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Literature suggests that mentally disordered offenders are considerably more difficult to treat and slower to respond to psychological treatment. Less is known about the particular factors that can contribute to this resistance. A more comprehensive understanding of the factors that treating psychologists feel can promote or inhibit progression through rehabilitative treatment may increase the likelihood of positive clinical outcomes. This paper aims to discuss these issues.

Four practising psychologists employed within a male medium- and low-secure forensic unit in the North East of England took part in a semi-structured interview. Their views, opinions and experiences regarding patient progression through treatment pathways were recorded, transcribed and analysed.

This thematic analysis identified that numerous patient-specific parameters influenced perceived progression, and environmental and external factors had a significant impact on the patients’ expressed attitude towards treatment.

Alongside issues of motivation and engagement, participants identified external factors that influence perceived treatment success with their forensic patients.

Additional research is needed to identify the factors that are the most influential in promoting or inhibiting perceived and actual progress. This will hopefully optimise treatment engagement and the motivation to change problematic behaviours in mentally disordered offenders.

In forensic mental health wards, patients spend more time with healthcare assistants (HCAs) than qualified nurses. Despite this, there is no universally utilised standardised HCA training. The purpose of this paper is to assess the HCAs’ experiences in the HCA role in order to better understand how to build on the HCA role to ensure safe practice, and enhance staff well-being.

HCAs working on low and medium secure NHS forensic mental health units were recruited through purposive methods. HCAs engaged in a semi-structured interview, with questions surrounding their support needs, clinical decision making and perception of risks in the role. Template analysis was used, applying an a priori template based on the existing literature to interview transcripts.

The participants described the HCA experience to be defined by two master themes: “HCA factors” and “organisational factors”. HCAs valued a holistic patient view which prized patients’ experiences. The participants described a lack of role clarity which may be defined through ward expectations and professional experience.

HCAs seek a holistic view of the patient; however, some overlooked patient offences in order to do their job. Future research should address how looking past offences impacts security and HCAs’ well-being long term.

Previous literature has reported that working with sexual offenders can impact staff negatively (Hatcher and Noakes, 2010). In addition, working with individuals with intellectual disability also appears to be challenging. There are benefits stated of working with sexual offenders and the purpose of this paper is to seek to highlight the challenges and positive experiences of staff members working with sexual offenders who have autism.

As working with this population has not been previously investigated, a semi-structured interview was conducted to explore the challenges and benefits of working with this population. Eight participants were interviewed who work on the autism specialist ward at a forensic secure hospital in the UK.

Template analysis identified three master themes: mediating factors, challenges and consequences, which were incorporated into the Model of Person-Organisation Wellbeing (M-POW). The findings show the specific challenges of working with a population that has not been previously studied.

The study utilised a small, heterogeneous self-selecting sample from one clinical site.

Findings suggest there are a number of specific challenges this staff group face, and steps that can be taken at the personal and organisational level to mediate these. Recommendations are made for how staff are supported in their work from recruitment and induction onwards.

The M-POW highlights mediating factors that can be adjusted to develop more effective coping strategies for working in what, for some, is a challenging environment. This model provides a framework that can be adopted by organisations to ensure that the likelihood of their staff experiencing negative feelings is reduced and also suggests future avenues of research.

People with intellectual disabilities (ID) can be vulnerable to developing mental health problems. It has been found that participating in regular exercise can help to improve emotional well-being, both in typically developing people and those with ID. The purpose of this paper is to investigate the experiences of community clients with ID who have engaged in a football training programme, and the perceived impacts on attitudes, mood and behaviour.

Interviews with seven patients from generic or forensic community ID services were conducted. The transcripts were analysed using interpretative phenomenological analysis.

Two master themes were identified from the interviews, “Striving” and “Togetherness”.

The most important factors related to taking part in the football programme were the social, emotional and personal growth associated with being part of a team and general enjoyment of being part of something. Although aspects of football knowledge and physical fitness were still evident, their impact seemed to be less significant. The experience of football was overwhelmingly positive.

Social media use in autistic people has been identified as a potential avenue for less pressured social contact. Given shifts towards online socialisation, this study aims to systematically review the available literature on how autistic people experience and use social media.

