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.     

An analysis of the relationship between being deaf and sexual offending

Abstract

Research demonstrates that deaf offenders are over-represented within the criminal justice system. In addition, those deaf offenders who are incarcerated within prison estates or psychiatric units are predominantly incarcerated for sexual offences. This paper will evaluate the existing literature surrounding the reasons behind this bias. In particular, this review will examine the characteristics of deaf offenders in relation to their personalities, language and brain development and abilities to communicate. This paper will consider proposed associations between mental illness and childhood sexual abuse amongst deaf individuals and later sexual offending. This paper attempts to evidence differences between deaf and hearing offenders in order to explain why more deaf offenders commit sexual crimes than hearing offenders. This paper will conclude that the research is scarce and inconclusive and that current assessments and treatment are potentially inadequate due to the profound difficulties associated with accurately understanding and communicating with the deaf offender.     

Intervention with sexually abusive young people in Australia and New Zealand

Abstract

Research into the treatment of sexual offenders with an intellectual disability has increased over the past decade. This research can be used to investigate the efficacy of treatment; however, empirical limitations of the research make generalizations difficult. Marques has provided a framework for examining treatment efficacy that emphasizes the contribution of researchers and clinicians to report treatment outcomes rather than a strict reliance on rigorous empirical investigations, such as controlled outcome research. This review uses Marques’ framework to present an overview about group treatment for sexual offenders with an intellectual disability using nine identified studies. This paper attempts to consolidate our knowledge about specific treatment issues, while demonstrating the varied outcomes that are reported in the literature. In employing this framework, the literature suggests that our knowledge can be substantially improved by research addressing specific areas of treatment.     

Social problem-solving correlates of sexual deviancy and aggression among adult child molesters

Cognitive-behavioral treatment programs for adult sex offenders often include training geared to improve a perpetrator's social problem-solving skills. However, little empirical evidence exists to date that documents the relationship between problem-solving and deviant sexual interest or behavior among child molesters. As such, this study investigated the association between problem-solving and two aspects of sexual offending—self-reported sexual deviancy and clinician-rated sexual aggression among a recruited sample of incarcerated child molesters. To minimize the potential for biased self-reports, criterion scores on a lie scale were employed to exclude individuals who might be prone to misrepresent their responses. Results indicated this sample to be characterized by significant deficits on all measures of social problem-solving as compared to the general population. In addition, a series of correlational analyses indicated that an avoidant problem-solving style was significantly associated with past sexual aggression, whereas a negative problem orientation and an impulsive/careless problem-solving style were significantly related to a measure of current sexual deviancy. Of particular interest is the finding that a rational problem-solving style (i.e., the constructive style that involves the systematic application of specific problem-solving skills geared toward identifying an effective solution) was not significantly related to either sexual offending measure. The implications of these collective results are discussed.     

An examination of the role of neuropsychological deficits in mentally disordered sex offenders

Abstract

The present study examines the neuropsychological model of sexual offending proposed by Flor-Henry (1987) in relation to a group of mentally disordered sex offenders and a control group of mentally disordered non-sex offenders. The model predicts that the sex offender group would show specific left fronto-temporal dysfunction as compared with the control group. The results, while in the predicted direction, failed to reach statistical significance. Implications and limitations of the study are discussed.     

Is Violence Bad for Your Health? An Assessment of Chronic Disease Outcomes in a Nationally Representative Sample

Longitudinal offending research has grown substantially in the last two decades. Despite this increased scholarly attention, longitudinal investigations of the effects of offending on physical health have not kept pace. Acknowledging the intersections of criminology, criminal justice, and public health, this study examines the relationship between violent offending and chronic diseases among a nationally representative longitudinal sample of young adults. Results suggest that variation across offender typologies (i.e. adolescence-limited, adult-onset, and consistent violence during youth and young adulthood) significantly predicts experiencing chronic disease in early adulthood, with the risk being the most pronounced among those individuals, who demonstrate violence continuity. Study limitations and policy implications are discussed.     

Bullying in Childhood,Externalizing Behaviors,and Adult Offending: Evidence From a 30-Year Study

This study examined the developmental processes linking childhood bullying to criminal offending in adulthood, using data from a 30-year longitudinal study. The linkages between bullying in childhood and three criminal offending outcomes in adulthood were estimated both before and after control for a range of confounding factors. A series of protective factors that potentially mediated these linkages were also examined. The results of the study showed that while the majority of the association between childhood bullying and adult offending could be explained by confounding factors including childhood externalizing behavior, there was evidence for direct linkages from bullying to violent offending and arrest/conviction. There was little evidence to suggest mediation of the associations. The results suggest that bullying prevention requires interventions aimed specifically at bullying behavior.     

曹氏益肾方辨治慢性肾衰竭68例

目的 观察曹氏益肾方治疗慢性肾衰竭（chronic renal failure,CRF）的临床疗效。方法 将128例CRF患者分为治疗组（68例）与对照组（60例）。治疗组服用曹氏益肾方,对照组服用肾衰宁胶囊和包醛氧淀粉胶囊,疗程12周。观察治疗前后两组患者血清肌酐（serum creatinine,SCr）、血尿素氮（blood urea nitrogen,BUN）、胱抑素C(cystatin-C, Cys C)、肾小球滤过率（glomerular filtration rate,GFR）的变化,观察并比较两组临床疗效和中医证候疗效。结果 治疗组的临床疗效和中医证候疗效均显著优于对照组（P＜0.05）。 治疗后两组SCr、BUN和CysC水平均显著降低（P＜0.01）,而GFR水平显著升高（P＜0.01）;治疗组在降低SCr、BUN和CysC水平和升高GFR水平方面显著优于对照组（P＜0.01）。两组在治疗期间均未出现药物不良反应。结论 曹氏益肾方对非透析阶段CRF具有显著疗效及良好的安全性。     

中药离子导入治疗慢性阻塞性肺疾病急性加重期痰热郁肺证临床观察

目的 观察中药离子导入技术辅助治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)痰热郁肺证患者的临床疗效.方法 将60例AECOPD痰热郁肺证患者随机分为对照组及观察组,每组30例.两组均予以西医常规治疗...