The purpose of this paper is to outline the process of risk assessment for terrorists and violent political extremists and to present an example of such an approach. The approach proposed is referred to as the VERA 2 or violent extremism risk assessment protocol (Consultative Version 2).
A review of the knowledge base relating to risk assessment and risk assessment methodology was undertaken with a focus on relevance to individual terrorists and violent extremists. The need for a specific approach for the risk assessment of terrorists that differs from approaches used for ordinary violent criminals was identified. A model that could be used for the risk assessment of terrorists was identified with pertinent risk indicators. This was structured into a protocol referred to as the VERA (Consultative Version 2). The approach is intended to be applied to different types of violent extremists, terrorists and unlawful violent offenders motivated by religious, political or social ideologies.
First, risk assessments of adjudicated terrorists and violent extremists should be undertaken with risk indicators that are relevant to ideological motivated violence. Indicators used for ordinary common violence differ in substantive ways from those relevant to terrorists and therefore may have questionable relevance for the assessment of risk in terrorists. Second, it is possible to construct an evidence‐based risk assessment approach for the range of violent extremists and terrorists using a structured professional judgment approach with pertinent risk indicators. The VERA 2 is an example of this type of risk assessment protocol for terrorists and unlawful violent extremists.
Risk assessment tools that have been developed for ordinary violent criminals and members of organised criminal gangs should be used with caution with terrorists, violent extremists and other perpetrators of ideologically motivated unlawful violence. Specific risk assessment approaches for terrorists with relevant indicators should be used. At this time, terrorist oriented approaches such as the VERA 2 are to be considered consultative and used as an add‐on to other established approaches.
There are few transparent, structured risk assessment approaches that use indicators specifically relevant to violent political extremists and terrorists. One new approach, the VERA 2 is outlined in the paper using risk indicators that differ in substantive ways from those used for other ordinary violent criminals.
]]>Reports on quality of life (QOL) measures for forensic patients are severely limited. The present paper aims to consider how to assess chronic patient's well‐being and to identify and evaluate the content validity of measures used to assess health‐related QOL in psychosis.
A review was undertaken to gather information on the different QOL measures from relevant databases, exploring their strengths and weaknesses.
Results from the review indicate a broad range of assessment tools are used in practice, although very few have been used in forensic settings. A preference for subjective tools is emerging, in addition to patient rated scales as opposed to clinician rated scales.
The application of QOL measures in the forensic population is of particular interest and a relatively new area of study, thus of value to practicing clinicians. It is hoped that the use of appropriate tools will enhance understanding of the treatment and service needs for mentally disordered offenders.
]]>The aim of this paper is to highlight the practical utility of using repertory grids with sexual offenders in denial and to demonstrate through a case study how they can be used to bolster both initial assessment and psychological formulation.
The study uses a single case study design and applies a repertory grid methodology, which is underpinned by personal construct psychology, to make sense of the case study. The analysis predominately focuses on the structure of the repertory grid.
The case study appeared to elicit factors that were of clinical utility and which could be used as tentative hypotheses for problem formulation and also seemed to point to an adequate starting point for intervention.
The use of the case study makes generalisation difficult and future research may benefit from more large‐scale research.
Rather than subscribing to fatalist notions of deniers as untreatable, the paper argues that constructive work can be done with this population and that repertory grids can be one way to initially facilitate this process.
Currently “total deniers” are excluded from treatment and are seen as untreatable. It is argued here that this need not be the case and it is demonstrated how repertory grids can inform initial formulation with such offenders. Repertory grids have not been used with deniers before and this is an original feature of this research.
]]>The profile of personality disorder in forensic clinical practice has been raised by key developments over the last decade, although services remain in the large part piecemeal and disconnected. This paper aims to describe the lessons learnt from the development of one specialist service for personality disordered offenders.
The policy context in which the service was developed, the challenges of working in this area, and data relating to the clinical and risk profile of referred cases are presented.
Data demonstrate extensive comorbidity and heterogeneity amongst those referred to the service. With reference to the experience gained in the first four years of the service, it is suggested that a systematic and formalised model of “understanding” the psychology of the individual should be the core process of future developments for this group of offenders, and subsequently recommendations are made to enhance the practical utility of such formulations rate.
Conclusions are mostly based on expert opinion and upon one particular service provision, and therefore care should be exercised in generalising the results of this study to existing services. The need for further research in order to enhance knowledge and understanding of this complex group is highlighted.
The heterogeneity and comorbidity within this group of offenders emphasises the need for services to offer a range of assessment methods and interventions to meet individuals' requirements.
The experiences and recommendations in this paper are valuable to professionals working with personality disordered offenders and to the development of more extensive services for such individuals.
]]>The principle of equivalence states that the provision of healthcare in the community should be extended into prisons. Stress control is a psychoeducational intervention that has had success in the community and has been adapted for use in different settings. The purpose of this paper is to establish whether stress control can be beneficial in a custodial setting.
Stress control was evaluated by looking at clinical effectiveness, satisfaction, attrition rate, cost effectiveness and suitability of the materials for use in a custodial environment. In total, 14 prisoners completed six sessions of stress control. Data were obtained using two clinical scales and an evaluation questionnaire.
Participants' anxiety significantly decreased and their wellbeing increased after completing Stress Control. Prisoners were satisfied with the intervention and there was a small attrition rate.
The audit had a small sample size, there were no control conditions and measures were self report. There was a selection bias arising from the exclusion criteria. A large‐scale randomised controlled trial should be conducted to further test effectiveness.
The adapted materials are effective and appropriate for use in a custodial setting. There can be improved access for psychological therapy for a prison population, a cost effective intervention, acceptable to a prison population and evidence based. Further recommendations for future developments are discussed.
The applicability of an established programme for mood management to custodial settings is an area of significance to forensic practice.
]]>The purpose of this paper is to provide an overview of the rationale for appropriate treatment for offenders with personality disorder and intellectual disability co‐morbid with intellectual disability (ID), and to describe a specific treatment model.
The paper provides a narrative review of approaches to treatment for offenders with personality disorder and draws on the available research for the treatment of personality disordered offenders without ID as well as the treatment of offenders with ID.
The relevance and validity of the construct of personality disorder in intellectual disability is reviewed. Evidence from treatment of personality disorder in mainstream populations is summarized. A treatment model, which integrates adapted cognitive behavioural programmes with a social milieu approach, is then described. It is argued that this treatment model addresses the criminogenic, psychological and social needs of those with personality disorder and intellectual disability.
Services being developed for people with both intellectual disability and personality disorder should take account of the literature on treatment of mainstream personality disorder when developing treatment models.
There are few published papers concerning treatment approaches with offenders with intellectual disability and personality disorder. This descriptive paper will be of interest to clinicians working with such populations.
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