Changes in staff confidence and attributions for challenging behaviour after training in positive behavioural support within a forensic medium secure service

Positive behavioural support (PBS) is a non-aversive approach to preventing and managing challenging behaviours. Seventy-nine qualified and unqualified nursing, psychology and occupational therapy staff were trained in using PBS. To measure the effectiveness of the training, confidence in managing challenging behaviour and attributions for causality, control and stability were measured before and after the training. To measure confidence, an adapted version of the Confidence in Coping with Patient Aggression Instrument was used. Attributions were measured using the Challenging Behaviour Attributions Scale and the Causal Dimension Scale II. There was a significant increase in confidence after training. In addition, there were significant changes in attributions relating to causality and stability of challenging behaviour, particularly for qualified staff. The results suggest that confidence and attributions are affected positively by training in PBS within a medium secure forensic mental health setting.     

An evaluation of the effectiveness of positive behavioural support within a medium secure mental health forensic service

A number of recent influential reports recommend the use of proactive and preventative approaches such as Positive Behavioural Support (PBS) in the management of challenging behaviours. Although evidence supporting the use of PBS is mainly drawn from studies of learning disability and child populations, it is recognised that PBS could have a much wider utility. In this study, PBS was implemented in a medium secure forensic mental health service, a novel context. Impact was evaluated using an adapted version of the Checklist of Challenging Behaviour at baseline and then at 3 monthly intervals for a year. Significant reductions were observed in aggression frequency, management difficulty and severity and other challenging behaviour frequency and management difficulty. Reductions in challenging behaviour were still evident after six months for the full group and twelve months for the sub-group with the exception of other challenging behaviour management difficulty. In contrast, no such significant differences were found for a control group. This study indicated that PBS was an effective intervention in the management of challenging behaviour in this forensic mental health context.     

The dynamic prediction of antisocial behavior among forensic psychiatric patients: a prospective field study

Staff ratings of 595 supervised forensic psychiatric patients on the Proximal Risk Factor Scale and the Problem Identification Checklist were completed monthly for an average of 33 months. During the follow-up, there were 265 incidents, 86 of which were violent. The average ratings, excluding those from the index month, differentiated patients who had incidents from those who did not. As well, the average ratings distinguished between individuals with and without incidents of a violent or sexual nature. There were significant increases in staff ratings in the months preceding the index incident month. Within-patient analyses showed that changes in dynamic risk scales comprising the best items for predicting incidents of any kind and violent or sexual incidents were strongly related to their respective outcomes and were significantly related to outcome in an independent sample. Changes in monthly staff ratings predict the imminent occurrence of antisocial and violent behaviors.     

Health and social care staff responses to working with people with a learning disability who display sexual offending type behaviours

Abstract

This study found that 59% of social care staff were currently supporting a client with a learning disability who had offended or displayed an offending type behaviour. The range of behaviours was similar to that displayed by clients in a secure health facility and included rape, sexual assault and exposure. Only 22.9% of social care staff had received training in this area, while none of the health staff had. Both groups expressed low levels of confidence in supporting this client group. The areas of difficulty were common to both groups and included personal attitudes and attitudes of others to the behaviour, and concerns over risk, responsibility and safety. In respect of attitudes, social care staff were found to be significantly more likely to hold negative attitudes towards the person's behaviour, while health staff were significantly more likely to feel negatively towards the person. Health staff were significantly more likely to identify training as a means of further support, while social care staff identified professional input. Both groups identified the need for theoretical training about working with this client group. Despite this no significant differences were found between those who had and had not received training and confidence, attitudes and the need for further support.     

Staff members’ evaluation of inpatients’ motivation for aggression – the roles of staff restrictions and aggression severity

Improved understanding of inpatient aggression can come from systematic assessment of motivation for aggressive incidents. This study investigates staff members’ evaluation of motivation for aggressive incidents, and how such evaluations are influenced by staff restrictions and aggression severity. Staff reports of aggressive incidents in a secure psychiatric unit were collected in clinical practice over a ten-year period (2006–2015). Motivation for aggression was assessed with the Aggressive Incident Motivation Evaluation Scale, measuring irritable, instrumental, and defensive dimensions. Information about staff restrictions was collected with the Staff Observation Aggression Scale – Revised, and severity was rated with the Visual Analog Scale. Multilevel analyses of 2649 aggressive incidents, committed by 67 inpatients, revealed greater variation in aggression motivation across incidents than between individual patients. Staff restrictions preceding the aggressive incident and rating of severity were positively related to staffs’ evaluation of motivation for aggression, but their impacts differed across motivational dimensions. Staff reports of motivation provide important additional information beyond current standard report forms. Systematically evaluating motivation is essential to risk management, and may contribute to develop more fine-tuned interventions for preventing and managing aggression in inpatient settings.     

