ASAP-ID: substance abuse programme for a forensic ID population
| Pages | 157-165 |
| Date | 11 December 2017 |
| DOI | https://doi.org/10.1108/JIDOB-07-2017-0014 |
| Published date | 11 December 2017 |
| Author | Joseph Allan Sakdalan,Daniel McGarry Kittner,Devika Judd |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour,Sociology,Sociology of crime & law,Deviant behaviour,Education,Special education/gifted education,Emotional/behavioural disorders |
ASAP-ID: substance abuse programme
for a forensic ID population
Joseph Allan Sakdalan, Daniel McGarry Kittner and Devika Judd
Abstract
Purpose –There are a lack of recourses for substance abuse (SA) treatment for forensic clients with
intellectual disabilities (ID). Many complexities arise when treating this population, calling for the creation of
comprehensive resources which not only address the SA, but also account for the risk and offending issues.
The purpose of this paper is to detail a pilot programme which aims to provide treatment for forensic ID clients
with substance abuse issues as well as a significant risk of reoffending.
Design/methodology/approach –Six participants completed a 27-week SA treatment programme
(the Alcohol and Substance Abuse Programme-Intellectual Disability) which incorporated the use of
dialectical behavioural therapy (DBT) and the Good Lives Model concepts. Pre- and post-measures aimed to
assess readiness for change and confidence in ability to stay clean and sober.
Findings –Preliminary findings showed a marked improvement in confidence of the participants’ability to
stay clean and sober in risk-related situations as well as an increase in overall readiness for change.
Originality/value –This research paper addresses a gap in the current forensic ID research and clinical
treatment options pertaining to SA, by focussing on supporting forensic ID clients in their recovery journey
from SA. Being at the forefront of SA treatment for forensic ID, further research in this domain should attempt
to consolidate the findings of this programme.
Keywords Substance abuse, Intellectual disability, Forensic, Treatment, Dialectical behavioural therapy,
Good lives model
Paper type Research paper
Introduction
While there has been a growing awareness of substance abuse (SA) among individuals with
intellectual disabilities (ID), the lack of response in terms of treating this population has created a
gap in available resources (Singh, 2016). SA treatment programmes have attempted to
incorporate individuals with ID, but there is a lack of SA resources developed specifically for
those with ID. There is also a lack of findings around the effectiveness of the treatment
programmes that do incorporate individuals with ID or were specifically developed for this
population. While community-based samples have found mixed results with findings of SA in
people with ID from 8 to 14 per cent, SA has been found to be five times more likely in individuals
with ID who have a forensic history (McGillivray and Newton, 2016). Due to the high probability of
SA being a factor in the treatment of the forensic ID population, there is an urgent need for the
creation of more comprehensive and effective resources. Aside from SA, many more
complexities arise when working with an ID population in a forensic setting.
The complexities of individuals in a forensic setting with SA issues and ID include co-morbid
mental health problems, forensic environmental factors, personality disorders, and risk and
offending issues (Alexander et al., 2010). While SA is widely seen as a strong correlational factor
with offending, individuals with ID regularly encounter the forensic mental health system due to
serious offending, particularly violent and sexual offences rather than purely SA-related offending
(Camilleri and Quinsey, 2011). Within the forensic ID population, having a history of SA is often
more likely than having a SA-related offence, meaning SA acts a stronger risk factor than is
displayed in the offence history (Lindsay et al., 2013). The complexities of these individuals’
Received 17 July 2017
Revised 2 September 2017
Accepted 2 September 2017
Joseph Allan Sakdalan is a
Consultant Clinical Psychologist,
Daniel McGarry Kittner is a
Student and Devika Judd is
an Occupational Therapist,
all at the Mason Clinic, Auckland,
New Zealand.
DOI 10.1108/JIDOB-07-2017-0014 VOL. 8 NO. 4 2017, pp.157-165, © Emerald Publishing Limited, ISSN 2050-8824
j
JOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR
j
PAGE157
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