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PSYC 3604 A > Criminal Behavior > Flashcards

Criminal Behavior Flashcards

1
Q

What are the three kinds of multiple homicides?

A
  1. Spree Murder
  2. Serial Murder
  3. Mass Murder
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2
Q

Most definitions of multiple homicides focus on:

A

The number of victims

The number of events over which the killings take place

The number of locations involved in the killings

Whether there is a cooling off period between the killings

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3
Q

What are the characteristics of a spree murder?

A

Victims: 2+
Events: 1
Locations: 2+
Cooling off period? NO

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4
Q

Explain the Case of Gabriel Wortman

A

Killed 22 people and injured three others over a 13 hour time period in 16 different locations in rural Nova Scotia.
Driving a replica RCMP cruiser.
Eventually died in stand off with police.

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4
Q

What are the characteristics of a serial murder?

A

Victims: 2+
Events: 2+
Locations: 2+
Cooling period: YES

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4
Q

What are characteristics of a mass murder?

A

Victims: 4+
Events: 1
Locations: 1
Cooling period: NO

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4
Q

Gabriel Wortman personality characteristics..

A

Obsessed with police
Ran dentures clinics
Domestic violence perpetrator
Gun fascination

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4
Q

What kind of killer was Gabriel Wortman?

A

Spree

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4
Q

What kind of killer was Clifford Olson?

A

Serial

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5
Q

Explain the case of Clifford Olson

A

One of the most prolific serial killers in Canada

Killed at least 11 children and young adults in BC

Incarcerated in maximum security prison - consistently denied parole - died in 2011

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6
Q

Who was Ted Bundy?

A

Murdered 35+ young across US between 1974 and 1978

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7
Q

When/how did Ted Bundy die?

A

Executed in 1989

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8
Q

What was Ted Bundy involved in (community wise)?

A

Earned a scholarship to Stanford University

Studied both psychology and law

Volunteered at a rape crisis center in his free time

Was commended by Seattle police for saving the life of a three-year-old drowning boy

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9
Q

What kind of killer was Marc Lepine?

A

Mass

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10
Q

What was the worst mass killing in Canadian history?

A

Marc Lepine, aged 24, at Ecole Polytechnique in Montreal

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11
Q

Explain the case of Marc Lepine

A

Claiming he was “fighting feminism” he shot 28 people, killing 14 women, and then committed suicide over the course of 20 minutes

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12
Q

How many mass shootings in the US (September 4)

A

484

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13
Q

What are most mass homicides linked to?

A

68.2% of mass homicides are linked to domestic violence

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14
Q

Who are some of the infamous Canadian serial killers?

A

Wayne Boden (“The Vampire Killer”

Clifford Olson

Paul Bernardo and Karla Homolka (Ken and Barbie)

Robert ‘Willie’ Pickton (the Pig Farmer)

Ex-colonel Russell Williams

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15
Q

Annual Report on Serial Killer Statistics

A

5752 serial killers from US and other countries

Seperate section with 15, 088 victims

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16
Q

What does Aamodt et al. 2023

A

Number of active serial killers peaked in the US in the 1980s; with an average of 173 active serial killers per year

In 2010-2019, there were an average of 53 per year

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17
Q

What is a hypotheses for the decrease in serial killers?

A

Increased technology (e.g., Black widows makes insurance fraud harder)

Decreased availability of vulnerable targets (hitch hikers, taking a ride from a stranger)

Striker criteria for parole

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18
Q

Explain international comparisons

A

115 countries have at least one identified serial killer

64% (3, 690) of known serial killers are American

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19
Q

Which countries have at least 100 serial killers?

A

United States (3, 690)
England (182)
Russia (164)
Japan (138)
India (130)
South Africa (120)
Canada (125)

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20
Q

Which gender more likely to be serial killers?

A

Males

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21
Q

What are women motivated vs men? (homicides)

A

Women motivated by money

Men have varied motives

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22
Q

What are some of mens varied motives for homicide?

A

Enjoyment, anger, criminal enterprise

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23
Q

T/F: Men shoot; Women use poison

A

True

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24
Q

Who is the angel of death?

A

Registered nurse, long term care worker
Killed 8 elderly patients, 6 injured

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25
Q

How did the angel of death kill?

A

Lethal amounts of insulin

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26
Q

Why did the angel of death kill?

A

Claimed she felt uncontrollable urge to kill

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27
Q

Who did angel of death target?

A

Those with dementia

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28
Q

What are the typologies of serial killers? (Holmes & Holmes)

A
  1. Visionary
  2. Mission Oriented Serial Murder
  3. Hedonistic
  4. Power/control
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29
Q

What is a visionary serial killer?

A

Suffers from psychosis (break from reality)

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30
Q

What is a mission oriented serial murder?

A

No psychosis, self appointed to rid the world of undesirables (e.g., prostitutes)

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31
Q

What is a hedonistic serial killer?

A

Do it for pleasure (lust & thrill - sexual arousal & murder linked, comfort - does it for non-sexual gains: financial, money, “Black Widow”)

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32
Q

What is power/control serial killer?

A

Desire to hold victims life in his/her hands

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33
Q

What is the theory of serial killing?

A

Trauma Control Model

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34
Q

What are predispositional factors?

A

Biological: extra Y chromosome

Psychological: mental illness

Sociological: poor parenting

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35
Q

What are facilitators examples?

A

Pornography, alcohol, drugs to amplify violent/sadistic imagery

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36
Q

What are examples of traumatic events?

A

Abuse, which can lead to anxiety, mistrust, etc (exacerbated by predispositional factors)

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37
Q

What are low self esteem/fantasies?

A

Traumatic events lead to feelings of low self esteem

Fantasy substitutes for unhealthy social relationships

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38
Q

Why do violent fantasies emerge?

A

In response to traumatic events

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39
Q

What is homicidal behavior?

A

Exhibited in an attempt to satisfy fantasies

Encounters trauma again, which triggers process

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40
Q

What is dissociation? (TCT)

A

Individual creates a mask or facade to cope with trauma

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41
Q

What is trauma reinforcement?

A

As adult, exposed to triggers (e.g., rejection); unable to cope, conjures up emotions linked to childhood trauma and they retreat into fantasy

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42
Q

What are the theories of violent offending?

A

Crime specific theories, general theories of violence

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43
Q

What are crime specific theories?

A

Serial homicide (e.g., trauma control model)

Substance use specific models

Intimate partner violence (PIV; e.g., Patriarchal Theory)

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44
Q

What are general theories of violence?

