Compassion in custody: developing a trauma sensitive intervention for men with developmental disabilities who have convictions for sexual offending

2021 ◽  
Vol 15 (5) ◽  
pp. 185-200
Author(s):  
Jon Taylor
Keyword(s):  
Sexual Offending ◽  
Service Evaluation ◽  
Therapeutic Modality ◽  
Service Users ◽  
Sexual Offences ◽  
Future Directions ◽  
Content Type ◽  
Intervention Service ◽  
Harm To Others ◽  
Insight Into

Purpose This paper aims to provide a description of a trauma sensitive intervention for men who have committed sexual offences. The intervention aims to support men to process and make sense of their own experience of trauma before inviting them to acknowledge their role in causing harm to others. The intervention draws on compassion focussed therapy (CFT) as the overarching therapeutic modality. Design/methodology/approach As part of a service evaluation changes in routine repeat measures completed by service users were analysed prior to joining the intervention and after 12 months of intervention. Service users were encouraged to provide regular feedback relating to their experience of the intervention at regular intervals. This feedback was collated and patterns were identified collaboratively to understand the context for assessed change in the measures. Findings Prior to the intervention men reported high levels of shame and limited experiences of guilt (as compassion for others). Early findings indicate that men experience less shame and increased experiences of guilt after 12 months. An increase in insight into risk was also evident. Service user feedback pointed towards a more engaging therapeutic style and highlighted the importance of both a collaborative and trauma sensitive approach. Originality/value This is the first evaluative description of forensic CFT for sexual offending. Findings offer insight into potential future directions for forensic interventions with this population.

A community forensic team for people with intellectual disabilities

2016 ◽  
Vol 18 (4) ◽  
pp. 274-282 ◽  
Author(s):  
Morna Browning ◽  
Rosemary Gray ◽  
Rose Tomlins
Keyword(s):  
Intellectual Disabilities ◽  
Service Evaluation ◽  
Service Users ◽  
Mild Intellectual Disability ◽  
Evaluation Tool ◽  
Sexual Offences ◽  
Retrospective Case ◽  
Content Type ◽  
Wide Range ◽  
Restrictive Settings

Purpose The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and interventions delivered. It discusses the clinical implications of these and examines outcomes such as recidivism. Design/methodology/approach A retrospective case note review of all 70 service users open to the CFT during June 2013 was carried out, using a structured service evaluation tool. Findings The majority of service users (74.3 per cent) had a mild intellectual disability. Multiple mental health and/or physical health diagnoses were common, and 28 per cent had problematic drug or alcohol abuse. Almost half of service users had been victims of physical or sexual abuse, or neglect. Sexual offences were the most common index offence, followed by assault and fire-setting. A wide range of multi-disciplinary interventions were delivered within the Community Forensic Team. Following CFT involvement there was an increase in service users living in supported living in the community and a decrease in people in secure or out of area placements. Over half of service users engaged in no further offending behaviour since their referral, and those who did offend generally showed a decrease in the severity of offending behaviours. There was a large decrease in the number of convictions received. Practical implications The study shows the benefits of a multi-disciplinary Community Forensic Team for offenders with intellectual disabilities in terms of reduced recidivism and range of interventions delivered. It highlights the importance of clinicians within such a team having the skills to work with people with co-morbid diagnoses (e.g. autism) and people with trauma backgrounds and problematic substance use. Originality/value This paper demonstrates the complexity of the service users who are supported by the CFT, as well as the integral role played in supporting individuals to move to less restrictive settings, with positive outcomes.

scholarly journals Technological mediation in the future of experiential tourism

2019 ◽  
Vol 5 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Ellis Urquhart
Keyword(s):  
Technological Development ◽  
Tourism Industry ◽  
Future Directions ◽  
Technological Mediation ◽  
Content Type ◽  
Academic Literature ◽  
Considerable Research ◽  
Theoretical Perspectives ◽  
The Future ◽  
Insight Into

Purpose The purpose of this paper is to consider the role that technology may play in the future of experiential tourism. This viewpoint paper begins to question future developments in technological mediation and how these may challenge the author’ view of experiences and their construction in a period of immense and rapid technological development. Design/methodology/approach This is a short viewpoint paper driven by theoretical perspectives in the existing academic literature and the author’s personal stance on the future of experiential tourism. Findings This paper suggests that while there is considerable research into the role and application of technology within tourism, there is a lack of future-orientated debate. The views expressed within the paper argue that three potential directions exist for the future of technological mediation in experiential tourism: mass acceptance and customisation; experiential convergence or “rewinding the clock”, each with significant implications for the management of technological mediation in experiential tourism. Originality/value The paper provides an initial insight into future directions of the tourism industry in a period of immense technological development. Based on existing theoretical perspectives, these viewpoints indicate three potential routes for the industry and act as a catalyst for further dialogue within tourism scholarship.

