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"Let's Do More Than Talk About Sex: Promoting Good Lives In Practice" Dr F Douds, Consultant LD Psychiatrist, The State Hospital Dr M Doyle, Forensic Psychologist,

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Presentation on theme: ""Let's Do More Than Talk About Sex: Promoting Good Lives In Practice" Dr F Douds, Consultant LD Psychiatrist, The State Hospital Dr M Doyle, Forensic Psychologist,"— Presentation transcript:

1 "Let's Do More Than Talk About Sex: Promoting Good Lives In Practice" Dr F Douds, Consultant LD Psychiatrist, The State Hospital Dr M Doyle, Forensic Psychologist, NHS Fife

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3 Process for use when considering facilitating a sexual relationship between community clients with forensic needs and other adults NB: Disclosure of previous sexual offending. At which point of pathway, if any, will this take place

4 What makes your life a ‘Good Life’? Choose three things in you life that are important to you. (count partners as one thing & children as a different one )Choose three things in you life that are important to you. (count partners as one thing & children as a different one ) Nothing too sensitive!Nothing too sensitive! Write each one on a separate post-it.Write each one on a separate post-it. What do they contribute to your life? Why are they important?What do they contribute to your life? Why are they important? Which would you give up first? Second? Third?Which would you give up first? Second? Third?

5 $$ SURVEY OF US LOTTERY WINNERS $$ WHAT DO YOU VALUE MOST? NUMBER ONE ANSWER? CAN MONEY BUY IT?

6 Good Lives ‘All meaningful human action reflects attempts to achieve primary human goods’ Ward & Mann (2005) Autonomy Relationships & Community Inner Peace Achievement Purpose

7 The Good Lives Model (GLM)  Key Argument  Human behaviour is directed towards goal of achieving fundamental needs or ‘primary human goods’.  Difficulties in achieving primary goods in socially appropriate ways will possibly lead to anti-social or offending behaviour.  Strengthening the ability of offenders to achieve primary human goods in socially appropriate ways will reduce their offending behaviour

8 Achieving Primary Goods through Secondary Goods Relatednes s Friends Intimate Partners Staff Family Social skills Money, work Secure Consist -ency

9 The Good Lives Model (GLM) Central role of construct of personal identity and self-narrative.Central role of construct of personal identity and self-narrative. ‘…not enough to simply equip individuals with skills to control or manage risk factors, it is imperative they are also given the opportunity to fashion a more adaptive personal identity..’ Ward & Gannon (2006) Not ‘New me’ but perhaps ‘Better me’.

10 The Good Lives Model (GLM) ‘Twin focus’‘Twin focus’ ‘managing the delicate balance between the …. promoting offender goods and..reducing risk. Erring on the side of either goal can have disastrous social and personal consequences…’ Ward, Mann & Gannon, (2007) Human action is context-dependent. Ability of an individual to implement coping strategies is dependent on the social and physical environments they inhabit.Human action is context-dependent. Ability of an individual to implement coping strategies is dependent on the social and physical environments they inhabit.

11 Treatment plan needs to address all of human goods needed for psychological well-being and should be explicitly constructed in form of a ‘good lives formulation’. Goal of treatment is to recognise individual agency and build capacity and opportunity to meet primary goods in socially appropriate ways.Treatment plan needs to address all of human goods needed for psychological well-being and should be explicitly constructed in form of a ‘good lives formulation’. Goal of treatment is to recognise individual agency and build capacity and opportunity to meet primary goods in socially appropriate ways. Requires a strong ‘therapeutic alliance’ non-confrontational, motivational and collaborative approach.Requires a strong ‘therapeutic alliance’ non-confrontational, motivational and collaborative approach. Implies creating ‘bespoke’ person- centred holistic interventions to address individual need.Implies creating ‘bespoke’ person- centred holistic interventions to address individual need. The Good Lives Model (GLM)

12 SAPROF (Structured Assessment of Protective Factors) Internal factors 1. Intelligence ❑ 2. Secure attachment in childhood 3. Empathy ❑ ❑ 4. Coping ❑ ❑ 5. Self-control ❑ ❑ Motivational factors 6. Work ❑ ❑ 7. Leisure activities ❑ ❑ 8. Financial management ❑ ❑ 9. Motivation for treatment ❑ ❑ 10. Attitudes towards authority 11. Life goals ❑ ❑ 12. Medication ❑ n/a ❑ ❑ External factors 13. Social network ❑ ❑ 14. Intimate relationship ❑ ❑ 15. Professional care ❑ ❑ 16. Living circumstances ❑ ❑ 17. External control ❑ ❑

13 Good Lives Assessment & Formulation ‘Jim’ 29 years old; ‘mild’ learning disability History of serious offences from ages 9 years to 16 years against female children. Convicted age 17. (1998) Lynebank Hospital (via HMP Edinburgh) 1998 – 2003 Community-based CTO /7 ‘Core & Cluster’ Support Package 2008 – 2009 Community Outreach Support

14 Good Lives Assessment & Formulation ‘Jim’ ‘Hopeless’ – ‘never get out’ Clear set of future goals obscured by ‘anger balloon’ Marriage Family Work Motorbik e Hom e

15 Jim’s Good Lives Assessment & Formulation  Knowle dge Sexual Knowle dge Proble m- Solvin g Insigh t Empat hy

16 Jim’s Good Lives Assessment & Formulation  Autonom y Relationship s with female peers Motorbi ke Tenanc y Stepped reduction in support

17 Sex Offences Group  Jim’s Intervention History 1:1 Emotiona l Regulatio n  Social ProblemSol ving  Work Placemen ts Engaged to Girlfriend Motorbik e

18 The Good Lives Model (GLM) ‘Jim’ and SRAG/MAPPA Jim and Anne. Jim and Claire Motorbike Stepped reduction in support

19 Process for use when considering facilitating a sexual relationship between community clients with forensic needs and other adults NB: Disclosure of previous sexual offending. At which point of pathway, if any, will this take place

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