Transcript Treatment programmes GMN A2 Psych

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Treatment programmes
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Treatment programmes
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The main approaches within this area are Individual
Differences, Cognitive, Social and Physiological Psychology.
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This is because this section focuses upon how these factors
can increase/reduce the success of treatment programmes
for offenders.

The recidivism rate in the UK is approximately 64%.
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In order to break the ‘revolving door’ phenomenon of repeat
offending effective treatment and rehabilitation programmes
are needed.
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Learning outcomes
 Cognitive
skills programmes (Cann, J. (2006)
‘Cognitive skills programmes: impact on
reducing reconviction on a sample of female
offenders’, Home Office Findings 276);
 Anger
management (Ireland, J. (2000) ‘Do anger
management courses work?’, Forensic Updates 63,
12–16);
 Using
ear acupuncture with a drug rehabilitation
program (Wheatley, M. (2007) ‘Needles help beat
drug addiction’, Prison Service Magazine with
Cambridge University Institute of Criminology).
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Cognitive Skills
Key study: Cann (2006)
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Background:
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Psychologists believe that one way to stop the cycle is to
break down the faulty thinking patterns which they believe
underlie criminal behaviour.
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Before a criminal act can occur, it must be preceded by a
criminal thought.
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Therefore, changing the way offenders think can prevent reoffending.
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This idea is the rationale behind cognitive behavioural
therapy (CBT), in other words if you change the way a person
thinks you will change the way they act.
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CBT is a type of talking treatment that focuses on how your
thoughts, beliefs and attitudes affect your feelings and
behaviour, and teaches you coping skills for dealing with
different problems.
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Background
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Friendship (2002) reported that re-offending rates for
prisoners who received CBT were 14% lower than those who
had not.
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However, a later study by Falshaw & Friendship (2003)
failed to find a significant difference.
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A major issue is that in order for CBT to be effective it must
be well delivered by competent therapists and the prisoners
must have a reasonably high IQ (at least 80), good literacy
skills and be highly motivated.
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Mainly males used in all research and therefore females
needed to be represented.
Cognitive skills programmes were first introduced in
+ England and Wales in 1992, when two programmes
were introduced:
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Reasoning and Rehabilitation (R & R) – the aim was to develop prisoners’
cognitive skills, targeting thinking style; self control or impulsivity;
interpersonal problem-solving; critical reasoning; moral reasoning; social
perspective training.
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The programme was made up of 36 sessions each of 2.5hrs, with
assignments for prisoners to do between the sessions and after the
programme was complete.
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Those on the programme had served sentences of varying lengths, from a
few months to over 4 years, and had to have basic literacy skills and an IQ
of at least 80 to qualify for inclusion on the programme.
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To study the effectiveness of the programme prisoners were classified into
4 different risk of reoffending categories: low risk, moderate low risk,
moderate high risk and high risk.
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They were also categorised in terms of the reason for their sentence:
violent, sexual, theft or “other”.
Cognitive skills programmes were first introduced in
+ England and Wales in 1992, when two programmes
were introduced:
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Enhanced Thinking Skills (ETS) - ETS is a relatively short programme (20
sessions), similar to R&R, which addresses thinking and behaviour
associated with offending.
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This includes impulse control, flexible thinking, social perspective taking,
values/moral reasoning, reasoning, and inter-personal problem solving.
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It was designed for the prison population in England and Wales who are at
medium to high risk of reoffending and is currently the programme most
frequently delivered, with over 40,000 offenders having completed this
course within prison over the past 12 years.
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Cognitive Skills
Key study: Cann (2006)
Aim
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To find out if Cognitive Skills programmes were effective in terms of
lower re-offending rates for a sample of women prisoners.
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Sample
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180 offenders who started Enhanced Thinking Skills (ETS) or
Reasoning and Rehabilitation (R&R) between 1996 and 2000
(including fourteen non-completers).
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A comparison group comprised 540 female offenders who
did not participate in these programmes.
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Procedure
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Expected two-year reconviction rates were calculated for all
the women.
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Actual reconviction rates were calculated for one and two
years after release.
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Results
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No significant difference was found between the treated
group and the comparison group on expected reconviction.
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No significant difference was found between the groups for
actual reconviction after one or two years.
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No significant difference was found for ETS but for R&R the
treated group actually fared worse and were significantly
more likely to re offend.
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Discussion
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Cann suggests the following reasons in the case of females:
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Women offend for different reasons than men and while they
may have cognitive skills deficits, these are not necessarily
criminal in nature.
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Women offend because of drug abuse, relationship problems,
emotional factors and severe financial hardship.
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Discussion (cont.)
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The programmes were inappropriate for the women’s
needs, having been developed for men and with men’s risk
factors in mind.
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The programmes were not delivered consistently in the
women’s prisons and were limited in length.
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Evaluation
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Class to complete
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Anger management
Key research: Ireland (2000)
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Background
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There is instrumental aggression (means to an end,
calculated) and hostile aggression (an uncontrolled reaction,
someone provokes you).
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Hostile aggression common in prisons so prisoners have
training on this.
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CALM is a cognitive behavioural programme used in prisons.
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It is an anger management programme which aims to
develop prisoners emotional control.
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One example is ‘thought-stopping’ in which the prisoner
learns to stop negative aggressive thoughts and direct them
somewhere else.
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Anger management
Key research: Ireland (2000)
Aim
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To assess whether anger management programmes work with a group
of young male offenders.
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Sample
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50 prisoners who had completed an anger management
course and a control group of 37 prisoners who had been
assessed as suitable for such a course but had not actually
completed one.