“It’s changed my life!” Evaluation and improvement of a pilot Tier 2 weight management course, “Balance”

2021 ◽  
Vol 26 (1) ◽  
pp. 71-86
Author(s):  
Sally McGuire ◽  
Alex Stephens ◽  
Emma Griffith
Keyword(s):  
Mental Health ◽  
Weight Management ◽  
Evaluation Study ◽  
Service Evaluation ◽  
Service Users ◽  
Tier 2 ◽  
Content Type ◽  
Management Interventions ◽  
Cognitive Behavioural

Purpose This paper aims to describe a service evaluation study of “Balance” – a National Health Service Tier 2 pilot weight management course delivered in a primary care mental health service. The 12 weekly sessions included dietetic, psychological and behavioural elements underpinned by cognitive behavioural theory and “third-wave” approaches, including acceptance and commitment therapy, compassion-focused therapy and mindfulness. Design/methodology/approach A mixed-methods design was used in this service evaluation study that included analysis of outcome measures (weight, eating choices, weight-related self-efficacy and mental health) and focus group data (n = 6) analysed using thematic analysis. Eleven clients with a body mass index of 25–40 kg/m2 enrolled, and nine clients completed the course. Outcome data were collected weekly with follow-up at three and six months. Findings Quantitative data analysis using non-parametric Wilcoxon signed-rank tests showed that the group mean weight decreased significantly (p = 0.030) by the end of Balance, but the group mean weight loss was not statistically significant at the three-month (p = 0.345) or six-month (p = 0.086) follow-up. The qualitative results showed that participants valued the course ethos of choice and also welcomed learning new tools and techniques. Balance was very well-received by participants who reported benefitting from improved well-being, group support and developing new weight management skills. Research limitations/implications Only one client attended all sessions of the group, and it is possible that missed sessions impacted effectiveness. Some of the weight change data collected at the six-month follow-up was self-reported (n = 4), which could reduce data reliability. Focus group participants were aware that Balance was a pilot with a risk that the group would not be continued. As the group wanted the pilot to be extended, the feedback may have been positively skewed. A small sample size limits interpretation of the results. A group weight management intervention, including dietetic, psychological and behavioural elements, underpinned by cognitive behavioural theory was well-received by service users and effective for some. Commissioners and service users may have different definitions of successful outcomes in weight management interventions. Practical implications Longer-term support and follow-up after Tier 2 weight management interventions may benefit service users and improve outcomes. Originality/value The paper contributes to a small but growing evidence base concerned with the design and delivery of weight management interventions. Areas of particular interest include: a gap analysis between the course content and National Institute for Health and Care Excellence clinical guidelines, participants’ views on the most impactful course features and recommendations for course development. The results also show a disconnect between evidence-based guidelines (mandatory weight monitoring), participants’ preferences and clinicians' experience. The difference between client and commissioner priorities is also discussed.

Bridging the gap: from service user to service provider

2020 ◽  
Vol 24 (3) ◽  
pp. 157-162
Author(s):  
Maddi Faith
Keyword(s):  
Service Provider ◽  
Service User ◽  
Design Methodology ◽  
First Person ◽  
Service Users ◽  
Content Type ◽  
The Past ◽  
Personal Experiences ◽  
Insight Into

Purpose The purpose of this paper is to share the author’s personal experiences as both a service user for the past 10 years and becoming a professional working in the same field. This paper aims to provide an insight into some of the barriers faced relating to support and procedures, as well as provide advice and guidance to service users and professionals. Design/methodology/approach This paper is designed primarily as a narrative; a first-person approach is taken. Findings Advice and reflections for service users is given as well as guidance for professionals. Originality/value This paper is a narrative of an individual’s personal experiences and observations therefore providing a unique outlook. This paper contributes to both service users who may feel unsure about or overwhelmed by their treatment and their involvement in decisions, as well as professionals trying to develop their understanding and awareness of less thought about needs for autonomy for service users and improving their practice.