A systematic review was carried out using the preferred reporting items for systematic reviews and meta-analyses system, with relevant literature reviewed and synthesised using a narrative approach. Inclusion criteria included adults and/or adolescents as the sole sample, a focus on autism and social media use as the sole/main topic.

A total of 1,278 research studies were initially identified; following screening, 15 papers were reviewed. Studies demonstrated some support for the positive role social media can play and presented its use as a smart adaptation for the challenges of neurotypical socialising. For autistic people, social media may provide a balance between meeting the need to be connected to people without the pressure of managing aspects, such as tone of voice or body language.

Most studies were questionnaire-based with substantial threats to validity. Samples were self-selecting, with autism status not always confirmed. Individual studies used a broad approach to the definition of social media, including online gaming and other online activities, precluding firm conclusions being made.

There may be a Goldilocks “just right” level of social media contact that could maximise connectedness to others without impacting negatively on mental health, offline relationships and activities of daily living.

This paper presents a novel account of research from case studies and larger scale questionnaire studies.

This paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.

There is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.

EMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.

This paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

The assessment for and diagnosis of personality disorder (PD) continue to be contentious, with many prominent practitioner psychologists arguing against this specific label and providing a credible alternative framework to psychiatric diagnosis more generally. This paper aims to summarise the literature and support practitioners identifying PD in people with intellectual disabilities (ID).

Relevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide a service position on the assessment and diagnosis of PD in people with ID.

For people with intellectual disabilities, the PD label can be even less robustly applied and may be even more pejorative and obstructive. That said, there are people for whom a PD diagnosis has clear clinical utility and opens access to suitable specialist services.

Evidence suggests that a diagnosis of PD can be both facilitative and obstructive, and the assessment and diagnosis process should, therefore, be undertaken with caution.

This paper presents an account of NICE guidance and evidence on the assessment and diagnosis of PD in people with intellectual disabilities.

Nursing teams supporting people with intellectual disabilities in inpatient settings are known to be vulnerable to burnout, compassion fatigue and vicarious trauma. Aspects such as resourcing, support, training and the fundamental challenges of supporting this patient group are known risk factors for these difficulties. The aim of this paper is to synthesise the literature on these issues and provide suggestions for operationalising solutions.

Literature on the experiences of nursing teams supporting people with intellectual disabilities in inpatient settings was considered, alongside the established offer of clinical psychologists working into these services.

There are common themes of staff’s emotional health and the impact this can have on patient care and the steps that managers and organisations can take to support their teams to remain emotionally healthy, compassionate and effective practitioners. Clinical psychology can play a role in offering this support only where services and teams are aware of the contribution they can make.

Clinical psychology has been undersold and under-represented in inpatient settings for people with intellectual disabilities, and this practice paper outlines the important contributions that they can make to the psychological well-being of all within the system, not just patients.

People with learning disabilities (LD) often lack necessary support in navigating and coping within the Criminal Justice System (CJS). The purpose of this paper is to explore their experiences, from their own perspective, and identify the supports which need to be implemented.

Focus groups were held with nine patients in a forensic LD service, discussing their experiences and support needs within the CJS. Template analysis was undertaken on the transcripts.

Four themes were identified: negative feelings, professional attitudes, suitability of the CJS, and supports needed.

This research demonstrates the valuable opinions to be obtained from offenders with LD on their experiences and needs. Implications for the CJS include a need for further awareness, training, and expertise to work effectively with people with LD. Participant perspectives also highlight the importance of consistent liaison and diversion schemes, and indicate that CJS services may have something to learn from healthcare settings.

Previous knowledge of offenders with LD overlooked the perspective of the service user. This research has given this group a voice, and has benefited from their insight. This is a timely piece of research in the current landscape of the CJS, and so these findings may be of practical value to the implementation of supports, particularly the liaison and diversion schemes.

This review seeks to systematically review studies where personality disorder has been explored as a descriptive or possible predictive factor in offending behaviour in people with an intellectual disability. The papar aims to discuss this issue.

A systematic search of several databases was conducted and 15 studies met the inclusion criteria and were included in this review.

Methodological limitations and problems in accurate diagnosis within this client group preclude firm conclusions being reached.

It is concluded that further research should be conducted, with particular attention paid to the conceptualisation and assessment of personality disorder.