DOCSLIB.ORG

Network Effects on Treatment Results in a Closed Forensic Psychiatric Setting

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Network Effects on Treatment Results in a Closed Forensic Psychiatric Setting NETWORK EFFECTS ON TREATMENT RESULTS IN A CLOSED FORENSIC PSYCHIATRIC SETTING Ruud van der Horst ISBN: 978-90-5335-457-5 ISBN (digital): 978-90-367-5211-4 Cover design: Ian Tijhuis Layout: Simone Vinke, Ridderprint BV Printing: Ridderprint BV, Ridderkerk, The Netherlands The research presented in this dissertation was partly financed by the Forensic Psychiatric Center Dr. S. Van Mesdag. © 2011 R. P. van der Horst All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage or retrieval system, without permission in writing from the author. RIJKSUNIVERSITEIT GRONINGEN NETWORK EFFECTS ON TREATMENT RESULTS IN A CLOSED FORENSIC PSYCHIATRIC SETTING Proefschrift ter verkrijging van het doctoraat in de Gedrags- en Maatschappijwetenschappen aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus, dr. E. Sterken, in het openbaar te verdedigen op maandag 7 november 2011 om 14.30 uur door Rudi Peter van der Horst geboren op 15 oktober 1975 te Leiderdorp Promotores: Prof. dr. T. A. B. Snijders Prof. dr. B. Völker Copromotor: Dr. M. Spreen Beoordelingscommissie: Prof. dr. S. Bogaerts Prof. dr. A. Flache Prof. dr. P. Nieuwbeerta Voor Ellen, Tijn en Bram ‘The result of sociometric development has been that the investigation of the smallest social aggregates has become more interesting than that of the large ones’ - Jacob. L. Moreno (1934) Contents 1 INTRODUCTION 11 1.1 Introduction 13 1.2 Background 15 1.3 Procedure 20 1.4 Description of the studies in the dissertation 22 2 APPLYING SOCIAL NETWORK ANALYSIS IN A FORENSIC PSYCHIATRIC CENTER 25 2.1 Introduction 27 2.2 Method 28 2.3 Results 31 2.4 Discussion 39 3 RELATIONAL PATTERNS AND NETWORKS OF FORENSIC In-pATIENTS 41 WITH DISTINCT PERSONALITY DISORDERS 3.1 Introduction 43 3.2 Arguments and expectations 45 3.3 Method 52 3.4 Results 63 3.5 Conclusions and discussion 72 4 ASSESSING RIsk-relaTED FUNCTIONING IN FORENSIC PSYCHIATRIC 75 In-pATIENTS 4.1 Introduction 77 4.2 Background 78 4.3 Method 83 4.4 Results 86 4.5 Conclusion and discussion 95 5 SOCIAL INTERACTION RELATED TO THE FUNCTIONING OF FORENSIC 99 PSYCHIATRIC In-pATIENTS 5.1 Introduction 101 5.2 Arguments and expectations 103 5.3 Method 105 5.4 Results 109 5.5 Conclusions and discussion 111 6 THE Co-eVOLUTION OF SOCIAL RELATIONS AND RIsk-relaTED 115 BEHAVIOR OF FORENSIC PSYCHIATRIC In-pATIENTS 6.1 Introduction 117 6.2 Background 118 6.3 The study 121 6.4 Method 124 6.5 Results 128 6.6 Conclusions and discussion 136 7 SUMMARY AND CONCLUSIONS 139 7.1 Summary 141 7.2 General conclusions 149 7.3 Limitations of the research 152 7.4. Recommendations for future research 154 Samenvatting en conclusies (Summary and conclusions in Dutch) 157 Appendices 177 References 191 Dankwoord (Acknowledgements in Dutch) 203 Curriculum vitae 209 ICS Dissertation Series 213 Chapter 1 Introduction watermerk.indd 1 28-09-11 06:50 Introduction 1.1 Introduction Chapter The ‘terbeschikkingstelling’ (TBS) is a court-ordered treatment measure in the Dutch penal system that can be imposed on any perpetrator who is deemed at risk to reoffend after 1 committing an offence with a minimal custodial sentence of four years. TBS patients cannot be held fully responsible for their crimes because they were suffering from a mental illness at the time they committed their offence. As psychiatric patients, they are usually treated in a forensic psychiatric hospital, with the aim of reducing their risk to society. The duration of TBS is not predetermined, but depends on reducing the patients’ risk of reoffending during the treatment process. For as long as the patient is deemed still dangerous, TBS may be prolonged every two years. After a certain time or after reaching a certain level of progress in treatment, patients may be allowed to go on temporary leave. If patients show no progress in their psychological treatment for lengthy periods and are placed in long-term care, temporary leave under supervision may be admitted for humanitarian reasons. When sufficient reduction in risk behavior is established, patients are permitted to leave the forensic hospital for short periods to begin with, superintended by a guard or therapist. After evaluation and continued good results, the duration of leaves and freedom of movement