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Background: In forensic settings, patients with intellectual disabilities are overrepresented. A relative novel treatment approach for this population is schema therapy. The goals of schema therapy for offenders with intellectual disabilities are to reduce maladaptive emotional states and to reinforce healthy emotional states and enhancing the patient's ability to ask for help. No studies are examining the effectiveness of this approach. Method: We examined the effectiveness of Schema Therapy for offenders with intellectual disabilities (ST-ID) in terms of emotional states, psychological complaints, and violence risk in six participants. Results: Reliable change analyses showed significant improvements in emotional states and certain psychological complaints. Conclusions: While many questions remain about the effectiveness of ST-ID, our study shows that offenders with ID can benefit from this psychological treatment.

The aim of this study was to examine the emotional states preceding and during sexual and violent offenses in a Dutch sample of male forensic inpatients. Moreover, the predictive impact of these emotional states on institutional violence in the first year of mandated care was examined using an incident scheme. Observer-ratings of emotional states by 103 male offenders and 97 sex offenders were examined using Mann-Whitney U tests. Using hierarchical multiple regression analyses, the predictive relationship between crime-related emotional states and incidents was examined. Sexual and violent crimes were equally preceded by painful emotions, primarily feelings of abandonment. During violent crimes, a state of bully and attack was dominant whereas sexual crimes were also characterized by self-aggrandizement and manipulation. These emotional states were not predictive for institutional violence. This study emphasizes the importance of emotional states in offending behavior and usefulness of schema therapy's crime theory. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been consistently linked to interpersonal violence and are highly prevalent in correctional populations, particularly in men who perpetrate (sexual) violent behavior. Although exposure to ACEs is common in men who perpetrate interpersonal violence, less is known about the differences between men who commit sexual versus non-sexual violence. This cross-sectional study reports on the differences in prevalence of adverse childhood experiences in Dutch men who committed sexual offenses (N = 29) versus those who committed (non-sexual) violent offenses (N = 29), all who have been mandated to forensic clinical care. Drawing on data from a RCT-study among male forensic psychiatric inpatients with cluster B personality disorders from seven forensic hospitals in the Netherlands, the study explored potential differences in ACEs, and its relationship to treatability in the first year of forensic treatment. No significant differences were found in prevalence of childhood abuse and neglect among men convicted for sexual offenses versus those convicted for violent offenses. In our study, ACEs were not predictive of risk relating to treatability at the start of forensic treatment. Our findings suggest that taking into account trauma histories is of equal importance for both offending groups. Implications regarding trauma-informed forensic care are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study is to assess treatment change at both a group and individual level in a sample of 81 Dutch male patients who received mandated care for either violent (non-sexual) behavior or sexual violent behavior. Psychiatric nurses rated patients' social skills, insight, hostility, physical violence with the BEST-Index every 6 months over the course of 2 years after patients were admitted to hospital. Mixed analysis of covariances and the reliable change index indicated that patients, irrespective of offense type, showed treatment change over time with exception of physical violence. This study shows that general treatment may be useful in the first 18 month for risk factors common to different types of offenses, but that specialized treatment is needed to establish further change. [ABSTRACT FROM AUTHOR]

This article explores how probation officers (POs) in France employ evidence-based practice in the real world. Using 78 audio tapes of 11 POs and 33 offenders in 2 probations services, we assessed PO skills with an adapted version of the Jersey Checklist. Our results suggest that French probation officers generally possess good communication skills, and use – to a certain extent – core correctional practices. They do, however, underperform with regard to cognitive behavioural techniques. [ABSTRACT FROM AUTHOR]

In forensic settings, patients with intellectual disabilities are overrepresented. A relative novel treatment approach for this population is schema therapy. The goals of schema therapy for offenders with intellectual disabilities are to reduce maladaptive emotional states and to reinforce healthy emotional states and enhancing the patient's ability to ask for help. No studies are examining the effectiveness of this approach. We examined the effectiveness of Schema Therapy for offenders with intellectual disabilities (ST-ID) in terms of emotional states, psychological complaints, and violence risk in six participants. Reliable change analyses showed significant improvements in emotional states and certain psychological complaints. While many questions remain about the effectiveness of ST-ID, our study shows that offenders with ID can benefit from this psychological treatment. [ABSTRACT FROM AUTHOR]

