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Journal articles on the topic 'Forensic occupational therapy'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Fan, Chia-Wei, Mary Morley, Mike Garnham, David Heasman, and Renee Taylor. "Examining changes in occupational participation in forensic patients using the Model of Human Occupation Screening Tool." British Journal of Occupational Therapy 79, no. 12 (July 20, 2016): 727–33. http://dx.doi.org/10.1177/0308022616651644.

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Introduction In occupational therapy, there has been an increased interest in patients’ occupational participation within forensic settings. This retrospective study involved a longitudinal analysis of occupational participation within six forensic hospitals in England. The aim was to contribute to the understanding of forensic patients’ occupational participation over a two-year period. Methods The Model of Human Occupation Screening Tool (MOHOST) was rated by 78 occupational therapists on 489 patients in low and medium secure units who were receiving occupational therapy over two years. The many-faceted Rasch Model was used to convert their MOHOST scores at each time point into interval scales. Regression analysis was used to examine changes in occupational participation over time. Results Patients’ overall occupational participation improved over time. Specifically, participation improved in five of the six MOHOST subdomains, which included their motivation for occupation, pattern of occupation, communication/interaction skills, process skills, and environment. Patients did not demonstrate significant change in their motor skills, which varied as expected. In addition, patients in low secure units had better occupational participation than those in medium secure settings. Conclusion Our findings indicated improvements in the patients’ occupational participation over the 2-year period. Further investigations are needed to understand factors contributing to change.

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2

Dunn, Christopher, and Alison Seymour. "Forensic Psychiatry and Vocational Rehabilitation: Where are We at?" British Journal of Occupational Therapy 71, no. 10 (October 2008): 448–50. http://dx.doi.org/10.1177/030802260807101008.

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Having a productive occupation is seen as fundamental to an individual's health and wellbeing. Employment provides structure, self-identity, a means to provide for oneself and social inclusion. The Government has made a commitment to invest in supporting people back into the workplace following illness. This opinion piece reflects the authors' interest in how this applies to service users with a forensic history, who face additional barriers to employment. It calls on occupational therapists to share research and practice accounts of vocational rehabilitation within forensic settings in order to contribute to the evidence base for this area of occupational therapy practice.

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3

Stewart, Paul, and Christine Craik. "Occupation, Mental Illness and Medium Security: Exploring Time-Use in Forensic Regional Secure Units." British Journal of Occupational Therapy 70, no. 10 (October 2007): 416–25. http://dx.doi.org/10.1177/030802260707001002.

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Research investigating occupational experience among people with mental illness has highlighted their difficulties in selecting, organising, valuing, enjoying and competently performing occupations. Although occupational therapy literature consistently identifies environmental factors as key in facilitating successful and valued engagement, few authors have studied the implications of detention in secure mental health settings for this population. This study investigated the occupational experiences of five people with schizophrenia in two forensic regional secure units. Quantitative and qualitative methodologies were used, with semi-structured interviews adding depth and subjectivity to Occupational Questionnaire (Smith et al 1986) responses. The quantitative data were analysed using non-parametric analysis, with content analysis applied to the qualitative data. Time-use was characterised predominantly by engagement in passive leisure and rest occupations. This reflects the findings of both inpatient and community-based studies elsewhere and suggests that mental illness is a common factor influencing time-use. The participants chose occupations based on expectations of enjoyment and success, and associations with independence and normality. Significant correlations were found between perceived competence, value and enjoyment (p<0.01), and the participants were more likely to enjoy self-chosen occupations (p<0.05). Forensic occupational therapists must use evidence to optimise resources and deliver interventions that facilitate choice and autonomy and reflect individual needs. Further research with larger samples and longitudinal methodologies will facilitate generalisation and establish temporal perspectives.

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4

Chacksfield, John D., and David M. Forshaw. "Occupational therapy and forensic addictive behaviours." British Journal of Therapy and Rehabilitation 4, no. 7 (July 1997): 381–86. http://dx.doi.org/10.12968/bjtr.1997.4.7.14417.

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5

Lloyd, Chris. "Evaluation and Forensic Psychiatric Occupational Therapy." British Journal of Occupational Therapy 48, no. 5 (May 1985): 137–40. http://dx.doi.org/10.1177/030802268504800509.

