Early maladaptive schemas in convicted sexual offenders: Preliminary findings

Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.     

‘Monsters don’t bother me anymore’ forensic mental health service users’ experiences of acceptance and commitment therapy for psychosis

Acceptance and Commitment Therapy for psychosis (ACTp) is an approach that aims to change the relationship an individual with psychosis has with difficult thoughts, emotions and experiences. It promotes the use of acceptance, defusion, mindfulness and focussing on valued outcomes as opposed to struggling with psychotic experiences. This service evaluation project explored service users’ experiences and meanings of ACTp within a medium secure mental health service. Thematic analysis was used to analyse interviews with 10 male service users. Four main themes emerged from the data: ‘Recovery’, ‘Insight’, ‘Developing Skills’ and ‘Accessibility’. Overall, service users viewed their experience of ACTp positively and identified encouraging therapeutic outcomes. These findings suggest that ACTp is an approach that should be considered a therapeutic option within forensic mental health contexts. These outcomes were compared with previous research findings. Limitations of the study, clinical implications and ideas for future research have been discussed.     

Managing children's and adolescents' medical complaints amid parent conflict: Strategies and tools for professionals

Children and adolescents who are having difficulty coping with stress often present with complaints of physical discomfort. Effective treatment approaches exist for many of these issues. Among high-conflict parents, however, children's medical issues can become another canvas for conflict, with parents focused more on blaming one another for the child's distress than on options for assisting the child. Professionals can be drawn into the conflict to such a degree that they overlook essential steps for addressing and managing these issues. The authors present a research-informed model for managing medical and psychophysiological issues amid parental conflict.     

Forensic occupational therapy to reduce risk of reoffending: a survey of practice in the United Kingdom

Forensic services are required to reduce an individual’s risk of reoffending. Despite being integral to forensic mental health services, the contribution of forensic occupational therapy to achieving this aim is unclear. This study describes current forensic occupational therapy practice to reduce reoffending risk in the United Kingdom. Responses to a cross-sectional survey consisting of multiple choice and free-text questions were analysed using frequency counts and percentages, and thematic analysis respectively. Of the 58 participants, 83% actively addressed reoffending risk. Participants informed practice with occupation-focused theories, models and assessment tools. Five themes described forensic occupational therapy to reduce reoffending risk: an occupational perspective of risk assessment and formulation; volitional realignment; increasing protective factors; community integration; and enhancing understanding of forensic occupational therapy. Forensic occupational therapists perceive their practice to contribute to reducing reoffending risk, but are yet to establish routine outcome measurement in this area. Implications for practice and future research are discussed.     

Body- and movement-based interventions with male offenders – a narrative review

Therapeutic and psychosocial accompaniment of offenders is increasingly being understood as a communal responsibility. Apart from recognised treatment batteries, an increasing amount of body- and movement-based interventions is carried out within the prison environment. Extensive literature searches were performed for this review. From a total of 2908, 23 publications were included. An increase in research interest in body- and movement-based interventions during the past 5 years was observed. Such interventions are being flexibly applied in detention contexts across western countries, transnationally. Effects of emotional nature as well as competence are being described. Body- and movement-based interventions may contribute substantially in the supervision within the prison regime and can be applied in different modalities as well as low- and high-threshold treatments. Scientific development in this field still is rudimentary and thus further research is necessary in order to provide more evidence for modification processes and efficacy from validated studies.     

Delivering effective therapeutic interventions for men with severe personality disorder within a high secure prison

Abstract

The Fens Unit is a government-initiated facility for male prisoners reaching criteria for Dangerous and Severe Personality Disorder (DSPD). Prisoners are assessed using a standardised process; those meeting criteria engage in a five-year treatment programme using a cognitive interpersonal model. Personality disorder is seen as a combination of coping strategies, developed in response to experience, which results in dysfunctions of thinking, feeling, behaviour and interpersonal relationships. These dysfunctions are linked to offending. Therefore, in order to reduce risk, multiphasic interventions – individual and group therapies – specifically target each dysfunction area, focusing on the developmental experiences that generated them. Each man's individual risk factors become treatment targets that are addressed in every aspect of the programme. All staff on the unit, clinical and operational, attempt to improve the quality of interpersonal relationships the prisoner has access to in order to create remedial experiences that are necessary to attain the capacity to develop socially adaptive cognitive, emotional and behavioural responses. This paper describes the treatment provided to these prisoners and the outcomes for the first cohort to have completed treatment (n=18). Results indicate that there is a reduction in violent behaviour, a higher than expected attendance at therapy, a decrease in actuarial risk measures and the majority of men are successfully managed in lower security after programme completion.     

On a clear day you can see forever: Integrating values and skills in sex offender treatment

Abstract

The topic of sex offender rehabilitation frequently evokes fierce reactions, ranging from strident demands for harsher sentences contrasted with calls for more imaginative and compassionate sentencing options. There seems to be a polarization of positions centred on the question of offenders’ moral standing: are they moral strangers or fellow travellers? This fundamental disagreement about offenders’ moral status is at the core of a number of independent, although related current practice and research issues confronting the field, namely: (1) risk management versus strength-based treatment approaches; (2) the utility of utilizing individually tailored versus manual-based programmes for offenders; (3) focusing on the technical aspects or therapy as opposed to relationship and therapist factors (what has been called process issues); and (4) the conflict between protecting the community versus promoting the interests of offenders. In this paper I suggest that an approach to sex offender treatment based on a combination of human rights theory (an ethical resource) and strengths-based approaches can help us navigate our way through the above dilemmas in a way that addressees both the needs of offenders and those of the community.     

Narrative Therapy and Peacebuilding

Dealing with trauma and loss in a post-conflict environment demands nuanced responses that take into account individual-level healing work and avoid standardized, statist, institutionalized solutions which tend to prioritize national unity by subordinating disparate individual memories. This article explores how narrative therapy advances the use of local initiatives, skills and values, challenges notions of therapeutic governance and generates possibilities of experiencing an increased sense of agency. Further, it introduces a range of collective narrative methodologies that open up the space for diverse meanings and alternative stories that can contribute to peacebuilding and recovery from the effects of trauma.     

儿童精神分析学的主要方法及其应用

儿童精神分析的出现被视为是精神分析"新范式的开始".儿童精神分析学的方法主要来自并运用于临床实践与临床发现,迥异于学院心理学的方法,有其自身的特色与优势.其方法主要包括两个方面,一是研究方法,二是治疗方法.儿童精神分析学最主要的方法包括重构法、观察法、实验法、测验法以及游戏疗法.纵观儿童精神分析学的主要方法,我们会发现它们与发展心理学的研究方法有某些共同之处,但发展心理学则更多地是进行标准化研究和对发展过程的详细描绘,而儿童精神分析学者更多研究心理发展动力与潜意识的影响.二者在研究结果与研究内容方面出现了逐渐融合的趋势,越来越多的儿童精神分析学的研究主题,如母婴关系、自我功能、自我发展、分离与剥夺、受挫与攻击性等逐渐纳入发展心理学的视野.