Forensic psychotherapy

Last updated

Forensic psychotherapy is the application of psychological knowledge to the treatment of offender-patients who commit violent acts against themselves or others. This form of treatment allows for a therapist to potentially understand the offender and their mental state. It gives the individual providing treatment the opportunity to examine further whether the offender’s criminal behavior was a conscious act or not, what exactly their association with violent behavior is, and what possible motives could have driven them. [1] The discipline of forensic psychotherapy is one that requires the involvement of individuals other than simply the therapist and patient. A therapist may collaborate with other professionals, such as physicians, social workers, nurses and other psychologists in order to best serve the offenders’ needs. [2] Whether the treatment is successful or not relies on a multitude of things, but typically ensuring that a systemic approach is taken and that all involved in the treatment process are well informed and supportive has proven to be the most effective. In addition to group work forensic psychotherapy may also involve therapeutic communities, individual interaction with victims as well as offenders, and family work. In order for this specialized therapy to be as effective as possible, it demands the compliance of not only the patient and therapist, but of the rest of society as well. The main focus of forensic psychotherapy is not to condone the acts of the offender, but to obtain a psychodynamic understanding of the offender in order to attempt to provide them with an effective form of treatment to help them take responsibility for any crimes committed and to prevent the perpetration of crimes by the offender in the future. [2] Guidelines have been set to ensure proficiency in the field of Forensic Psychology.

Contents

Controversy Regarding Treatment

It has been difficult to illustrate a clear link between psychological interventions and the successful reduction of offenses. Nothing has brought about the complete eradication of crime in patients being treated using this practice. At times this difficulty has contributed to a profound pessimism about the effectiveness of any form of treatment. [3] This began in the United States of America, but pessimism regarding the effectiveness of treatment soon spread to the United Kingdom. [4] This was said to have adversely affected the provision of rehabilitative treatments. The development of cognitive behavioral therapy made it possible to demonstrate an effect upon some attitudes and offending behaviors. These behaviors being measured in controlled research studies led to the introduction of structured treatment programs in prisons across Canada, the United States, the United Kingdom and more recently, mainland Europe. For a period of time, there have been positive benefits in the provision of resources, particularly in prison settings. [5] However, there has been serious conflict as professionals continue to compete for limited resources and one model claimed superiority over another.

It has remained difficult to establish with great certainty which methods, if any, are effective over a significant period of time. However, psychodynamic forensic psychotherapy has been shown to have some successful impact, [5] as have Therapeutic Communities. [6]

Role of Forensic Psychologists

Forensic psychology conceptualizes both the criminal and civil sides of the justice system, while simultaneously encompassing the clinical and experimental aspects of psychology. Forensic psychologists can receive training as either clinical psychologists or experimental psychologists, and will generally have one primary role in terms of employment. A large portion of forensic psychologists are treatment providers, who evaluate and provide some sort of psychological treatment or intervention. [7] However, many individuals in this field engage in other roles that are more related to their specific interests and/or training. These secondary roles are often involved with the criminal justice system- for example, forensic psychologists often will step in as an expert witness, being called upon to testify in court about a topic in which they have a specialized knowledge. [8] Forensic Psychologists often assume the role of evaluators, typically being asked to evaluate a criminal defendant’s mental state. This is done in order to determine factors such as whether or not the defendant is competent to stand trial, if the defendant would be a future risk factor, and what the defendant’s mental state was like at the time in which they committed the alleged offense. Much of the time, once an assessment has been made by the forensic psychologist, they are then asked to testify in court as an expert witness about their findings. Areas of concern include potential risk and confidentiality. [9]

Settings

There are many different settings in which a forensic psychologist may work. An individual that has specialized knowledge in regards to mental health, as well as the legal system, proves to be a vital asset for the courts and the criminal justice system. Many forensic psychologists spend a significant portion of time working in legal settings, but there are a lot of other locations in which a forensic psychologist can receive training to work at. [10] Police departments, research centers, hospitals, medical examiners offices and universities are also settings in which forensic psychologists are often employed. Community settings are settings in which patients are managed by community forensic teams.

Forensic Psychotherapy

The aim of forensic psychotherapy is not only to understand the crime an individual has committed, but to understand the person as a whole within his/her environment. Forensic psychotherapy may involve group work, individual work, work with victims, and work with families, as well as within therapeutic communities.

