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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: What interventions do Psychologists and other mental health / therapeutic services provide to people in custody with emotional dysregulation difficulties (over and under controlled) and also to those who are actively self-harming? Can responses include, where possible:
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There are mainly three types of intervention: - Suicide Prevention programme. - Intervention on violent behaviour. - Close regime programme.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…)- Suicide ideas. - Self harm conducts. - Violent behaviour.
Theoretical approach / Model used- Good lives model. - Risk/Need/Responsivity model. - Cognitive-Conductual models.
Group / individual (or both)?Both.
Referral, inclusion, exclusion criteria, length of intervention?Inclusion criteria: suicide risk, self-harm conducts, violent behaviour, violent crimes. Lenth of the intervention: - Individual: it depends on each situation. - Group: one year approximately.
Qualifications of facilitators, supervision required?Mainly Psychology with the collaboration of other professionals.
Pre and post / outcome measures used?Pre and post evaluation in the violent behaviour programme.
Northern Ireland Prison Service (NIPS) Psychology department deliver intervention programmes only to sentenced prisoners and do not run any groups specifically in relation to emotional regulation. The South Eastern Health and Social Care Trust deliver health services (including mental health services) to prisoners in Northern Ireland.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…)Rather than considering the identified area of work in the context of emotional dysregulation (over/under controlled personality), we would identify an individual as a having treatment need in relation to emotional regulation. Some may perceive impulsivity in the context of lacking self-control or being able to self-regulate. As the question outlines, problems in relation to emotional regulation can take a number of forms; from breaking down emotionally to self-harm to acting out towards property (damaging prison or personal property) or people (assaults or fights). We also need to consider the origins of the difficulties – for some emotional regulation may be as a result of other underlying conditions such as Personality Disorder, ADHD, ASD etc.
Theoretical approach / Model usedReferrals to Psychology would generally be made in the context of referrals to engage in Offending Behaviour Programmes, each of which has its own eligibility and assessment criteria.
Group / individual (or both)?There are aspects of emotional regulation within most of our group programmes e.g. Thinking Skills Programme (TSP), Resolve, Building Better Relationships (BBR), Horizon, but realistically where emotional regulation is identified as a treatment need it will more likely be addressed through individual work either as additional follow up work from a group programme, or where an individual has been assessed as not suitable for group based interventions such as due to low cognitive abilities. Some individuals may have emotional regulation may be identified as a treatment need through risk assessments, or as recommendations by the Parole Commissioners. Such work would then generally be undertaken as a piece of individual work undertaken by either a qualified Psychologist or by a Forensic Psychologist in Training (FPiT) or Psychology Assistant under the supervision of a qualified psychologist.
Referral, inclusion, exclusion criteria, length of intervention?Each establishment has Multidisciplinary Intervention Panels who agree priorities for those being allocated to group programmes and for those being allocated to individual work. Group based interventions/programmes, like individual work tend to be based on CBT and Psychoeducational Models.
Qualifications of facilitators, supervision required?The duration of intervention would be determined by the qualified or supervising psychologist, and reviewed during supervision.
Pre and post / outcome measures used?We would not necessarily use pre/post measures in the sense of psychometrics. Doing so would need to take cognizance as to whether the presenting need is state or trait based as this would determine expectations regarding potential change following intervention work (group or individual).
The penitentiary facilities of Lithuania do not have a universal intervention or specific theoretical approach to people in custody with emotional dysregulation difficulties. Psychological crisis management is based on early diagnostics, psychosocial evaluation. Furthermore, the individual support plan is formulated in accordance with the materials collected during psychosocial assessment. All penitentiary facilities have Crisis Management Teams, which react to crisis events, self-harm, suicide attempts or suicides (they act following the procedure on prevention of suicides and self-harm in penitentiary facilities and its validated algorithm, approved by the Director General of the Prison Department). Interventions for inmates are personalized, recommendations (on intense supervision) and intervention measures (e.g. individual counselling) are determined and applied on a case-by-case basis, so is the length. The trainings on CAMS (a therapeutic framework for suicide-specific assessment and treatment of a patient's suicidal risk) are planned, however this approach is not yet widely used.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…) Theoretical approach / Model used Group / individual (or both)? Referral, inclusion, exclusion criteria, length of intervention? Qualifications of facilitators, supervision required? Pre and post / outcome measures used?The Norwegian model of cooperation with the main agencies, like health service, is based on the import-model. This ensures an independent and free role to serve inmates with the same services as all inhabitants are given. The ordinary health system and their staff delivers all health service to inmates in Norway. The prison service does not interfere in the interventions, methodology, treatments or other kinds of health-care. All closed prisons and most of the open facilities in Norway have a health-care unit. The two sectors are collaborating on all levels of the organization, from the ministries to the needed cooperation for each of the inmates inside the prisons. There is a guideline made for health and prison staff, to inform and give recommendations to how the cooperation between the correctional and health services should be done. Specific questions regarding internal health- issues, as requested in this questioner have to be directed to: [email protected] or the websites www.helsedirektoratett.no/english
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…) Theoretical approach / Model used Group / individual (or both)? Referral, inclusion, exclusion criteria, length of intervention? Qualifications of facilitators, supervision required? Pre and post / outcome measures used?This content is only available to registered members of EuroPris.
