Forensic psychology - assessment of offenders - Flashcards in University Psychology

what is forensic assessment

dynamic, diverse and complex process as offenders bring with them a complex set of difficulties & a complex set of systems around them; requires effective offender/practitioner engagement, idiographic assess

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what is the consequence of offender assessment

formulation in order to ensure accurate assessment, treatment planning and aid service evaluation.

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what is multi-modal

therapy is based on the idea that the therapist must address these multiple modalities of an individual to identify and treat a mental disorde

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Forensic psychologists are routinely asked to address the following

To understand why the person committed the offence; The nature, level and management of risk the offender presents with; The treatment needs of the person; The persons treatability and treatment readiness

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psychological formulation can be defined as:

A conceptual model representing an offenders various difficulties, the hypothesized underlying mechanisms and their interrelationships’.

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psychological formulation also aims

suggest what individual and systemic factors continue to maintain a person’s difficulties/offending behaviour.

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An assessment may be completed at any or all of the following stages:

Pre-sentence; Admission; Pre-treatment; Whilst in treatment; Post-treatment; Follow-up; Pre-release; Post-release

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why do psychiatrist assess

‘Assessment should be embedded as an ongoing part of the entire journey through the offenders management and care’ Brown, Shell & Cole (2015)

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Assessments are multi-modal and include

Information gathering & review of collateral information; Engagement & collaboration, including attending to the therapeutic relationship; Psychometric testing Specialist psychophysiological assessments; clinical interview; report

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what must you do in an assessment

be clear=purpose; Issues of consent to use collateral information; different sources of collateral information may require greater levels of corroboration; Deal with the preconceptions, emotional response of the offender; record keeping

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who can do a forensic psychometric test

qualified forensic psychycologist

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what must you report in the assessment

articulate any limitations to the testing within the assessment process, including the reliability and validity of tests used critical and any problems with norms for the person tested

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what kind of psychometric test

dependent on the purpose of the assessment

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Beholden on the forensic psychologist to ensure that

Appropriate test interpretation of measures is used; That tests are not misinterpreted/over-interpreted; care in the presentation of results; practitioners demonstrate a sound knowledge of the relevant literature underpinning each test utilised

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Penile plethysmograph (PPG)

Used to identify individuals sexual interests ; moderately resistant to attempts at faking

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where is polygraph used most

in North America as part of enhancing disclosure

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how useful is a polygraph

Not infallible but is seen to be on balance useful

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what/why do offenders get referred for assessment

Offenders are referred by statutory services; Present with a range of interrelated needs; level of risk the person poses to society/themselves. offender usually doesn't want assessment; referrers perception differ from offenders

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is there ever true consent in forensic psychology

no

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key areas to asses (1)

Capacity to consent; goals aspirations, strengths & their perceived difficulties; Social support & other protective: Neurocognitive abilities & difficulties; DEVELOPMENT HISTORY; FAMILY BACKGROUND/FUNCTION; Social care history; Trauma/victim history

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key areas to asses (2)

Education & employment; Psychosexual background; Relationship (romantic and peers) history; Attachment style; MENTAL HEALTH & SUBSTANCE MISUSE; PERSONALITY; PYCHOPATH; Attitudes towards treatment and motivation; Treatment history

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key areas to asses (3)

History of hospital admissions & time in prison; Offending history; Attitudes towards offending; Current offence analysis; Current mental state (self-harm/suicide); Medication & attitude towards medication

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key areas to asses (4)

Legal restrictions & response to restrictions & adherence to them; Safeguarding issues

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Developmental Histories of sexual Offenders

Cultural norms and expectations(male dominance and sexual entitlement); Early life experiences; Situational contingencies; Inter-generational issues of sex offending replicated and transmitted down the generations through processes of normalization

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what does it mean by early life experience

insecure attachments, abuse experiences and neglect

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what are Situational contingencies

Parental separation, lack of appropriate role-models, exposure to offence supportive attitudes that unfold during childhood and adolescence

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what to do with mentally disordered offender

Common and you will encounter routinely; Secure psychiatric facilities tend to opt for psychiatrists and clinical psychologists traditionally – medical dominance; RMO changed to RC in the MHA 2007 ; Patients and not offenders

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Developmental Histories of mentally disordered Offenders

Victorian period saw co-existence of madness and criminality warranted separate individual care

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what were the victorian period groups of mentally disordered Offenders

mentally ill- detached from their crime, easily managed, occasionally challenging behvaiour ; personality disorder - routinely oppositional and aggressive, but less mad

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what where the types of disorders that were part of the mentally ill division in the Victorian period

Functional psychoses , bipolar disorder and schizophrenias

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what where the types of personality disorders that were part of the personality disorder division in the Victorian period

Antisocial/dissocial PD and psychopathy

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what is the problem with the personality disorder and mentally ill division used in the Victorian period

no clear distinction between MI/PD or normal/abnormal behav; Non-criminal expression of PD can be found in opportunist politicians, business men, military personnel;Habitual criminals often fulfill criteria for antisocial and dissocial PD- no disorde