in the resocialization process may be extended. TBS normally ends only when the risk of reoffending has been reduced to an acceptable level. On 23 June 2004, a forensic psychiatric patient ordered to undergo TBS failed to come back from unsupervised leave. Instead, he abducted a 13-year-old girl and, as became apparent following his re-arrest, seriously threatened and abused her. The situation caused a great wave of unrest in the Netherlands. Parliament called the Minister of Justice to account for the mistakes made in allocating permitted leave for this patient. Under pressure, the minister tightened routine procedures for forensic patients’ leave. Nevertheless, on 7 June 2005, another forensic patient on short leave escaped from his supervisor and shortly afterwards, murdered an elderly man. The Minister of Justice was again called to account in an emergency debate. Demands for his resignation were rejected only because the vote of no confidence found insufficient support. These incidents led to a proposal by two members of parliament, Wolfsen and Weekers who stressed the importance of investigating why the TBS measure in its present form was not working to protect society against reoffending forensic psychiatric patients.1 A proper investigation would provide crucial information to improve the TBS system. Parliament approved the resolution and established the Visser Committee, a temporary research committee named after its chair, VVD Second Chamber member Arno Visser. Besides instigating several procedural changes, such as policy adjustments for providing leave and stricter monitoring of patients released from a closed facility, the 1 Second Chamber, session 2004-2005, 29 452, nr. 25 13 Chapter 1 committee recommended conducting scientific research into the effectiveness of TBS treatment to obtain insight into factors that establish the risk of reoffending (Final TBS research report, 2006). The Ministry of Justice Research Center was instructed to develop a research program based on an inventory of research needs in the forensic field, within the latitude of the committee’s recommendations. The result was a three-year program studying the TBS measure along two lines: 1) the effectiveness of specific treatment interventions during the treatment process, and 2) underlying (risk) factors of recidivism. Now, in 2011, most of the studies begun in the past two years are still ongoing; others will begin next year. This dissertation presents research into social relationships of forensic psychiatric in- patients in association with their risk-related behavior. It is independent of the three-year research program but takes place in the same general domain. That social inter-relatedness affects all kinds of behavior and wellbeing has been long recognized, since the work of Durkheim (1858-1917) and Simmel (1858-1918). The association between social interaction and delinquent behavior is also assumed in prominent criminological theories. For instance, social control theory argues that criminal acts result from a lack of social integration, and deficient bonds to other individuals and social institutions (see Hirschi, 1969). In contrast, differential association theory (Sutherland & Cressey, 1955; Warr, 2002) posits that delinquent behavior is learned from interactions with other delinquents. Research into delinquent behavior has confirmed the importance of social relations to delinquent behavior (see Haynie, 2001, 2002) and mental and physical health (see Kawachi & Berkman, 2001; see Halpern, 2005 for a review). Despite the well- known literature and related empirical findings, surprisingly little research has been done into the social interaction of forensic psychiatric patients. Almost everyone in this group of delinquents commits very serious offences, and they do so because of their severe psychopathology. The largest population of forensic patients has the psychopathology known as personality disorder (80%, de Beurs & Barendregt, 2008), a relational disorder characterized by disturbances in relations with the self, others, and the environment (American Psychiatric Association (APA), 1994, 2000). In most cases, these patients receive psychological treatment in a forensic psychiatric hospital. The dominant aim is to prevent them from reoffending by reducing their risk-related behavior. Because of the importance of social relations for the behavior and mental health of individuals, and the