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Some individuals with autism may engage in violent behaviour. Research into autism specific factors (ASFs) that may contribute to violence is limited. The purpose of this paper is to explore the feasibility of use of an ASF framework which was developed to inform risk formulation and treatment needs.

Retrospective identification and evaluation of ASFs in offenders with autism (N = 13) at childhood, time of index offence and in current risk behaviours. The ASFs described in the framework were repetitive behaviours and circumscribed interests; poor social understanding and empathy; sensitivity to sensory stimulation; and disruption to rigid behavioural routines or difficulties coping with change.

There was evidence for all four ASFs being consistently present in childhood, contributing to violent behaviour at the index offence and current risk behaviours in at least one case. Poor social understanding and empathy was often present at both childhood and index offence in all cases. Of the seven cases with offence paralleling behaviour, five had at least one ASF present at each timepoint.

This proof-of-concept study provides initial support that ASFs play a role in offending behaviour of individuals with autism. Clinicians working in specialist and generic forensic services, with an in-depth knowledge of autism, could use the ASF framework to enhance risk assessments and facilitate more targeted treatment planning for offenders with autism in specialist and general forensic services.

To the best of the authors’ knowledge, this study is the first to test the application of the ASF framework in an autistic offending population.

Within controlled environments such as prisons or forensic facilities, strong sanctions and other factors can inhibit the expression of offence-linked behaviours otherwise observable in community settings. For example, institutional restrictions may distort the offender’s habitual expression of aggressive behaviours such that the individual’s aggressive characteristics are less intense or observable. Thus, the influences of controlled settings can make it difficult for staff to capture idiosyncratic evidence of change or lack thereof over time or with treatment. The purpose of this paper is to describe an assessment and measurement framework that can be used to assist treatment and correctional staff collectively focus attention on relevant characteristics and behaviours idiosyncratically linked to offending.

The authors use the terms “offence analogue behaviours (OAB)” to describe proxies of offence behaviours observable in controlled settings and “offence replacement behaviours (ORB)” as the contrasting positive, pro-social skills and strategies that the individual implements to change and manage problem areas linked to aggression and criminality. This paper discusses the application and practical utility of the framework and an associated assessment and measurement tool; the Offence Analogue and Offence Replacement Behaviour Guide (Gordon and Wong, 2009-2013).

The OAB and ORB Guide has shown to be useful by directing the attention of treatment personnel to the here-and-now offence related behaviours displayed by offenders in custodial settings. In the absence of such focused attention, relevant proxy behaviours can often be masked in these highly controlled environments. The Guide is therefore a useful adjunct to identify such behaviours for treatment and for assessing treatment-related changes.

The OAB/ORB Guide was developed based on a conceptual framework derived from the empirical literature on correctional treatment, risk assessment, psychological theories and clinical practice. While there has been some positive pilot use of the Guide’s utility and preliminary research, at this point, empirical evidence is still lacking.

The OAB/ORB Guide provides quantified and structured guidelines to assess offence proxy and offence replacement behaviours observable day-to-day within controlled environments, such as during custody or supervised release to the community.

This guide was developed to assist staff with the identification, documentation and measurement of idiosyncratic negative and positive offence-related proxy behaviours observable across custodial or supervised contexts. Accordingly, the authors suggest that OAB/ORB guide information can be used to evaluate changes in risk over treatment and/or time. Further, the authors describe how this framework may enhance the efficacy of multi-disciplinary treatment and management teams. Two cases are used to illustrate the application of the Guide.

The purpose of this paper is to outline the initial development of a framework to assist in clinical case formulation for individuals diagnosed with autistic spectrum disorder (ASD) who have been convicted of violent and other offences.

The proposed framework obtains information on the presence of ASD features from an individual’s developmental history, index offence and offence paralleling behaviours. Through obtaining information across these three domains the framework helps the practitioner make an informed assessment of the possible contribution of ASD to offending.

