Comprehensive evaluation: a holistic approach to evaluating domestic violence offender programmes

This article argues that the focus on behavioural outcomes in evaluations of domestic violence offender programmes has been too narrow, and that a more holistic approach incorporating investigation of the psychological characteristics of offenders and treatment characteristics may be required to determine what works, for whom, and under what circumstances. To this end, one interpretation of a comprehensive evaluation framework is outlined. The article hypothesises the insights to be gained by assessing the contribution of several potential mediating variables of the treatment process in the evaluation of these programmes. These variables are the heterogeneity of treatment targets in the target population; motivation to change; programme integrity variables; and therapeutic factors. The article concludes that only by implementing theoretically informed, multifaceted evaluations will we move closer to understanding the process of successful rehabilitation.     

Drunk driving and the ecological fallacy: Comments on a paper by Phillips,Ray, and Votey

Phillips, Ray, and Votey (1984a) used a model of traffic casualties incorporating three independent variables—miles driven, rainfall, and alcohol consumption. They applied it to British data to attempt to determine (1) whether the British Road Safety Act of 1967 had an impact on road casualties and (2) the relative contribution of the three variables to road casualties. They accomplished the first objective using interrupted time series analysis, but fell victim to the ecological fallacy in their interpretation of the second.     

Drugs and driving: a systematic analytical approach

To collect useful epidemiological data about drug involvement in highway safety, it is essential that sensitive and specific analytical procedures be used to establish the presence of and to determine the concentrations of drugs and metabolites in samples collected from drivers. This paper describes a comprehensive and systematic screening procedure requiring 6 mL of blood, which has been used for the analysis of samples collected from injured and fatally injured drivers. The procedure uses radioimmunoassay, gas chromatography with selective detectors, and high performance liquid chromatography. Drugs and metabolites presumptively identified are then confirmed primarily using gas chromatography--chemical ionization mass spectrometry.     

Using a cognitive analytic approach to formulate a complex sexual and violent offender to inform multi-agency working: developing a shared understanding

Abstract

Cognitive Analytic Therapy (CAT) is a collaborative time-limited psychotherapy developed by Ryle. The approach aims to formulate how early experiences influence the development of unhelpful patterns that maintain a person's current difficult experiences. Within the UK, forensic services personnel are increasing their uses of CAT approaches within contextual, i.e. treatment teams, settings. Offending behaviour is relational (perpetrator to victim), and CAT is a relational model. Within the context of National Health Service consultation service (Serious Offender Liaison Service) working with the Police and Criminal Justice Social Work to assess, formulate and give advice regarding working with serious sexual and violent offenders, often with personality disorders, a case example is presented. The paper suggests that utilising a relational model, such as CAT, and applying one of the main the tools of this approach, through diagrammatic representations (maps) of the formulation, can enable agencies working with an individual to share a common formulation and language.     

Methodological considerations in the evaluation of offender interventions: the problem of attrition

Attrition from offender interventions presents methodological problems when the effectiveness of the intervention is under evaluation. This article proposes a treatment-received (TR) design, which incorporates one-to-one matching on criminogenic variables. This design permits the comparison of completer, noncompleter, and nonstarter groups with their paired comparisons and, hence, allows a more accurate evaluation of program completion and noncompletion effects. A sample of 173 offenders, referred to one of two general offending behavior cognitive skills programs within community settings, was matched one-to-one by criminogenic variables to offenders from an appropriate comparison group. Reconviction analyses were undertaken using intention to treat (ITT) analysis, TR analysis using the full comparison group, and TR analysis using matched comparison groups. The ITT design found no impact of group membership on reconviction. The TR designs, however, provided evidence of moderate effects of completion: For every three completers, five of the matched comparison group members were reconvicted. The analysis also suggested a noncompletion effect: Noncompleters were twice as likely as their matched comparison group to be reconvicted.     