A

Reactive/instrumental typology
Evolution
Biosocial Model of Violence
Social Learning Theory
General Aggression Model

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45
Q

What is instrumental/proactive violence?

A
  • Violence is not emotionally driven
  • Violence is precipitated by revenge, power and control, and financial or material gain
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46
Q

What is gratuitous violence?

A

Part of instrumental/proactive violence

Beyond that required to meet goal (not typical of this type of violence)

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47
Q

What is key for instrumental/proactive violence?

A

Cognitive distortions regarding sense of entitlement and motivations

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48
Q

What is arousal regarding instrumental/proactive violence?

A

Arousal is coincidental (not antecedent) and therefore not a legitimate treatment target

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49
Q

What is difficult to identify in instrumental/proactive violence?

A

Proximal triggers

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50
Q

What is affective/reactive violence?

A

Violence is emotionally driven

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51
Q

T/F: In affective/reactive violence, violence has high arousal component and is a legitimate treatment target

A

True

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52
Q

In affective violence, why is victim injury more excessive?

A

Because of poor internal controls

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53
Q

T/F: In affective violence, proximal triggers are more readily identifiable (physiological symptoms, faulty thinking)

A

True

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54
Q

What does a person often describe (reactive violence)?

A

Person often describes a tenuous ability to “control self”

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55
Q

What is reactive/instrumental typology?

A
  • Not a clear dichotomous
  • More complex models continue to emerge
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56
Q

Explain the evolutionary theory of violence

A

Violence is something that has been designed and maintained over hundreds of thousands of years of evolution.

Our ancestral environment was comprised of various adaptive problems - finding a mate, hunting, protecting children, avoiding predators, etc. Modern homicide is a remnant of these adaptions - it is a response to perceived reputational and status threats.

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57
Q

What can failure to establish oneself do?

A

Can send a signal to potential threats that one is weak and to potential mates that one may not be a good provider

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58
Q

What is Raine’s biosocial mode of violence?

A

Biological and social risk factors / social protective factors interact

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59
Q

What is missing from Raine’s model?

A

The person - thoughts, attitudes, learning

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60
Q

How is violence socially learned?

A

Violence is more likely when it is expected to be more rewarding than non-violent alternatives

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61
Q

It is not just direct reinforcement and punishment that shapes behavior (operant conditioning) but…

A

Watching others being reinforced or punished for their behavior (social learning)

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62
Q

What are sources of social learning?

A

Family, peers, friends, media

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63
Q

What are person inputs?

A

Traits, beliefs, attitudes that people bring to situation, which can predispose people toward or against aggression

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64
Q

What are situation inputs?

A

Factors such as aggressive cues, provocation, drugs, which can influence aggression in a given episode

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65
Q

What are routes?

A

Routes through which person and situation inputs influence behavior; includes cognitive states (e.g., hostile thoughts), affective states (e.g., mood), and arousal states (physiological arousal, labelled as anger)

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66
Q

What are outcomes?

A

Deliberate actions or impulsive actions that result in particular actions occurring, some of which will be aggressive; the outcomes influence the social encounter, which provides in the next episode

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67
Q

What are some specific theories of violence?

A

Substance use and intimate partner violence

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68
Q

What are the components of a substance use specific theory of violence?

A

Psychopharmacological crime

Economic-compulsive crime

Systemic crime

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69
Q

What is psychopharmacological crime?

A

Effects of drugs - reduced inhibitions, increased impulsivity, impaired thinking - leads to crime

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70
Q

What is economic-compulsive crime?

A

The need to finance one’s drug use due to insufficient legal sources leads to crime (e.g., selling drugs, stealing from friends, family, employers, committing robbery)

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71
Q

What is systemic crime?

A

Violence is inherently part of the illegal drug trade system - turf wars, debt collection, disputes over product quality - lead to assaults, intimidation, and homicide)

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72
Q

What can domestic assault of women by men be attributed to? (Patriarchal Theory)

A

Can be attributed to long standing cultural beliefs and values that support idea of male dominance of women

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73
Q

What does Dobash and Dobash (1979) say about intimate partner violence and patriarchal theory?

A

“The seeds of wife beating lie in the subordination of females and in their subjection to male authority and control”

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74
Q

Is there a link between IPV (intimate partner violence) and patriarchal theory?

A

Difficult to identify a causal link, but correlations have been found between IPV and patriarchal theory

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75
Q

How to recidivism rates differ between general and violent reoffending?

A

Recidivism rates for violent reoffending are lower than for general reoffending

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76
Q

What are the tools for predicting reoffending?

A

Unstructured clinical judgement
Actuarial tools
Mechanical tools
Structured professional judgement

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77
Q

What are examples actuarial tools?

A

Violence Risk Appraisal Guide (VRAG)
Domestic Violence Risk Appraisal Guide (DVRAG)
Ontario Domestic Assault Risk Assessment (ODARA)

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78
Q

What are examples of mechanical tools?

A

Psychopathy Checklist - Revised (PCL-R)

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79
Q

What are examples of structured professional judgement?

A

HCR-20
Spousal Assault Risk Assessment (SARA)

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80
Q

What are some yes/no items on the ODARA (Ontario Domestic Assault Risk Assessment)?

A
  • Previous Domestic Incident
  • Previous Non Domestic Incident
  • Perpetrator’s Violence Against Others
  • Perpetrator’s Substance Abuse
    Etc
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81
Q

What is small r?

A

+- .10

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82
Q

What is medium r?

A

+-. 24

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83
Q

What is large r?

A

+-. 37

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84
Q

What are the primary treatment targets relevant to general (and family) violence are?

A

Problem solving
Goal settings
Cognitive restructuring
Emotion management
Self regulation

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85
Q

What is the effectiveness of reducing violent recidivism?

A

Few studies examining effectiveness of treatment, but increasing (Papalia et al.)

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86
Q

What does it mean if Odd Ratio = 1.0 (violence)?

A

There is no effect of treatment - The odds of failing violently are just as likely for those who went through treatment vs those who did not

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87
Q

OR < 1.00 =

A

positive effect of treatment

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88
Q

OR > 1.00 =

A

negative effect of treatment

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89
Q

What was the overall OR between treatment and reduced violence?

A

.69

(31% decreased odds of future violence associated with being in treatment)

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90
Q

Conclusions from the table: Effect Sizes for Violent Recidivism by Program or Study Features

A

Basic life skills has no effect on violence reduction; rest of treatment examined do

Teaching cognitive behavioral skills does have an effect on violence reduction

Risk principle matters!