Gender Bias in Attributions of Responsibility for Abuse

The bulk of previous research investigating attributions of responsibility in victimization scenarios have portrayed the assailant as male and the victim as female. The present study varied gender of the participant, gender of the assailant, and gender of the victim in order to examine gender bias in attributions of responsibility in abuse scenarios. Male and female participants were presented with scenarios depicting an abusive interaction between two males, two females, or a male and a female character and then made judgements of responsibility either with or without the narratives present. The results indicated that attributions made by females were biased against male victims of a male assailant when judging actions of the assailant. Attributions made by females and, to a lesser degree, attributions made by males were biased against the victim when the assailant and the participant were of the same gender and attributions of assailants' actions were made without the narrative present. In the analysis of attributions of actions of the victim, males attributed more responsibility to male than female victims. It is concluded that gender of all parties may be an important consideration when judging responsibility in victimization scenarios.     

A systematic review of effective therapeutic interventions and management strategies for challenging behaviour in women in forensic mental health settings

Women in secure forensic mental health care require therapy and care that is responsive to their specific needs. Despite the policy recognition that women require a distinct service, evidence based practice is not available for this population. This review was undertaken in response to a clinical need within a medium secure unit in Glasgow that was experiencing high levels of challenging behaviour, in a female ward. The review aimed to identify effective strategies or interventions for the management of challenging behaviour in women in secure services and, therefore, improve practice and patient care. A synthesis of the findings from the 11 identified studies revealed variability in the approaches used to support women in forensic services, including: behavioural programmes; organisational change with a focus on staff training and support; medication; ECT and mechanical restraint. The challenging behaviours assessed included self-harm; physical and verbal aggression; suicide attempts and arson/fire setting. The majority of articles suggested some improvement in aspects of challenging behaviour, however this was limited by the lack of control groups and small sample sizes. Further investigation is required to find out whether interventions identified in this review can sustain a reduction in challenging behaviours in the long-term.     

Personality differences between women police recruits, their male counterparts, and the general female population

Presently police manager and their recruiting staff are using an increasing number of screening tools including psychological testing during the hiring processes. Prior research suggests that gender is often ignored in the review of testing results. This could lead to problems in the interpretation of results. This research investigates the existence, if any, in the pre-socialization personality differences between male and female police recruits as well as between female police recruits and the general population of females. Subjects (N=104) were from a multi-agency training facility in a southern state. Subjects completed the MMPI-2 at the beginning of their police academy training to control for any socialization effects the training may have. The diagnostic clinical scales, the content scales, and the gender scales of the MMPI-2 were subjected to independent discriminant function analyses to determine if differences between male and female recruits exist. Scale 5 (Mf), GM, and GF were analyzed via t-tests to determine if differences between the female recruits and women in the normative sample exist. All discriminant functions were significant at the .05 level. Scales that differentiated male and female recruits were: Ma (Scale 9), ASP, FRS, BIZ, Mf (Scale, 5), and GF. Female recruits differed from the female normative sample on only GF (recruits were lower). It is suggested that future research focus on the predictive power of the content scales for continuation in the police field. It is also suggested that future research investigate the flexibility of the gender constructs throughout the policing career. Author Notes: Send all enquires to Larry A. Gould, Ph.D., Dept. of Criminal Justice, Northern Arizona Univerity, Box 15005, Flagstaff, AZ 86011-5005. 1. A special thank you is given to Northern Arizona University for providing the funding of the parent project from which this research was accomplished. I also wish to extend my gratitude to those whose time and effort went into the collection and computer entry of the data—Dr. Larry Gould and Rachel Rowland. In addition, I would like to thank Dr. Clay Moore for the statistical “chats”.     