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Matched pairs design
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their responses to a cognitive behavioural interview;
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the Wing Behavioural Checklist (WBC);
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a self-report questionnaire on anger management (AMA)
completed by the prisoners themselves.
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Method
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A quasi-experiment taking advantage of the two naturally
occurring groups.
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The three measures were given to the prisoners in the
treatment group before and after they completed the
program.
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The control group also got them twice but without any
intervention in between.
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Results
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There was a significant reduction in prison wing-based
aggression in the experimental group but not in the control
group.
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The experimental group scored lower on the self-report
measures after completing the course but there was no
difference in the control group.
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Results (cont.)
Overall
 92%
of the prisoners in the experimental
group showed improvement on at least one
measure;
 48%
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on two measures;
% showed deterioration on both
measures upon completing the course.
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Conclusions
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In the short term these prisoners appeared to be helped by
the programme.
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It is interesting that 8% actually got worse which would
require further investigation.
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Evaluation:
Method – Quasi Experiment
This allows a cause and effect relationship to be inferred
as we can assess the offenders’ aggressive behaviours before
and after the intervention
However, there is a lack of control over other extraneous
variables which may have affected inmates’ anger such as
relationships with other inmates, news from family, etc.
Some ecological validity as carried out in the institutional
setting, however it is unclear whether these results apply
when prisoners are released
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Evaluation:
Method – (cont’d...)
It wasn’t possible to randomly assign participants to each
group, so they couldn’t be matched on variables such as age
or offence type
There are inherent difficulties in using self-reports in a
forensic setting where there may be clear incentives for
individuals to appear successful following treatment e.g., for
parole purposes
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Evaluation:
Sample
The sample comprised all male young offenders (mean age
of 18-19 years) in a young offenders’ institution serving
sentences of less than 3 months on average.
Therefore, the results cannot be generalised to other
settings and groups such as female offenders, released
offenders or those in a prison.
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FOCUS ear acupuncture
Key research: Wheatley (2007)
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Background
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Ear acupuncture is a more modern type of alternative
treatment for prisons (although historically a very old
treatment).
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Its cheap, easily taught and is not effected by prisoners
motivation levels.
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Sometime difficult with drug-addicted offenders and they
would need a talk-based therapy first.
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Among the offender behaviour programmes delivered in HMPS are those
specifically aimed at drug rehabilitation, helping offenders to give up
substance abuse.
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These use a variety of techniques. One such programme, FOCUS, is a
high-intensity drug and alcohol treatment programme operating in five
of our high security prisons.
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The FOCUS programme looks to enhance motivation, change thinking
associated with drug misuse, improve social and emotion management
skills and develop relapse prevention skills using role-play.
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This alternative treatment has been used in prisons for 5 years and is
popular as it is cheap, easily taught (prison officers can be taught in a 4day course and two officers can administer the treatment to 10-15
inmates at a time in a 40 minute session).
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Michael Wheatley, (Senior Manager for the Drug Strategy & Services
Directorate of High Security Prisons in England and Wales), argue that it
is a useful addition to the drug rehabilitation programme and does not
require the prisoner to be highly motivated to participate.
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FOCUS ear acupuncture
Key research: Wheatley (2007)
Aim
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To test the effectiveness of acupuncture in treating drug addicted
prisoners.
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Sample
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350 prisoners in six high security prisons who received
acupuncture and the standard care program which is called
FOCUS with a control group who did not receive acupuncture
but did get the standard care.
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Procedure
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Two trained practitioners worked with groups of 10-15
prisoners in a relaxed setting.
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Fine needles were inserted into five acupuncture points in
the ear and prisoners relaxed for a 40 minute period.
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They then returned to normal duties.
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Qualitative and quantitative data were collected.
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Results
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Qualitative data:
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Prisoners reported better sleep, improved relaxation, better
coping skills, reduced cravings for nicotine, amended cognitions
and health improvements.
They made more effort to communicate with their families and
attend classes.
Staff commented that they could tell when prisoners had been to
acupuncture because the wing was calmer and there was less
demand for healthcare services.
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Results (cont.)
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Quantitative data:
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70% reduction in drug related incidents from six months pre
treatment to six months post treatment.
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41% reduction in serious incident reports.
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42% reduction in positive drug testing results (mandatory).
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33% reduction in positive drug test results (voluntary).
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Conclusion
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Wheatley believes that acupuncture works as a
complementary therapy with other programmes.
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There is enough evidence to expand the delivery of the
programme throughout the prison system.
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Evaluation:
Method – Experiment (Independent Measures)
This allows a cause and effect relationship to be inferred
as we can assess the offenders’ drug-taking behaviours
before and after the acupuncture treatment
Independent measures design means that participant
variables could potentially confound the results – e.g.
motivation levels, etc.
Using a control group means not only can we see the
effects of treatment in the experimental group, but we can
also compare the results to those not receiving treatment
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Evaluation:
Sample
Large sample used and participants were randomly
assigned to the treatment or control groups. This allows for
greater generalisability of findings.
Qualitative/Quantitative Data
Qualitative data allows prisoners to report how the
treatment makes them feel, however as this is self-report
data there is the potential for offenders to be dishonest.
Quantitative data gives a more objective description of
the treatments’ success and cannot be manipulated by
offenders.
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Evaluation:
Reductionism/Holism
This study takes a reductionist approach as it is only
studying the effect that ear acupuncture has on treating drug
addiction
However, it is stated that ear acupuncture is only a small
part of a more holistic approach to treating drug addiction
Therefore, how useful is it to isolate only one part of this
treatment and using it as an independent variable?
Whilst the scientific method is usually preferred, it is worth
considering whether developing other methods of
assessing holistic alternative treatments is preferable