RCT’s rendered no significant effects

Magnitude of effects vs. p values dont always align

Need more research re: empathy training and emotional regulation

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91
Q

What did Matthew Raymond do?

A

Shot and killed 4 people from his window in 2018, believed he was surrounded by demons; was found not criminally responsible on account of mental disorder

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92
Q

What did Vince Li do?

A

Killed Tim Mclean, NCRMD

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93
Q

What has Delley (Tim McLeans mother) been working on?

A

Trying to change Criminal Code to ensure that mentally ill killers remain behind bars for the rest of their lives in places where they can receive treatment

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94
Q

What crimes do PMDs (persons with mental disorders) most likely to engage in?

A

Most do not engage in crime but if they do, most likely to trespass, shoplift, or commit minor assault

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95
Q

What is a mental disorder?

A

A syndrome characterized by a clinically significant disturbance to cognitions, emotions, or behaviors - Is not short lived

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96
Q

What are the two ways of assessing mental disorders?

A

The DSM and ICD

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97
Q

What is the ICD?

A

International Statistical Classification of Diseases

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98
Q

Where is ICD most often used?

A

Worldwide

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99
Q

What is the DSM

A

Diagnostic and Statistical Manual of Mental Disorders

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100
Q

Where is DSM most often used?

A

North america

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101
Q

When was matter of degree introduced into the DSM?

A

2013, DSM-5

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102
Q

Who can make diagnoses?

A

Psychiatrists & Psychologists

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103
Q

Why does DSM get lots of criticism?

A

People could be faking it

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104
Q

Why are diagnoses important?

A

Important as it has treatment recommendations and is usually needed for payment by health care providers

Act as a specialized shorthand for describing symptoms, preferred treatment approach, and prognosis

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105
Q

Diagnoses also reported at specialized treatment facilities that are combined prisons and accredited hospitals, often known as

A

Regional Treatment Centres (RCTs)

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106
Q

What were the 5 axis of DSM?

A
  1. Clinical disorders; impact an individual’s perceptions of reality
  2. Intellectual Impairment and personality disorders (e.g., antisocial personality disorder)
  3. General medical condition
  4. Psychosocial and environmental factors (e.g., family problems)
  5. General functioning
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107
Q

How is axis 1 still forensically useful?

A

More relevant because they impact an individual’s ability to form criminal intent

and

More overt and therefore police, court, and corrections better able to detect

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108
Q

Impairment from mental disorder is considered at two key times during the criminal justice process:

A
  1. At the time of the alleged crime (criminal responsibility assessment)
  2. At the time of the court proceeding (fitness assessment)
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109
Q

How has deinstitutionalization (1950s -onwards) resulted in more contacts between PMDs and police?

A

The development of community health services progressed slower than the transfer of patients out of hospitals. Police are now the “informal first responders of our mental health system”

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110
Q

Why is it bad that police are now the informal first responders of our mental health system?

A

They do not have the proper training or resources to properly deal with most mental illness calls

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111
Q

Can you give an example of how deinstitutionalization caused issues in Ontario?

A

As of 2016 Ontario only had 2760 beds for patients in need of long term in patient care

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112
Q

How many PMDs in Western countries are arrested at least once in their lifetime?

A

1/4

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113
Q

How many PMDs encounter police during their introduction to the mental health system?

A

1/10

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114
Q

How many calls for police services involve a PMD?

A

1/100

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115
Q

How much are calls for service involving PMDs in Canada increasing by?

A

5.2% to 16% annually

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116
Q

What is the fitness and criminal responsibility test?

A

Courts determine whether individuals with apparent mental health symptoms should be diverted to the forensic mental health system

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117
Q

What 3 categories do mentally disordered individuals who come into contact with the court fall into?

A
  1. Convicted in the CJS + PMDs (also have a mental disorder)
  2. Those found unfit to stand trial
  3. Those found not criminally responsible (NCRMD)
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118
Q

What are the 3 options for NCRMD

A
  1. Detention secure psychiatric facility
  2. Absolute discharge
  3. Conditional discharge
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119
Q

When would be an example of an absolute discharge?

A

Sleepwalker who killed his mother in law received absolute discharge non insane automatism

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120
Q

In cases where the police immediately consider the individual to have a mental illness, they can…

A

Take them directly to a psychiatric emergency department hospital

OR

Can be arrested, taken to jail/court, and then referred for a forensic assessment of fitness to stand trial or criminal responsibility (usually time limits - 30 days)

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121
Q

If concerns about mental health (after being brought in by police) remain after examination by a psychiatrist, what can happen?

A

The accused can be involuntarily admitted to a psychiatric hospital under a civil commitment order

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122
Q

What are civil commitment orders typically related to?

A

A determination of risk of harm to self or others and are time limited

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123
Q

What is the first priority dealing with a PMD in the CJS?

A

Restoring fitness to stand trial

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124
Q

T/F: If there are ongoing mental health concerns but the individual is found fit to stand trial as well as criminally responsible, they proceed through the corrections system

A

True

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125
Q

T/F: If mental health concerns arise while in prison, the individual can be transferred to a psychiatric hospital within the corrections system

A

True

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126
Q

How many treatment beds in RTCs does the CSC have for federally sentenced mentally disordered persons?

A

approx 700

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127
Q

When is release granted for mentally disordered persons within the corrections system?

A

Release is granted by the Parole Board or at expiration of sentence

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128
Q

When is release granted for those in the mental health system?

A

The release authority is generally the Criminal Code Review Board

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129
Q

What is the goal of fitness to stand trial assessments?

A

Determine whether the condition interferes with ability to perform legal tasks

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130
Q

What does section 2 of the Criminal Code state?

A

Unable, on account of having a mental disorder, to understand nature of the proceedings, understand consequences of the proceedings, or communicate with counsel

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131
Q

Is mental disorder enough to prove unfit to stand trial?

A

Mental disorder is necessary, but not sufficient

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132
Q

What test is used to determine trial fitness?

A

Fitness Interview Test-Revised

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133
Q

If found unfit, where is the case diverted to?

A

Review Board System

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134
Q

What are the outcomes from Review Board System?

A

Conditional discharge or detention order (forensic mental health facility)

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135
Q

Who can grant an absolute discharge?

A

Only the courts

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136
Q

What are the four conditions for criminal responsibility?

A
  1. Mens rea
  2. Actus reus
  3. Causation
  4. Absence of a viable defense
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137
Q

What is mens rea?

A

Criminal intent

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138
Q

What is actus reus?