When dealing with an acute situation, psychologists provide a crisis intervention to an inmate in such case. If the intervention of a psychiatrist is required, it is an examination in order to determine the diagnostic category and pharmacotherapy settings or other recommendations such as hospitalization with more intense and complex treatment. Convicts with mental illness, personality disorder or other serious mental health problems requiring specialised treatment or convicts with problems of adapting to the imprisonment conditions are placed to a specialised treatment unit based on the proposal of case manager, psychologist or psychiatrist following the previous discussions within the commission. In this unit, the regime and organisation of the activities are adjusted to personal characteristics of convicts, their mental state and the therapy. When dealing with individual convicts, the seriousness of the determined diagnosis and their mental state is taken into account and based on that, the program of intensive medical and educational treatment is applied. While doing so, the special-pedagogical, consulting and therapeutic methods and group and individual working forms are applied.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…)The interventions are aimed at self-harm prevention, or in some cases the suicidal tendencies or elimination of aggressive tendencies toward the community, but also prevention of any other aggravation of the mental state e.g. aggravation of the disease diagnosed by a psychiatrist. The priority is to meet the need for psychical compensation and renew the adaptation potential of the inmate.
Theoretical approach / Model usedIn terms of theoretical background, the specialised staff assess from the available recourses and from the initial intervention with the inmate, his/her personality structure and resistance against the burden and also the usable resources which he/she has available in the crisis situations. Therapeutically, the direction is used by which the given specialist dispose of and at the same time it appears to be effective for a particular personality and his/her current problem. Sometimes, when dealing with personalities with difficulties in regulating their reactions, it is sufficient to “open” another communication channel in order that the inmate does not have to abreact his/her internal tension through inappropriate aggressive impulsive behaviour and to expand his/her repertoire of perception possibilities and also processing of demanding situations.
Group / individual (or both)?As for preventive measures of mental decompensation of the inmate, models of group and also individual approach are used. Individual approaches are used in an acute phases of the difficulties of the emotional dysregulation until the recovery of regulatory personality mechanisms.
Referral, inclusion, exclusion criteria, length of intervention?The prison staff working daily with inmates, also monitor and assess their behaviour. Any member of the prison staff may alert the superiors determining the risk level of psychical decompensation of the inmate, about inadequate changes in behaviour and mental state the inmate. Relevant information on the mental state of the inmate are obtained also from persons from the civilian environment who were in contact with the inmate (e.g. relatives, law enforcement authority, advocates and similar). Then, a psychologist shall determine to the inmates at risk the Program of Psychological Services Provision. In this program, there is evaluated the acuteness of psychical decompensation, described criteria, based on which difficulties the inmate was considered to be at risk in the view of the adaptation and determined the intervention frequency. Based on the progress of the mental state, it is decided on duration of psychological and psychiatric interventions and following exclusion from the treatment of psychologist and psychiatrist. The convict who was placed in the specialised unit and the reasons for such placement are no longer present, he/she shall be excluded from this unit based on the proposal of the case manager, psychologist or psychiatrist after discussion within the commission.
Qualifications of facilitators, supervision required?The mental state in the view of possible decompensation and adaptation difficulties is evaluated by the specialised prison staff (psychologist and general practitioner) when admitting the person to the prison environment. If the person is evaluated as currently stable or not at risk, the inmate is further monitored by the non-medical (front line) prison staff which is regularly trained in assessing the risky behaviour of inmates in terms of their mental decompensation. In case of evaluating the deterioration of the mental state, then this staff shall inform the specialised prison staff who shall assess the state of the inmate and take the necessary measures regarding further surveillance. After the agreement with the staff, a certain form of surveillance may be performed also by another convict who is accommodated with the convict with the mental health problems (so called peer supervision).
Pre and post / outcome measures used?As for pre-measures - the contact with specialised staff who shall analyse previous tendencies towards decompensation of the mental state from objective and subjective resources and shall determine the level of risk of the potential psychological decompensations and their inadequate solutions e.g. self-harm or suicidal behaviour. As for post–measures – determination of the prognosis with the attention to the risk factors leading to further possible decompensation (e.g. possible long prison term, divorce and similar).
