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Systematic review and meta-analysis of the effectiveness of teacher delivered interventions for externalizing behaviorsThis systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit either teachers and/or children with externalizing behaviors were included. The review focused on qualified teachers working with children aged 2-13. The results of the current meta-analysis revealed a positive effect of teacher intervention on teacher and child outcomes, including the increased use of teacher-appropriate strategies, as well as significant and moderate improvements in teacher-child closeness, and small reductions in teacher-child conflict. For child outcomes, the interventions reduced externalizing behavior problems and ADHD symptoms and enhanced prosocial behavior. Only one fully blinded analysis for conduct problems was possible and revealed a moderate but significant reduction in favor of intervention. These findings provide evidence to support the role of teacher interventions for both teachers and children with externalizing behaviors. Future research should include more PBLIND measurements so that MPROX findings can be confirmed. More research should be done to evaluate the influence of teacher interventions on teachers' well-being.
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Protocol for a feasibility randomised controlled study of a multicomponent intervention to promote a sustainable return to work of workers on long-term sick leave — PROWORK: PROmoting a Sustainable and Healthy Return to WORKThe cost of sickness absence has major social, psychological and financial implications for individuals and organisations. Return-to-work (RTW) interventions that support good quality communication and contact with the workplace can reduce the length of sickness absence by between 15 and 30 days. However, initiatives promoting a sustainable return to work for workers with poor mental health on long-term sickness absence across small, medium and large enterprises (SMEs and LEs) are limited. This paper describes the protocol of a pilot randomised controlled trial (RCT) to test the feasibility of implementing a RTW intervention across SMEs and LEs across all sectors.
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Knife crime offender characteristics and interventions – A systematic reviewKnives and sharp objects are tools used in a wide range of violent offences. However, knife offending may have different risk factors than general violence, thus requiring tailored interventions. This systematic review aims to synthesise evidence on the characteristics of knife offenders and interventions aimed at the reduction of knife crime. After screening 1352 titles and abstracts, 344 articles were fully considered of which 21 papers met the inclusion criteria and were quality assessed. These consisted of 15 offender characteristic studies and six intervention studies. Findings suggested that knife crime may be associated with illicit drug use, exposure to any violence as a witness, victim or perpetrator and mental health problems. Males were more at risk of engaging in knife crime in the community and females in domestic settings. Different risk factors were found between gang involved and non-involved knife offenders. Primary prevention strategies, such as stop and search, knife amnesties, media campaigns and curfews did not show a significant impact in reducing knife crime. By contrast, increasing offenders' access to tailored support regarding housing, education, and employment showed an impact in reducing weapon carrying. Further research is required in the area to support the reliability of outcomes.
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Managing minds at work: Development of a digital line manager training programMental ill-health is the leading cause of sickness absence, creating a high economic burden. Workplace interventions aimed at supporting employers in the prevention of mental ill-health in the workforce are urgently required. Managing Minds at Work is a digital intervention aimed at supporting line managers in promoting better mental health at work through a preventative approach. This intervention was developed as part of the Mental Health and Productivity Pilot, a wider initiative aimed at supporting employers across the Midlands region of the United Kingdom to improve the future of workplace mental health and wellbeing. The aim of the study is to describe the design and development of the Managing Minds at Work digital training program, prior to feasibility testing. We adopted a collaborative participatory design involving co-design (users as partners) and principles of user-centred design (pilot and usability testing). An agile methodology was used to co-create intervention content with a stakeholder virtual community of practice. Development processes were mapped to core elements of the Medical Research Council (MRC) framework for developing and evaluating complex interventions. The program covers five broad areas: (i) promoting self-care techniques among line managers; (ii) designing work to prevent work-related stress; (iii) management competencies to prevent and reduce stress; (iv) having conversations with employees about mental health; (v) building a psychologically safe work environment. It was considered by stakeholders to be appropriate for any type of organization, irrespective of their size or resources. Pilot and usability testing (n = 37 surveys) aligned with the Technology Acceptance Model (TAM) demonstrated that the program was perceived to be useful, relevant, and easy to use by managers across sectors, organization types, and sizes. We identified positive impacts on manager attitudes and behavioral intentions related to preventing mental ill-health and promoting good mental wellbeing at work. The next step is to explore the feasibility and acceptability of Managing Minds at Work with line managers in diverse employment settings. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview studyObjectivesThere is a lack of research informing service delivery for older forensic mental health patients. This study explored service provision in forensic mental health inpatient and community services in England, investigating what is required for progress in terms of quality of life, health, wellbeing, recovery and reduced risk, and the barriers and facilitators associated with this.MethodsSemi-structured interviews were undertaken with 48 members of staff working with older forensic mental health patients in secure inpatient units or the community in England. Data were analysed using thematic analysis.ResultsTwo global themes ?What works? and ?What doesn?t work? were identified comprising themes representing environmental, interpersonal and individual factors. ?What works? included: positive social support and relationships; individualised holistic patient-centred care; hub and spoke approach to patient care; and suitable environments. ?What doesn?t work? included: absence of/or maladaptive relationships with family and friends; gaps in service provision; and unsuitable environments.ConclusionsFor older patients to progress to improved quality of life, health, wellbeing and reduced risk, multilevel and comprehensive support is required, comprising a range of services, interventions, and multidisciplinary input, and individualised to each patient?s needs. The physical environment needs to be adapted for older patients and provide a social environment that seeks to include supportive families, friends and expert professional input. A clear patient progression pathway is required; this must be reflected in policy and provision.
