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week 8
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role of the forensic clinical psychologist
member of a multidisciplinary team
provide care to mentally disordered offenders
provide individual assessments & therapy, group treatments, supervison or research ect
Psychological distress & offending
p w/psychosis are generally not violent
may be a link w/command hallucinations & persecutory delusions
but 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 is strongly linked to poor mental health
circular definition of personality disorder
have these feelings as result of the moo
Rosenhan - Sane in insane places
Had researchers put into NY insane asylum
considered mad for taking notes → considered bizzare ways
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
Hearing voices
can help individuals learn their coive and mistakes in their inner speach
identify fluctuation sin voice acitiu to develop coping strategies
Identify problematic voices
challenges beleifs about vocies
clinical decisions
Psychopathy checklist revised (Hare, 1991)
early behavioural problems, parasitic lifestyle
important considerations for actuarial assessment
maximise true postive diangosis (will offend, identified
minimise false negative diagnoses (will offended, not identified)
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
clinical decisions
sentencing protocol → people who have served their sentence will be legally have to be allowed
but yet they are probably not ready to be
Parole boards
Approx. 88,225 prisoners in E&W (October 2023)
Prison system cost £6.09bn for year ending March 2023 (Statista 2023)
Recidivist crime costs £13bn/year (MoJ 2013)
Prediction errors in assessments
Want high true positives and low false negatives (protect public).
But false positives (people who won’t reoffend labelled high-risk) are a major justice problem and easy to ignore.
Parole and policy context
Big prison population, high cost, and huge financial/social cost of recidivism
decisions are made under uncertainty, with pressure to avoid rare but politically explosive failures.