Exploring alliance–outcome associations in a combined mental health and academic counselling setting for at‐risk students: The differential role of alliance components, personality, gender and pre‐treatment severity

Author(s):  
Cynthia Bilodeau ◽  
John Meissner ◽  
Sara Antunes‐Alves ◽  
Robert Konecki ◽  
Lorena Ruci
CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 630-637 ◽  
Author(s):  
Justin Barry-Walsh ◽  
David V. James ◽  
Paul E. Mullen

The rediscovery of the importance of mental illness in the risk assessment and management of those who threaten, approach, and harm public figures has led to a new way of dealing with those that threaten public figures. This approach emphasises the role of “fixation” which may be defined as an intense preoccupation pursued to an abnormally intense degree. It integrates a threat assessment paradigm with the literature on stalking. The need for such an approach was highlighted in research on the prevalence of harassment of public figures. Psychiatry has a key role in this approach which sees mental health clinicians and Police work together in Fixated Threat Assessment Centres (FTACs). An FTAC functions by assessing the level of concern and sharing information to facilitate interventions that are often mental health based. The purpose is not the hopeless task of identifying those who will go on to perpetrate serious violence, rather to intervene in the group they emerge from, to prevent harm. As well as decreasing risk to the persons fixated upon, this approach improves care to the mentally disordered people who harass and threaten them and, in doing so, decreases the likelihood of their criminalization while enhancing their quality of life. As expertise in the area has grown, policing and security agencies in several countries have expanded the FTAC model to cover individuals thought at risk of lone-actor grievance-fueled violence, a term that captures both different forms of mass killing and lone actor terrorism.


2021 ◽  
Author(s):  
◽  
Alexis Harris

<p>At-Risk Units (ARUs), which contain and prevent suicide and self-harm among prisoners, have been criticised for their isolating, non-therapeutic nature. This thesis explores the potential for care-oriented practice to develop in ARUs at two prisons, with a particular emphasis on the role that multi-disciplinary teams and an enhanced healthcare presence can play in achieving this goal. Adopting a qualitative framework, this research draws upon nineteen interviews with nursing, forensic and custodial ARU staff from Hawkes Bay Regional Prison (HBRP) and Rimutaka Prison (RP). This research found that while normative care-oriented operational safeguards and legal frameworks underpin current ARU policies, they can often become shaped, or in some cases inhibited, by managerial adherence to compliance, risk-management priorities, limited resourcing, staffing issues and a punitive prison culture. However, in instances where multi-disciplinary teams are well resourced, have open channels of communication and operate within health-focused ARU environments, as evidenced in the current workings of RP, positive care-oriented responses to ‘at-risk’ prisoners can be better provided. The thesis concludes by noting that incremental reforms to the current framework may be useful in enhancing care-oriented ARU practice. However, even with change, the question remains whether correctional ARUs can stem burgeoning mental health issues and ‘at-risk’ behaviours among prisoners.</p>


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