Exploring offender manager’s experiences of psychologically informed consultation on relationships with service users within the offender personality disorder pathway

2020 ◽  
Vol 25 (4) ◽  
pp. 317-328
Author(s):  
Kay Radcliffe ◽  
Bethany Carrington ◽  
Max Ward
Keyword(s):  
Personality Disorder ◽  
Interpretative Phenomenological Analysis ◽  
Small Scale ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Psychological Consultation ◽  
Probation Service ◽  
Harm To Others ◽  
The Relationship

Purpose The Yorkshire and Humber Personality Disorder Partnership (YHPDP) provides psychological consultation and formulation to offender managers (OMs) within the National Probation Service as part of the offender personality disorder (OPD) pathway. The pathway highlights the importance of formulation-led case management to develop pathways for offenders with personality difficulties at high risk of causing serious harm to others. This study aims to ask what is the experience of psychological consultation/formulation on the relationship between a sample of service users (SUs) and their OMs. Design/methodology/approach Semi-structured interviews were undertaken with five OMs who had engaged in at least three consultations with YHPDP psychologists/psychotherapists within the OPD pathway. Qualitative methods were used to analyse the data, specifically interpretative phenomenological analysis, which is useful when dealing with complexity, process or novelty. Findings OMs experienced the consultation/formulation process to be containing and reflective. They found complex, emotionally demanding clients who have offended and have personality disorder traits could be responded to differently as a result of this process. From an OM perspective, this improved the relationship between themselves and their SUs and supported risk management. These conclusions must be tentative, as they are drawn from a small-scale qualitative study, but provides the basis for further research. Originality/value Although there is increasing research into the outcomes of the OPD pathway, little has been done regarding the experience of the relationship between OMs and SUs. This research takes a qualitative perspective to explore this area.

scholarly journals Dysphagia assessment and intervention: evaluating inclusive approaches using video

2020 ◽  
Vol 14 (6) ◽  
pp. 247-261
Author(s):  
Susan Guthrie ◽  
Jois Stansfield
Keyword(s):  
Mental Health ◽  
Service User ◽  
Muscle Tone ◽  
Service Evaluation ◽  
Health Conditions ◽  
Inpatient Setting ◽  
Service Users ◽  
Content Type ◽  
Mental Health Conditions ◽  
Clinical Benefits

Purpose Dysphagia experienced by adults with mental health conditions and/or intellectual disabilities (IDs) has been well-reported. However, accessible and inclusive assessment measures to identify and monitor for deterioration in dysphagia are very limited. The purpose of this paper is to explore the use of video to enhance inclusion in dysphagia assessment and intervention for an inpatient setting. Design/methodology/approach This service evaluation involved adults with IDs and mental illness living in in-patient accommodation and their multidisciplinary team. Participants were invited to film and then reflect on videos and their comments were transcribed for qualitative analysis. Findings In total, 42 adults gave consent to film, review and discuss mealtime video-clips. Staff feedback was invited. Thematic analysis was conducted for service-user and staff comments. A global theme of “involvement” was identified from the data analysis, with sub-themes of “enhancing participation, insight and incentive”. An additional global theme “clinical benefits” resulted from staff comments. This included sub-themes of breadth of assessment, shared working and outcome measures. Research limitations/implications Limitations included refusal of video by people with heightened anxiety but these were a minority. Most people showed enthusiasm and enhanced engagement. Practical issues were resolved regarding governance. Practical implications Video offers a dynamic record of muscle tone, coordination, mealtime experience and individual context benefiting both service-user and staff practice. It stimulates insightful discussion of outcomes and supports the inclusion of service-user perspectives. Further research is indicated to develop a greater understanding of dysphagia in this population. Inclusion of service-users in planning and managing safer mealtimes may be enhanced through the sensitive use of video. Social implications This evaluation suggests opportunities for improving inclusive approaches for service-users using video to promote insight. Originality/value Further research is indicated to explore the nature of dysphagia in people with mental health conditions using video as a dynamic and unique resource.

