Themed issue: treatment in forensic practice

Citation

Ireland, C.A. and Gredecki, N. (2012), "Themed issue: treatment in forensic practice", The British Journal of Forensic Practice, Vol. 14 No. 1. https://doi.org/10.1108/bjfp.2012.54314aaa.001

Themed issue: treatment in forensic practice

Article Type: Editorial From: The British Journal of Forensic Practice, Volume 14, Issue 1

Welcome to the current issue of the British Journal of Forensic Practice. This is a themed issue looking at “Treatment in Forensic Practice”. As such, we have four invited papers focusing on treatment approaches with individuals who present with cognitive impairments. The issue concludes with an additional paper on treatment effectiveness and a case study.

The first paper is an invited one by Leam Craig and Ian Stringer, focusing on the treatment of sexual offenders with intellectual limitations in the community. This paper summarises the results of a cognitive-behavioural treatment group for sexual offenders with intellectual limitations in the community. They examined a small number of offenders who had been convicted for sexual offences, and whom attended a 14 month treatment programme. This programme had been adapted for individuals with intellectual limitations. This paper discussed the components of this treatment, considering the results from psychometric measures. They noted significant improvements in sexual offence related attitudes in this group post assessment, including an enhanced appreciation of victim empathy, and significant reductions in attitudes relating to cognitive distortions and pro-sexual assault beliefs. They carefully discuss the limitations of their research, and end their paper with a helpful review of the development and delivery of treatment programmes for sexual offenders with such intellectual limitations.

This is followed by the second invited paper by John Rose, David Rose, Cliff Hawkins and Caitlin Anderson. This paper also looks at a sex offender community group treatment therapy for individuals who have intellectual disabilities. Here they argue a rationale for the development of such community-based treatments, including a focus on men who may present with sexually inappropriate behaviour, but may not have been charged. They briefly introduce the focus and structure of such groups, and present some very preliminary data on outcome. From such initial data they note some promising, tentative, outcomes, arguing that participants demonstrated a reduction in attitudes consistent with offending, an increase in sexual knowledge and a more external locus of control on completion of the group. They conclude their paper by considering the advantages it has to other models, yet emphasising the need for further research.

Jenny Keeling and John Rose follow with the third invited paper, examining a model of self-regulation and treatment for sex offenders with intellectual disabilities. They present a careful consideration of applying theory to practice, using the self-regulation model of sexual offending (Ward and Hudson, 2000). They propose that difficulties in self-regulation may contribute to an increased risk of sexual offending. As such, they describe four potential pathways to sexual offending that are based on self-regulation style and offence-related goals. They argue that research has focussed on the application and implications of this theoretical model for mainstream sexual offenders, yet there is a need for its application to other groups. As such, they present an increasing interest into the application and treatment implications for this self-regulation model in sexual offenders with an intellectual disability. Their paper explores treatment implications of this model for such sexual offenders, and by doing so, they provide some well considered, practical applications that could be utilised in treatment settings.

Amanda Michie and William Lindsay follow with the final invited paper in this issue. Here they focus on the treatment component of empathy, discussing a therapy intervention designed to enhance empathy in sex offenders with intellectual disability. They present how their treatment group received an empathy component, and helpfully compared this with a control group. They examined therapeutic efficacy by pre and post treatment, and at follow up using psychometric measures which assessed fantasy, perspective taking, empathic concern and personal distress. They noted no significant differences between treatment and control groups at baseline. Yet, for the treatment group, significant differences were identified between pre, post and at a three month follow-up assessment, indicating increased empathy. They noted that the empathy component appeared to enhance empathic responses, yet argue the need for future research which can compare empathy measures, and which investigate specifically the relationship between what is taught in empathy programs and what is measured by empathy assessments. They conclude their paper with a helpful discussion as to the challenges with their research.

The issue continues with a paper by Mark Crane and Linda Blud, looking at the effectiveness of substance use therapies in an adult male category C prison. This paper was extremely well constructed, and considered the short-term impact of the Prisoners Addressing Substance Related Offending (P-ASRO) programme, which is a cognitive-behavioural intervention addressing offending related to substance misuse and targeting those with low-medium dependency. From their study, they noted that the majority of forensic clients fell into the high dependency need group. Yet, even with this presentation, there were significant differences between all of the pre and post measures, with large effect sizes reported. They concluded that, following intervention, clients were less impulsive, had increased their problem-solving ability, had developed a greater internal locus of control, and were more motivated toward taking action. They demonstrated clear and careful consideration as to the limitations of their research, yet argue its clear contribution to the field.

This issue is concluded with a carefully considered case study by Victoria Absalom-Hornby, Patricia Gooding and Nicholas Tarrier. This case study considers the feasibility of family intervention using a web camera within forensic services. It focuses on family intervention with a mother and sister of a forensic service user diagnosed with schizophrenia. They describe the successful implementation of a family intervention within forensic services, facilitated by a web camera and internet link. They note that the outcome variables assessed throughout treatment demonstrated that the sister and, particularly the mother, experienced reduced expressed emotion, reduced stress, improved knowledge of schizophrenia, reduced stigma and improved personal health. They also noted an improved understanding of and willingness for the family to work with forensic services following the intervention. Their paper presents a novel application of technology to family intervention, and which offers the potential for greater exploration of this approach.

Carol A. Ireland, Neil Gredecki