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Attachments:
PRISONER PROGRAMMES Constructs: Steps towards a Positive Life – 56 hours in length • Designed for persistent offenders, with a specific focus on addressing the poor problem solving skills typical of this particular group. • There are 4 stages to the programme: Motivation and Meaningful Goals, Problem Solving, Skill Acquisition and Self-Management. Developed by SPS and replaced the earlier version of Constructs (Positive Steps to Sop Offending). It was accredited in 2017. Currently available in: Addiewell, Barlinnie, Edinburgh, Glenochil, Grampian, Kilmarnock, Low Moss, Perth, Polmont, Shotts, Moving Forward Making Changes – Approx. 12-14 months (time dependent on level of needs and speed of progress and typically includes a break at some point) • Targeted at offenders who have committed sexual offences and who have been assessed as medium risk, or above, using the Stable and Acute (SA07) Risk Assessment. • Rolling format design with essential and optional modules that are tailored to the individual’s specific treatment needs based on what individuals require. • Optional modules include: Social Support, Relationship Skills, Thinking Skills, Healthy Sexual Functioning. Developed jointly by Scottish Government and SPS it was introduced and accredited in 2014. Currently available in: Barlinnie, Edinburgh, Glenochil, Polmont. Female Offending Behaviour Programme (FOBP) – Approx. 120 hours in length (time can vary significantly dependent on level of need and speed of progress) • Developed specifically for violent/non-violent female offenders. An in-depth cognitive behavioural programme targeting criminogenic need and improvement of well-being. • Rolling format design with mandatory and optional stages that can be tailored to individual needs using a process of collaborative formulation (with the participant) to determine optional stages required/relevant. • Example treatment goals: increase insight into offending pathways, challenge thinking patterns, develop self-management and relapse prevention plans. Developed by SPS in 2006-07. Currently available in: Polmont, Grampian. Pathways Anticipated maximum time to complete, 6 months in length (time can vary significantly dependent on level of need and speed of progress) • Designed to provide the opportunity for medium and high-risk offenders to address their substance-related offending behaviour. • Rolling format design with essential and optional modules that are tailored to the individual’s specific treatment needs based on what individuals require. • Optional modules include: Motivation and Attitudes towards Change, My Ways of Thinking, Relationships and Interpersonal Communication, Self-Management and Well-being. Developed by SPS throughout 2016/17 to replace the Substance-Related Offending Behaviour Programme (SROBP). It was accredited in 2017. Currently available in: Addiewell, Barlinnie, Edinburgh, Glenochil, Grampian, Kilmarnock, Low Moss, Perth, Shotts. Self-Change Programme (SCP) – Approx. 9-10 months for Engagement, Core and Transition stages (time dependent on level of needs and speed of progress) • Designed specifically for offenders at highest risk of future violent re-offending. A history of violent convictions is a pre-requisite for participation on this programme. • Targeted at the adult, male population. • Delivered in a rolling format, the programme contains a range of modules which explore and challenge offender's use of violence. Developed by NOMS, it was accredited in 2013 and is delivered in a range of sites in England. Currently available in: Low Moss, Shotts. Discovery: Finding New Me (Discovery) – 48 group hours and 6 individual hours. • Helps participant’s reduce their aggression. • Suitable for medium-risk adult males, who have difficulties with emotions, thinking, or inter-personal behavior that leads to violence. • The programme develops participant’s awareness of the origins and maintenance of their aggression by creating a responsive and positive therapeutic environment. • The programme introduces a broad menu of skills to enable participants to understand their thinking and emotions, self-regulate, approach problems with others positively, and realise their value-based goals. Developed by SPS in 2016-17 and accredited in December 2017. It will be rolled out in 2018. Will be available in: Addiewell, Barlinnie, Dumfries, Glenochil, Grampian, Kilmarnock, Low Moss, Perth, Shotts. Youth Justice Programme – 120-180 hours in length (time can vary significantly dependent on level of need and speed of progress) • Cognitive behavioural programme targeting general offending behaviour in medium-high risk 16-23 year old offenders. • Specifically developed to reflect the ages and developmental stages of group members, as a means to increase responsivity and enhance learning. • Rolling format design with essential and optional modules that are tailored to the individual’s specific treatment needs. Optional modules include: Thinking styles, Problem solving, Self-management, & Relationship skills. • Psycho-educational standalone sessions are also available to increase awareness and skills in areas that link with improving offender’s lives in the future. Developed by SPS in 2015 and accredited in September 2016. Currently available in: Polmont. APPROVED ACTIVITIES Groupwork which can address criminogenic needs, or activities that target important related