Emma Elizabeth Covernton, Amy Moores and Joseph Aaron Lowenstein
The assessment and management of risk towards others is an integral part of clinical practice, particularly in forensic and other psychiatric settings. Version 3 of the HCR-20 is…
Abstract
Purpose
The assessment and management of risk towards others is an integral part of clinical practice, particularly in forensic and other psychiatric settings. Version 3 of the HCR-20 is the latest version of a comprehensive set of professional guidelines based on the Structured Professional Judgement model. It is the most widely used and best validated tool available to assess risk of violence; however, clinicians perceive it as an additional task with limited clinical usefulness, which requires undergoing expensive training and takes considerable time to implement. The paper aims to discuss these issues.
Design/methodology/approach
Training was delivered to 148 clinicians to improve perceptions with regard to risk formulation and the HCR-20v3 as an effective and clinically useful tool in generating individual and robust care plans to minimise risk of violence.
Findings
Results indicated significant score increase post-training, indicating higher regard for the HCR-20 in terms of its usefulness, anticipated impact upon working, anticipated impact upon managing risk, ease of completion and perceived relevance to clinical practice. This was also consistent with qualitative feedback indicating improved risk management and care planning with reference to how learning would support respective roles. Feedback also highlighted the added value of certain aspects of the training provided, which may be useful to consider when designing HCR-20 training packages.
Research limitations/implications
This study demonstrates the importance of engaging clinicians in bespoke training on the practicalities of HCR-20 completion and the fundamentals of risk formulation.
Practical implications
This study highlights the importance of incorporating a training package for staff of all disciplines in changing perceptions of risk management tools and thus their use in the practical management of violence. The useful aspects of training may assist changing perceptions of the role that risk formulation and the HCR-20v3 play in the assessment and management of violence.
Originality/value
This research suggests that if this can be done successfully, it may lead to a change in the perception of the role that the HCR-20v3 can play in assessing risk of violence and generating meaningful management plans to reduce the future likelihood of violence.
Details
Keywords
Joseph Aaron Lowenstein, Jennifer Stickney and Ida Shaw
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…
Abstract
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.
Details
Keywords
The following classified, descriptive list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to supplement the…
Abstract
The following classified, descriptive list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to supplement the RSR review column, “Recent Reference Books,” by Frances Neel Cheney. “Reference Books in Print” includes all additional books received prior to the inclusion deadline established for this issue. Appearance in this column does not preclude a later review in RSR. Publishers are urged to send a copy of all new reference books directly to RSR as soon as published, for immediate listing in “Reference Books in Print.” The prevailing policy of including all reference books received has temporarily allowed the listing of titles with imprints older than two years; with increased receipt of more current titles from a longer list of publishers, this policy will soon be discontinued (with the exception of older books newly acquired for distribution by another publisher). An additional copy of any title specifically requested by Mrs. Cheney should be sent to her for review. A decision to review titles appearing in the present column will then be made by Mrs. Cheney at her own discretion.