Gathering meaningful service user feedback regarding a community forensic service

2015 ◽  
Vol 6 (2) ◽  
pp. 81-93 ◽  
Author(s):  
Karen Bamford ◽  
Carl Benton
Keyword(s):  
Risk Taking ◽  
Service Provision ◽  
Design Methodology ◽  
Service Evaluation ◽  
Third Party ◽  
Service Users ◽  
Engagement In Care ◽  
Content Type ◽  
Forensic Service ◽  
Practical Implications

Purpose – Engaging with people with a learning disability to develop and enhance service provision is central to the ethos of personalisation and citizenship. Despite this there appears to be a lack of research to gather users’ views on how they feel the services meet their unique needs and how these could be improved. A service evaluation was developed to understand service user’s experience of accessing a community forensic service (CFS). The paper aims to discuss these issues. Design/methodology/approach – The questionnaire was conducted by an independent third party experienced in facilitating complex communication, utilising a written format and Widget Rebus symbols. Questions were based on Trust Values, family and friends test and clinical forensic engagement. The samples were service users open to the CFS on 1 July 2014. Findings – Data were gathered from 28 individuals, there was an even spread of ages 17-65. In all, 93 per cent understood what help they needed from the service, there was acknowledgement of who they would go to if they wanted to complain, 100 per cent were happy with how information had been provided, most felt the service was respectful, fair, friendly and they were listened to. Practical implications – The findings suggest that more needs to be done around understanding and engagement in care planning. There are plans to gather information from direct carers and setting up focus groups to further understand some of the issues and ways forward. Originality/value – Asking for feedback from people who have offended, some of whom now experience increased restrictions, is fraught with concern and approached with trepidation. However, the responses received contradict the natural instincts. The results showed promising appreciation of the support received in the context of everyday lives and positive risk taking.

Resolve: a community-based forensic learning disability service specialising in supporting male sex offenders – our model, approach and evidence base for effective intervention

2016 ◽  
Vol 7 (4) ◽  
pp. 186-194 ◽  
Author(s):  
Anne Graham ◽  
Celia Harbottle ◽  
David King
Keyword(s):  
Learning Disability ◽  
Service User ◽  
Evidence Base ◽  
Social Implications ◽  
Service Users ◽  
User Group ◽  
Sexual Offences ◽  
Community Based ◽  
Content Type ◽  
Care And Support

Purpose The purpose of this paper is to examine a model of effective forensic practice with positive interventions for men with learning disabilities who have committed serious sexual offences. It outlines the theoretical and philosophical frameworks which have informed the model of care and support in a community-based setting and the evidence base for the efficacy of the approach. Design/methodology/approach This approach to a community-based forensic learning disability service is informed by systemic practice and underpinned by models of human occupation (Keilhofner, 2008) which informs occupational therapy and total attachment (Harbottle et al., 2014). This is a whole systems model for developing compassionate and participatory practice based on attachment theory and approaches to professional parenting drawn from foster care settings and prevention frameworks for adult safeguarding. It uses Klinean Thinking Environments (1999) to give practical communication to the model. Findings The attachment model which underpins both the support for staff and the framework for scaffolding the care and support provided for service users is building calm, consistent and respectful relationships. This enables workers and service users to feel accepted through the availability of support; to feel a sense of belonging and inclusion in which skills and confidence can flourish helping all to feel more effective. This is evidenced by the stability of the service user group and the staff team. Research limitations/implications The model of whole system care and support care outlined in this paper can help to provide a therapeutic environment in which men who have committed sexual offences can develop effective skills within a safe, supportive and effectively managed setting. This is on-going research but there is evidence of service users and staff in this model of practice, feeling scaffolded, able to enjoy and achieve progress and personal development. Practical implications This model appears to promote stable, sustained, supportive relationships. Placement breakdown has been minimal indicating that the disruption rate is low and therefore therapeutic interventions are likely to take place and be effective. This is a hopeful and positive approach which enables individuals to flourish in a safe environment. Social implications The social implications of this model are positive for creating a stable workforce in an industry plagued with rapid turn over of staff to the detriment of the quality of life for service users. It creates stability and confidence for the residents allowing them to begin to relax and thereafter achieve more positive relationships. Originality/value This paper examines the application of theoretical frameworks drawn from other disciplines and fuses them into a therapeutic approach to support this service user group. It is a model that can have great portability to other settings but it is its application in forensic services that is new and which is growing its evidence base for its effectiveness.

scholarly journals International overview of phallometric testing for sexual offending behaviour and sexual risk

2021 ◽  
pp. 1-4
Author(s):  
Andrew Bickle ◽  
Colin Cameron ◽  
Tariq Hassan ◽  
Hira Safdar ◽  
Najat Khalifa
Keyword(s):  
International Development ◽  
Sex Offender ◽  
Sexual Offending ◽  
Offender Treatment ◽  
Sex Offender Treatment ◽  
Sexual Offences ◽  
Future Directions ◽  
Legal Decisions ◽  
System Risk ◽  
Offending Behaviour

Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.

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