A Critical Analysis of Clinical Evidence from High Secure Forensic Inpatient Services

Tapp, James; Perkins, Derek; Warren, Fiona; Fife‐Schaw, Chris; Moore, Estelle

doi:10.1080/14999013.2012.760185

Cited by 16 publications

(23 citation statements)

References 72 publications

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“…Investigations into 'what works' in high secure forensic hospitals have predominantly been conducted from a clinical perspective, where evaluation methods and markers of what constitutes success are determined by care providers (Tapp, Warren, Fife-Schaw, Perkins, & Moore, 2011). This is consistent with the wider forensic mental health evidence base (Cohen & Eastman, 2000).…”

Section: Introductionmentioning

confidence: 82%

What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services?

Tapp

Warren

Fife‐Schaw

et al. 2013

The Journal of Forensic Psychiatry & Psychology

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The evidence base for 'what works' for patients detained in high secure hospitals has predominantly been established from a clinical perspective, with the voices of those at the centre of care, the expert by experience, absent. Neglecting this voice renders an important source of information for evidence-based practice inaccessible to outcome evaluators. Twelve high secure patients considered 'ready' to be discharged were interviewed to explore what in their view had helped or hindered their progress to this stage. Thematic analysis steps were applied to interviews and eight themes were generated that represented valued elements of high security: temporary suspension of responsibility, collaboration in care, learning from others, supportive alliances, specific interventions (medical and psy-chotherapeutic), a safe environment and opportunities for work. Narratives demonstrated the complementary and unique contribution of the patient experience in informing 'what works', and are discussed alongside existing theories relevant to promoting clinical change and risk reduction.

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Section: Introductionmentioning

confidence: 82%

What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services?

Tapp

Warren

Fife‐Schaw

et al. 2013

The Journal of Forensic Psychiatry & Psychology

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“…However, no consensus was reached on which of these aspects are essential elements of care in any of the subsequent survey rounds. The same author group undertook a systematic review of high secure care [103] identifying 22 studies (13 European). Evidence for effectiveness was found for high secure care itself, third wave cognitive-behaviourally based interventions, psychoeducation and antipsychotic interventions; however, the evidence base is weak given that mainly small, single, non-RCT studies contributed to the review.…”

Section: Treatment In Forensic-psychiatric In-patient Settingsmentioning

confidence: 99%

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

et al. 2018

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Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders (MDOs) are often cared for in secure psychiatric environments or prisons. In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective. We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings: The forensic psychiatrist as expert witness, risk, treatment settings for mentally disordered offenders, and what works for MDOs. We undertook a rapid review of the literature with search terms related to: forensic psychiatry, review articles, randomised controlled trials and best practice. We searched the Medline, Embase, PsycINFO, and Cochrane library databases from 2000 onwards for adult groups only. We scrutinised publications for additional relevant literature, and searched the websites of relevant professional organisations for policies, statements or guidance of interest. We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified. We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only. Practitioners need to follow general psychiatric guidance as well as that for offenders, adapted for the complex needs of this patient group, paying particular attention to long-term detention and ethical issues.

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“…Numerous commentators have identified the need for supplementary treatment options in forensic mental health (Duncan, Nicol, Ager, & Dalgleish, 2006;Tapp, Perkins, Warren, Fife-Schaw, & Moore, 2013). Although widely used with schizophrenia (Jones, Hacker, Cormac, Meaden, & Irving, 2012), Cognitive Behavioural Therapy (CBT) may not be effective when treating chronically psychotic offenders (Hornsveld & Nijman, 2005).…”

Section: Adjunct Treatmentsmentioning

confidence: 99%

Mindful yoga as an adjunct treatment for forensic inpatients: a preliminary evaluation

Sistig

Friedman

McKenna

et al. 2015

The Journal of Forensic Psychiatry & Psychology

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Although emerging evidence of yoga interventions shows benefits for people with schizophrenia, research is lacking regarding yoga interventions among forensic inpatients. This pilot study investigated the acceptability and effectiveness of an eight-week mindful yoga programme in improving psychological outcomes in 26 forensic inpatients. Outcome measures included the Five Facet Mindfulness Questionnaire, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale and the Clinical Outcomes in Routine Evaluation -Outcome Measure as well as a qualitative component post-intervention and at two-month follow-up. Trends in the predicted direction suggested reductions in clinical symptoms over time, specifically anxiety. Key themes revealed increased body awareness, relaxation and self-directed yoga practices and breathing techniques for anxiety management. Ninety-two percent reported acceptance of the programme. Preliminary findings are encouraging and warrant further research into the application of mindful yoga in the management of distress and risk with forensic inpatients.

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A Critical Analysis of Clinical Evidence from High Secure Forensic Inpatient Services

Cited by 16 publications

References 72 publications

What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services?

What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services?

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

Mindful yoga as an adjunct treatment for forensic inpatients: a preliminary evaluation

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