Evaluating innovative treatments in forensic mental health: A role for single case methodology?

Davies, Jason; Howells, Kevin; Jones, Lawrence

doi:10.1080/14789940701443173

Cited by 34 publications

(22 citation statements)

References 39 publications

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“…One of the most obvious findings of the literature review was the limited treatment literature in forensic mental health, an observation which has also been noted by other writers (e.g., Davies, Howells, & Jones, 2007;Hillbrand & Young, 2008). This may reflect the specialty's early stage of development and the emphasis, until quite recently on assessment-related issues including risk to others, legal classification and disposition, and the role of expert witness.…”

Section: Paucity Of Literature On Interventionmentioning

confidence: 78%

Sailing uncharted seas without a compass: A review of interventions in forensic mental health

Barnao

Ward

2015

Aggression and Violent Behavior

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Section: Paucity Of Literature On Interventionmentioning

confidence: 78%

Sailing uncharted seas without a compass: A review of interventions in forensic mental health

Barnao

Ward

2015

Aggression and Violent Behavior

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“…Current thinking on treatment evaluation now includes a much greater emphasis on measuring change through individual case formulation and monitoring of individual change (Davies et al, 2007) as well as more traditional group-based tests of treatment effectiveness. …”

Section: Discussionmentioning

confidence: 99%

“…Whilst these studies are not indicative of level of met or unmet need, they raise the notions of treatment intensity and frequency ('dosage'), service responsivity (how well specific service user needs are met) and how these relate to a timely care pathway. Within Broadmoor Hospital, amongst service users with complex and multiple needs, the challenge of reducing the average length of stay from 8 years was considered to be most appropriately met through the provision of a needs-responsive service which was clearly based on an individualised case formulation and monitoring of individual change (Davies, Howells and Jones, 2007). This in turn required clarity about met and unmet needs of the service users and the development of more logically sequenced, timely and relevant interventions in order to provide a comprehensive and streamlined pathway through the hospital.…”

mentioning

confidence: 99%

Domains of Need in a High Secure Hospital Setting: A Model for Streamlining Care and Reducing Length of Stay

Glorney

Perkins

Adshead

et al. 2010

International Journal of Forensic Mental Health

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There are financial and humanitarian consequences to unmet need amongst service users of high secure hospital care, not least in terms of length of stay. This paper presents two reviews of high secure service user needs. They provide support for the sequencing of interventions to meet service user needs and the utility of a structured framework for their review. Through analyses of these reviews, eight domains of need were identified: Therapeutic Engagement, Risk Reduction, Education, Occupational, Mental Health Recovery, Physical Health Restoration, Cultural and Spiritual Needs, Care Pathway Management. A model is presented, within which logically sequenced, timely and relevant interventions could be framed in order to provide a comprehensive and streamlined pathway through a high secure hospital. Domains of Need 3 Reducing Length of Stay in High Secure Hospital Settings: A Model for Streamlining CareThere are three high secure hospitals in England and Wales, the function of which are to provide a service to people who cannot be managed in conditions of lesser security, predominantly mentally disordered offenders (MDOs). More specifically, service users are detained under legislation which mandates assessment and treatment and emphasises public protection (Sarkar, 2010). Grounds for detention must include 'mental disorder' -any disorder or disability of mind -and a risk of harm to self or others (Mental Health Act 1983 as amended 2007. MDOs can be diverted into the Mental Health System from the Criminal Justice System at the point of contact with the police, during the pre-trial period of assessing fitness to plead, at trial, post-trial (advice on disposal prior to sentencing) and on disposal to a prison or psychiatric hospital (Wrench and Dolan, 2010). Some individuals will encounter the Criminal Justice System secondary to the Mental Health System and might find themselves transferring to facilities of increasing levels of security, through low, medium and high security. Under the Mental Health Act (1983 as amended 2007), provisions exist for MDOs to be admitted to hospital for assessment of mental disorder and risk, for offenders to be treated in hospital rather than serve a prison sentence and for prisoners to be transferred for 'urgent' treatment (for more complete descriptions of forensic mental health systems, services and concepts in England and Wales the reader is referred to Bartlett and McGauley, 2010).Broadmoor Hospital is one of three, publically-funded National Health Service (NHS), high secure hospitals in England and Wales which admit people with serious mental illness and severe personality disorders, often in combination (Adshead, 2010), who pose a serious risk of harm to themselves or others. Service users are most often referred from courts, prisons and Domains of Need 4 secure hospitals of lesser security (see Völlm, Daley and Silva, 2009 for further description) and most commonly have restrictions on their movement and liberty at the discretion of the Ministry of Justice (the gov...

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“…While it would evidently be unwise to over-generalize in such a context, it is nevertheless hoped that the following account might offer a modest illustration of how theory and practice have the potential to illuminate and synergize each other within the crucible of clinical practice. Nevertheless, despite this cautionary caveat, it is worth observing that in specialities such as forensic practice (in which the total number of patients treated is inevitably small) the single case study approach has been identified as being of particular value for enhancing our knowledge of how to work more effectively with these complex individuals (Davies et al, 2007).…”

Section: General Introductionmentioning

confidence: 99%

A Syncretic Approach to the Role of Pathological Organizations in Violence

Boyle¹

2013

Brit J Psychotherapy

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This paper considers the role of pathological organizations in violence from a syncretic perspective. It begins with a discussion of the idea of syncretism in psychotherapy that is followed by an overview of the development of the pathological organization concept. Donald Kalsched's work on the self‐care system is subsequently introduced to provide a complementary Jungian perspective on the role of trauma in the formation of pathological organizations. The remainder of the paper considers the role of pathological organizations in violence with particular reference to the work of Arthur Hyatt‐Williams on ‘the murder constellation’ and J. Reid Meloy's concept of the ‘psychopathic personality organization’. Two brief clinical vignettes are included to illustrate selected aspects of the theoretical material. By way of conclusion the paper evaluates some recent developments in conceptualization with particular reference to a ‘trauma amplification’ model of pathological organizations that could be of assistance in formulating the treatment needs of violent offenders.

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Evaluating innovative treatments in forensic mental health: A role for single case methodology?

Cited by 34 publications

References 39 publications

Sailing uncharted seas without a compass: A review of interventions in forensic mental health

Sailing uncharted seas without a compass: A review of interventions in forensic mental health

Domains of Need in a High Secure Hospital Setting: A Model for Streamlining Care and Reducing Length of Stay

A Syncretic Approach to the Role of Pathological Organizations in Violence

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