A

The crime itself

139
Q

What is causation?

A

One’s actions caused the offense to occur

140
Q

What is absence of a viable defense?

A

There are no mitigating circumstances that could reduce culpability for committing the criminal act

141
Q

What concept is insanity/responsibility?

A

A legal concept, not a medical or psychological one

142
Q

When is retrospective assessment conducted?

A

Has to be conducted to assess accused’s state of mind

143
Q

T/F: Definition of insanity is standard all over the world

A

FALSE - Standard in Canada, but varies in other jurisdictions

144
Q

What is the definition of NCRMD according to R v. Swain? (Criminal Code 16)

A

Not legally responsible while suffering from a mental disorder that rendered the person incapable of appreciating the nature of the act or incapable of knowing that the act was wrong

145
Q

What is on Rogers Criminal Responsibility Assessment Scales?

A

Patient reliability
Organicity (brain damage, mental retardation)
Psychiatric disorders (Axis 1)
Cognitive control (awareness, abilities, planning)
Behavioral control

146
Q

What are the three options if found NCRMD?

A
  1. Absolute discharge (13%)
  2. Conditional discharge (35%)
  3. Detention within hospital (52%)
147
Q

What levels does stigma occur at?

A

Individual
Group
Agency

148
Q

When does self stigma occur?

A

When people with mental illness accept and agree with negative cultural stereotypes

149
Q

What does public stigma encompass?

A

The prejudicial attitudes and discriminatory behaviors expressed toward people with mental illness by members of the public

150
Q

When does agency/structural stigma occur?

A

At the level of institutions, policies, and laws

151
Q

How common are NCRMD cases in Canada?

A

Very rare in Canada (<1%)

152
Q

Has the rate of NCRMD fluctuated?

A

Has remained stable

153
Q

T/F: Court case completion takes longer for NCRMD cases

A

True

154
Q

What are hallucinations?

A

False sensory input (hearing/seeing things that aren’t there)

155
Q

What are delusions?

A

False/nonsensical belief/fixed beliefs that can’t be changed in response to evidence

156
Q

What are the types of delusions?

A

Bizarre and non-bizarre

157
Q

What is an example of a bizarre delusion?

A

Aliens have implanted tracking devices on me, I am God, etc

158
Q

What is an example of non-bizarre delusion?

A

Everyone is out to get me, the FBI is following me, conspiracy theories, etc

159
Q

What are the most common crimes committed by NCRMDs?

A

Assault and threat related

160
Q

How many NCRMD crimes are homicides?

A

Less than 10%

161
Q

What is the most common diagnosis for NCRMD cases?

A

Psychotic spectrum disorders (psychotic symptoms often present at time of crime)

162
Q

What is the most common type of psychotic symptom?

A

Delusions

163
Q

What is the victim/offender relationship for NCRMD cases?

A

Mixed but 1/2 times they were known to each other

164
Q

How many NCRMD cases have prior criminal history?

A

About 1/2

165
Q

What did Teplin argue?

A

Jails have become “a repository of the severely mentally ill”

166
Q

What are the mental health indicators in federal prisons (at admission)?

A

Prior diagnosis

Prescribed psychiatric medication

Past psychiatric hospitalization

Psychiatric outpatient care in past

167
Q

What are the most common disorders in prison samples?

A

Antisocial personality disorder and substance use disorders

168
Q

Which disorders occur more rarely in prison samples?

A

Psychotic disorders

169
Q

Which incarcerated gender is more likely to have mental health issues?

A

Women

170
Q

How many suicides a year in federal prisons?

A

About 10

171
Q

What is the leading cause of unnatural death in prisons?

A

Suicide

172
Q

What is the most common method of suicide in prison?

A

Hanging/suffocation

173
Q

When are PMDs at heightened risk of engaging in violence?

A

When experiencing active psychosis

174
Q

What symptoms are likely to increase risk of violence?

A

Threat/control override (TCO) delusional beliefs or command hallucinations

175
Q

What are TCO (threat control override) symptoms (related to violence)?

A
  • Belief your mind is being controlled by outside forces
  • Thoughts put in your head that are not your own
  • Belief that someone wishes you harm
176
Q

What are other psychotic (TCO) symptoms, not related to violence?

A
  • Feeling like you have special powers
  • Thoughts being taken away by outside source
  • Possession by a spirit or devil
177
Q

What are the 5 areas of assessment?

A
  1. Fitness to stand trial
  2. NCRMD
  3. Mental health in prison
  4. Suicide
  5. Risk for violence
178
Q

Many organizations use a two stage approach for assessing mental health issues, consisting of:

A

Initial screening and more extensive evaluation if screening items are present

179
Q

Many agencies conduct suicide assessment at intake:

A

-Has made previous suicide attempts
-Has undergone recent psych intervention
-Has experienced recent loss
-Is experiencing major problems
-Is currently intoxicated or high
-Shows signs of depression
-Has expressed suicidal ideation
-Has a suicide plan

180
Q

What SPJ assessment tools work well with PMDs in criminal justice setting?

A

-HCR-20 (AUC > .70)
- Short Term Assessment of Risk and Treatability (START) (AUC > .70)
- Structured Assessment of Protective Factors for Violence Risk (SAPROF) (accurately predicts non-recidivism)

181
Q

What were the findings of Bonta et al. comparing predictive power of general personality, cognitive social learning variables, and clinical variables?

A

General personality and cognitive social learning variables (e.g., central eight) predict

Clinical mental health variables do not

182
Q

Clinical mental health variables do not predict except for:

A

Personal disorders and psychopathy/antisocial personality disorder

183
Q

Do mental disorder diagnoses and other indicators of psychiatric history predict re-offending?

A

No (excluding substance and antisocial personality)

184
Q

Two types of treatment for mental disorders and violence:

A
  1. Mental Health Courts
  2. Psychological/RNR and Pharmacological Interventions (delivered in custodial settings to persons with mental disorders)
185
Q

What are mental health courts?

A

Facilitates assessment, treatment, better access to services

The judge does the monitoring - person attends court regularly

186
Q

How effective are mental health courts?

A

Research found a small yet significant reduction in recidivism rates (effect size: d = .20)

187
Q

Do mental health courts reduce cost savings?

A

Yet to be examined

188
Q

How to treat PMDs in the criminal justice system through the lens of the General Personality Cognitive Social Learning perspective?

A

Adherence to the RNR model, Central Eight, and Rehabilitation

189
Q

What is the RNR model?

A

Risk = who
Need = what
Responsivity = how

190
Q

What are the central eight?

