Psycholegal treatment and intervention

In the same way that the interface of law and psychology has brought about the development of “psycholegal” assessment methods, parallel forms of psycholegal interventions are beginning to emerge as well. What distinguishes them from traditional forms of psychotherapy is that their administration requires an integration of both legal and psychological knowledge. Divorce mediation, treatment of incompetence to stand trial, and other examples are shown to fall within this new category of interventions. A conceptual model for the development of psycholegal interventions is presented. Forensic mental health professionals are urged to approach their development more systematically.     

Pedophile types and treatment perspectives

Pedophiles constitute a heterogeneous group of sex offenders. Direct physiological assessment of sexual arousal has significantly increased our diagnostic skill and capability of monitoring treatment response. Erectile response studies have indicated that the majority of pedophiles and incest offenders show arousal to other paraphilias and frequently to appropriate adult sexual stimuli. Many sexual offenders deny or minimize their problem during initial interviews, but when confronted with laboratory results indicating deviant sexual arousal, they often acknowledge and elaborate on the paraphilia(s). Complete data and diagnoses are crucial in integrating treatment in the cognitive-behavioral paradigm.     

Experiences of coercion during investigation and treatment

According to Swedish legislation (LVM) compulsory treatment shall be decided on if someone, due to ongoing abuse of alcohol, drugs or volatile solvents, is in need of care to overcome abuse and if a voluntary intervention is not possible. Very little research has been conducted in Sweden on this particular legislation with regard to the clients' experiences of entire process from assessment to aftercare. We interviewed 74 subjects who were being assessed prior to the court's decision on involuntary care (n=39), or with previous experience of assessment and involuntary care (n=35). The assessment group more often reported having the opportunity to express their opinions to the social worker during the assessment period (55% vs. 21%, p<.05) and they were more positive towards the final decision (60% vs. 24%, p<.05). In spite of the law, 18% were not contacted by the social services while in coercive treatment. The clients who did meet with a social worker, often described the conferences as more of a perfunctory nature with a lack of focus on the actual situation and aftercare planning. This study points at a need of studying the subjects' experiences of the whole continuum of the coercive process: from the investigation, to treatment and to aftercare. It also points at the need for new instruments to be developed covering all aspects of the coercive process and in particular the period of investigation prior to the decision on involuntary care.     

New Zealand's special treatment units: the development and implementation of intensive treatment for high-risk male prisoners

In the late 1980s, New Zealand developed two highly innovative residential treatment programmes for serious offenders that blended together the strengths of structured cognitive behavioural group programmes and therapeutic community approaches. Since the mid-1990s this hybrid model – recently advocated as a fruitful direction for future offender programme development – was adopted and further refined for use in New Zealand's four high-risk special treatment units (HRSTUs). We outline the HRSTU model, noting the challenges and potential benefits of providing an intervention that integrates therapy, resocialisation and reintegration experiences for high-risk, high need, low responsivity clients: many with significant psychopathic features. On average, the majority of those referred to HRSTUs complete the programme and make small but significant amounts of change on important treatment goals. But most changes remain tentative, suggesting the importance of more supportive aftercare. Although an earlier evaluation of the first unit to open found the programme to be modestly effective in reducing recidivism, an outcome evaluation currently underway will help establish whether improvements since that time are associated with reductions in disciplinary infractions and recidivism.