Case Studies in Forensic Psychology by Tully Ruth; Bamford Jennifer; & Jennifer Bamford

Author:Tully, Ruth; Bamford, Jennifer; & Jennifer Bamford
Language: eng
Format: epub
Publisher: Routledge
Published: 2019-03-20T16:00:00+00:00

Discussion

The results of the assessments above were critical in informing risk-reduction treatment planning for Patrick. Within secure psychiatric hospital settings, patient numbers are on a smaller scale when compared to the number of people residing on a prison wing. This means that patients within hospital settings can often be offered more bespoke treatment packages rather than the generic treatment groups usually offered within a prison setting. This is an especially relevant consideration for Patrick, who was assessed as having a number of difficulties including mild LD and DES, and so it was considered that mainstream group-based psychological treatment would be unlikely to meet his individual needs in relation to responsivity and risk and that a tailored responsivity plan would need to be in place if he were to engage with group-based interventions.

Based on risk assessment and Patrick’s identified LD, as well as his deficient abilities related to social skills and emotional recognition and management, he was offered a place on the ‘I Can Feel Good’ (ICFG) programme (Ingamells & Morrissey, 2014). This programme is based on Dialectical Behavioural Therapy (DBT; Linehan, 1993) and is adapted to meet the responsivity and treatment needs of individuals with LD. The modules of the programme cover mindfulness skills, managing feelings, coping in crisis, and people skills, all of which were identified as problems for Patrick within the case formulation. This includes group and individual sessions. Early preliminary research (Ashworth & Brotherton, 2018) indicates a positive effect for a male sample in managing feelings, coping in crisis, and people skills. There has also been evidence of positive effect on the client’s adaptive coping strategies (Ashworth, Mooney & Tully, 2017). Patrick took part in this programme for approximately one year. He was supported in his engagement through a responsivity plan, and as a result, he participated well in group discussions and enjoyed doing group activities; he particularly enjoyed aspects of the programme that involved role play and mindfulness. Despite significant effort by therapists to adapt material and communication to meet Patrick’s learning needs, he struggled to understand some of the material, particularly if it was new or of a complex nature. This sometimes led to superficial treatment engagement, which could be linked to his cognitive difficulties or his DES (Alderman, Fry & Youngson, 1995), and/or his motivation to engage (Medalia & Richardson, 2005). Conversely, it could have been that Patrick was at a stage of ambivalence, which is a normal stage on the route to change (Prochaska & Norcross, 2013). Patrick was advised to continue to engage with the ICFG programme in order to enhance retention of information through repetition, which was considered in line with his learning needs, and staff continued to support him to manage any difficulties he experienced as a result of DES.

Patrick was also offered weekly psychology sessions, which he attended for approximately one year. The sessions focused on rapport-building initially, and then focused on his offence utilising a sex offender treatment model approach (Craig, Lindsay & Browne, 2010). During this treatment,

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