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Young people in forensic mental health settings : psychological thinking and practice
\"Youth crime and youth violence blights our communities and shapes the lives of many, whether they are victims, perpetrators or family members. This book examines the application of psychological thinking and practice when working with young people who display high risk behaviours across a broad range of forensic mental health settings in the UK. It provides an up-to-date account of current thinking and practice in the field and the challenges of applying effective psychological approaches within forensic settings for young people.The contributors to Young People in Forensic Mental Health Settings are drawn from a range of environments including universities, youth offending services, secure in-patient settings, young offenders institutions, community forensic Child and Adolescent Mental Health Services (CAMHS) and secure children's homes. This volume serves as an important platform for debate and as a forum for discussing the future delivery of psychologically informed intervention and mental health provision with young people who display high-risk behaviours\"-- Provided by publisher.
BOOK
Hip abductor tears in ischiofemoral impingement
PurposeIschiofemoral impingement (IFI) is associated with abnormalities of the quadratus femoris muscle and narrowing of the ischiofemoral (IF) and quadratus femoris (QF) spaces. The hip abductors play an important role in pelvic stability and abductor tears might play a role in the pathophysiology of IFI. The purpose of our study was to assess the association between hip abductor tears and IFI on MRI.Materials and methodsThe study was IRB approved and HIPAA compliant. Inclusion criteria were MRI findings of IFI (narrowing of the IF space ≤ 15 mm or QF space ≤ 10 mm with associated ipsilateral quadratus femoris edema or fatty infiltration/atrophy). Two MSK radiologists assessed hip/pelvic MRIs and integrity of the tensor fascia lata, gluteus medius, and minimus tendons. IFI and control groups were compared with a two-tailed Student t test or chi-squared test.ResultsWe identified 140 patients with MRI findings of IFI (mean age 56 ± 13 years, 130 f, 10 m) and 140 controls of similar age and sex. Patients with IFI had a higher prevalence of gluteus medius/minimus partial tears (37 vs 21, p = 0.02) and full-thickness tears (24 vs 21, p = 0.03). Patients with IFI had a higher prevalence and higher grade of gluteal muscle atrophy compared with controls (p < 0.03). There were no tears of the tensor fascia lata in either group.ConclusionPatients with IFI had a higher prevalence of abductor tears and abductor muscle atrophy compared with matched controls. This suggests that abductor tears might play a role in the pathophysiology of IFI.
Journal Article
Value of low-dose whole-body CT in the management of patients with multiple myeloma and precursor states
ObjectiveTo determine the value of low-dose whole-body CT (WBCT) in the management of patients with multiple myeloma (MM) and precursor states.Materials and methodsThe study group comprised 116 patients (mean age: 68 ± 11 years, 48% women) who underwent WBCT for the work-up or surveillance of MM or MM precursor disease. WBCTs were reviewed for the presence of MM-related bone disease and incidental findings requiring therapy. The medical records, results from bone marrow aspirations and biopsies and follow-up imaging studies were reviewed to assess the influence of WBCT on patient management.ResultsWhole-body CT led to a change in management in 32 patients (28%). Of those, 17 patients with MM precursor disease were found to have MM-related bone disease, 13 patients had progression of MM, requiring a change in treatment, in one patient hepatocellular carcinoma was diagnosed, requiring a change in therapy, and one patient had a rib lesion requiring intervention. In 65 patients (56%), WBCT was performed for surveillance of MM precursor disease or stable treated MM, and did not detect new lesions, thereby providing reassurance to the hematologist on disease status and management. In 15 patients (13%) WBCT was performed as a new baseline before a change or new therapy. In 4 patients (3%), WBCT was performed for a change in symptoms, but did not detect lesions that would lead to a change in management.ConclusionWhole-body CT provides important information for disease monitoring and detection of incidental findings, thereby improving the management of patients with MM.
Journal Article
Intra-articular fibroma-like perivascular epithelioid tumor (PEComa) mimicking tenosynovial giant cell tumor, diffuse type
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms composed of perivascular epithelioid cells that are immunoreactive for both melanocytic and myogenic markers. Recently, a fibroma-like PEComa associated with tuberous sclerosis complex (TSC) has been identified. We describe the first intra-articular case of a fibroma-like PEComa in a 44-year-old man who presented with a hypointense intra-articular knee mass, which was mistaken for tenosynovial giant cell tumor, diffuse type. This case report demonstrates that fibroma-like PEComa should be included in the extended differential diagnosis of intra-articular soft tissue masses. In addition, given their strong association with TSC mutations, a diagnosis of fibroma-like PEComa should trigger an evaluation for TSC.