relational nature of the psychopathology of the most prominent group of forensic patients, behavioral change due to treatment is assumed to be closely related to changes in the social interaction of these patients. Insight into the association between social relationships and risk-related behavior can contribute additional insights into factors causing risk of reoffending. Conducting more of this type of research was one of the Visser Committee’s important recommendations. Research into the social 14 Introduction relations of this population is also interesting sociologically because of the special context Chapter of the closed facility, where forensic psychiatric patients are incarcerated or hospitalized involuntarily. Living together
Load more

Recommended publications
  • Downloaded by [New York University] at 12:44 14 August 2016
    Downloaded by [New York University] at 12:44 14 August 2016 “This book provides mental health professionals with a comprehensive, theory-based method for understanding the disorders in DSM-5. The utility of the Adlerian model is clear as each chapter incorporates theoretical concepts and techniques into a concise discussion of the disorder, case conceptualization, treatment considerations, and case studies. This updated edition should be required reading for professionals working with clients in a variety of settings.” Susan E. Belangee, Ph.D., LPC, private practice, Canton, Georgia “In the third edition of their fine book Psychopathology and Psychotherapy, the editors Drs. Len Sperry, Jon Carlson, Jill Duba Sauerheber, and Jon Sperry do what they have done frequently in the past—they continue to fill a vacuum and shed light on areas of great interest and benefit. With clarity and precision these acclaimed authors, editors and academics, along with additional respected authors who contributed chapters, enlighten readers and provide solid and substantial information about treatment for various DSM-5 diagnoses from an Adlerian perspective. Those of us who work in the field can find our work enhanced greatly by reading and applying the knowledge presented in this book. I most highly recommend.” Debbie Joffe Ellis, private practice, New York City “The editors of Psychopathology and Psychotherapy: DSM-5 Diagnosis, Case Conceptualization, and Treatment (3rd Edition)—Drs. Len Sperry, Jon Carlson, Jill Duba Sauerheber, and Jon Sperry—are to be congratulated for the development and timely release of a new resource for the conceptualization and treatment of a range of mental health disorders.
    [Show full text]
  • Psychopathological Correlates of Risk For
    PSYCHOPATHOLOGICAL CORRELATES OF RISK FOR ADOLESCENTS IN SECURE TREATMENT ©ARIANA MCCULLOCH B.A., University of Lethbridge, 1998 A Thesis Submitted to the School of Graduate Studies of the University of Lethbridge In Partial Fulfillment of the Requirements for the Degree MASTER OF EDUCATION COUNSELLING PSYCHOLOGY FACULTY OF EDUCATION LETHBRIDGE, ALBERTA March 2005 ABSTRACT This research utilized data concerning adolescents at imminent risk for harm confined to the Edmonton and Lethbridge secure treatment centres in Alberta. Once screened for inclusion criteria in a single stage, non-random convenience sampling protocol, 210 files were included in the study. From these files, the adolescents' psychopathological diagnoses, Suicide Probability Scale (SPS) scores as well as other demographic data (including age, gender, ethnicity and previous suicide attempts) were recorded. This research was designed to delineate the characteristics of adolescents admitted to secure treatment, examine the overall suicide risk in this sample, investigate the relationship between study variables via crosstabulation and chi-square analysis, and to determine which independent variable/s best predicted suicide risk via ANOVA and multiple linear regression analysis. Analysis results indicated that the sample was predominantly comprised of female adolescents, Caucasian ethnicity and was aged between 13 and 15 years. The majority of adolescents with suicide history information available in their file had previously attempted suicide. Youth demonstrated an average
    [Show full text]
  • The Ambiguous Loss of Post-Integration : a Theoretical Analysis of the Effects of Integration on Clients with Dissociative Identity Disorder
