Developing and evaluating interventions for women firesetters in high secure mental healthcare
| Date | 13 February 2017 |
| Published date | 13 February 2017 |
| DOI | https://doi.org/10.1108/JFP-12-2015-0054 |
| Pages | 59-76 |
| Author | Phyllis Annesley,Leonie Davison,Chris Colley,Liz Gilley,Louise Thomson |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
Developing and evaluating interventions
for women firesetters in high secure
mental healthcare
Phyllis Annesley, Leonie Davison, Chris Colley, Liz Gilley and Louise Thomson
Abstract
Purpose –The purpose of this paper is to discuss the implementation and evaluation of interventions for
women firesetters in high secure mental healthcare at the UK’s National Women’s Service.
Design/methodology/approach –Two types of Arson treatment programmesfor women, one delivered to
individuals, the other within a group context, were developed, delivered and evaluated. The evaluation
incorporated qualitative and quantitative data, including psychometric measures. Qualitative data were
analysed using thematic analysis.
Findings –The evaluation evidenced very high engagement with and attendance at treatment programmes,
and several post-treatment gains. Participants’ratings of programmes and qualitative feedback were similarly
very positive. The study demonstrated that engaging women firesetters in their treatment is paramount and
can be facilitated by consistent boundaries around therapy provision balanced with sensitivity, empathy
and flexibility; providing interactive and varied teaching methods; ongoing service user involvement and
recognising participants’achievements; employing a mixed cognitive analytic therapy and cognitive
behavioural therapy therapeutic approach; having input from fire service staff; and maintaining organisational
support for firesetting interventions.
Practical implications –In all, 12 key recommendations are made for clinicians considering offering
treatment programmes for women firesetters.
Originality/value –Amid few published papers on treating women firesetters this paper guides forensic
clinicians in establishing and delivering interventions for women firesetters.
Keywords Mental health, UK, Firesetting, Arson treatment, High secure, Treatment delivery
Paper type Research paper
Introduction
This paper discusses the implementation and evaluation of group and individual arson treatment
programmes over eight years at the UK’s National Women’s Service (NWS).
The term firesetting (vs arson) is mostly used throughout the paper as it embraces a wider range
of people who deliberately set fires. “Arson”defines the specific criminal act of intentionally or
recklessly setting fire to property or wildland areas (Dickens and Sugarman, 2012). A firesetter
“displays a behavioural phenotype, the deliberate setting of fires, which may not have been
prosecuted, for a number of reasons”(Dickens and Sugarman, 2012).
Overview of theories of firesetting
Early theories of firesetting included social learning theory (Gannon et al., 2012a); Jackson’s
functional analysis model: firesetting as the only viable option (Jackson et al., 1987; Jackson,
1994); and Fineman’s (1995) dynamic behavioural theory. Social learning theorists view
firesetting as the product of learning principles and a form of learnt hostility/aggression.
For example, firesetting can be instantly reinforcing through the sensory excitement, the sirens,
crowd and noise associated with the fire (Vreeland and Levin, 1980). Jackson et al. (1987)
Received 12 December 2015
Revised 14 February 2016
28 February 2016
Accepted 29 February 2016
Phyllis Annesley is a Consultant
Clinical Psychologist at
Rampton Hospital,
Nottinghamshire Healthcare
NHS Trust, Woodbeck, UK.
Leonie Davison is based at
Rampton Hospital,
Nottinghamshire Healthcare
NHS Trust, Woodbeck, UK.
Chris Colley is based at
Rampton Hospital,
Nottinghamshire Healthcare
NHS Trust, Woodford, UK.
Liz Gilley is a Trainee Clinical
Psychologist at the Clinical
Psychology Unit, Department
of Psychology, Sheffield
University, Sheffield, UK.
Louise Thomson is based at
the Institute of Mental Health,
Division of Psychiatry
and Applied Psychology,
University of Nottingham,
Nottingham, UK.