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6

Camus, Erica. "Occupational therapy on a forensic ward." Lancet Psychiatry 3, no. 1 (January 2016): 22–23. http://dx.doi.org/10.1016/s2215-0366(15)00572-6.

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7

Duncan, Edward A. S., Karen Munro, and Margaret M. Nicol. "Research Priorities in Forensic Occupational Therapy." British Journal of Occupational Therapy 66, no. 2 (February 2003): 55–64. http://dx.doi.org/10.1177/030802260306600203.

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National research priorities have been developed and published by the College of Occupational Therapists (Ilott and White 2001). Such an exercise, however, cannot provide the specific research priorities of a particular area of practice. A questionnaire survey was undertaken to ascertain the specific research priorities of forensic occupational therapists. The survey had three parts: determining research priorities, examining outcome measures and exploring the use of protocol-driven group work. Three specific research priorities were clearly defined by part one of the survey: the development of appropriate outcome measures, the development of rigorous and effective group-work programmes and the development of effective risk assessment tools. The nominal group technique was used in order to triangulate the data. The survey also examined the participants' use of outcome measures: a high number of the participants (62%, 44/71) stated that they used outcome measures in practice. The participants' responses to the third aspect of the survey, regarding the use of protocol-driven groups, were more varied. The majority of the groups reported by the participants were ‘home grown’, with little research base underpinning their implementation. The methodological weaknesses of undertaking such a survey are examined. The paper concludes that having identified clinicians' priorities in forensic occupational therapy research, the challenge is how best to gather robust evidence for practice.

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8

Lloyd, Chris. "Trends in Forensic Psychiatry." British Journal of Occupational Therapy 58, no. 5 (May 1995): 209–13. http://dx.doi.org/10.1177/030802269505800507.

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Forensic psychiatry is a specialty area of psychiatry. A review of the occupational therapy literature was conducted to examine occupational therapy practice in this area. The implications for developing opportunities for occupational therapists are then discussed.

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9

Chacksfield, John D. "Forensic occupational therapy: is it a developing specialism?" British Journal of Therapy and Rehabilitation 4, no. 7 (July 1997): 371–74. http://dx.doi.org/10.12968/bjtr.1997.4.7.14414.

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10

Flood, Brenda. "An introduction to occupational therapy in forensic psychiatry." British Journal of Therapy and Rehabilitation 4, no. 7 (July 1997): 375–80. http://dx.doi.org/10.12968/bjtr.1997.4.7.14416.

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11

Smith, Nicky. "Forensic occupational therapy for people with learning disabilities." British Journal of Therapy and Rehabilitation 5, no. 9 (September 1998): 472–76. http://dx.doi.org/10.12968/bjtr.1998.5.9.14174.

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12

Busuttil, Joseph. "Forensic occupational therapy in Malta: A historical overview." World Federation of Occupational Therapists Bulletin 36, no. 1 (January 1997): 25–26. http://dx.doi.org/10.1080/14473828.1997.11785353.

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13

Morris, Karen, and Kath Ward. "The implementation of a new conceptual framework for occupational engagement in forensic settings: feasibility and application to occupational therapy practice." Mental Health Review Journal 23, no. 4 (December 10, 2018): 308–19. http://dx.doi.org/10.1108/mhrj-03-2018-0007.

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Purpose Facilitation of genuine occupational engagement rather than a more superficial level of participation that has minimal therapeutic benefit is a challenge within secure mental health settings. The purpose of this paper is to develop, pilot and evaluate therapeutic tools based on a framework of occupational engagement. Design/methodology/approach The study used action research with occupational therapists from two secure residential units. Focus group discussions gathered participants’ views of how the occupational engagement framework could be used to inform a therapeutic tool. Following the development and piloting of the subsequent tools, focus groups were again used to review their usefulness in practice. Discussions were audio recorded and thematically analysed. Findings Three tools were designed and piloted. Evaluation revealed a number of benefits and different ways in which the tools could be used in practice. Research limitations/implications This research has indicated that the occupational engagement framework has potential for increasing understanding of the relationship between the value and consequences of participating in occupations. The limited timescale of the research restricted the opportunity to fully explore the tools’ potential effectiveness as outcome measures. Practical implications The clinical tools developed within this research have provided some information to the clinical teams which has contributed to their understanding of how service users experience participating in occupations. Originality/value The occupational engagement framework and resulting tools have the potential to enhance understanding of occupational engagement within secure settings.

