A multi-site controlled trial of a cognitive skills program for mentally disordered offenders

BMC Psychiatry

Susan Young¹  Gisli Gudjonsson¹  Angharad Rees-Jones¹ 

[1] King's College London, Institute of Psychiatry, London, UK

关键词: Cognitive skills;    Rehabilitation;    Reasoning &;    Treatment outcome;    Mentally disordered offenders;   

Others  :  1124387
DOI  :  10.1186/1471-244X-12-44

 received in 2011-11-24, accepted in 2012-05-07,  发布年份 2012

【 摘 要 】

Background

The effectiveness of offending behaviour programs in forensic mental health settings is not well established. Thus this study aimed to evaluate the Reasoning and Rehabilitation Mental Health program (R&R2 MHP) among a mentally disordered offender (MDO) population.

Methods

A sample of 121 adult males drawn from 10 forensic mental health sites completed questionnaires at baseline and post-treatment to assess violent attitudes, locus of control, social problem-solving and anger. An informant measure of social and psychological functioning, including disruptive behaviour, was completed by unit staff at the same time. At three month follow-up patients completed again the violent attitudes and locus of control questionnaires. The data of 67 patients who participated in the group condition were compared with 54 waiting-list controls who received treatment as usual.

Results

78% of group participants completed the program. In contrast to controls, significant treatment effects were found at outcome on self-reported measures of violent attitudes, rational problem-solving and anger cognitions. Improvements were endorsed by informant ratings of social and psychological functioning within the establishments. At follow-up significant treatment effects were found for both violent attitudes and locus of control.

Conclusions

R&R2 MHP was effective in a sample of MDOs and had a comparatively low drop-out rate. Future research should use a randomized controlled design.