DOI 10.1108/JFP-12-2015-0054 VOL. 19 NO. 1 2017, pp. 59-76, © Emerald Publishing Limited, ISSN 2050-8794
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JOURNAL OF FORENSIC PRACTICE
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developed the first multifactorial theory of firesetting which postulates that the behaviour is likely
to be repeated when the antecedents and consequences of arson are such that certain criteria
are met. Key antecedents are psychosocial disadvantage, dissatisfaction with life and self, social
ineffectiveness, specific psychosocial stimuli and a triggering stimulus. Clinicians have endorsed
this theory but it lacks explanatory depth, such as its failure to explain why some individuals who
experience psychosocial disadvantage do not engage in firesetting (Gannon and Pina, 2010).
Fineman’s (1995) model similarly views firesetting as a product of historical factors that
predispose to antisocial behaviour in general; historical environmental factors that have
legitimised firesetting; and immediate environment conditions that encourage firesetting. Whilst
containing strengths this theory leans more towards juvenile firesetters than adult firesetters.
Addressing their concerns regarding earlier theories, Gannon et al. (2012a) developed the multi-
trajectory theory of adult firesetting (M-TTAF). This theory positively organises research into
hypothesised dynamic risk factors or vulnerabilities associated with the facilitation and
maintenance of firesetting behaviour; combines distal (background characteristics) and proximal
factors (represent an immediate vulnerability) as contributors to firesetting; identifies key factors
associated with repeated firesetting and firesetting desistence; and describes key firesetting
trajectories (patterns of characteristics leading to firesetting). Five key trajectories are antisocial
cognition, grievance, fire interest, emotionally expressive/need for recognition and multi-faceted.
However, this theory lacks detail about how the process of setting fires unfolds for mentally
disordered offenders (Tyler et al., 2014). Consequently, Tyler et al. (2014) developed the
firesetting offence chain model for mentally disordered offenders. This model emphasises
childhood experiences of fire and mental illness as precursors to firesetting.
Firesetting in women
Coid et al. (2000) observed that women were more likely than men to have an index offence of
arson and histories of firesetting. Indeed, firesetting often precipitates women’s admissions to
secure treatment services (Cunningham et al., 2011). Within the NWS in December 2015,
63 per cent of patients had histories of firesetting and among these 47 per cent had received a
conviction for arson/firesetting. Comparable figures regarding male patients were unavailable.
Female firesetters are typically of low-average IQ (Noblett and Nelson, 2001), have low
socioeconomicstatus and are poorly educated(Harmon et al., 1985; Stewart,1993; Tennent et al.,
1971; Wachi et al., 2007) and are likely to have experienced attachment difficulties and trauma
(Harmon et al., 1985; Puri et al., 1995; Hickle and Roe-Sepowitz, 2010). These findings are
paralleledfor women firesetters withinthe NWS and have important implications for treatingwomen
firesetters, such as needing to consider their lack of education and their attachment difficulties in
providing treatment.
The research literature on motives for women’s firesetting is scant and underdeveloped (Gannon
et al., 2012b). Studies with a male firesetter comparison group (Rix, 1994; Dickens et al., 2007)
show that there do not appear to be large differences across female and male firesetters.
Revenge appears to be a common motivator for both genders. Firesetting as a cry for help
however, appears to be more prevalent among female firesetters (Dickens et al., 2007).
Promoting relocation was also found to be an important motivator for women (Rix, 1994)
supporting Jackson et al.’s (1987) work which proposes that firesetting can facilitate escaping or
changing difficult circumstances.
In studies without a comparison group Harmon et al. (1985) similarly noted that anger and a cry
for help were predominant motivators in women firesetters. Stewart (1993) in line with the
M-TTAF (Gannon et al., 2012a) noted that some female prisoners had multiple motives for
firesetting including revenge (33 per cent), attention seeking (20 per cent), instrumental
(20 per cent), mental illness (10 per cent), suicide (8 per cent) and pyromania traits (5 per cent).
Additional motives in Tennent et al.’s (1971) study of female firesetter in-patients were conflict
with authority and self-harm/destruction. Cunningham et al. (2011) found that female in-patients
reported firesetting alongside distressing life experiences.
Gannon’s (2010) review of research regarding characteristics, psychopathologies, and treatment
efforts with female arsonists noted that key features that differentiate female from male arsonists
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