China
Africa
Explore chapters and articles related to this topic
Introduction
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Psychiatrists have developed specialties within psychiatry, some of which are fully recognized in the UK as requiring defined and scrutinized specialist training and some which are called subspecialties, requiring particular knowledge and skills, but which are treated less formally in terms of the way in which people acquire those skills. Most are highly relevant to forensic psychiatry. The ‘recognized specialities’ are general adult psychiatry, forensic psychiatry, child and adolescent psychiatry, psychotherapy, the psychiatry of learning disability and old age psychiatry, while the subspecialties are addictions psychiatry, liaison psychiatry and rehabilitation psychiatry. Without a firm foundation in general adult psychiatry training, there could be no forensic psychiatry. An understanding of developmental processes is so important that a good grounding in child and adolescent psychiatric training is invaluable, but the needs of young people differ sufficiently from the needs of adults that a ‘superspecialty’ of child and adolescent forensic psychiatry has grown up, coupling higher/advanced training in forensic psychiatry with higher training in child and adolescent psychiatry, lengthening the process by about 12 months to accommodate the extra knowledge and skill development required. Forensic psychotherapy has developed in a similar way, linking recognized training in forensic psychiatry with recognized training in psychotherapy. Forensic learning disability psychiatry is emerging too.
Introduction
Published in David Jones, Working with Dangerous People, 2018
For most people who work in the field of forensic psychotherapy it clear that the work is very difficult and that it is unworthy to make extravagant claims of success, particularly when they are made at the expense of colleagues. As Christopher Cordess states at the beginning of his seminal work ‘. . . forensic psychotherapy always implies a corporate endeavour’.4 This implies a multi-disciplinary team, usually containing psychiatrists, nurses or prison officers, psychologists, psychotherapists together with the skills of a wide range of other practitioners. It is strange therefore that within prison and correctional services in North America and the United Kingdom a virtual monoculture exists. The nothing works/what works paradigm described by Richard Shuker has led to an overwhelming predominance of cognitive behavioural programmes (CBT), which seek to bear down on closely defined aspects of behaviour and thinking and take no note of the whole person or of the impact upon him of his previous life. To many clinicians it is clear that such programmes can have a beneficial but limited effect but it is equally obvious that they are sometimes banal and simplistic and arouse scorn from prisoners, at least when they are out of earshot of their instructors. Recent research is beginning to indicate that earlier highly optimistic treatment effects are not standing the test of time.5 This is to be expected and is a familiar pattern with ‘new revolutionary’ treatments, from leeches to Prozac. My hope is that this new realism will allow for the development of true multidisciplinary working within correctional services.
Psychological treatment of problematic sexual interests: cross-country comparison
Published in International Review of Psychiatry, 2019
Kateřina Klapilová, Liubov Y. Demidova, Helen Elliott, Charles A. Flinton, Petr Weiss, J. Paul Fedoroff
Different psychotherapeutic approaches are discussed and applied. Examples include psychoanalytic treatment of individuals convicted of sexual crimes (International Association for Forensic Psychotherapy, 2018), hypnosis (Zhitlovskii, 2007), or autosuggestion in supportive therapy (Goland, 1983). The patient is taught techniques relating to relaxation, distraction, and aversion to anomalous targets of sexual interest as well as techniques reinforcing normative sexual interest in adults. Hypnosis, suggestive programming, and modelling are used when the patient is exposed to suggestive thoughts about normal sexual intercourse. Catharsis and regressive techniques are used to address past traumatic experiences (Kocharyan, 2013).