【 授权许可】

   
2012 Rees-Jones et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 2.

【 参考文献 】

• [1]Ministry of Justice Statistics Bulletin: Population in custody monthly tables July. England and Wales; 2008. [http://www.justice.gov.uk/docs/population-in-custody-july08.pdf webcite]
• [2]Ministry of Justice: Statistics of mentally disordered offenders. [http://webarchive.nationalarchives.gov.uk/+/http://www.justice.gov.uk/publications/mentally-disordered-offenders.htm webcite]
• [3]Ministry of Justice: Payment by results in the justice system. [http://www.justice.gov.uk/news/features/features-030311a webcite]
• [4]Andrews DA, Bonta J: Rehabilitating criminal justice policy and practice. Psychology, Public Policy, and Law 2010, 16:39-55.
• [5]Hollin CR, Palmer E: Cognitive skills program for offenders. Psychology, Crime & Law 2009, 15:147-164.
• [6]Porporino FJ, Fabiano EA, Robinson D: Focusing on successful reintegration: Cognitive skills training for offenders. Research Report No. R-19. Correctional Service of Canada, Ottawa; 1991. [http://www.csc-scc.gc.ca/text/rsrch/reports/r19/r19e_e.pdf webcite]
• [7]Ross RR, Fabiano EA, Ewles CD: Reasoning and rehabilitation. Int J Offender Ther Comp Criminol 1988, 32:29-35.
• [8]Ross RR, Fabiano EA, Ross RD: Reasoning and rehabilitation. University of Ottawa, Ottawa; 1986.
• [9]Clark DA: Theory manual for enhanced thinking skills. Prepared for the joint prison accreditation panel. Home Office, London; 2000.
• [10]Antonowicz DH: The Reasoning and Rehabilitation Program: Outcome evaluations with offenders. In Social problem solving and offending: Evidence, evaluation and evolution. Edited by McMurran M, McGuire J. John Wiley & Sons, Chichester; 2005:163-182.
• [11]Ross RR, Ross RD: Thinking straight: the reasoning and rehabilitiation program for delinquency prevention and offender rehabilitation. AIR Training and Publications, Ottawa; 1995.
• [12]Andrews DA, Zinger I, Hoge RD, Bonta J, Gendreau P, Cullen FT: Does correctional treatment work? A clinically relevant and psychologically informed meta-analysis. Criminology 1990, 28:369-404.
• [13]Tong LS, Farrington DP: How effective is the “Reasoning and Rehabilitation” program in reducing reoffending? A meta-analysis of evaluations in four countries. Psychology, Crime and Law 2006, 12:3-24.
• [14]Donnelly JP, Scott M: Evaluation of an offending behavior program with a mentally disordered offender population. British Journal of Forensic Practice 1999, 1:25-32.
• [15]Clarke AY, Cullen AE, Walwyn R, Fahy T: A quasi-experimental pilot study of the reasoning and rehabilitation program with mentally disordered offenders. Journal of Forensic Psychiatry and Psychology 2010, 21:490-500.
• [16]Tapp J, Fellowes E, Wallis N, Blud L, Moore E: An evaluation of the Enhanced Thinking Skills (ETS) program with mentally disordered offenders in a high security hospital. Legal and Criminological Psychology 2009, 14:201-212.
• [17]Cullen AE, Soria C, Clarke AY, Dean K, Fahy T: Factors predicting dropout from the reasoning and rehabilitation program with mentally disordered offenders. Criminal Justice and Behavior 2011, 38:217-230.
• [18]Cullen AE, Clarke AY, Kuipers E, Hodgins S, Dean K, Fahy T: A multi-site randomized controlled trial of a cognitive skills program for male mentally disordered offenders: social-cognitive outcomes. Psychol Med 2012, 42:557-569.
• [19]National Offender Management Service Bulletin: Do cognitive skills programs work with offenders?. [http://www.swmprobation.gov.uk/wp-content/uploads/2010/06/What-works-Cognitive-skills.pdf webcite]
• [20]McMurran M, Theodosi E: Is offender treatment non-completion associated with increased reconviction over no treatment? Psychology, Crime and Law 2007, 13:333-343.
• [21]Palmer EJ, McGuire J, Hounsome JC, Hatcher RM, Bilby CAL, Hollin CR: Offending behavior programs in the community: the effects on reconviction of three programs with adult male offenders. Legal and Criminological Psychology 2007, 12:251-264.
• [22]Jones D, Hollin CR: Managing problematic anger: the development of a treatment program for personality disordered patients in high security. International Journal of Forensic Mental Health 2004, 3:197-210.
• [23]Hollin CR, Palmer EJ: Offending behavior programs; Controversies and Resolutions. In Offending Behavior Programs: Development, application and controversies. Edited by Hollin CJ, Palmer EJ. John Wiley & Sons, Chichester; 2007:247-278.
• [24]National Collaborating Centre for Mental Health: Antisocial personality disorder Treatment, management and prevention: Clinical Guideline 77. The British Psychological Society and The Royal College of Psychiatrists. 2009. [http://www.nice.org.uk/nicemedia/pdf/CG77NICEGuideline.pdf webcite]
