to offer an overview of the research to date, including how some findings have informed practice within child care organisations in England and Wales. The challenges of applying this research are considered, along with some of its key limitations. Avenues for...
- Does PTSD predict institutional violence within a UK male prison population?
Purpose: Given the amount of research examining the association between trauma and post-traumatic stress disorder (PTSD) with aggression and violence, few studies have focussed on a UK prison population. Additionally, few have examined the relationship between PTSD symptoms, aggression and violence ...
- Evaluation of two community outreach forensic psychological services
Purpose: – The purpose of this paper is to gauge service user’ perspectives on the effectiveness of two community outreach forensic psychological services in London for people with personality disorder and serious mental illness who pose a risk of sexual and violent offending. Both services are...
- Group treatment in a male low secure mental health service: a treatment description and descriptive evaluation
Purpose: – The purpose of this paper is to describe the development, content and structure of an intensive group-based intervention designed to address a range of needs common to individuals within low secure forensic mental health settings. Additionally, the feasibility, acceptability, resource...
- Lifers over tariff: exploring psychological barriers to progression
Purpose: There are a significant number of life-sentenced prisoners in Scotland who are over tariff (i.e. past their punishment part expiry date) and who appear to have difficulty in making the transition towards community reintegration. The factors involved in their repeated returns to closed...
- Predictive validity of the START with intellectually disabled offenders
Purpose: – Offenders with intellectual disability (ID) have been largely neglected in past forensic literature on assessment of dynamic risk factors. The purpose of this paper is to evaluate the predictive validity of the Short-Term Assessment of Risk and Treatability (START), in a sample of males...
- Self‐control, fluctuating willpower, and forensic practice
Purpose: This article aims to explain the relevance of new findings about self‐control and willpower for antisocial behaviour and forensic practice. Design/methodology/approach: The relevance of the phenomena is covered first, followed by an exposition of how self‐control works. Findings: The...
- The 3 R’s of risk assessment for violent extremism
Purpose: The purpose of this paper is to explore two distinct yet complimentary “structured professional judgement (SPJ)” approaches to terrorist/extremist risk assessment on the vexing issue of how best to deal with the subjectivity inherently involved in professional judgement. Design/methodology...