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FORENSIC CLINICAL PSYCHOLOGY

Published byGerald Richards Modified over 9 years ago

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Presentation on theme: "FORENSIC CLINICAL PSYCHOLOGY"— Presentation transcript:

1 FORENSIC CLINICAL PSYCHOLOGY
Dr Nicola Gillespie Highly Specialist Clinical Psychologist Belfast Trust

2 Overview The roles of Clinical Psychologists in Forensic settings
My (former) role in particular Where Who – the clients, the MDT The role Best Parts Questions

3 Forensic Clinical Psychology
BPS (2006a) core competencies for clinical psychologists: Commitment to reducing psychological distress and enhancing and promoting psychological well-being through the systematic application of knowledge derived from psychological theory and evidence. Forensic psychology covers legal and criminological psychology. This is concerned with the understanding, assessment and treatment of criminal behaviour.

4 Forensic Clinical Psychology
Seeks to combine both Alleviation of distress Enhancement of skills Reduce future offending risk Protect the public

5 Roles Reports to court Expert Witness (court, media)
Consultation (police, court, PBNI) Profiling (not so much if at all in NI) Prison service Training Offending behaviour work Mental health problems CFMHTs ‘Forensic’/ high-risk work in other settings (mental health inpatient, community) Evidence base – books/ articles/ research Secure hospitals Low, medium, high

6 My Role Specialist Clinical Psychologist Regional Medium Secure Unit
1st step – understand the system.. Procedural and Relational security Ascertain psychological needs of patients/ system Try to meet the needs!

7 Where – the Service Regional Medium Secure Unit Belfast
34-beds, 3 wards Referrals from Prison, PICUs, LSUs, HSUs, recall from community Preadmission assessments in those locations

8 Who – The Clients Up to 29 males, up to 5 females Age 18+
Detained/TDOs Severe mental health difficulties (psychosis) Risk to the public – offending/ violence

9 Clinical Presentations
Trauma History Psychosis Mood disturbance Brain injury Learning disability PDD/ASD ADHD Addiction/Substance misuse issues Personality disorder Psychopathy (DSPD)

10 Offending Wide range, e.g. Violence Stalking Organised crime Theft
Murder Assault Spousal assault Sexual violence Stalking Organised crime Theft Fraud Drug dealing Arson

11 Who – The Multidisciplinary Team
5 MDTs Psychiatry Nursing Social Work Occupational Therapy Clinical Psychology User and Carer Advocates

12 The Role of Clinical Psychology
Engagement Number 1 Assessment (incl. preadmission) General clinical Risk assessment Neuropsychological Intellectual Personality attributes PTSD Psychosis Malingering & deception

13 Formulation Telling the story of mental health/ risk Collaborative
Predisposing Precipitating/ Triggers Perpetuating/ Maintaining Protective Collaborative Intervention targets Enhance strength/ protective factors Reduce or manage risk factors Re-evaluate/ reformulate

14 Therapy Issues Individual Group Trust Shame Stigma Fear
Misunderstanding in MDT Safety Location

15 Indirect intervention
Consultation Indirect intervention Formulation Behaviour plans Function of dangerous behaviour Self harm Violence towards others Substance use Staff support/ reflective practice Impact of clients, the work, environment Training E.g. psychological models/ interventions

16 Meetings Supervision Case Conference PQC Reviews Discharge planning
Service development/ review Tribunals Parole Commission Supervision Trainee clinical psychologists Assistant psychologists Other professionals

17 Research/ Service Evaluation
E.g. recent studies – Childhood trauma is associated with risk of violence Low levels of social support associated with trauma history and negative beliefs about self Sharing Psychological Research/ Theory Formulation Individual approach Training

18 Best parts of the job Chance to contribute something different
Opportunity for long-term therapy in a safe place – really getting to know the clients Can do the work that isn’t possible in other settings Working with other disciplines to enhance recovery Instilling hope – client, team, self Lots of variety Get to visit other locations, e.g. prison, other MSUs Challenging It’s never dull!

19 Questions

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