• [25]Andrews DA, Bonta J, Hoge RD: Classification for effective rehabilitation: rediscovering psychology. Criminal Justice and Behavior 1990, 17:19-52.
• [26]Young SJ, Ross RR: R&R2 for youths and adults with mental health problems: a prosocial competence training program. Cognitive Centre of Canada, Ottawa; 2007. [www.cognitivecentre.ca webcite]
• [27]Young S, Chick K, Gudjonsson G: A preliminary evaluation of reasoning and rehabilitation 2 in mentally disordered offenders (R&R2M) across two secure forensic settings in the United Kingdom. Journal of Forensic Psychiatry & Psychology 2010, 21:336-349.
• [28]Young S, Hopkin G, Perkins D, Farr C, Doidge A, Gudjonsson GH: A controlled trial of a cognitive skills program for personality disordered offenders. J Atten Disord[http://dx.doi.org/10.1177/1087054711430333 webcite]
• [29]Gudjonsson GH, Young S, Yates M: Motivating mentally disordered offenders to change: instruments for measuring patients' perception and motivation. Journal of Forensic Psychiatry & Psychology 2007, 18:74-89.
• [30]Gudjonsson GH, Savona C, Green T, Terry R: The recovery approach to the care of mentally disordered patients. Does it predict treatment engagement and positive social behavior beyond quality of life? Personality and Individual Differences 2011, 51:899-903.
• [31]Walker JS: The Maudsley violence questionnaire: initial validation and reliability. Personality and Individual Differences 2005, 38:187-201.
• [32]Nowicki S, Duke MP: A locus of control scale for non-college as well as college adults. J Pers Assess 1974, 37:136-137.
• [33]Beretvas NS, Suizzo MA, Durham JA, Yarnell LM: A reliability generalization study of scores on Rotter’s and Nowicki-Strickland’s Locus of Control scales. Educ Psychol Meas 2008, 68:97-114.
• [34]Page GL, Scalora MJ: The utility of locus of control for assessing juvenile amenability to treatment. Aggression and Violent Behaviour 2004, 9:523-534.
• [35]D’Zurilla TJ, Nezu AM, Maydeu-Olivares A: A Social Problem-Solving Inventory-Revised (SPSI-R): Technical Manual. Multi-Health Systems, North Tonawanda; 2002.
• [36]Novaco RW: The novaco anger scale and provocation inventory. CA, Western Psychological Services; 2003.
• [37]Mills JF, Kroner DG, Forth AE: Novaco Anger Scale: Reliability and validity within an adult criminal sample. Assessment 1998, 5:237-248.
• [38]Young S, Gudjonsson G, Ball S, Lam J: Attention deficit hyperactivity disorder in personality disordered offenders and the association with disruptive behavioural problems. Journal of Forensic Psychiatry and Psychology 2003, 14:491-505.
• [39]McMurran M, Huband N, Duggan C: A comparison of treatment completers and non-completers of an in-patient treatment program for male personality-disordered offenders. Psychol Psychother Theory Res Pract 2008, 81:193-198.
• [40]Emilsson B, Gudjonsson G, Sigurdsson JF, Einarsson E, Baldursson G, Olafsdottir H, Young S: R&R2 Cognitive Behaviour Therapy in Medication-Treated Adults with ADHD and Persistent Symptoms: A randomized controlled trial. BMC Psychiatry 2011, 11:116.
• [41]Gendreau P, Goggin CE, Law MA: Predicting prison misconducts. Criminal Justice and Behavior 1997, 24:414-431.
• [42]Polaschek DLL, Collie RM, Walkey FH: Criminal attitudes to violence: development and preliminary validation of a scale for male prisoners. Aggress Behav 2004, 30:484-503.
• [43]Slaby RG, Guerra NG: Cognitive mediators of aggression in adolescent offenders: 1. Assessment. Developmental Psychology 1988, 24:580-588.
• [44]Unnever JD, Cullen FT, Agnew R: Why is 'bad' parenting criminogenic? Implications from rival theories. Youth Violence and Juvenile Justice 2006, 4:3-33.
• [45]Nijman HLI, Muris P, Merckelbach HLGJ, Palmstierna T, Wistedt B, Vos AM, van Rixtel A, Allertz W: The staff observation aggression scale-revised (soas-r). Aggress Behav 1999, 25:197-209.
• [46]Palmstierna T, Wistedt B: Staff observation aggression scale-Revised: presentation and evaluation. Acta Psychiatrica Scandinavia 1987, 76:657-663.
• [47]Laithwaite HM, Gumley A, Benn A, Scott E, Downey K, Black K, McEwen S: Self esteem and psychosis: a pilot study investigating the effectiveness of a self-esteem program on the self-esteem and positive symptomatology of mentally disordered offenders. Behav Cogn Psychother 2007, 35:569-577.
• [48]Mak AS: Psychosocial control characteristics of delinquents and nondelinquents. Criminal Justice and Behaviour 1991, 18:297-303.
• [49]Eysenck SB, McGurk BJ: Impulsiveness and venturesomeness in a detention centre population. Psychol Rep 1980, 47:1299-1306.