A

-Criminal history
-Antisocial attitudes
-Antisocial associates
-Antisocial personality
-Substance use/misuse
-Employment/education deficits
-Marital/family deficits
-Unstructured leisure time

191
Q

T/F: Treat mental health symptoms (e.g., threat control override delusions, command hallucinations) as criminogenic needs/risk factors and mental health diagnoses (related indicators) more broadly as specific responsivity factors

A

True

192
Q

What is the changing lives changing outcomes (CLCO) program?

A

Targets both mental illness and criminogenic needs (CBT based)

193
Q

CLCO results thus far?

A

-Are encouraging in men and women
-Pre/post change evident in all domains
-Need more research to understand effect on recidivism

194
Q

What category does antisocial personality disorder fall into?

A

Specific responsivity factor perhaps, and static risk factor; but also, potentially a need - Central Eight

195
Q

T/F: Dynamic risk factors = Criminogenic needs

A

True

196
Q

Examples of psychopaths

A

Ted Bundy
Robert Pickton
Hannibal Lecter
American Psycho
Wolf of wall street
Catch me if you can

197
Q
A
198
Q

What do psychopaths have in common?

A

-Cold and calculating
-Intelligent
-No empathy/no remorse
-Extremely deceitful and manipulative
-Egocentric
-Appear ‘normal’
-Some very charismatic, charming
-“loving” parent
-Manipulative
-NO psychoses evident

199
Q

Can psychopaths have surface level emotions

A

Yes (anger, frustration)

200
Q

Are psychosis and psychopathy the same?

A

NO

201
Q

How many serial killers are psychopaths?

A

90%

202
Q

Are psychopath and sociopath different?

A

No, just used in different cases

203
Q

What was Hervey Cleckley known for?

A

“Mask of Sanity” - Book of case studies - American Psychiatrist - Influential description of psychopathy

204
Q

Describe Cleckley’s Psychopath

A

Appears ‘normal’ (keep normal jobs, appear kind)

No remorse, no empathy

Impulsive, deceptive, grandiose

Lack of emotional response (know the words but not the music)

205
Q

People who score high on psychopathy:

A

-are void of emotions
-approach the world in a predatory manner
-do not play by our rules
-put on a good show
-make it hard not to get sucked in
-are more likely to reoffend, and reoffend violently
-are versatile and persistent law breakers
-are more likely to secure easy release from prison

206
Q

For antisocial personality disorder, must have at least 3 of:

A

-Failure to conform to social norms
-Irritable/aggressiveness
-Reckless disregard for others/self
-Consistent irresponsibility
-Impulsive/failure to plan ahead
-Deceitfulness
-No remorse

207
Q

What are the types of assessment methods for psychopathy?

A

Rater based methods
Self report methods
Informant methods

208
Q

What are rater based methods psychopathy?

A

Done by professionals

Hare Psychopathy Checklist Revised

209
Q

What are self report methods psychopathy?

A

Responded to by person of question

Youth Psychopathic Traits Inventory
Self report Psychopathy Scale
Business Scan

210
Q

What are the four facets of psychology?

A
  1. Manipulative
  2. Callous
  3. Unreliable
  4. Intimidating/aggressive
211
Q

How are the 4 facets divided?

A

Personality (interpersonal relationships, affective)

Behavior (criminal vs utility, not criminal - behavior are offshoots of your personality)

212
Q

What are informant methods?

A

Asking people who know the person in question well

Antisocial process screening device

Business Scan

213
Q

What are the conerns with psychopathy in youth?

A

Labeling a child a “psychopath” can have many negative connotations

Scores on measures of psychopathy may be inflated by general characteristics of adolescence

Unknown stability of psychopathic traits from childhood to adulthood

214
Q

What did Hare recommend?

A

Hare recommended if you get over a 30 you’re a psychopath (implicated into death penalty and dangerous offender designation)

DONT DO THAT ANYMORE

215
Q

Explain facet 1

A

Interpersonal:

  • Superficial charm
  • Grandiose
  • Conning/manipulative
215
Q

Explain facet 2

A

Affective:

  • No remorse
  • Shallow affect
215
Q

Explain facet 3

A

Lifestyle:

  • Parasitic lifestyle
  • Lack of realistic goals
  • Impulsive
216
Q

Explain facet 4

A

Antisocial:

  • Poor behavioral controls
  • Criminal versatility
217
Q

What is the PCL-R scored using?

A

20 items scored using semi-structured interview (long, challenging) and collateral file information

218
Q

How is the PCL-R scored?

A

Scored on a 3 point scale rendering a total score from 0 to 40

219
Q

What should you consider in scoring PCL-R?

A

Intensity, duration, and frequency

220
Q

T/F: Psychopathy exists along a continuum

A

True

221
Q

How much of the prison population will score over a 30?

A

10-15%

222
Q

What did Diane Downs do?

A

Shot her 3 children because her boyfriend didn’t like children (2 died, 1 paralyzed)

223
Q

What is the hypothesized problem in psycopaths?

A

Emotional deficits (Affective Deficits Model)

Cognitive Deficits (Attention Model)

224
Q

Explain emotional deficits (Affective Deficits Model)

A

Can’t experience emotions

Can’t recognize emotions in others (sadness/distress)

Inability to experience fear (low-fear hypothesis)

225
Q

Explain cognitive deficits (Attention Model)

A

Response modulation deficit - Once started down one path, impossible to switch paths (can’t learn to inhibit their behaviors)

226
Q

What is the emotion paradox?

A

Psychopaths appear to understand emotions in others but do not experience emotions

227
Q

How do we study emotional deficits?

A

Startle response –> Reflex when something occurs unexpectedly (magnified if person feels negative affect, smaller if person feels positive affect)

Usually through looking at pictures and measuring reactions (not self report)

228
Q

What is the evolutionary hypothesis about psychopathy?

A

Psychopathy is an evolutionary adaptation

229
Q

When did cheater strategies enhance reproductive success?

A

When only present in a small % of the population

230
Q

What is the heritability of psychopathy (CU)?

A

.45 to .67

231
Q

What are the methodological problems with studies for psychopathy?

A
  • Mixed criteria for ‘psychopathy’ group
  • Small sample size studies
  • What came first - a different inherited brain” or the environment made a different brain
232
Q

What is the stress response system?

A

HPA axis & Autonomic nervous system

233
Q

What are the 3 functions of the stress response system?

A
  1. Coordinate body’s response to challenges
  2. Filter environmental info
  3. Help regulate growth, maturation, reproduction
234
Q

Explain the lawsuit on Rice et al.