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“Some body else”: Harlequin’s journey in forensic sandplay and gender dysphoriaForensic Sandplay tells tragically ambivalent tales from deep within the unconscious, and body and mind, of devastating physiological and psychological impact of a parental split, abandonment-trauma, loss, and bereavement, from the masculine (and death of the father), and emotional and physical abuse from the feminine (mother). Using both sand trays at a time, Alex’s identity formation existed in the periphery between male and female, and masculine (conscious) and feminine (unconscious) energies in emotional detachment, de-personalisation and over-separation. Sacrificial archetypes, such as Harlequin, surrender the ego to the Self in order for previously masked emotional states, and aspects of Self, to become known, in a process of initiation; containing, liberating, and uniting internal opposing forces, and achieving balance (Jung et al., 1964). As a pretending Fool, yet paradoxically, intelligent Trickster, Harlequin transcends resistance and emancipates suppressed anxieties and threat sensitivity. Through uncovering buried, past resentment, and safely exploring the risk of gender violence, control and rigidity are abandoned in a dual representation of both masculine and feminine forces, in order for self-preservation, adaptation, authenticity, acceptance, and self-realisation. Alex’s separation of body and mind took authority, and desperately sought a sense of agency. Alex’s prohibited sexual and emotional life (perhaps witnessed in hand-printing in the sand) required bodily acknowledgement, and in being seen. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: chapter)
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Me-thinking: report on a pilot intervention with women in custodyPurpose This pilot study aims to assess the feasibility of conducting shared philosophical inquiry with women at risk of re-offending to improve motivation to change. The philosophy sessions aimed to give participants new ways to think about their lives and to help them have more control over their own mind by learning new ways to think differently. Design/methodology/approach The pilot study adopted a mixed-methods approach to collect and analyse data pre- and post-intervention. Ten women serving a custodial sentence at the Democratic Therapeutic Community (DTC) in HMP Send were recruited to take part in ten weekly sessions of philosophical discussion. The intervention was adjunctive and not meant to replace other treatments an inmate may already be receiving. Findings The results showed that most participants experienced improved levels of well-being and mental health post-intervention, and that the intervention has the potential to help participants better critically assess their own behaviour and ways of thinking. It also suggested that the intervention has the potential to help participants engage more effectively with the therapeutic process. Research limitations/implications The results of this study are limited by the small sample size and the lack of a control group. As such this study cannot rule out that the changes observed in participants were a function of time or the specific therapeutic environment they were in (or both). Originality/value This pilot study is innovative not just for introducing philosophy classes to the women’s prison estate for the first time in England and Wales, but also in its ambition to contribute to the “what works” agenda in offender rehabilitation.