Working from the premise that the offender has a complex internal world which may be characterized by punitive and unreliable internal representations of paternal and other figures, psychotherapy can shed light on the unconscious impulses, conflicts, and primitive defense mechanisms, involved in his or her destructive actions and "acting out". It helps to understand the triggers to the violent acts and timing of the acts. Forensic psychotherapy aims to help the offender understand why they committed the act and take responsibility for it, aiming to prevent future crimes committed. [2]

The intimacy and profound experience of therapy may enable an offender to reframe and restructure these harsh images which tend to blunt sensitivities and, when projected out onto others, act as a rationale or driving force for criminal acting out. The patient may develop self-awareness, and an awareness of the nature of their deeds, and ultimately be able to live a more adjusted life. The effectiveness of psychodynamic psychotherapy, as is the case with other psychological therapies, is limited far as behavioral change for antisocial personality or psychopathic offenders. These two types of offenders comprise the primary diagnostic group found in forensic psychotherapy work. [2] The evidence which is emerging, suggests that a range and variety of treatments may be most helpful for such offenders.

Treatment of high risk offenders poses particular problems of perverse transference and counter transference which can undermine and confound effective treatment so it would be usual to expect such treatment to be conducted by experienced practitioners who are well supported and supervised.

Controversy Regarding The Application of Forensic Psychotherapy

There have also been some controversies regarding the application of forensic psychotherapy within courts and its use during or after trials. Among clinicians there are prejudices that judges see the analysis of unconscious motivations as simply adminshing the guilt of the offender and as a means of working around legal systems. [2] Because of the scenarios in which forensic psychotherapy is utilized often times the patient-offender will face punishment for their crimes just as they are prepared to undergo proper treatment. The success of forensic psychotherapy could likely result in this, leading to many patients not receiving full treatment. [2]

Another controversy that affects the development of forensic psychotherapy is the publics perception of an offender, especially those involved in serious crimes like pedophilia. It's common for trial outcomes to be viewed as black and white, the victim is good and the perpetrator is bad. Because of this preconception any treatment for the perpetrator is generally looked down upon. It is not an uncommon occurrence that people who were once victims may later on become perpetrators. [2] Another important fact to consider is that in the vast majority of child abuse cases the primary offender is either the victims family or close friends of the family. [11] When forensic psychotherapists attempt to determine what causes in an offenders past could have led to their motivations for perpetrating a crime they could be met with public scrutiny for appearing to sympathize with the offender.

Guidelines for Forensic Psychotherapy

In 1931, a group of individuals who established the Association for the Scientific Treatment of Delinquency and Crime developed Forensic Therapy at the Portman Clinic in London. Determined to influence and enhance the understanding of this method of treatment, the International Association for Forensic Psychotherapy (IAFP) was formed in June 1991 and is still active today. [2] The main function of this association is to advance the understanding people have of forensic psychotherapy, including the forms of treatment and risk factors associated with this practice. This helps to promote the health of not only offenders, but of victims as well. [12] The American Academy for Forensic Psychology and the American Psychology-Law Society published the Speciality Guidelines for Forensic Psychologists in 1991. It provides direction to forensic psychologists in identifying competent practice, practicing responsibly, establishing relationships with parties involved and identifying issues. APA also created guidelines in the 1990s for new forensic psychologists. In 1994 the Guidelines for Child Custody Evaluations in Divorce Proceedings was adopted by the APA Council of Representatives to promote proficiency. [13] In 1998 the Guidelines for Psychological Evaluations in Child Protection Matters was adopted by the APA Council of Representatives as well.

Certification is done statewide and nationwide to ensure competence. More classes are being offered in Forensic Psychology and more opportunities are available at the graduate and post graduate level.

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Type of therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.

Applied psychology is the use of psychological methods and findings of scientific psychology to solve practical problems of human and animal behavior and experience. Educational and organizational psychology, business management, law, health, product design, ergonomics, behavioural psychology, psychology of motivation, psychoanalysis, neuropsychology, psychiatry and mental health are just a few of the areas that have been influenced by the application of psychological principles and scientific findings. Some of the areas of applied psychology include counseling psychology, industrial and organizational psychology, engineering psychology, occupational health psychology, legal psychology, school psychology, sports psychology, community psychology, neuropsychology, medical psychology and clinical psychology, evolutionary psychology, human factors, forensic psychology and traffic psychology. In addition, a number of specialized areas in the general area of psychology have applied branches. However, the lines between sub-branch specializations and major applied psychology categories are often mixed or in some cases blurred. For example, a human factors psychologist might use a cognitive psychology theory. This could be described as human factor psychology or as applied cognitive psychology. When applied psychology is used in the treatment of behavioral disorders there are many experimental approaches to try and treat an individual. This type of psychology can be found in many of the subbranches in other fields of psychology.