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14

Lloyd, Chris, and Fidel Guerra. "A Vocational Rehabilitation Programme in Forensic Psychiatry." British Journal of Occupational Therapy 51, no. 4 (April 1988): 123–26. http://dx.doi.org/10.1177/030802268805100407.

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A key objective for occupational therapists in forensic psychiatry is to integrate those patients who are employable back into the community as productive citizens. There is a need for expertise in evaluating the employability of the individual and the development of work-related skills in order to assist the individual to obtain a job in a competitive market.

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15

Clarke, Channine. "Clinical Application of the Canadian Model of Occupational Performance in a Forensic Rehabilitation Hostel." British Journal of Occupational Therapy 66, no. 4 (April 2003): 171–74. http://dx.doi.org/10.1177/030802260306600407.

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In order to improve the quality and effectiveness of occupational therapy service provision, therapists should be using models of practice. This paper describes the Canadian Model of Occupational Performance and critically evaluates its application within a forensic rehabilitation hostel. It provides examples from practice and discusses the strengths and limitations of the model.

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16

Flood, Brenda. "Implications for Occupational Therapy Services following the Reed Report." British Journal of Occupational Therapy 56, no. 8 (August 1993): 293–94. http://dx.doi.org/10.1177/030802269305600808.

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This article represents a personal viewpoint following the publication of the Reed Report, which is likely to bring about changes in the provision of forensic psychiatric services. Contained within the Reed Report are recommendations, some of which will directly affect the occupational therapy profession. Occupational therapists need to be aware of the recommendations made and to take a proactive role in their implementation and development. This article outlines the main recommendations and highlights the implications of these for occupational therapy practice.

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17

Lloyd, Chris. "Vocational Evaluation in a Forensic Psychiatric Setting." Canadian Journal of Occupational Therapy 53, no. 1 (February 1986): 31–35. http://dx.doi.org/10.1177/000841748605300107.

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The Forensic Unit of the Alberta Hospital Edmonton has moved from evaluating the performance of a client in a work setting by observation to providing a comprehensive data base on the client through the use of a work history, interest screening and commercial work evaluation systems. A standardized approach, to evaluation has enabled the Occupational Therapists to develop a unique treatment programme for the individual client as a result of the evaluation process and provided reliable data in returning the client to competitive employment.

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18

Taylor, Renee, and Fan Chia-Wei. "Did Occupational Therapy Services Facilitate Forensic Patients’ Participation Over Time?" American Journal of Occupational Therapy 69, Suppl. 1 (July 1, 2015): 6911515049p1. http://dx.doi.org/10.5014/ajot.2015.69s1-rp103c.

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19

Chui, Adora L. Y., Chantal Isabelle Wong, Sara A. Maraj, Danielle Fry, Justine Jecker, and Bonny Jung. "Forensic Occupational Therapy in Canada: The Current State of Practice." Occupational Therapy International 23, no. 3 (February 17, 2016): 229–40. http://dx.doi.org/10.1002/oti.1426.

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20

Soeker, Mogammad Shaheed, Saabirah Hare, Saadia Mall, and Jean van der Berg. "The value of occupational therapy intervention for the worker roles of forensic mental healthcare users in Cape Town, South Africa." Work 68, no. 2 (February 26, 2021): 399–414. http://dx.doi.org/10.3233/wor-203381.

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BACKGROUND: There is a void in research that focuses on how OT programs facilitate self-esteem in forensic mental healthcare users’ return-to-work in the open labor market, particularly in South Africa. OBJECTIVE: To explore the experiences and perceptions of forensic mental healthcare users, transitioning from an OT program to the open labor market. METHODS: Five individuals, diagnosed with Schizophrenia, and two key informants participated in this study that was positioned in a qualitative paradigm, with an exploratory and descriptive design. Semi-structured interviews were used to collect data. RESULTS: Theme one reflects on the challenges experienced by forensic mental healthcare users, when returning to work. Theme two describes various OT programs, as well as how they facilitate the reintegration of forensic mental healthcare users into the worker role. Theme three describes the positive support for forensic mental healthcare users, in the mental healthcare setting, workplace, and the greater community. Theme four describes how participation in occupation installs hope in forensic mental healthcare users, reinforcing the value of work, while positively influencing their work identity. CONCLUSION: The results revealed that stigma, residual symptoms, relapse due to substance abuse/mental health, and the lack of family support, were not be conducive to work skills development. However, the support of family and friends, workplace occupational therapy support, assembly line work, and therapeutic groups in an OT program, ensured positive workplace reintegration.