The framework aims to assist the practitioner to develop a clinical formulation based on hypothesised linkages between these domains for use in forensic assessment reports and to aid treatment planning. The use of the proposed framework is illustrated through a reference formulation based on a fictive case example.

The framework is still in the early stages of development and has not been tested. The next stage is to utilise case information data to assess the validity of the items. This does not preclude the use of the framework by practitioners as an aid to generating clinical hypotheses about the possible link between autism and offending as the development of the tool has been informed by research on ASD and offending.

The framework may be used in conjunction with structured professional judgement tools. For example, the recently published third version of the HCR-20 includes pervasive developmental disorders as a historical risk item. This possible relevance of this item in terms of forensic risk could be presented using information obtained from the framework outlined in this paper. This in turn could be used to inform the formulation section of the HCR-20 and in the generation of treatment plans. In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning.

In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning.

Although there is an emergent body of research on ASD and offending this has not yet been translated into a tool to help practitioners. This paper sets out an approach to do this and therefore makes an original contribution to the literature.

This paper aims to review the clinical approach adopted in prison-based therapeutic communities (TCs) for working with residents who have committed sexual offences. It reviews recent research and practice developments and explores the implications for TCs.

This paper describes a “think tank” review process which explores and reviews practice. This paper discusses the current approach adopted by TCs when working with those who have sexually offended and explores changes in clinical approach which could be considered in the light of current developments.

This paper explores the implications for TCs of the recent research and wider practice developments in interventions for those who have sexually offended.

This paper presents clinical options for working with those who deny their offence and undertaking victim empathy and offence disclosure work. It makes recommendations regarding staff training and support. It also discusses the strengths of the TC approach and how these can be built upon.

This paper makes recommendations concerning how practice could be improved which promotes safety and public protection and enhances resident well-being.

There has been no recent review of TC clinical practice for working with those who have sexually offended.

The purpose of this paper is to increase our understanding of the role of mental disorder in sexual offending as well as identifying innovations in assessment and treatment with offenders who present with these typically complex risks and needs.

The converging literatures on “good lives” and other developments in sexual offender treatment are compared with recovery from mental disorder and what is known about the particular needs and characteristics of sexual offenders with mental illness and severe personality disorder (PD).

A key outcome of this review is that many mentally disordered sexual offenders have similar needs to those in prison and the community but there are particular challenges posed by severe PD, paraphilias and the relatively rare individuals whose offending is functionally linked to psychotic symptoms.

Practical implications include the need for case formulation of complex needs related to mental disorder using direct and indirect measures of attitudes and interests. Treatment needs to be responsive to very different personality and mental health presentations as well as problems with offending and cognitive schemas. Direct functional links between mental health symptoms such as delusions and hallucinations are very rare in practice and are usually secondary to PD and sexual offending issues. In practice, treatment promoting recovery from mental disorder is highly compatible with the “good lives” approach to sexual offender treatment. Staff development, supervision and support are particularly important for staff treating mentally disordered sexual offenders.

It is argued that mentally disordered sexual offenders are an under-researched sub-group within the wider sexual offender population. This paper brings together the relatively limited literature on treatment with examples of recent treatment innovations, multi-modal assessment approaches and reviews of research on the needs of this relatively uncommon but highly risky group.

The purpose of this paper is to present the development and evaluation of an original training package for staff members on fire-setting in people with intellectual disabilities. It also included training on functional analysis as a model of formulating the fire-setting behaviour. The quality and effectiveness of the training was assessed and is reported in this paper.

The training was delivered on a ward for people with intellectual disabilities in a UK NHS Trust Low Secure Hospital and was attended by various members of the multidisciplinary team for the ward. The workshop consisted of four modules: theoretical background of fire-setting, the functional analysis model of fire-setting formulation, offence-paralleling behaviours in secure settings and a case study practice. Level of self-reported understanding of the various aspects of the training was measured by an evaluation questionnaire completed pre and post training.