Forensic psychology is the practice of psychology applied to the law. Forensic psychology is the application of scientific knowledge and methods to help answer legal questions arising in criminal, civil, contractual, or other judicial proceedings. Forensic psychology includes research on various psychology-law topics, such as jury selection, reducing systemic racism in criminal law, eyewitness testimony, evaluating competency to stand trial, or assessing military veterans for service-connected disability compensation. The American Psychological Association's Specialty Guidelines for Forensic Psychologists reference several psychology subdisciplines, such as social, clinical, experimental, counseling, and neuropsychology.

Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

Criminal psychology, also referred to as criminological psychology, is the study of the views, thoughts, intentions, actions and reactions of criminals and suspects. It is a subfield of criminology and applied psychology.

<span class="mw-page-title-main">Forensic psychiatry</span> Subspeciality of psychiatry, related to criminology

Forensic psychiatry is a subspeciality of psychiatry and is related to criminology. It encompasses the interface between law and psychiatry. According to the American Academy of Psychiatry and the Law, it is defined as "a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.

Psychodynamic psychotherapy and psychoanalytic psychotherapy are two categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies. Psychodynamic psychotherapy is evidence-based; the effectiveness of psychoanalysis and its relationship to facts is disputed.

<span class="mw-page-title-main">Offender profiling</span> Law enforcement investigative technique

Offender profiling, also known as criminal profiling, is an investigative strategy used by law enforcement agencies to identify likely suspects and has been used by investigators to link cases that may have been committed by the same perpetrator. The ancestor of modern profiling, R. Ressler of the FBI, considered profiling as a process of identifying all the psychological characteristics of an individual, forming a general description of the personality, based on the analysis of the crimes committed by him or her.

Psychological resistance, also known as psychological resistance to change, is the phenomenon often encountered in clinical practice in which patients either directly or indirectly exhibit paradoxical opposing behaviors in presumably a clinically initiated push and pull of a change process. In other words, the concept of psychological resistance is that patients are likely to resist physician suggestions to change behavior or accept certain treatments regardless of whether that change will improve their condition. It impedes the development of authentic, reciprocally nurturing experiences in a clinical setting. Psychological resistance can manifest in various ways, such as denying the existence or severity of a problem, rationalizing or minimizing one's responsibility for it, rejecting or distrusting the therapist's or consultant's suggestions, withholding or distorting information, or sabotaging the treatment process. It is established that the common source of resistances and defenses is shame. This and similar negative attitudes may be the result of social stigmatization of a particular condition, such as psychological resistance towards insulin treatment of diabetes.

<span class="mw-page-title-main">History of psychotherapy</span>

Although modern, scientific psychology is often dated from the 1879 opening of the first psychological clinic by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. Early examples of such psychological thinkers included Patañjali, Padmasambhava, Rhazes, Avicenna and Rumi.

Services for mental health disorders provide treatment, support, or advocacy to people who have psychiatric illnesses. These may include medical, behavioral, social, and legal services.

A clinical formulation, also known as case formulation and problem formulation, is a theoretically-based explanation or conceptualisation of the information obtained from a clinical assessment. It offers a hypothesis about the cause and nature of the presenting problems and is considered an adjunct or alternative approach to the more categorical approach of psychiatric diagnosis. In clinical practice, formulations are used to communicate a hypothesis and provide framework for developing the most suitable treatment approach. It is most commonly used by clinical psychologists and is deemed to be a core component of that profession. Mental health nurses, social workers, and some psychiatrists may also use formulations.

Psychology encompasses a vast domain, and includes many different approaches to the study of mental processes and behavior. Below are the major areas of inquiry that taken together constitute psychology. A comprehensive list of the sub-fields and areas within psychology can be found at the list of psychology topics and list of psychology disciplines.

Paradox psychology is a counter-intuitive approach that is primarily geared toward addressing treatment resistance. The method of paradoxical interventions (pdxi) is more focused, rapid, and effective than Motivational Interviewing. In addressing resistance, the method seeks to influence the clients' underlying attitude and perception by providing laser beam attention on strengthening the attachment-alliance. This is counter-intuitive to traditional methods since change is usually directed toward various aspects of behavior, emotions, and thinking. As it turns out, the better therapy is able to strengthen the alliance, the more these aspects of behavior will change.