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what is the risk with mentally disorder offender (MDO)

controversial; risk to others/themselves; media exaggerates/distorts risks; correlation studies="dual diagnosis" to justify; prevalence rates suggested of 20-30% of substance misuse in psychiatric patients

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Specific symptoms of mental illness – controversial

risk of violence increases with the presence of positive not negative symptoms; Command hallucinations with violent content predict violence; Delusions & hostile content predicts violence; Treatment compliance reduces but does not eliminate risk

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mentally disorder offenders and risk - facts (1)

serious mental disorder will be the victim of violence than perpetrator; risk fluctuates over time & depends on many factors other than mental disorder; violence determined by social-demographical and socio-economical factors;

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mentally disorder offenders and risk - facts (2)

multifactorial formulation needed= offender variable & contexuaul factors; mental disorder neither necessary or sufficient cause of violence; public exaggerate relationship between disorder and violence, & their personal risk from ill;

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mentally disorder offenders and risk - facts (3)

substance abuse appears a major determination of violence, whether in mental disorder context or not; intimacy- most victims of violent crimes are known to the perpetrator; mental illnes is not represented in academic articles (PD & stalking is)

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mentally disorder offenders and risk - facts (4)

large presence of non-patient in offending categories warrant a diagnosis of mental disorder- some with dual

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what is co-morbidity

Refers to the presence of more than one disorder in the same person

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how high is the risk for someone with mental disorder

Having a mental disorder more than doubled the risk of an alcohol disorder and increased four-fold the risk of drug abuse disorder

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Lifetime prevalence of substance misuse disorder

APD-83.6%; manic bipolar-60.7%; schizophrenia-47%; anxiety disorder-32%

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which mental disorder are more likely end up with dual diagnosis

Auditory processing disorder(APD); manic bipolar; schizophrenia; anxiety disorder; borderline personality disorder (BPD)

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what % of alcohol influencing offending

40-60% assault and homicide; 30-70% ****; 40-80% domestic violence

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what is the problem with substance misuse

highest proportion of violent individuals, but they committed more severe acts of violence with greater frequency.

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substance misuse & major psychiatric illness

statistically significant predictor of violence.

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MacArthur Violence Risk Assessment Study (1996)

Most violent offending occurred within one month of release from psychiatric care

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Interactions predisposing to violence

sought-after dug effects; intoxication/withdrawal effects; affective symptoms; personality changes from long usage; Acquisitive offending to sustain the economic cost of substance misuse

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what does it mean by Intoxication or withdrawal effects - Interactions predisposing to violence

Irritability, autonomic arousal, cognitive impairment

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what does it mean byAffective symptoms - Interactions predisposing to violence

Depression following stimulant withdrawal elevates risk of suicide

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what should risk assessment and risk management

provide the opportunity for consideration of an individuals strengths/capabilities. This enables a balanced, informed and positive focus which will enhance co-operation , optimism and collaboration between all engaged

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what is a risk

Is the likelihood of an adverse event or outcome

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what is a risk factors

Are the particular features of substance misuse, mental health, behaviour, social circumstances that alone or in combination lead to an increased risk

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what is a risk assessment

Is an estimation of the likelihood of particular adverse events occurring under particular circumstances within a specified period of time

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what is a risk formulation

Process of summary and organisation of the risk data, and identification of the risk factors. It provides the information for risk management

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what is a risk management

Aims to minimise the likelihood of adverse events within the context of the overall management of the individual, to achieve the best possible outcome, and deliver safe, appropriate, effective car

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is risk dynamic or static

dynamic- changes over time; need regular review/assessment

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when is assessment/prediction is more accurate

short term - never 100%

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what is the problem with risk management

critical points - pot in the duration of therapy wherein the patient observes their issue with unclouded judgment and determines what route to take to solve or manage their issue

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what is The most important way to minimise risk

good clinical management

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what are the ethics of assessment

Tension between protecting rights of clients & protecting public; Issues with info sharing; Power imbalance between the practitioner & offender; Managing resistance, defensiveness and deception in assessment; offenders not sharing info in assess

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Confidentiality and Information Sharing

those who pose risk=range of problems=needs range of services; protocols for sharing by GOV & DoH Confidentiality Guidance; info shared follow guidlines

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risk management VS Confidentiality and Information Sharing

if Risk Management is to be effective good systems of communication ARE vital.

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what is the DoH Guidelines on Information Sharing when needing to pass information

persons explicit consent; 'need to know basis'- staff from 1+ agency involved & client advised; needed to protect others outweigh the duty of confidence to patient ('98)

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Impact on practitioners

Demanding task at both a personal & professional level, Emotional impact Requirement for professional support & supervision essential; In addition we must be aware of the impact of the assessment on the offender

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Forensic psychology - assessment of offenders

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