Presentation on theme: "MANAGING PERSONALITY DISORDERED SEXUAL OFFENDERS IN THE COMMUNITY A model for providing clinical input to support criminal justice agencies Dr Rajan Darjee."— Presentation transcript:
1 MANAGING PERSONALITY DISORDERED SEXUAL OFFENDERS IN THE COMMUNITY A model for providing clinical input to support criminal justice agenciesDr Rajan DarjeeConsultant Forensic PsychiatristDr Katharine RussellConsultant Forensic Clinical PsychologistThe Orchard Clinic,Royal Edinburgh Hospital
2 Referral CriteriaSo how do agencies know who to refer? What are our criteria?There are no explicit criteria and we have no referral form that needs to be filled out. We ask staff to phone or and engage in a brief discussion about the main issues. We then tell them whether we think we can help. We have used broad descriptions such as WEIRD, UNUSUAL, COMPLEX, CONCERNING. Although we know that we mainly deal in PD we don’t ask for a diagnosis of PD in order that we see the offender – that is one of the things we hope to help people identify and understand. We focus on the problematic behaviour or the problems staff are having.Lack of explicit criteriaFocusing on evidence of problematic behaviourWEIRD, UNUSUAL, COMPLEX, CONCERNINGNot concerned about previous diagnosis or lack of such, or previous convictionsWe have had referrals for people with HI and Psychosis – we don’t need someone to have a PD diagnosis to be referred – if that was the case we would have no referrals – the point is we are helping people to identify and work with this
3 Clinical input Full clinical assessment AttendMAPPAmeetingsAvailable for telephone consultation and adviceRegular meetings with police sex offender management units and criminal justice social work sex offender serviceDetailed case discussion meetings with case managerFull clinical assessment
4 Issues we have been asked to address What is the risk of serious harm?Who does he pose a risk to?Is it safe for him to have contact with children?Is it safe for him to work with women?Can he do offence focussed work?Does he need treatment from mental health services?What are the signs that he is moving towards offending?Are these restrictions necessary?What response has he made to treatment?Does he need further treatment?What was his motivation for offending?What should be the focus of supervision sessions?Should a disclosure be made to employers?Is this behaviour concerning?How should staff interact with him?Will this treatment make him more risky?
5 Case discussions Documents provided in advance or at meeting Attended by anyone involved with caseDiscuss case in detailUse structured professional judgment frameworkProvide formulation, scenarios and management adviceConsider suitability for full assessment
6 Assessment Initial referral and case discussion Information gathering InterviewsRatings of psychopathy and personality disorderRisk assessment instrumentsFormulation including risk scenariosManagement recommendationsFeedback to referrer
7 Communication with referrer Written reportMake sure report layout is structuredUse understandable languageExplain clinical terms (e.g. psychopathy, personality disorder, paraphilia)Don’t have long sections explaining methodology etc. (use appendix if necessary)Verbal feedback & discussionDiscuss report and implications with referrerAttend case conferences, e.g. Risk Management Case Conferences (RMCCs), Multi-Agency Public Protection Arrangement (MAPPA) meetingsAvailable for follow-up queries or advice at any point in the future
8 Outcome of assessment Risk management Managing relationships What should and shouldn't be monitoredTailored restrictionsAppropriate victim safety measuresDisclosureManaging relationshipsUnderstanding interpersonal functioningInteractions with staffTeam dynamicsSex offender treatmentSuitability for programmesPreparatory workMethod of treatment deliveryImpact on others in groupMental health inputReferral for psychological treatmentSupport from forensic mental healthAssessment and treatment for cormorbid mental illness
9 Serious Offender Liaison Service Consultant Psychologist Consultant PsychiatristPsychology AssistantSenior Social WorkerSecretary
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