The results of this study showed that following the training there was a significant increase in self-reported understanding of staff members. The participants reported an increase in understanding of fire-setting, functional analysis and formulation of individuals with an intellectual disability and history of fire-setting.

This study highlights the potential for staff training to increase awareness of fire-setting behaviours by people with intellectual disabilities. The staff training in formulation would encourage their involvement in development of team formulations and may subsequently increase their understanding of such individuals.

Individuals being treated in medium secure hospitals have typically engaged in some form of offending in other service settings or while in the community. Although psychological treatment for addressing such behaviour in medium secure hospitals is beginning to be developed, at present there is a lack of evidence of ‘what works’. This paper reports a review of the type and level of offending behaviour engaged in by those in a single medium secure service, including the conviction histories for such behaviours and the psychological approaches to risk reduction and offending behaviour taken in medium secure hospitals in England and Wales. The need to develop an evidence base for psychological treatment in medium secure services including at the individual level is clearly indicated.

The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a focus on identifying how systemic practice is used or adapted in working with families who have a family member who has presented risk and caused harm.

Four case studies are used to provide a basis for the exploration of commonalities in practice between the cases and the utility of FI within forensic services, which have the dual purpose of promoting mental health recovery and reducing offending/risk behaviour.

Family work can be a key healing tool in the recovery journey of forensic service users and their families. An integrated systemic and psycho-educational FI approach was found to be appropriate in the cases described. Issues particular to forensic services are identified; these include the role of safety planning; the function of talking about the history of trauma in the family including the impact of offending behaviour; mediating difficult relationships between family members and professionals; and overcoming barriers to having difficult and emotive conversations.

The absence of outcome assessments limits the findings to observational data and self-reported experiences from the authors.

FI can be safely and effectively used within forensic settings, facilitated by practitioners competent in working with trauma and complexity, as an integrated component of the therapeutic treatment.

There are recognised barriers to the provision of FI within forensic settings, with limited research regarding the application of such therapies with forensic patients and their families. This paper adds to the small pool of knowledge regarding useful applications of FI in such settings.

The topic of offender rehabilitation has been subject to much research over the past decade. Numerous meta‐analytic reviews of offender treatment, particularly group treatment based on cognitive behavioural principles, have been reported. Together with the ‘triad of principles’ — risk, need and responsivity — they have formed the foundation upon which most offending behaviour interventions have developed. However, outcome data from existing programmes provides mixed evidence, and evidence for interventions for those in forensic mental health settings are still in their infancy. This paper critically considers the current evidence for the treatment of offending behaviour, and its application in forensic mental health settings, in order to inform development of such treatments in low secure mental health care. Most of the research focuses on non‐mental health settings, and is largely what will be considered here. The paper concludes that low secure interventions need to capitalise on the evidence of ‘what works’ while revisiting key concepts such as ‘dose’ and responsivity in order to design appropriate treatments. Individual outcome evaluation needs to form part of development in this area.

The criminogenic needs and psychological vulnerabilities of offenders with intellectual disability (ID) has only recently received attention within the academic literature. The purpose of this paper is to provide an overview of an approach to identifying such needs in order to inform treatment planning and service delivery.

The paper describes the methods employed to identify relevant psychological variables for this population, provides an overview of the framework and describes the practices employed to establish the relevance of a range of criminogenic needs.

A range of psychological variables derived from a systematic literature review are presented in the context of an assessment framework.

The Treatment Need Matrix (TNM) is currently an experimental framework for identifying the needs of offenders with ID (and personality disorder (PD)). Further research is needed to establish the reliability and validity of the tool.

The TNM offers clinicians a practical methodology for determining the significance of a range of psychological variables cited in the literature as relevant treatment targets for offenders with IDs.

The specific criminogenic needs of offenders with ID (and PD) has received little attention within the academic and research communities. This paper offers a novel approach to the identification of relevant treatment targets for individuals with such difficulties.