Naming oneself criminal: gender difference in offenders' identity negotiation

This qualitative research examines gender differences in offenders'ability to negotiate a positive identity once the pejorative labels of criminal, prostitute, drug dealer, and incompetent parents have been imputed onto them. In-depth semi-structured focused interviews were conducted with a purposeful information-rich sample of eight male and eight female offenders. Content analysis reveals that males were much more adept than female offenders at juggling with conventional and street norms to justify and/or resist stigmatizing labels in order to construct a favorable identity. Appeal to such personal strengths as know-how, competence, loyalty, and a code of honor allowed male offenders to challenge the boundaries between conventional and delinquent worlds. Concomitantly such an appeal gave rise to a sense of efficacy perception and an optimistic explanatory style. In contrast, even though female offenders were able to justify the labels of drug dealer, prostitute, and thief by appeal to higher loyalties and reject that of insane, all their justifications collapsed when having to negotiate the identity of incompetent mother. Female offenders' negative internal attributions and deprivation of the normative center-motherhood resulted in apathy, anomie, and lack of confidence in their ability to do something worthwhile. Rehabilitation guidelines would build female offenders' personal strengths while redirecting those exhibited by male offenders into lawful enterprises.     

A look from the inside: balancing custody and treatment in a juvenile maximum-security facility

This article is based on an ethnographic study of a cottage for violent offenders in one state's maximum-security training school. Staff members working in the cottage were the institution's front line in its attempts to hold the youth accountable for their crimes while also trying to resocialize and rehabilitate young men who were growing up with few conforming role models. As such, cottage staff members were put in the difficult position of juggling their roles as corrections officers, counselors, and surrogate parents. To effectively do their job, they had to find ways to balance the rhetoric of rehabilitation with the punitive reality of daily life in the institution. This article details the juvenile justice career paths of the staff members in the cottage and provides a sociological analysis of the roles, responsibilities, and interactions of the staff members with each other and with the young men in their care.     

Does executive functioning predict improvement in offenders' behaviour following enhanced thinking skills training? An exploratory study with implications for rehabilitation

Purpose . This study focused upon whether outcome following Enhanced Thinking Skills (ETS) groups for incarcerated offenders could be predicted by the offenders' pre‐training levels of executive function. It also addressed whether this predictive function was above and beyond that predicted by intelligence, demographic information, conviction history, emotional distress and social compliance. Methods . Offenders due to undergo ETS were assessed using a battery of neuropsychological measures of executive functioning and other psychometric instruments. Change in behaviour following ETS was assessed using the Behaviour Rating Scale (BRS). The results of this assessment were entered into regression analyses, with the post‐ETS changes in the positive and negative scales of the BRS as the independent variables in 2 separate analyses. Results . Aspects of executive functioning related to attentional set shifting ability were found to be highly predictive of outcome, with those with relatively weaker executive functioning showing the most improvement. Participant age and number of previous convictions were found to be predictive of reductions in negative behaviour but not of improvements in positive behaviour, with older participants and those with more previous convictions showing the greatest degree of improvement. Conclusions . ETS can be of particular benefit to those offenders with relatively poor executive functioning.     

The importance of staff practice in delivering effective correctional treatment: a meta-analytic review of core correctional practice

Several meta-analyses have rendered strong support for the clinically relevant and psychologically informed principles of human service, risk, need, and general responsivity. However, each of these reviews has focused on specific program components and not on the characteristics of the staff or the specific techniques used to deliver the program. This meta-analytic review examines the role of core correctional practices in reducing recidivism and provides strong preliminary evidence regarding their effectiveness. Staff characteristics and training in core skills must be addressed to ensure the maximum therapeutic impact of correctional treatment programs.     

Predictors of Underreporting of Male Violence by Batterer Program Participants and Their Partners

Self-reports on domestic violence inventories remain the basis of court and clinical decision-making and program outcome evaluations, but previous research questions their reliability and validity. Accurate prediction of underreporting would help practitioners and researchers adjust batterer and victim self-reports. We develop prediction equations of underreporting on the Conflict Tactics Scale, using a multi-site database of men admitted to batterer programs and their female partners (n = 840). First we use variables measured at program intake to predict female and male underreporting of male violence at program intake. Second, we use variables measured at program intake, as well as measures of program participation, to predict male-female disagreement (male underreporting) at 12-month follow-up. Several variables were predictive of underreporting, both at intake and follow-up, but overall prediction was marginally better than chance. The findings suggest that men and women underreport based on situational factors (such as relationship characteristics) and rational reasons, rather than based on personality traits or social desirability. However, the ability to predict underreporting is too weak for adjustment of self-reports by clinicians and program evaluators.     

