Treatment in forensic populations

Question 1

What is an offender behaviour programme (2)

Answer 1

A course of activity, aimed at bringing about some outcome change in behaviour, typically to reduce offending

Question 2

What are the different types of treatments (6)

Answer 2

Prison(punishment/deterrent/rehabilitation)

Medication (e.g. mental health, detox)

Staff behaviour (respect, bullying)

Programmes (Anger, Sex Offending, drugs)

Work or education

Privileges

Question 3

Why is prison an effective treatment? (4)

Answer 3

Punishment
Deterrent
Containment
Place for rehabilitation/training

Question 4

What are the problems associated with prisons as treatment? (6)

Answer 4

Containment - remove people from society - But incarceration forever Until ‘treatment’ ‘worked’?

Rehabilitation: prevent re-offending - does it work? Set targets for
successful completion of treatment ‘programmes’

Training: for the outside world? - but is that for more crime, more drugs? Or for a job/education? Or for more ‘normal’ social world?

Question 5

Who argued that prisons are not effective as a deterrent what reason did they give for this? (4)

Answer 5

Ainsworth (2000)
95% who commit a crime not convicted
Those convicted go to prison months (years?) after the crime committed, so does not work in behaviourist terms

Question 6

If an individual has a drug habit what treatment is given to them? (1)

Answer 6

Detox regime

Question 7

Why is a detox regime used and which drugs are used and how is it prescribed? (3)

Answer 7

Significantly reduces suicide, self-harm, deaths in custody

Methadone and buprenorphine (Subutex) most common detox drugs for opiate/opioid addiction

Prescribe the drug on a gradually diminishing dose

Question 8

What is treatment by staff? (6)

Answer 8

Anecdotally, find a range of attitudes, despite initiatives to improve treatment

Prison staff often recruited from Armed Forces

Mixture of trainers, individuals committed to rehabilitation, and those committed to containment and punishment

Bullying, harassment not unknown Or not dealt with if committed by other prisoners

Selection processes improving

Question 9

What are the characteristics of an effective program? (10)

Answer 9

Structured, focused, addressing distinct problem

Staff need to be firm, but fair, who reinforce anti-criminal attitudes

Staff committed, enthusiastic, supported by management

Needs to target attitudes and values that support offending

Uses problem-solving and social learning

Matched to offender characteristics

Monitored in terms of recidivism & personal growth

Target medium and high risk offenders

Attempt to generalise beyond institutional setting

Recent focus on RNR: Risk, Needs, Responsivity

Question 10

What is the most effective treatment? (1)

Answer 10

Cognitive behavioural therapy

Question 11

What are six key areas of social-cognitive functioning improved by intervention? (6)

Answer 11

Self-control/management

Interpersonal problem-solving & social interaction

Rigid/inflexible thinking

Social perspective taking

Analytical thinking

Moral reasoning

Question 12

What is the aim of a cognitive skills program? (1)

Answer 12

To alter thinking, and behaviour – the two are linked

Question 13

How many Offender Behaviour Programmes are accredited? (1)

Answer 13

19 accredited for those in custody, 12 for the community

Question 14

How are Offender Behaviour Programmes accredited? (4)

Answer 14

Accredited by Ministry of Justice = evidence-based, consistent with ‘What Works’, typically CBT, appropriate assessments, quality monitored, and evaluated

Question 15

What do Offender Behaviour Programmes focus on? (5)

Answer 15

General offending behaviour

Aggression and anger

Substance misuse

Sexual offending

Question 16

How is delinquent behaviour reduced? (3)

Answer 16

Parent education (home visits) and parent management training
Child skills training
Pre-school intellectual enrichment

Question 17

What are Cognitive behavioural programmes used with violent offenders? (4)

Answer 17

BBR (Building Better Relationships: for those with convictions for Intimate Partner Violence (IPV)

Kaizen (for high or very high risk, also used for those convicted of sexual or violent offences)

Horizon (for medium and higher risk individuals convicted of sexual offences)

COVAID-GS (Control of violence for angry impulsive drinkers: for those who are violent under the influence of alcohol)

Question 18

What is chemical castration? (3)

Answer 18

Injecting hormones or anti-androgens to reduce testosterone

Side effects, reversible, ineffective

Also SSRIs to reduce intensity of intrusive or ruminative thoughts, and to reduce arousal generally

Question 19

What are Sex Offender Treatment Programmes (SOTP)? (4)

Answer 19

Adapted, Core, Rolling, Extended, Booster (replaced with Kaizen – high risk, Horizon and iHorizon – criminogenic need March 2017)

Mixed success: groups, mixed, criteria unmet, biggest problem – not targeted at individual needs

Denial prevents access (though not with Kaizen and Horizon)

Also now community variant of Horizon and Becoming New Me + (for those with learning disabilities)

Question 20

What are Drugs intervention programmes? (3)

Answer 20

DIP: Drug Intervention Programmes such as Pillars of Recovery and Breaking Free Online

The Forward Trust

Monitored by the National Drug Treatment Monitoring System (NDTMS): Provides comprehensive statistics about treatment.

Question 21

What are the questions regarding the ‘what works’ debate? (5)

Answer 21

No violence or less violence?
Accountability?
Clean from drugs, or using less?
How to measure success?
What criteria for effectiveness?

Question 22

Mixed effects of programmes (6)

Answer 22

Some NDTMS reports of DIPs show a small proportion (2%) actually increasing their drug usage

Some sex offenders, actually see SOTPs as training

Complex interaction between programme intentions and
delivery by staff

If not supported on release often return to crime

Meta-analyses do show that treatment for violence ‘works’

Evidence for treatment for sexual offending is more
mixed

Question 23

Odds of reoffending in those treated for violent crimes (1)

Answer 23

Odds of reoffending in those treated were 35% lower

Question 24

Odds of reoffending in those treated for sexual crimes (1)

Answer 24

Odds of sexual reoffending for those treated was 32.6% lower