<span class="mw-page-title-main">David P. Bernstein</span>

David Philip Bernstein was professor of forensic psychotherapy at Maastricht University in the Netherlands, an endowed chair jointly sponsored by Forensic Psychiatric Center "de Rooyse Wissel". His work is also supported by the Expertise Center for Forensic Psychiatry (EFP). At Maastricht University, Bernstein leads the forensic psychology section, which is embedded within the department of clinical psychological science. Bernstein has served as President of the Association for Research on Personality Disorders, Vice President of the International Society for the Study of Personality Disorders and Vice President of the International Society for Schema Therapy.

Victor Campbell Meyer, or Vic Meyer, was a British psychologist at the Middlesex Hospital Medical School of the University of London and has been called the father of behavioral case formulation, an approach toward understanding complex psychiatric problems using learning principles derived from scientific psychological research and uniquely adapted to the individual case by means of the experimental method as a way to develop an effective intervention regimen. Meyer is credited by the British Psychological Society for his influential work in creating case formulation along with three other innovators: Hans Eysenck, Monte B. Shapiro, and Ira Turkat. Turkat credited Meyer as the pioneer of the framework of what is generally known today as case formulation, a required core skill for all British practicing psychologists since 2011.

<span class="mw-page-title-main">Karen Franklin</span> American forensic psychologist

Karen Franklin is an American forensic psychologist. For her doctoral dissertation, she conducted research on anti-gay violence. She has also published commentaries about sex crimes, primarily expressing her opposition to the use of the hebephilia and other diagnoses in sexually violent predator regulations. She received the 2012 Distinguished Scientific Achievement Award in Psychology and the Monette-Horwitz Trust Award in 2001.

Eclectic psychotherapy is a form of psychotherapy in which the clinician uses more than one theoretical approach, or multiple sets of techniques, to help with clients' needs. The use of different therapeutic approaches will be based on the effectiveness in resolving the patient's problems, rather than the theory behind each therapy.

Sexual trauma therapy is medical and psychological interventions provided to survivors of sexual violence aiming to treat their physical injuries and cope with mental trauma caused by the event. Examples of sexual violence include any acts of unwanted sexual actions like sexual harassment, groping, rape, and circulation of sexual content without consent.

References

  1. "What is Forensic Psychotherapy?". PWR Health Consultants, Inc. Retrieved 2018-04-10.
  2. 1 2 3 4 5 6 7 8 Welldon, Estella (2015). "Definition of forensic psychotherapy and its aims". International Journal of Applied Psychoanalytic Studies. 12 (2): 96–105. doi:10.1002/aps.1442.
  3. Martinson R. 1974, What Works?- Questions and Answers About Prison Reform. The Public Interest. 35. p 22-54
  4. Maguire J.What Works: Reducing Offending. Wiley. Chichester. 1999
  5. 1 2 Leichsenring F, Leibing E. The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. Am J Psychiatry 2003;160: 1223-32 https://doi.org/10.1176/appi.ajp.160.7.1223
  6. Taylor R. A seven year reconviction study of HMP Grendon. Home Office Research Unit, London 2000.
  7. "What are the Roles and Responsibilities of a Forensic Psychologist? | ClinicalForensicPsychology.org". www.clinicalforensicpsychology.org. Archived from the original on 2015-04-02. Retrieved 2018-04-10.
  8. Roesch, R., Zapf, P. A., & Hart, S. D. (2010). Forensic Psychology and law. Hoboken, NJ: Wiley.
  9. McGauley, Gill; Humphrey, Martin (2003). "Contribution of forensic psychotherapy to the care of forensic patients". Advances in Psychiatric Treatment. 9 (2): 117–124. doi: 10.1192/apt.9.2.117 .
  10. "Forensic Psychology Careers, Jobs and Degree Information - Criminal Justice USA". Criminal Justice USA. Retrieved 2018-04-10.
  11. Sanchez-Rodriguez, Mary I., "Gender Differences in Child Maltreatment: Child Sexual and Physical Abuse" (2021). Honors Projects. 828. https://scholarworks.gvsu.edu/honorsprojects/828
  12. "International Association for Forensic Psychotherapy". International Association for Forensic Psychotherapy.
  13. Otto, Randy; Heilbrun, Kirk (2002). "The Practice of Forensic Psychology". American Psychologist. 57 (1): 5–18. doi:10.1037/0003-066x.57.1.5. PMID   11885302. ProQuest   614377501.

Further reading

Welldon, Estela (1993). "Forensic Psychotherapy and Group Analysis". Group Analysis. 26 (4): 487–502. doi:10.1177/0533316493264009. S2CID   144418101.