Forensic Psychology

week 8

Role of the forensic clinical psychologist

• member of multidisciplinary team, includes psychiatrists, social workers, occupational therapists, nurses

• provide care to mentally disordered offenders

  • violent/sexual offences, psychosis, arson, self harm

Psychological distress & offending

• p w/psychosis are generally not violent

• may be a link w/command hallucinations & persecutory delusions, although someone’s response to these experiences may be more important than the experiences themselves

• p w/PD or psychopathy may be more likely to be violent

• child trauma may lead to difficulties w/emotional regulation, impulsivity & empathy

  • leads to violence & antisocial behaviour

    • may underlie PD

Confounding variables of psychological distress & offending

• social inequalities experienced by psychiatric patients

• circular definition of personality disorder 

Treatment approaches to sexual offending

• education in model of offending

  • wanting to offend, giving self permission, creating situation, overcoming the victim

• increasing self-awareness of thoughts, feeling & situations that increase the risk of offending

• addressing cognitive distortion & building victim empathy

• developing coping strategies to deal w/high risk situation

• some positive effects observed but may do more harm then good (Mews et al, 2017)

Assessment

• The aim of assessment is to develop a formulation

  • A hypothesis about causal factors that can be addressed in therapy

• Methods

  • Interview

  • Psychometric tests e.g.: personality, cognitive functioning

  • Observations

  • File review

  • Discussion with other key individuals, e.g relatives

Risk assessment approaches

• Clinical approach

  • Based on clinical judgement, experience of individual

• Statistical or Actuarial approach

  • Assessment of scores on standardised tests known to be correlated with recidivism

  • Interpretation of large datasets

clinical decisions

• Psychopathy checklist revised (Hare, 1991)

  • early behavioural problems, parasitic lifestyle

Statistical/Actuarial assessment

• Based on shared characteristics of other offenders committing similar offences

  • Demographic characteristics e.g age, education

  • Assessment of scores on standardised tests known to be correlated w/recidivism

  • Interpretation of large datasets

• Recidivism risk assessment

  • Measurement e.g. reconviction for similar offence within five years of release

Actuarial estimates of risk

• more statistically accurate

  • more frequent the crime more accurate it is to predict

• Clinical judgement is important when considering individuals and the impact of treatment

  • Actuarial assessment would not alter after therapeutic intervention

• Actuarial methods should inform multiple clinical judgements (second opinion)

Risk assessment

• Instruments such as the HCR-20 & SVR-20 are based on research and can be used to guide clinical judgement

• Risk factors can be:

  • Static (e.g. gender, previous history) or;

  • Dynamic (e.g. age, level of alcohol use)

• Risk assessment should identify strategies for managing dynamic risk factors