A

Study believed that psychopaths can be treated - Was considered a breakthrough study at the time
Made psychopaths worse
Was actually torture - Given LSD, allowed to make diagnoses and give medications to each other, were handcuffed naked to each other, denied food, segregation, etc

235
Q

Historically, how do JIPs who score high on PCL-R respond to treatment?

A
  • Respond poorly to treatment
  • Have little motivation (what do i need to change if nothing is wrong?)
  • Have high drop out rates
  • Have higher recidivism rates
236
Q

Is there hope for psychopathy treatment?

A

Yes

237
Q

What is the Social Therapy Unit?

A
  • Minimum 2 year treatment nonvoluntary program - Goal to foster responsibility and empathy
238
Q

What is the recommended approach to treat psychopaths?

A

Two Component Model (1. Specific Responsivity Issue, 2. Criminogenic Needs)

239
Q

What is component 1 - Specific Responsivity Issue?

A

Manage treatment interfering Factor 1 traits

240
Q

How does Component 1 - Specific Responsivity Issue work?

A

Careful staff selection, teamwork, boundary maintenance, appeal to motivations, reward based, don’t rely on self report measures

241
Q

What is component 2 - Criminogenic needs?

A

Target the criminogenic needs linked to factor 2 scores

242
Q

In sum, treatment programs for psychopathic individuals should:

A

Adhere to the RNR model closely (specific responsivity)

Focus on behavioral and lifestyle components

Target other traditional criminogenic needs

Use a highly structured, cognitive behavioral approach

Focus on enhancing psychopaths motivation for staying in treatment (immediate positive reinforcement)

243
Q

What should treatment programs for psychopaths not do?

A

Try to change personality

Enhance empathy and perspective taking

Be unstructured

Allow for psychopaths to take advantage of more vulnerable group methods

Be offered by junior and inexperienced staff

244
Q

Is there hope for treatments of psychopathy?

A

Yes there is cause for optimism! Need more outcome studies

245
Q

What is pedophilia?

A

Sexual attraction to children who have not begun puberty

246
Q

What is the estimated prevalence of paraphilia?

A

1%

247
Q

How many sexual offences result from pedophilia?

A

About 50%

248
Q

Is pedophilia equal to pedophilic disorder?

A

No, not all paraphilias manifest as (criminal) sexual offending

249
Q

What are examples of paraphilia?

A

Pedophilia, exhibitionism, voyeurism, frotteurism, sexual sadism, etc

250
Q

What is paraphilia?

A

Abnormal sexual desires

251
Q

What is pedophilic disorder?

A

Over a period of at least 6 months, recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child

The individual has acted on the sexual urges or the urges caused marked distress or interpersonal difficulty

The individual is at least 16 years older than the child

252
Q

What are the rates of self reported sexual victimization in Canada

A

1 in 8 girls
1 in 3 women
1 in 12 boys
1 in 6 men

253
Q

How many sexual offences are reported to police?

A

Underreported - 8 in 10 sexual offenses in Canada are not reported to police

254
Q

What were some reasons people did not report sexual offenses (GSS)?

A

“Felt it wasn’t important enough”
“Would not be believed”
“Incident dealt with another way”
“Family would find out”
“Would be blamed”

Rape myths

255
Q

How do rape myths relate to underreporting of sexual offenses?

A

Beliefs that support the sexual assault of women by placing blame on the victim rather than the perpetrator

256
Q

What are the subscales of Illinois Rape Myth Acceptance Scale?

A

Subscale 1: She asked for it
Subscale 2: He didn’t mean to
Subscale 3: It wasn’t really rape
Subscale 4: She lied

257
Q

What are examples of rape myths?

A
  1. When girls get raped, its often because the way they said “no” was unclear
  2. Guys don’t usually intent to force sex on a girl, but sometimes they get carried away
  3. It shouldnt be considered rape if a guy is drunk and didnt realize what he was doing
  4. If a girl doesnt physically fight you back, you cant say it was rape
  5. A lot of times, girls who say they were raped agreed to have sex and then regret it
258
Q

Which individuals are more likely to hold rape myths?

A

Those who hold stereotypical attitudes toward rape

Men

Lower education

More oppressive beliefs, sexist beliefs, racism, sexual conservatism, religious intolerance

259
Q

Who is most often the perpetrator of sexual offenses involving children?

A

Family members

260
Q

Who is most likely the perpetrators of sexual offenses involving adolescents and adults?

A

Strangers and acquaintances

261
Q

When is serial sexual offending more likely?

A

Very rare but more likely to happen outdoors, involve a weapon, not known the target

262
Q

What are factors of explaining sexual offending?

A

Motivation factors
Facilitation factors

263
Q

What is the cost of SA Victimization?

A

200 mil/year CJS

4.8 billion

Second most expensive crime in Canada after homicide

Each incident: 136k to 164k

264
Q

What are motivational factors?

A

Atypical sexual interest

265
Q

What are facilitation factors?

A

Enduring/stable dynamic factors: Antisocial tendencies & Cognitive tolerance/attitudes

Acute dynamic factors: Situational (disinhibition): access to children, intoxication

266
Q

How does evolution explain rape?

A

Rape is simply part of general antisocial, risk-tolerant lifestyle - It enhances reproductive success in the ancestral environment

267
Q

What are potential causes of sexual offending (risk factors)?

A

Beliefs tolerant of sexual offending

Atypical sexual interest (small&consistent predictor)

Emotional congruence with children (small effect for unrelated children)

Sexual preoccupation (small predictor)

Risk factors common across offending (antisociality, psychopathy, poor self regulation/impulsivity/employment instability)

Pornography, child abuse (no convincing evidence)

268
Q

What are atypical sexual interests?

A

Deviant sexual arousal to children
Deviant sexual arousal to rape (small, inconsistent effects)

269
Q

What is a static predictor that matters?

A

History of sexual offending

270
Q

What are beliefs tolerant to sexual offending?

A

Beliefs that condone, justify, excuse, minimize, rationalize, or otherwise support sexual offending (ex. rape is sex, dressing like that you are asking for it, women like it rough)

271
Q

How do you measure sexual interests?

A

Penile plethysmography (PPG)

Self report measures

Indirect measures

272
Q

What’s wrong with the PPG?

A

Ethical concerns, intrusive, expensive, lack standardized, low responders, faking

273
Q

What’s positive about PPG?

A

Widely used, large research base

274
Q

What are the + and - of indirect measures sexually interests?

