McDonnaugh, Tanya;
(2018)
Service Users’ Experiences of Discharge from a Medium Secure Forensic Unit.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Aims: This systematic review used a narrative synthesis approach to explore the extent to which current interventions for the inpatient Mentally Disordered Offender (MDO) population adhere to principles of the Recovery Model (Empowerment, Lifesatisfaction and Positive Identity), as adapted from the conceptualisation by Resnick et al., 2005). Method: A systematic search was carried out across four databases: PsycINFO, Embase, CINAHL and Web of Science, along with hand-searching of relevant journals and articles, and Cochrane and NICE guidance. After screening against the inclusion criteria, qualifying studies were quality assessed using the Effective Public Health Practice Project ‘Quality Assessment Tool for Quantitative Studies’ (EPHPP) (2004), and a total of ten studies were included in the review. The heterogeneity of the studies ruled out meta-analysis, therefore a narrative synthesis approach was adopted. Results: Studies were assessed based on the content and aims of the intervention described. Only one study explicitly named a recovery-focused intervention (Laithwaite et al., 2009). Several programmes adhered to some recovery principles but 13 did not label their interventions as recovery-focused. Cognitive Skills Programmes (CSP) were most frequently reviewed in the literature, however these were the least aligned with recovery principles, tending to judge the effectiveness of the intervention by a reduction in criminal traits (e.g. violent attitudes), rather than by wider recovery principles. Conclusions: There is a startling lack of evidence for recovery-focused interventions with the inpatient MDO population. This lack of evidence may be due to the challenges of combining recovery principles with risk management in the highly restrictive and highly regimented secure environment. This may also arise from sensitivity about public criticisms of rehabilitation insufficiently meeting expectations of punishment for offenders. The skills focus of interventions, in the absence of wider contextual principles of the Recovery Model, raises questions about the generalisability of these interventions to the community. The findings also highlight a disparity between what current interventions report to deliver and what they actually deliver. Crucially, these findings suggest that the principles of ‘equity of access’ are not being applied.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Service Users’ Experiences of Discharge from a Medium Secure Forensic Unit |
| Event: | UCL |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| UCL classification: | UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10056987 |
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