Respond's Community-based Forensic Services
Most people referred to Respond's community-based forensic services have experienced some form of abuse or neglect and gone on to abuse others. They may also have worrying sexualised behaviours. Service users often come with a multitude of diagnoses, many having a complex mixture of learning disabilities, mental health problems, Autistic Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
This is almost always coupled with a history of victimisation and often with a history of being violent towards themselves and/or others. Many service users have had a number of placement breakdowns, have been sectioned under the mental health act or have a history of repeated hospital admissions. These service users are often considered as being hard to treat due to misunderstandings about their ability to engage in psychotherapeutic treatment.
Respond has developed specialist assessment and treatment services reflecting the needs of these service users as well as the needs of professionals and carers.
Case specific advice and support
Professional development courses and workshops
Forensic Risk Assessment
Respond has been providing Risk Assessments for over 10 years, and the growing recognition that victims and perpetrators are often a complex mixture of both, has led Respond to develop treatment models that can cater for both the abuser and the abused. The provision of forensic risk assessments have, over the years, become an important part of Respond?s services, drawing together its psychotherapeutic and investigative work.
Respond provides forensic psychotherapy which uses the therapeutic relationship to think about and end or significantly reduce offending behaviour. Attention to the transference and counter transference experienced in the consulting room is central to the treatment, employing Respond's own ASA forensic model. It aims to bring about long-term sustainable change by involving the supportive network in the therapeutic process.
Forensic psychotherapy is essentially an attempt to grapple with core issues of aggression, perversion and hostility and their manifestation in behaviours. There is a need to provide such a service for those who may have engaged in behaviours which put others as well as themselves at risk. These range from what one might describe as sexually inappropriate behaviours - for example, masturbating in public - to serious sexual assaults, paedophilia and fetishistic enactments that might put themselves or others at risk.
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Circles of Support and Accountability (COSA)
We have recently secured funding from the Esmée Fairbairn charitable Trust to establish the first Circles of Support and Accountability (COSA) specifically aimed at young people with learning disabilities. COSA are an innovative and successful community contribution to reducing sex offending, working in close partnership with criminal justice agencies to provide a holistic approach to supervising and supporting young people at risk of offending. Respond will be developing this service alongside Circles UK over the coming year and evaluating its effectiveness.
In their examination of the effectiveness of probation for sex offenders with learning disabilities, Lindsay and Smith's (1998) research led them to recommend a two-year probation orders over one-year probation periods, as the shorter term was not long enough for any sex offender programming to take effect. Group-based therapy, as described by Swanson & Garwick (1990) has been discussed for its potential in providing effective treatment.
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We use a variety of outcome measures depending on the referral, the service accessed and the particular situation of the individual. These measures include:
Psychological well-being scales (Beail)
A central aim of psychotherapeutic treatment is to lessen the negative or unhelpful defences against internal conflict by supporting the client to identify and address unconscious dynamics. As Hodges (2003) writes, 'this aim is hopefully achieved by making internal objects, inner worlds and their workings more available or accessible to the client,' leading to a more useful expression of feelings.
Experience so far suggests that interventions of this kind can provide a thoughtful and containing space, for both the client and also for those who work with the client, supporting and supervising him or her in the community. Learning disabled sex offenders may find themselves beyond the reach of the criminal justice system and attendant treatment programmes. They are, therefore highly dependent on care providers to offer interventions which respect their human rights and also recognise the impact of early trauma and of the lived experience of learning disabilities.
These interventions and treatments should also allow for the personal growth, for the development of the offender and for the possibility of change of his or her dangerous behaviour.