Outpatient commitment: a therapeutic jurisprudence analysis.

This article analyzes the legal and therapeutic jurisprudence considerations raised by outpatient commitment. Although older forms of outpatient commitment have both legal and therapeutic advantages, preventive outpatient commitment raises serious legal problems and potential antitherapeutic consequences that may outweigh its claimed therapeutic value. As a result, alternatives are proposed, including wider availability of community treatment and outreach and case management services, assertive community treatment, police and mental health court diversion programs, and creative uses of advanced directive instruments and behavioral contracting. Proposals also are made for how preventive outpatient commitment can be applied more therapeutically, including hearings that accord patients a sense of procedural justice and techniques designed to motivate individuals facing such hearings to agree to accept treatment voluntarily.     

Outpatient civil commitment: a dangerous charade or a component of a comprehensive institution of civil commitment?

This article examines three criticisms frequently directed toward preventive commitment as one form of outpatient commitment. These criticisms contend that preventive commitment (a) abandons the dangerousness criteria for civil commitmnet, (b) promotes unwarranted inpatient commitment of those who do not meet civil commitment criteria, and (c) undermines important individual liberties by diluting the right to refuse treatment. Understanding and evaluating these criticisms requires analysis of the intersection among empirical, conceptual, and justificatory claims. According to the analysis presented here, advocates of preventive commitment can defend a legitimate role for preventive commitment. This analysis applies to preventive commitment as a dispositional alternative within a comprehensive institution of civil commitment involving distinct parens patriae and police power components.     

Outpatient commitment and coercion in New Zealand: a matched comparison study

BACKGROUND: It has been hypothesized that a degree of coercion is a necessary component in using outpatient commitment to attain therapeutic outcome for those people subject to mental health law. However, what degree of coercion is required and how it is sustained is poorly understood. There is speculation that patients' recognition of beneficial as well as unwanted aspects of outpatient commitment (ambivalence) maybe an indicator that the necessary level of coercion has been achieved to facilitate a therapeutic outcome. AIM: The aim of this study was to determine the level of coercion perceived by those under outpatient commitment in New Zealand. Emphasis was given to consideration of the presence of ambivalence and the role of interactive processes, including procedural justice, in influencing patients' perceptions of coercion. METHOD: A cross-sectional comparative study was undertaken to compare the perceptions of coercion of patients on outpatient commitment (n = 69) to a matched sample of voluntary outpatients (n = 69), using the Perceived Coercion Scale. The influence of a range of variables, including patients' knowledge of and beliefs concerning outpatient commitment, were considered. RESULTS: Although the level of coercion for involuntary outpatients was relatively low, it was significantly higher than that experienced by voluntary outpatients. Yet involuntary outpatients were more likely to espouse benefits of outpatient commitment. Although there was an inverse correlation between perceptions of procedural justice and perceived coercion, procedural justice did not feature in the linear regression analysis. DISCUSSION: In the New Zealand context, involuntary outpatients hold contrasting views to outpatient commitment. We suggest that this ambivalence is an indicator that the degree of coercion is suffice to achieve therapeutic outcome. Furthermore, this study suggests the impact of procedural justice on patients' perceptions of coercion may be more crucial during admission to hospital than in the context of on-going community care.     

Outpatient civil commitment in Texas for management and treatment of sexually violent predators: a preliminary report

Texas established in 1999 outpatient civil commitment for sexually violent predators discharged from prison with or without parole. These individuals suffer from a behavioral abnormality, have been convicted of two or more sexually violent crimes and are deemed likely to reoffend. Civilly committed individuals are managed by a team composed of case manager (supervision), treatment provider, public safety officer (global positioning satellite monitoring), and other professionals. Treatment consists of individual and group therapy using a standard workbook. Out of 21 committed individuals, 7 are in the treatment, 1 died, 10 are in custody after breaking conditions of commitment that constitute a felony, and 3 await release from prison. Cost of outpatient civil commitment is less than $20,000/person/year compared with more than $100,000 for inpatient commitment in other states. Texas has found outpatient civil commitment to be an effective and relatively low-cost way to protect the public and treat the offender.     

Strategies for an empirical analysis of the prediction of violence in emergency civil commitment

Dix (1976) recently has proposed that a “true experiment” be conducted to assess the validity of predictions of imminent violence. A random sample of persons predicted to be iminently violent would be denied emergency civil commitment in order to test whether they do, in fact, commit a violent act. This article analyzes Dix's proposal and finds that it presents an unacceptable level of risk to the community. Four alternative methodologies by which preliminary data can be gathered on the validity of predictions of violence in emergency civil commitment are described.     

Restorative justice in Belgian prisons: the results of an empirical research

Justice – when spelled with a capital ‘J’ – should be discursive [31] and based on equal respect ([40]: 206, 210) allowing a plurality of voices within the discourse. Particularly in the present research, this thread of pluralism is important. Prisoners’ voices have rarely been heard. Yet, if we wish to be true to the principle that restorative justice is discursive, it follows that the discourse is not complete without also accommodating their voices. To date, little research attention has been paid to the inner motivations of imprisoned offenders for willing to participate in restorative justice initiatives, as well as to their perceptions about their relationships with the victim and the community and the impact of religion on them. Hence, the present empirical study, conducted in several prisons across Belgium, endeavours to shed light on these aspects that have been theoretically overlooked, providing valuable information at policy-level about the design of future restorative justice programmes.     

Participation and commitment in third-party research funding: evidence from Italian Universities

Over the last few years, the emergence of universities’ third mission has significantly affected objectives, sources of funding and financing methods, as well as the management, of universities. Although the university–industry relationships have been widely investigated, several interesting theoretical and empirical issues still remain open in the literature. In this paper we construct an original data set, combining financial information with structural and organizational data on Italian University departments, with a twofold aim. First, to describe the importance and the extent of third-party funding in the Italian system of research as well as the pattern of evolution over the last few years. Second, to investigate the factors that influence both the probability and the intensity of the commitment of departments in third-party activities by building a multi-level framework combining factors at individual, departmental, university and territorial levels. The results obtained suggest a number of policy implications for universities and policy makers. On one hand, universities should explicitly recognize the role of dedicated internal organizations and provide training for professional staff capable of acting as value-added intermediaries. On the other hand, if policy makers wish to improve the relationships between universities and external actors, disciplinary differences across departments as well as regional inequalities in growth levels should be carefully considered, giving up a one-size-fits-all approach.     

事态犯罪的共犯理论研究

关于事态犯罪的研究已经形成若干成果。但关于其共犯形态的专门性研究尚属少见,为了实现司法实践中对事态犯罪具体案件的正确认定,本文着力探讨了事态犯罪共犯的相关理论,重点论述了事态犯罪的间接正犯、身份犯问题,事态犯罪的共同故意和犯罪目的问题,以及共犯行为方式的不同结合等几个问题。     

Treatment of human-caused trauma: attrition in the adult outcomes research

Attrition or dropout is the failure of a participant to complete, comply, or the prematurely discontinuation or discharge from treatment, resulting in lost data and affecting outcomes. This review of 10 years of adult posttraumatic stress disorder (PTSD) treatment outcome literature specific to Criterion A events of human origin examines how attrition is defined and addressed, methodologically and statistically. Of the 13 experimental or quasi-experimental studies, 11 report attrition information. Compared to treatment completers, attriters more often had elevated pretest scores on PTSD and other symptom measures. The characteristics of dropouts given the intentional nature of the traumatic events reviewed in this study are shared to inform clinical practice. Recommendations for consistent methods in examining, analyzing, and interpreting treatment outcome data are also discussed.