Journal Article
Psychological Therapy in Prisons and Other Secure Settings
This book examines a range of therapeutic approaches used in prisons and other secure settings and explores the challenges in such work.
The approaches include Cognitive-Behavioural Therapy (CBT), Cognitive-Analytic Therapy (CAT), Attachment-Based Psychodynamic Psychotherapy and Systemic Psychotherapy. It provides insights into debates about providing therapy in prisons and other secure settings and discusses specific topics such as mental health in-reach teams, working with women in prison, therapy within therapeutic communities and therapy with black and minority ethnic groups.
This book addresses developments in mental healthcare by the National Health Service (NHS) within prisons and on-going policy developments which aim to improve access to psychological therapies for prisoners. The contributors draw on experience both in clinical psychology and forensic psychology, as well as psychotherapy and criminology. They draw on experience too in a range of environments, including juvenile and young offender establishments, local prisons and dispersal prisons.
Psychological Therapy in Prisons and Other Secure Settings will be essential reading for people who work to improve the psychological wellbeing of individuals in prisons and other secure settings.
eBook
Psychological Therapy in Prisons and Other Settings
This book examines a range of therapeutic approaches used in prisons and other secure settings and explores the challenges in such work.
The approaches include Cognitive-Behavioural Therapy (CBT), Cognitive-Analytic Therapy (CAT), Attachment-Based Psychodynamic Psychotherapy and Systemic Psychotherapy. It provides insights into debates about providing therapy in prisons and other secure settings and discusses specific topics such as mental health in-reach teams, working with women in prison, therapy within therapeutic communities and therapy with black and minority ethnic groups.
This book addresses developments in mental healthcare by the National Health Service (NHS) within prisons and on-going policy developments which aim to improve access to psychological therapies for prisoners. The contributors draw on experience both in clinical psychology and forensic psychology, as well as psychotherapy and criminology. They draw on experience too in a range of environments, including juvenile and young offender establishments, local prisons and dispersal prisons.
Psychological Therapy in Prisons and Other Secure Settings will be essential reading for people who work to improve the psychological wellbeing of individuals in prisons and other secure settings.
Foreword, Graham J. Towl 1. Introduction, Joel Harvey and Kirsty Smedley 2. Therapy and Mental Health in-reach Teams, Alice Mills and Kathleen Kendall 3. Attachment Based Psychodynamic Psychotherapy, Mary Haley 4. Cognitive Behaviour Therapy with Adolescents in Secure Settings, Kirsty Smedley 5. Cognitive Analytic Therapy with Young Adult Offenders, Abigail Willis 6. Systemic Psychotherapy in Prison, David Shelton 7. Working with Trauma in a Prison Setting, Andrew Rogers and Heather Law 8. Therapeutic Practice with Women in Prisons and Other Secure Settings, Jules Pearson 9. Therapy with Black and Minority Ethnic People in Prisons and Secure Mental Health settings: keeping race in mind, Frank Lowe and Jules Pearson 10. The Role of Therapeutic Communities in Forensic Settings: developments, research and adaptations, Richard Shuker and John Shine 11. Therapy and Offending Behaviour Programmes, Danny Clark
eBook
Educator perceptions of the complex needs of young people in Pupil Referral Units: An exploratory qualitative analysis
Alternative education provision such as Pupil Referral Units support young people who have been excluded from mainstream school settings and often from disadvantaged backgrounds. However, there is limited research to date exploring educators' perceptions of the complex needs of young people in PRUs, and the extent to which PRUs as currently configured can meet such needs.
Between March 2019 and October 2020 twenty-two participants holding various educational roles from five different Pupil Referral Units across London and Southeast England were interviewed. The interviews aimed to explore the participants' experiences of working with students in PRU's and examine some of the challenges that they might encounter. Semi-structured interviews were analysed using Reflexive thematic analysis.
The three identified themes and their sub-themes highlighted the complex needs of these young people and identified significant barriers to effective service provision. The first theme 'Complexities of PRU population' highlighted the challenges that young people in PRUs face and perceived systemic short falls in addressing such complexity. The second theme 'Challenges of the PRU environment' highlights the frustrations that educators experience when it comes to providing adequate support to young people in PRU's, the absence of agency support, and the uncertainty that these educational settings can bring. The third theme 'Peer Group Influences' highlights the impact of peer groups from beyond the classroom on engagement within the classroom.
