Outcome measurement in forensic mental health research: an evaluation

Abstract

Measuring change resulting from healthcare interventions is critical to evaluating their usefulness. The choice of outcome measure is an important part of such evaluations and is driven by assumptions about what is likely to change and how best to capture this. Despite its importance, forensic mental health has paid little attention to determining which are the best measures of outcome. This study used a panel of relevant professionals to (i) assess the relative importance of different areas of potential outcome measurement and (ii) evaluate specific instruments used currently as outcome measures in forensic mental health research. Although a wide range of potential outcomes were endorsed as appropriate, few corresponding instruments have been used consistently. Only three psychiatric instruments deemed by our panel as feasible, relevant and psychometrically adequate have been used in five or more studies (the Beck Depression Inventory; the Brief Psychiatric Rating Scale, and the Symptom Checklist-90–Revised). Significant measurement gaps were noted in areas such as social and emotional functioning. Although instruments exist that could capture most areas, none were sufficiently developed for routine use as outcomes. Further research to develop robust, sensitive and diverse outcome measures is needed. This is an essential precursor to extending the evidence base for forensic mental health interventions.     

How do therapists contribute to therapeutic change in sex offender treatment: An integration of the literature

Abstract

Psychotherapy research suggests that therapists contribute to the process of therapeutic change. Research into sex offender treatment has tended to focus on the content rather than the process of therapeutic change. This paper reviews the evidence for the role of therapist characteristics in relation to therapeutic change in sex offender treatment. A literature search of a number of electronic databases and additional manual searches identified a total of 15 relevant articles. Studies were carried out in different treatment contexts and with a variety of methodological approaches. A number of therapist characteristics were identified in relation to the process of therapeutic change in sex offender treatment. Due to the methodological limitations of the studies, no conclusive evidence was found for the contribution of therapist characteristics to treatment efficacy. Nevertheless, the findings may have some clinical utility in relation to improving the therapeutic effectiveness of sex offender treatment.     

The Effects of Visitation on Incarcerated Juvenile Offenders: How Contact with the Outside Impacts Adjustment on the Inside

The present study investigates how visitation from parents impacts youths’ mental health in the first two months of incarceration in a secure juvenile facility. A diverse sample of 276 male, newly incarcerated serious adolescent offenders (14–17 years) was interviewed over a 60-day period. Results indicate that youth who receive visits from parents report more rapid declines in depressive symptoms over time compared to youth who do not receive parental visits. Moreover, these effects are cumulative, such that the greater number of visits from parents, the greater the decrease in depressive symptoms. Importantly, the protective effect of receiving parental visits during incarceration exists regardless of the quality of the parent–adolescent relationship. Policy changes that facilitate visitation may be key for easing adjustment during the initial period of incarceration.