Service v. Security Focus in Training Assessments

ABSTRACT

As jails have moved to professionalize their staffs the role of the correctional officer has become broader in scope and now encompasses both service and security functions. However, some research suggests that female correctional staff may have more of a “service” orientation than males. In our analysis of one dataset from exclusively women's jail facilities we investigate correctional officer preferences for training (service v. security) to see if they differ by gender. We find that both male and female correctional officers generally rank service type training over security and that they differ little in their overall assessment of initial training provided and usefulness of in-service training. We also find that minority officers may be more likely to value service training than their nonminority counterparts.     

A new psychometric instrument assessing vulnerability to risk of suicide and self-harm behaviour in offenders: Suicide Concerns for Offenders in Prison Environment (SCOPE)

This study aimed to develop a new psychometric instrument to assess vulnerability to risk of suicide and nonfatal self-harm behaviour in young adult male and female offenders. In total three studies were conducted to assess the psychometric properties of the new instrument using both exploratory and confirmatory factor analysis in different samples. Participants in all three studies included a total of 1,166 young adult offenders across six Her Majesty's Prisons. The new instrument, Suicide Concerns for Offenders in Prison Environment (SCOPE), contained 28 items scoring on two subscales. The factorial structure of the new instrument initially obtained with exploratory factor analysis was subsequently confirmed in a new sample. The internal consistency of the two subscales were acceptable but the test-retest reliability coefficients were moderate. Concurrent validation with the Beck Hopelessness Scale was acceptable and SCOPE showed the ability to discriminate between those at risk and those with no known history of attempted suicide and nonfatal self-harm behaviour ( p < 0.01).     

Offender personality disorder pathway: the impact of case consultation and formulation with probation staff

The latest government policies for personality disordered offenders emphasise the importance of a formulation-based approach to rehabilitation and pathway planning. However, research into forensic case formulation is limited. This paper examines the impact of consultation and formulation, on probation staff working with personality disordered offenders. Staff rated their knowledge, confidence, motivation, and understanding (of offenders), and satisfaction with management plans at three stages: pre-consultation, post-consultation and after receiving a written formulation. The analyses revealed that ratings on all variables examined increased after attending a consultation meeting, with no additional increase in scores following receipt of the formulation letter. The findings provide evidence that consultation has a range of benefits for probation staff, and offer support for the current model of joint-agency working. Further research is needed to clarify the benefits of providing written formulations after consultations, and to explore what features of a formulation are most useful to probation staff.     

The Organization of Child Representation Services in Child Welfare Cases: A Study of Washington State

To date no empirical studies have analyzed delivery of legal services to children and considered the implications of organizational structure for child representation practice. This study of 126 attorneys in Washington State compares children's lawyers working in solo practice, private law firms, and specialty staff attorney offices. The manner in which child representation is organized has lessons for the recruitment, training, and support of such lawyers. Staff attorney offices offer a number of advantages but rural areas with fewer cases may not be able to support such offices and the attorneys in specialty offices were less experienced and report lower incomes.     

STRESS IN PRISON STAFF: AN OCCUPATIONAL STUDY*

A survey was conducted into the sources of occupational stress and their effects on levels of health for a group of New Zealand prison staff: Staff were categorized into three groups: Prison Officers. Ranking Prison Officers, and Instructors In addition, a control group of noncommissioned Army personnel was used as a comparison sample. Subjects were administered a job-specific “sources of stress” questionnaire, a life events measure, a personality measure (the Neuroticism Scale Questionnaire), and three health measures-the General Health Questionnaire, a medical visit checklist, and a psychosomatic symptom checklist. Factor analysis of the stress questionnaire revealed six job-specific sources of stress factors These were identified as staff relationships, task pressures, relationships with inmates, promotion, the work environment, and the impact on family life of living in a prison village. Results showed that the levels of stress experienced by staff varied across the three groups. In addition, on the three health measures all staff groups were found to score significantly higher than the control group. Further analysis showed that the variables isolated could be related to a general model of stress.