    Smith ScholarWorks Theses, Dissertations, and Projects 2013 The ambiguous loss of post-integration : a theoretical analysis of the effects of integration on clients with dissociative identity disorder Elise A. Manning Smith College Follow this and additional works at: https://scholarworks.smith.edu/theses Part of the Social and Behavioral Sciences Commons Recommended Citation Manning, Elise A., "The ambiguous loss of post-integration : a theoretical analysis of the effects of integration on clients with dissociative identity disorder" (2013). Masters Thesis, Smith College, Northampton, MA. https://scholarworks.smith.edu/theses/628 This Masters Thesis has been accepted for inclusion in Theses, Dissertations, and Projects by an authorized administrator of Smith ScholarWorks. For more information, please contact [email protected]. Elise Manning The Ambiguous Loss of Post- Integration: A Theoretical Analysis of the Effects of Integration on Clients with Dissociative Identity Disorder ABSTRACT Although undergoing integration treatment and achieving intrapsychic integration is widely considered an unmitigated positive outcome for individuals diagnosed with dissociative identity disorder, the literature suggests that integration, which may include experiences or perceptions of loss, may be an outcome of far more complicated and varied resonance than is generally acknowledged. This theoretical study examines this little-examined element of the treatment outcome—the phenomenon of an individual’s experience or perception of loss following
    [Show full text]
  • A Research Agenda for DSM-V
    A Research Agenda for DSM-V A Research Agenda for DSM-V Edited by David J. Kupfer, M.D. Michael B. First, M.D. Darrel A. Regier, M.D., M.P.H. Published by the American Psychiatric Association Washington, D.C. Note: The authors have worked to ensure that all information in this book is accu- rate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate as of the time of publication and consistent with stan- dards set by the U.S. Food and Drug Administration and the general medical com- munity. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a spe- cific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family. The findings, opinions, and conclusions of this report do not necessarily represent the views of the officers, trustees, or all members of the American Psychiatric Asso- ciation. The views expressed are those of the authors of the individual chapters. Typeset in Adobe's Janson Text and Frutiger Copyright ã 2002 American Psychiatric Association ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 06 05 04 03 02 5 4 3 2 1 First Edition American Psychiatric Association 1400 K Street, N.W., Washington, DC 20005 www.psych.org Library of Congress Cataloging-in-Publication Data A research agenda for DSM-V / edited by David J.
    [Show full text]
  • PROCEEDINGS of PERSISTENTLY SAFE SCHOOLS 2007
    THE 2007 NATIONAL CONFERENCE ON SAFE SCHOOLS PROCEEDINGS OF PERSISTENTLY SAFE OCTOBER 29–31, 2007 SCHOOLS WASHINGTON, DC THEHAMILTONFISHINSTITUTEONSCHOOLANDCOMMUNITYVIOLENCE INSTITUTEFOREDUCATIONSTUDIES The Hamilton Fish Institute was established by the U.S. Congress in 1997. The HAMILTON FISH INSTITUTE’s Persistently Safe Schools: The 2007 National Conference on Safe Schools * PROCEEDINGS of PERSISTENTLY SAFE SCHOOLS 2007 Washington, D. C. * This project was supported by Grant No. 2005-JL-FX-0157 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice. The Hamilton Fish Institute on School and Community Violence conducts primary and secondary research, conducts research synthesis, and provides technical assistance to schools and communities in order to make schools safer for high achievement. The views expressed by the authors of the papers in this Proceedings belong to them. Their views do not represent the official positions or policies of the Hamilton Fish Institute, The George Washington University, or the Office of Juvenile Justice and Delinquency Prevention (OJJDP), Office of Justice Programs, the U.S. Department of Justice. The research, case studies, and anecdotal accounts that the authors prepared and are published herein were received in response to an open call for papers. The George Washington University does not unlawfully discriminate against any person on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or sexual orientation. This policy covers all programs, services, policies, and procedures of the University, including admission to education programs and employment.
    [Show full text]