Despite the clear complex needs of young people in PRUs, staff reported feeling ill-equipped to support these individuals and lacked access to effective inter-agency support. Participants reported that pupils' mental health difficulties were exacerbated by exclusion and reintegration practices, an over-zealous focus on educational outcomes and the impact of gang influences on their school lives. Implications include more specific mental health training for staff working in PRU's, improved inter-agency working and the incorporation of trauma-informed approaches in educational practice.
Journal Article
The perceived challenges of working with patients who use new psychoactive substances: a qualitative study in a medium secure unit
Purpose
New psychoactive substances (NPS) are increasingly being used in secure mental health settings. Within these settings, NPS use presents a range of challenges and staff currently lack adequate training to manage these challenges. The purpose of this paper is to explore nursing staffs’ perception of the challenges of working with patients who use NPS and to explore nursing staffs’ perception of their training needs in relation to NPS.
Design/methodology/approach
A cross-sectional qualitative design was employed. Semi-structured interviews were conducted with eight nursing staff from a medium secure unit (MSU).
Findings
A thematic analysis identified three overarching themes: “There Will Always Be Something”, “We Are Doing Our Best” and “If We Know More, We Can Do More”. The findings describe how nursing staff manage NPS use at present, and their perceptions of how training could improve their management of NPS use in the future.
Practical implications
The findings suggest that MSUs require a local policy for managing NPS use. The research implies that staff training programmes should recognise the existing methods staff use to manage NPS use. The findings also suggest that NPS interventions should target the whole peer group and not just the individual using NPS.
Originality/value
This paper contributes to the limited literature on NPS. The findings demonstrate the importance of developing evidence-based mechanisms for managing NPS use. Changes to practice are suggested, with the view of developing ways in which staff currently manage NPS use by complementing this with specific training on NPS.
Journal Article
Prison officers’ experiences of key-working with women living in a psychologically informed planned environment (PIPE)
Purpose
A key aspect of psychologically informed planned environments (PIPEs), are the attachment theory-informed relationships between residents and staff (Bainbridge, 2017). The key-work provision of one-to-one support from officers to residents is one of the main ways through which relationships are formed. The purpose of this paper is to explore prison officers’ experiences of the key-work role within a PIPE in a women’s Prison in England.
Design/methodology/approach
Semi-structured interviews explored ten prison officers’ experiences. Interviews were analysed using thematic analysis.
Findings
Five main themes were identified; “Professional support”, “Negotiating Professional Boundaries”, “A Successful Relationship”, “Rupture and Repair” and “Growth for Everyone”. These themes reflected the framework around keywork; what support officers need to cope with the emotional demands of the role, and how to manage challenging situations and build meaningful key-work relationships.
Research limitations/implications
Limitations include the lack of focus on diversity, the impact of the COVID-19 pandemic on officer experience and applicability to other PIPE services. Future research could address some of these limitations.
Practical implications
Practical implications highlight the need for consistent supervision, greater consideration of officers’ transition to the role and trauma-informed training.
Originality/value
The research provides an unprecedented account of prison officers’ experiences of the key-work role, adding to the limited literature within PIPEs in the women’s estate. The supportive nature of the key-work relationship was perceived by officers to contribute towards people’s sentence progression and officers’ personal and professional development.
Journal Article
Working with adolescents who display sexually harmful behaviour
Purpose
The purpose of this paper is to explore the psychosocial experience of staff in a UK youth offending team (YOT) who work with adolescents displaying sexually harmful behaviour (SHB).
Design/methodology/approach
Eight participants were questioned by means of a semi-structured interview schedule about their experiences of working with adolescents displaying SHB. Subsequent data were analysed using Interpretative Phenomenological Analysis.
Findings
Three superordinate themes were identified: client-focused; challenges within the role; and looking after the self. Staff appreciate the factors contributing to SHB and they experience challenges within their role, but are also aware of the importance of maintaining their own well-being. They demonstrate positive attitudes towards young people displaying SHB, whilst contending with the challenge of misconceptions within society. When addressing the self, YOT practitioners are able to adopt both individual and group methods of coping with the nature of the work.
Research limitations/implications
The participant group could have included a wider range of disciplines as the YOT is a multi-agency service. A further study exploring staff from different professional backgrounds would be of value.
Practical implications
The findings will be valuable for both practitioners and policy makers working in the field of youth justice as they offer a unique insight into the role of youth justice staff and the complexities within their role when working with a group of young people often vulnerable to poor outcomes. It is important for practitioners and managers to be able to reflect on the challenges in the role in order for clinical supervision to be emphasised when working with this client group.
Originality/value
To the authors’ knowledge this is the first study to provide an in-depth exploration of the experience of UK YOT officers working with adolescents who have displayed SHB.
Journal Article