A

+ = hard to fake a socially desirable response, inexpensive

  • = construct validity unclear
275
Q

What are the + and - of self report measures sexual interests?

A

+ easy to administer
- social desirable responding, access to cognition

276
Q

Explain emotional congruence with children

A

Emotional needs met by children, not adults

Interest in child oriented activities

Has children as friends

Feel more comfortable with children

May report being in love with children

277
Q

What is sexual preoccupation?

A

Aka hypersexuality or compulsive sexual behavior

Includes actions: high frequency of sexual activity or sexual arousal and feelings

278
Q

What does NOT predict sexual re-offending?

A

Depression
Mental illness
Poor victim empathy
Poor treatment motivation
Denial
Low self esteem
Childhood sexual abuse

279
Q

What factors are less relevant for men who offend against intrafamilial members?

A

Antisociality
Atypical sexual interests
Sexual self regulation
Emotional congruence with children

280
Q

How should assessment be?

A

Assessment should always be multi-dimensional, maybe different sources and methods

281
Q

Why do we assess?

A

To develop comprehensive treatment and case management plans

282
Q

What are correctional agencies predominantly interested in?

A

Risk assessment and risk (case) management

283
Q

What instruments are used to assess risk of sexual recidivism?

A

Static-99R
Rapid Risk Assessment for Sexual Offender Recidivism
Sex Offender Risk Appraisal Guide
Risk for Sexual Violence Protocol
Violence Risk Scale: Sex Offender Version

284
Q

What is the Stable 2007 and Acute 2007?

A

Rater based assessment method
Scored from interview
Stable dynamic section scored based on typical functioning over past year
Acute dynamic section scored based on change since last assessment

285
Q

Stable 2007:

A

-Significant social influences (1 item)
-Intimacy deficits (5 items)
-General self regulation (3 items)
-Sexual self regulation (3 items)
-Cooperation with supervision

286
Q

Acute 2007:

A

-Victim access
-Hostility
-Sexual preoccupations
-Rejection of supervision
-Emotional collapse
-Collapse of social supports
-Substance abuse

287
Q

How do the treatments of sexual offending fit together?

A

Static-99 - Baseline of risk

Stable 2007 - Treatment targets and change measurement

Acute 2007 - Warning when recidivism may be imminent

288
Q

Can we successfully treat people convicted of sexual offenses?

A

Many challenges:
- Low recidivism rates
- Small sample sizes
- Comparison group equivalency issue (ethics)
- Dropouts
- Not all treatment is created equal

289
Q

What are pharmacological treatment approaches of sexual offenses?

A

Reduce sex drive (antiandrogens that reduce or block testosterone / antidepressants - reduces compulsivity)

290
Q

What are behavioral treatment approaches to sexual offenses?

A

Attempt to reduce deviant sexual interest and/or increase non-deviant sexual interest (aversion, masturbatory satiation)

291
Q

What are cognitive behavior treatment approaches of sexual offenses?

A

Attempt to change cognitions that mediate behavior, relapse prevention, self regulation model

292
Q

Explain the meta analysis conducted by Gronnerod et al.

A

Examined the effectiveness of programs designed to reduce sexual reoffending among men with offenses against children

“Despite a large amount of research only a tiny fraction of studies, meet a minimum of scientific standards, and even fewer provide sensible and useful data from which it is possible to draw conclusions”

293
Q

Explain the meta analysis conducted by hanson, bourgon, helmus, hodgson

A

130 studies rated according to Collaborative Outcome Data Committee study quality guidelines

294
Q

What were the results of the meta analysis by hanson, etc

A

Among the acceptable studies
- 3 adhered to none of RNR principles
- 7 adhered to ONE
- 9 adhered to TWO
- 3 adhered to THREE
- 1 could not be rated

295
Q

Why the variability in results for sexual offenses?

A

Research itself
Treatment design
Treatment implementation

296
Q

Does treatment for sexual offending work?

A

Yes, if the program follows best practices and if well implemented but we really need more methodologically rigorous studies

297
Q

Who is Jamie Gladue?

A

19y/o Cree woman from Nanaimo, BC

Killed husband by stabbing in chest

Was intoxicated at time and believed husband had cheated on her

Charged with second degree murder but pled guilty to manslaughter

Judge ruled Gladue not eligible for alternatives bc she didnt live in an Indigenous community

298
Q

What does Section 718.2 of Criminal Code?

A

Use of alternatives to incarceration, especially for Indigenous persons

299
Q

What is a Gladue report?

A

Indigenous persons have a right to prepare a Gladue report, which highlights ways Indigenous peoples have been marginalized

Gives all background characteristic of persons that should be known (not used a lot)

300
Q

What are Gladue Factors?

A

Substance misuse
Poverty
Racism
Family breakdowns/Exposure to abuse
Unemployment
Loss of identity, culture and ancestral knowledge, family involvement in crime, attendance at a residential school

301
Q

What is the over-representation of Indigenous people in CJS?

A

30% ish vs 5% (men)
50% vs 5% (women)

302
Q

What are the root causes of overrepresentation of Indigenous persons?

A

Cultural Clash

Colonialism (results in cultural genocide: forced assimilation, displacement of Indigenous families, residential school system, the 60s scoop)

Racial Discrimination (over policing, access to lawyers, in custody deaths, length of time in pre trial holding)

303
Q

What is differential impact of policies?

A

Policies of CJS could differentially impact Indigenous people, thus contributing to over-representation (A JIP is required to pay a fine - they cannot pay - end up serving time in prison)

*Needs more work

304
Q

What is colonialism?

A

Citizenship transformed insiders into aliens inside their own territory, while simultaneously transforming outsiders into insiders

305
Q

What was the Indian Act (1876)

A

Treated Indigenous peoples like children
Almost any band decision needed to be bureaucratically approved by the federal government

306
Q

Gender biased means of terminating one’s Indian status:

A
  1. Status Indian woman married a non Indian man would cease to be Indian
  2. If an Indian woman married another Indian man, she would cease to be a member of her own band, and become a member of his
  3. If a woman was widowed, or abandoned by her husband, she would lose status altogether
307
Q

Explain residential schools

A

More than 150, 000 Indigenous children were forcibly removed from their homes and sent to residential schools

308
Q

What was the purpose of residential schools?

A

to “kill the Indian in the child”

309
Q

How many residential schools were there and how long were they operated for?

A

130 schools in Canada
1970s - 1996

310
Q

What was the 60s Scoop?