RU 486 examined: impact of a new technology on an old controversy

Abortion is an extremely divisive issue in American politics and culture. Prothro begins this Article by analyzing the current legal standards governing reproduction, which draw a sharp distinction between abortion and contraception. Prothro then examines the function of RU 486, demonstrating that it acts both as a contraceptive and as an abortifacient. Because of this dual capacity, RU 486 does not fit neatly into the current legal framework. Prothro concludes this Article by arguing that RU 486 should force the Supreme Court to create a new framework for the "procreative right." Prothro argues that this new framework should treat the procreative right as a continuum, basing legal protections on a close analysis of the rights at stake, rather than on artificial distinctions that do not accurately mirror the physiological process of pregnancy. This new continuum analysis, Prothro contends, will expand and deepen the abortion debate by focusing it on the broader issues underlying the current debate.     

The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains

In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years.This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of “less eligibility” within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more “deserving”, groups are perceived to be in continuing need.     

Patient dumping in the hospital emergency department: renewed interest in an old problem

Alarm about the adverse effects of transferring emergency patients for economic reasons has resulted in federal legislation aimed at curbing the practice. We review the history of common law hospital liability for denial of emergency care and analyze the federal legislation designed to restrict the transfer of medically indigent patients with emergency problems. We conclude that the currently proposed solutions to patient dumping will have limited effectiveness without more specific incentives for the provision of health care to the medically indigent.     

Practice in search of a theory: The case of intensive supervision— An extension of an old practice or a new approach?

Intensive supervision of probationers and parolees has recently emerged as a potential solution to the chronic problem of overcrowding in our jails and prisons. This emergence has taken place in the absence of any true theory which supports the contention that more supervision will lead to lower recidivism rates. The future of this option is analyzed within this framework. This article represents an updated version of a paper, “Practice In Search of a Theory: The Case of Intensive Probation,” delivered at the Annual Conference, Academy of Criminal Justice Sciences, Chicago, Illinois, March, 1984. While prepared under the auspices of the National Institute of Justice, the views expressed are those of the author and do not necessarily represent the official position or policies of either the National Institute of Justice or the U.S. Department of Justice.     

Testing the utility of a geographical profiling approach in three rape series of a single offender: a case study

The purpose of the study was to test the potential utility of a geographical profiling approach for three separate series of rapes committed by a single offender. Two different mathematical distance-decay functions using either a normal distribution with a mean distance and standard deviation based on previous research or a truncated negative exponential function based on distances between crime sites in the series under investigation were applied to each of the series giving prioritised search areas the accuracy of which was then assessed. The prioritised area that had to be searched before the home base of the offender could be located varied from 7.60 km(2) or 2.15% of the total search area at its best to 15 1.10 km(2) or 42.66% at its worst for the normal distribution based on previous research and from 42.06 km(2) or 11.88% to no improvement when the truncated negative exponential function was used. The functions used showed less predictive ability when the offender was a commuter. Explanations for the variations in the findings as well as suggestions for improvements were outlined in the discussion.     

Using context and difference in sex offender treatment: An integrated systemic approach

Summary

The primary objective of this paper is to promote a re-examination of the current use of cognitive-behavioural programmes in work with men who have sexually offended against children or adults and to encourage the application of ideas from the systemic field. In order to support this objective, the paper puts forward and develops the following arguments:

1. That the current content of manualised programmes in this field has been distilled too far and left behind some of the most important principles of the cognitive approach. Returning to the work of Marshall et al (1999), the need for a thorough and broad-based assessment of each individual prior to deciding treatment goals is clearly recommended. Further, there is a need to pay much more attention to differences between, as well as similarities of those who sexually offend.

2. That ideas from within the systemic therapeutic field be integrated within existing approaches to attempt to address some of the limitations of cognitive-behaviour therapy as currently employed. Evidence for the potential benefits of this comes from a broad personal experience of working directly with offenders and consulting to group facilitators.

It is concluded that all therapeutic approaches reach a ‘moment of integration’ (Pinsof, 1994), when their failures are recognised and other approaches are drawn on. It is suggested that this moment may be upon us in this area.