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A systematic review of the evidence relating to disclosure of psychological distress by mental health professionals within the workplaceObjective: To systematically review evidence regarding prevalence and choices of disclosure of psychological distress, by mental health professionals within the workplace. Methods: Six databases were searched in June 2020. Studies were included if they were published in English language and included empirical quantitative, qualitative or mixed-methods data. Studies were excluded if they focused on general healthcare professionals or the general population, or on stress or physical health problems. Study quality was assessed using the Mixed Methods Quality Appraisal tool. Results: Nine studies, with a total of 1891 participants, were included. Study quality varied, with studies generally reporting descriptive surveys using hypothetical disclosure scenarios. Distress was often conceptualized in psychiatric terms. These limitations mean conclusions should be treated with caution. Individuals were less likely to disclose in work and had negative experiences of doing so compared to social circles. Fear of stigma inhibited disclosure. There were differing levels of disclosure relating to recipient, trust, quality of supervision, how distress was conceptualized, and type of problem. Disclosure was experienced by some as valuable. Conclusion: There is a need for further research, which addresses the nuanced complexities surrounding disclosure choices for mental health professionals. © 2022 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC
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"When you have got like twenty thousand thoughts in your head, that one little thing can just make it all go away": Trauma and non-suicidal self-injury in forensic settingsThis chapter explores the relationship between trauma and non-suicidal self-injury (NSSI) within forensic settings. In particular, it considers prevalence rates, pathways to NSSI, and the dual risk presented by those who engage in both NSSI and violence. The primary reference group for this chapter is those in the National High Secure Healthcare Service for Women (NHSHSW) and it considers responses within this setting to understand, manage, and reduce the occurrence of NSSI, considering the impact of these on both staff and patients. The chapter advocates Trauma-Informed treatment responses for this population, drawing on the Trauma and Self-Injury (TASI) service. Interwoven throughout the chapter are the lived experiences of patients, using the patients voice as part of the narrative.
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Early trauma, psychosis, and violent offendingPsychosis tends to be an experience that socially isolates the sufferer and generates fear and distance in others. This is likely intensified when this presentation is combined with offending. In this chapter, using case examples we describe the possible pathway to psychosis through trauma and the links to violence. We illustrate the function and method in “madness”, clear evidence for the need to understand, and make sense of, what is being communicated through delusional and/or psychotic experience, and the importance of looking beyond diagnostic frameworks. In doing so, we can explore the function of hypervigilance, the parallels with childhood experience, and the efforts to avoid further victimisation.
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Trauma, personality disorder, and offendingThis chapter provides an overview of the presence and relevance of childhood traumas in the histories of individuals who have been given a diagnosis of personality and offended. A summary of the impact of childhood traumas, adverse attachments, and adversity and the lack of relational security on individuals’ personality development is described in relation to the diagnostic traits for personality disorders and dynamic risk factors. A service user provides his narrative of the impact of childhood attachment adversity and traumas on his development, mental health, and offending and describes what has been significant in supporting his recovery journey so far. The significant overlap across these areas and the increasing recognition of the need to understand developmental antecedents of individuals’ mental health difficulties and offending are highlighted. Current psychological treatment approaches across forensic services, including those based on a developmental model, are briefly described and the application of Schema Therapy for individuals who have been given a diagnosis of personality disorder and offending is discussed. Overall, the importance of asking individuals what has happened to them and developing a shared understanding of the impact of what happened to them is considered fundamental to supporting development and risk reduction.
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Trauma and intellectual disabilityIndividuals with Intellectual Disabilities (ID) are exposed to higher rates of adverse experiences in childhood than those without ID. However, there is also an under-reporting of trauma-related disorders in this population, possibly attributed to communication deficits in those who experience it and diagnostic overshadowing. These issues are further compounded when exploring the role of trauma and offending in this population due to legal and social variations in what constitutes challenging versus criminal behaviour. This chapter looks to draw together our current understanding in this area, its implications for clinical practice, and provides a case example.
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Deafness and trauma: A journey to equitable trauma-informed careThis chapter explores the unique relationship between Deafness and trauma and emphasises the fundamental need for an equitable and inclusive trauma-informed care for Deaf people in forensic services. It describes the prevalence of trauma in the Deaf population, the trauma experience of many Deaf children and the unique characteristics of trauma experienced in the Deaf population. The chapter also offers key insights into the experience of being Deaf in the Criminal Justice System, highlighting that Deaf individuals are often vastly overrepresented (and often stuck) within it. The chapter explores in detail what is needed to achieve equity in trauma care for Deaf people in forensic services. The chapter aims to promote the importance of a resilience – and a strength – orientated approach to care that produces balance between retribution and rehabilitation, resilience and empowerment in a system that has re-traumatised Deaf people for too long. This chapter emphasises need for equality in research, strategy, delivery, and evaluation.
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From care to custody?This chapter explores the social care system’s role in trauma and adversity experienced by young people in care and the potential impact on the trajectory from care to custody. We include the unique perspectives of care-experienced individuals and highlight a need for more research that captures the voices of a marginalised population. Finally, we provide recommendations for practitioners and policy makers to embed trauma-informed care and identify bottom-up and top-down processes to ensure a more integrated, proactive, and compassionate system.