A

Between 1951 and 1991

Quite literally involved “scooping up” Indigenous children and placing them in foster homes or having them adopted by non-Indigenous families in the US and Canada

Resulted in psychological, emotional, cultural consequences (Johnston, 1983; Native Children and the Child Welfare System Report)

Class action lawsuit settled in 2018

311
Q

Unmarked graves of children:

A

Unmarked graves found across Canada near residential schools

Truth and Reconciliation Commissions report: 1 in 50 students believed to have died (about 4.1K)

To date: 1, 800 confirmed unmarked graves and counting

312
Q

What are responses to overrepresentation?

A
  1. First Nations police services
  2. Indigenous courts
  3. Indigenous assessment and treatment programs
313
Q

Where is Gladue Court located and what does it do?

A

Toronto

Same functions as regular court (limited impact)

314
Q

What percent of foster care children are indigenous?

A

52% (only account for 8% of the Canadian children)

315
Q

How is average life expectancy of Indigenous persons different from non-Indigenous?

A

Average life expectancy is 6.6 years shorter than non-Indigenous Canadian

316
Q

How are suicide rates worse for Inuit youth?

A

Suicide rates 11x higher than national average

317
Q

T/F: Status Indians living on reserve are 4x more likely to be unemployed

A

True

318
Q

T/F: Indigenous Canadians earn an average of 1/3 less than non-Indigenous Canadians

A

True

319
Q

How many Indigenous Canadians have not completed high school?

A

More than 4 in 10

320
Q

Treatment of Indigenous crime?

A

Legislation requires provision of Indigenous specific treatment programs

Assumes loss of culture is at heart of Indigenous offending

Re-establishing culture is part of the solution to overrepresentation

321
Q

What is the Corrections and Conditional Release Act (1992)?

A

Due to the unique circumstances surrounding Indigenous clients, Correctional Service Canada (CSC) must provide a range of Indigenous-specific treatment programs

322
Q

What is Section 81 of the Corrections and Conditional Release Act?

A

Allows transfer of Indigenous clients out of the CJS and into the Indigenous community

Enables Indigenous community to provide correctional services to Indigenous clients in a manner that respects culture

323
Q

Treatment needs of Indigenous persons?

A

Assumed that traditional treatment programs will not be as effective

Indigenous treatment programs also need to be offered:
- Traditional spiritual practices
- Sweat lodge ceremonies
- Indigenous literacy classes

324
Q

What is the typical incarcerated female?

A

Abused/traumatized as child/adult
Characterized by internalizing mental health problems
Has traditional criminogenic needs as well
Lower risk to reoffend than male counterpart, particularly in terms of violence

325
Q

Why study justice impacted females?

A

Low prevalence
Increasing numbers
Almost 1 n 2 incarcerated women in Canada are Indigenous

326
Q

What is the gender gap in crime?

A

males account for vast majority of crime, particularly violent crime (rape, homicide, robbery)

327
Q

What percent of serial killers are male?

A

85%

328
Q

When is gender gap most narrow?

A

Shoplifting & writing bad checks, welfare fraud

329
Q

What is the nature of female perpetrated violence?

A

Rare but when it occurs…
Relational in nature (against someone they know well)
More often motivated by intense emotions (anger, jealousy, revenge) rather than instrumental reasons (money)

330
Q

What is pathways theory?

A

Childhood adversity/trauma leads to:
- (Mal) adaptive coping strategies (running away, internalizing disorders, substance abuse)
- ‘Survivalist’ coping strategies that are criminalized (sex work, drug dealing, robbery)
- Inability to form and maintain healthy relationships

331
Q

What is gender netural?

A

-Social Learning Theory
-Risk-Need-Responsivity
-Central 8

332
Q

what works for gender neutral?

A

Metaanalysis’s

333
Q

What are female specific?

A

-Pathways Theory
-Trauma-informed
-‘Central 10’

334
Q

What works for female specific?

A

Qualitative and quantitative approaches

335
Q

What are the Ten Central Reintegration Needs of Justice-Impacted Women?

A
  1. Over-coming interpersonal maltreatment & trauma
  2. Developing healthy and prosocial intimate partner relationships
  3. Fostering motherhood
  4. Creating sustainable, healthy, and prosocial support systems
  5. Developing empowering and prosocial cognitions
  6. Fostering self-regulation, coping and problem solving skills
  7. Overcoming substance misuse
  8. Promoting meaningful and sustainable financial stability
  9. Securing access to safe and affordable housing
  10. Providing women-centered health care (mental and physical)
336
Q

What are some risk assessment tools for females?

A

SPIN-Service Planning Inventory for Women

Women Risk Need Assessment

337
Q

How do existing gender neutral risk assessment tools perform?

A

Very well from a predictive point of view

338
Q

How does LSI predict for each gender?

A

LSI total score predicts equally well for both genders

339
Q

What are domain level differences for LSI?

A

Substance use and ‘personal/emotional’ may be slightly stronger predictors of recidivism for females

‘Antisocial personality pattern’ predicts slightly better for males

340
Q

What are domain level similarities LSI?

A

Education/employment, family/marital, financial, accomodations, friends, leisure, attitudes

341
Q

What are criticisms levied against gender-neutral tools?

A

Risk over estimation
Context not captured
Factors not sufficiently weighted:
- family dynamics
- transient living - group homes, streets
- older, male peers/romantic partners
- mental health factors
- safety issues/children
- $$$$

342
Q

What are gender criticisms of RNR criticisms?

A

White middle class men developed cognitive behaviorism

Risk principle = less resources for women/girls

Need principle - ignores women’s needs

Cognitive behaviorism individualizes and decontextualized women

343
Q

What are key elements of Gender Responsive Models

A

Holistic Approach

Greater emphasis placed on ‘responsivity’ issue

Multiple outcomes: recidivism reduction, healthy relationships restored

344
Q

What is holistic approach?

A

(criminogenic and non-criminogenic factors addressed simultaneously)

Target addictions, be skilled based, enhance self-efficacy whilst dealing with internalizing mental health issues

345
Q

What is greater emphasis placed on ‘responsivity’ issues?

A

Trauma-informed, relational, female only, strengths

Parental stress, empowerment focus, safety issues

346
Q

What are third wave CBT programs?

A

Blend traditional CBT with mindfulness, mind/body connections

Are strength based and trauma inforced

Meditation/yoga

Breathing techniques

347
Q

So GR or RNR?

A

The evidence supports an integrated approach rather than an ‘either’, ‘or’, strategy

*We need more primary studies that are well controlled

348
Q
A

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