Background: Little is known about people who are admitted to medium secure services (MSSs) from prison, including characteristics and factors that influence clinical pathways and subsequent discharge. We recently published the first study to establish the circumstances by which MSS "prison-transfer" patients are returned to prison. Of particular concern was the finding that a quarter of prison-transfer patients were returned to prison by Responsible Medical Officers (RMOs) because they were not engaging with treatment or were deemed too "high risk" to remain detained within the services, circumstances that would be unacceptable when considering discharge via a community care pathway. It is important to further explore the characteristics of people admitted to MSSs from prison, and to investigate how these may differ for individuals who are returned to prison, as compared to those discharged into the community. Aim: (a) To describe the characteristics of prison-transfers who receive an RMO directed discharge fromMSSs; and (b) to compare these characteristics by discharge destination; prison return and community discharge. Methods: Prospective cohort comparative study: all prison-transfer patients discharged under the instruction of their RMO over a 6-month period, from 33 NHS medium secure units across England and Wales. Data on patient demographic, clinical and legal characteristics were extracted via full patient health record review and collateral information from clinicians was also obtained. This information was used to complete The Historical, Clinical and Risk--20 items (HCR-20v3) and The Structured Assessment of Protective Factors (SAPROF). Individuals who were returned to prison were compared with those who were discharged to the community. Results: Persons returned to prison represented a vulnerable group at time of discharge as compared to those discharged into the community and had a significantly shorter length of stay in MSSs. Over half of those returned to prison had a length of stay of <6 months. Individuals returned to prison displayed significantly more issues with psychological adjustment at time of discharge, and had a higher risk of future violence and a lower prevalence of protective factors that mitigate subsequent risks of relapse and reoffending. Discussion: MSs in England and Wales are returning vulnerable individuals to prison in lieu of adequate aftercare services. The role of and responsibilities of MSSs as regards admissions from prison needs to be reconsidered. [ABSTRACT FROM AUTHOR]

The current study focused on examining the relationship between adverse childhood experiences (ACEs) and personality disorders in offenders with antisocial, borderline or narcissistic personality disorders. We tested whether emotional states mediate the relationship between ACEs and personality disorders in an offender sample. Self-ratings of adverse childhood experiences, emotional states and personality pathology by 102 male offenders with personality disorders were examined using hierarchical multiple regression analyses and mediation analyses. The findings show that personality disorders were characterized by certain emotional states. ACEs did not differentiate between personality disorders. Only the relationship between Physical Neglect and NPD showed a small negative direct effect and one small positive indirect effect, with healthy emotional states as mediator. [ABSTRACT FROM AUTHOR]

Forensic professionals have a unique role due to the precarious balance between providing care and enforcing control. In the Netherlands, the term "forensische scherpte", which we translated as "forensic vigilance", is widely used to indicate a core competency professionals require during work in forensic psychiatric settings. However, a clear definition and understanding of the construct is lacking, which hinders theory building, measurement, research and training. The current study aimed to capture this concept and provide a first definition. Thirty statements about possible aspects of forensic vigilance were formulated. Participants (N = 700) were forensic psychiatric professionals. By means of an online survey, participants had to indicate how much they endorsed each statement by means of a 100 mm Visual Analog Scale (VAS) ranging from "totally disagree" at 0 mm to "totally agree" at 100 mm. The most endorsed statements included "Forensic vigilance is being able to recognize even subtle signs of impending danger/possible escalation" and "Forensic vigilance is daring to be assertive". Fifteen statements were endorsed with a mean of 70 mm or more. Cronbach's α of these 15 items was good (α =.844; αrange.828 –.845). The professionals regarded forensic vigilance as highly important (µ = 89.01 mm out of 100) for their work. Further research will include testing a newly constructed 15-item instrument for measuring forensic vigilance, and explore its relationship with personal and professional characteristics. [ABSTRACT FROM AUTHOR]