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Trauma and sexual offending: Causal mechanisms and change processesIn the past trauma has been as an area to be avoided in working with people who have offended sexually because it was seen as providing individuals with exculpatory narratives. In this chapter an alternative view to this will be examined. The chapter explores a range of pathways linking different kinds of experience of adversity, oppression, and trauma and sexual offending. The utility of making sense of the developmental context of offending in order to facilitate interventions and developing case formulations will be explored. A range of interventions that focus on different biological, psychological, and social, trauma-derived processes in the lives of people who have offended sexually are explored.
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Trauma, violence, and genderThere are marked differences between men and women in the overall frequency, severity, and type of offences that they commit. However, there is relatively little research into the reasons for these differences. This chapter examines the differences between men and women in the forms of early maltreatment and adversity they experience and its impact, how survivors and communities regard and respond differently to different forms of adversity in men and women, and how these factors can shape the responses of male and female survivors. This chapter uses the Power Threat Meaning Framework as a basis for exploring these factors and illustrates the ways in which the impact of adversity can be mediated by gender with the accounts of a female and a male forensic psychiatric patient.
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Trauma-informed forensic practiceTrauma-Informed Forensic Practice argues for placing trauma-informed practice and thinking at the heart of forensic services. It is written by forensic practitioners and service users from prison and forensic mental health, youth justice, and social care settings. It provides a compassionate theoretical framework for understanding the links between trauma and offending. It also gives practical guidance on working with issues that are particularly associated with a history of trauma in forensic settings, such as self-harm and substance use, as well as on working with groups who are particularly vulnerable to trauma, such as those with intellectual disabilities and military veterans. Finally, it considers organisational aspects of delivering trauma-informed care, not just for service users but for the staff who work in challenging and dangerous forensic environments. The book is the first of its kind to address such a broad range of issues and settings. It is aimed at forensic practitioners who wish to develop their own trauma-informed practice or trauma-responsive services. It also provides an accessible introduction to trauma-informed forensic practice for undergraduate and postgraduate students.
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Childhood maltreatment and its links to offendingThe link between childhood trauma and offending has been largely overlooked in forensic psychology. This chapter argues for the central importance of childhood trauma in understanding offending behaviour. However, it is not the presence of childhood trauma per se that is criminogenic, but rather patterns of childhood trauma that are chronic and pervasive, and that compromise the child’s sense of safety. This has profound impacts on a range of developmental processes including neuropsychological development, attachment, emotional and social development, and mental health. It is argued that the most important criminogenic needs can all be understood as resulting, at least in part, from childhood trauma. Effective correctional programmes therefore need to address these trauma-related developmental processes if they are to be effective.
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The future of trauma-informed forensic practiceIn this chapter a number of areas for further exploration and growth will be explored. While recognising the roles of trauma, adversity, and oppression in the development of offending behaviour and as impacting often disproportionately on the lives of people who have offended has been a significant breakthrough in recent years, this chapter will also examine some of the pitfalls in taking an unthinking approach to this area. Trauma-informed and responsive practice is at an early stage of its development and there are a range of opportunities for growth, innovative practice research and development. A number of growth points are suggested. Practitioner, organisational and national agendas for development and change are highlighted and explored.
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Trauma-informed risk assessment and intervention: Understanding the role of triggering contexts and offence-related altered states of consciousness (ORASC)Risk assessment and intervention has, historically, not made direct links between trauma-linked developmental psychological processes and dynamic risk. In this chapter two critical areas of consideration in risk assessment (safety planning) and intervention will be outlined, using an integrative framework pulling together evolutionary motivational, resource functional analytic, and good lives thinking. Specifically, the need for contextual resource provision in offence-related trauma-triggering situations is highlighted. In addition, the need to understand offence-related altered states of consciousness (ORASC), linked often with trauma-related altered states of consciousness (TRASC) will be proposed, as a significant component of risk and safety work with people who have offended. Practitioners need to attend to both areas to work in a trauma-informed way. Preventing re-traumatisation and trauma-triggering exposure to deprived or abusive contexts that increase the chances of offence-related solutions to resource losses or deprivations is a significant task for practitioners working with people who have offended. Understanding the ways in which felt agency and ORASC can change in contexts where trauma and related resource need processes are triggered is a significant component of this work.