issues, or which focus on life skills, employability or pre-release issues: SUBSTANCE MISUSE: Alcohol Awareness (22 Hours) – Developed at Edinburgh. Available at Aberdeen, Barlinnie, Cornton Vale, Edinburgh, Glenochil, Greenock, Inverness, Polmont. Drugs Action for Change (25 Hours) – Developed at Edinburgh. Available at Cornton Vale, Edinburgh, Greenock, Inverness. SMART Recovery (Drugs) (40 hours) – Developed at Inverness. Available at Open Estate. First Step (36 Hours) – Developed at Barlinnie. Available at Barlinnie, Dumfries, Polmont. INTER PERSONAL SKILLS: Relationship Skills (35 hours) – Developed at Peterhead. Available at Dumfries. START (LTP Coping Skills) (25 Hours) – Developed at NIC, Shotts. Available at Shotts. Connections for Women (23.5 Hours) – Developed at Cornton Vale. Available at Cornton Vale. PARENTING: Parenting for women who have a substance misuse problem (44.5 Hours) – Developed at Cornton Vale. Available at Cornton Vale. PREPARATION FOR RELEASE: Sense of Balance (25 hours) – Developed at Open Estate (for offenders who are about to access the community through Community Placement or Home Leave). Available at Open Estate. HEALTH: Anxiety & Sleep Management (20.5 hours) – Developed at Cornton Vale. Available at Cornton Vale.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…)As Q1
Theoretical approach / Model usedAs Q1
Group / individual (or both)?As Q1
Referral, inclusion, exclusion criteria, length of intervention?As Q1
Qualifications of facilitators, supervision required?Psychologists and trained programme officers.
Pre and post / outcome measures used?A range of psychometrics.
Individual consultation and crisis interventions Participation in the psychological assistance activities and rehabilitation programs is voluntary and prisoners, including detainees, are not obliged to participate in them, but this will be taken into account when examining the option of changing the penal regime or conditional release.
What need / risk being intervened with (i.e. self harm, over controlled emotion, under controlled emotion, other…)Specially trained staff of Resocialization department, including psychologists, lead specialized resocialization programs for people with adaptation problems (e.g. the “Stress Reduction Program”), with predisposition to suicide (e.g. the “I am aware!” program, etc.).
Theoretical approach / Model usedWhen providing psychological assistance activities, in accordance with the regulatory framework in the country, professional activity in prison places is entitled to be performed by specialists (psychologists) in the field of legal psychology who have a certificate in the relevant field or by non-certified psychologists who perform their professional activity under the supervision of a psychologist. Each psychologist working in the prison has an appropriate education and a master's degree in the field of legal psychology, as well as a certificate certifying professional competence, so the psychologist is entitled to choose the theoretical approach and methods for working with the prisoner. Specialized resocialization programs, on the other hand, are based on the basic principles and methods of Dialectic Behavioral Treatment (“I am aware!” program for prisoners with a predisposition to suicidal behavior), as well as on methods based on cognitive behavioral approach.
Group / individual (or both)?Both approaches are being pursued when dealing with prisoners with adaptation difficulties, unstable emotional conditions and suicidal predisposition: individual work (individual counselling, crisis interventions) and group work are organized (involvement of prisoners in resocialization programs, with a maximum number of members in the group of 8 prisoners).
Referral, inclusion, exclusion criteria, length of intervention?Crisis interventions shall be provided immediately, but no later than the next working day. The involvement in the individual counselling of a psychologist shall take place when inmate submits the request for counseling to prisons Administration. Cooperation with a psychologist within the framework of individual consultations may have been terminated by mutual agreement or after the provision of 10 (ten) consultations. A prisoner shall be excluded from participation in a resocialization program if he: • do not comply with the rules and requirements of the program; • breaches internal rules of procedure at the place and time of implementation of the program; • have been transferred to another detention or have been released; • has submitted a request to exclude him or her from the program.
Qualifications of facilitators, supervision required?Higher education, a master's degree and a certificate in the field of legal psychology are required to carry out individual counseling or crisis intervention. In order to implement resocialization programs, it is necessary to participate in the selection, training and testing of the leaders of an appropriate resocialization program.
Pre and post / outcome measures used?Following a series of consultations (10 consultations), the psychologist, in cooperation with the prisoner, decides on the need to continue the ongoing consultative work. If the objective need does not exist, the individual consultative work shall be terminated. If the participation in the resocialization program was terminated or the prisoner has not achieved the objective of the program, he may be re-involved in the program.