Rehabilitation frameworks in forensic mental health
Research highlights
► Review of rehabilitation models evident in forensic mental health settings. ► Outline of core features of a rehabilitation model. ► Argument for use of strength based models to reduce risk and enhance offenders' well-being. ► Outline of the Good lives Model as an example of a strength based rehabilitation model suitable for use in forensic mental health settings.
Section snippets
Introduction, rationale, and methodology
Forensic mental health services represent the interface between the criminal justice and mental health services providing assessment and treatment for individuals with both mental illness and offending histories. While there are jurisdictional differences, forensic mental health populations typically comprise a heterogeneous group that include insanity acquittees, people found guilty but mentally ill, people found unfit to stand trial, and inmates seen in prison or transferred to mental health
Rehabilitation theory: features of a good forensic rehabilitation model
In order to critically evaluate each of the broad rehabilitation approaches used in forensic mental health it is first necessary to elucidate the theoretical basis of each model. We therefore start by specifying what is meant by the term rehabilitation theory and identify its essential features. We then go on to consider how this knowledge might inform a critical analysis of models of forensic rehabilitation. In doing so we identify key questions or issues that a sound rehabilitation theory
The risk need responsivity (RNR) model
In this section we review risk centered approaches to forensic mental health care. First, we outline the original Risk-Need-Responsivity (RNR) model of offender rehabilitation. We then review applications of the RNR model to a forensic population. Finally, we explore how RNR-derived approaches used in a forensic context conform to the essential features of a good rehabilitation theory outlined earlier.
Various models have been developed to guide clinicians in the process of managing risk of
Therapeutic models targeting individual psychopathologies
In this section we review literature that discusses application of therapeutic approaches to forensic clients where the focus is on the treatment of various psychopathologies and other clinical needs. First, we will explore the treatment literature for forensic clients including interventions for both major mental illness and personality disorder. We then go on to evaluate the reviewed literature with reference to the tenets of good rehabilitation theory
Despite frequent occurrence of psychotic
Strength based approaches to forensic mental health care
In this section we review the extremely limited literature on approaches to forensic rehabilitation that take a strength based, holistic perspective. These models go beyond the risk/treating illness dichotomy to a more systematic consideration of an individual's needs and strengths.
General discussion
Our review of the literature has highlighted four major points for discussion: First, there is a surprisingly small amount of literature pertaining to treatment and rehabilitation approaches to forensic mental health clients. We summarize areas of broad agreement in the extant literature and speculate on some of the reasons for the limited attention to treatment issues. Second, we discuss some of the problems associated with blending RNR and psychopathology paradigms with mentally disordered
Conclusion
The GLM-FM is a strength-based, client-centered, and recovery oriented approach that combines a humanistic approach to rehabilitation with the imperative of protecting society. In our view, effective and ethical interventions with mentally disordered offenders ought to explicitly address what is most important to offenders as well as aiming to reduce their potential for harming others. By virtue of its strength based orientation, the GLM-FM is ideally positioned to provide such therapeutic
Acknowledgment
We are grateful to Ceri Evans for his helpful comments on an earlier version of this paper.
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The Good Lives Model among detained female adolescents
2017, Aggression and Violent BehaviorCitation Excerpt :For example, property offending could be either the result of peer pressure or the result of alcohol/drug use and related financial problems, both requiring a different set of interventions. Clearly, understanding the specific causal mechanisms behind detained female adolescents' offending behavior is necessary to identify change mechanisms and provide effective, tailored treatment (Robertson et al., 2011). Complementing the RNR model's problematic etiological assumptions (because of its reliance on the construct of dynamic risk factors; Ward & Fortune, 2016), the GLM's etiological assumptions may help researchers and practitioners to understand why detained female adolescents were involved in offending and may be at risk for future offending.
Dilemmas in applying strengths-based approaches in working with offenders with mental illness: A critical multidisciplinary review
2017, Aggression and Violent BehaviorCitation Excerpt :Internal and external capacities/obstacles, respectively, enhance/impede the fulfillment of one's primary goods (Purvis, Ward, & Willis, 2011). By addressing both individual/personal and environmental/structural capacities and obstacles, the GLM stresses the importance of considering individuals as social beings, who are mutually interdependent and who pursue the construction of their own good lives within a social context (Robertson et al., 2011). The GLM has been applied to a broad range of offender populations, yet only scantly to offenders with mental illness.
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