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21

Best, Diana. "The Developing Role of Occupational Therapy in Psychiatric Intensive Care." British Journal of Occupational Therapy 59, no. 4 (April 1996): 161–64. http://dx.doi.org/10.1177/030802269605900403.

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Occupational therapy has an established role in the delivery of mental health services. Psychiatric Intensive Care Units (PICUs) are a development found in many psychiatric inpatient facilities and their numbers are increasing. The introduction of occupational therapy to a recently established PICU is examined. A comparison is made between PICU and forensic client groups, and the developing need for PICUs as a distinct service and the client group they serve are described. An example of successful service delivery of occupational therapy in a PICU is offered, and the challenges to the therapist working in this demanding and rewarding setting are outlined.

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22

Cordingley, Kevin, and Susan Ryan. "Occupational Therapy Risk Assessment in Forensic Mental Health Practice: An Exploration." British Journal of Occupational Therapy 72, no. 12 (December 2009): 531–38. http://dx.doi.org/10.4276/030802209x12601857794736.

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23

Fan, Chia-Wei. "Correlations Between Overall Health Status and Occupational Participation in Forensic Clients." American Journal of Occupational Therapy 73, no. 4_Supplement_1 (August 1, 2019): 7311500028p1. http://dx.doi.org/10.5014/ajot.2019.73s1-po7010.

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24

Hitch, Danielle, QK Hii, and Ian Davey. "Occupational therapy in forensic psychiatry: Recent developments in our understandings (2007–2013)." British Journal of Occupational Therapy 79, no. 4 (September 8, 2015): 197–205. http://dx.doi.org/10.1177/0308022615591018.

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25

York, Colin. "Book Review: Forensic Psychiatry for Health Professionals." British Journal of Occupational Therapy 58, no. 3 (March 1995): 130. http://dx.doi.org/10.1177/030802269505800316.

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26

Fitzgerald, Martin, Gemma Ratcliffe, and Cherelle Blythe. "Family Work in Occupational Therapy: A Case Study from a Forensic Service." British Journal of Occupational Therapy 75, no. 3 (March 2012): 152–55. http://dx.doi.org/10.4276/030802212x13311219571864.

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27

LLOYD, CHRIS. "The Role of Occupational Therapy in the Treatment of the Forensic Psychiatric Patient." Australian Occupational Therapy Journal 34, no. 1 (August 27, 2010): 20–25. http://dx.doi.org/10.1111/j.1440-1630.1987.tb01561.x.

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28

Craik, Christine. "Occupational Therapy in Mental Health: A Review of the Literature." British Journal of Occupational Therapy 61, no. 5 (May 1998): 186–92. http://dx.doi.org/10.1177/030802269806100501.

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This review of the literature was conducted as part of the development of a position paper on the way ahead for research, education and practice in occupational therapy in mental health. It included publications over the past decade and concentrated on the British Journal of Occupational Therapy. Recognising that experience from other countries would be beneficial, aspects of the literature from the national journals in the USA, Canada and Australia which were most relevant to practice in the United Kingdom were included. The shortage of articles on mental health was conspicuous and their diverse topics and descriptive nature were notable. In the United Kingdom literature, the clinical subjects featured most often were dementia, work rehabilitation, community mental health and forensic psychiatry, with other subjects either appearing infrequently or not included. The literature from the other countries also explored new roles for occupational therapy, reflecting the changes in the delivery of mental health services. In the American Journal of Occupational Therapy, there was concern about the declining number of occupational therapists working in mental health. The review identified major themes in the literature, posed questions for research, education and practice in occupational therapy and formed the foundation for the position paper.

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Talbot, Emily, Yvonne Bird, Jo Russell, Karan Sahota, Justine Schneider, and Najat Khalifa. "Implementation of individual placement and support (IPS) into community forensic mental health settings: Lessons learned." British Journal of Occupational Therapy 81, no. 6 (March 26, 2018): 338–47. http://dx.doi.org/10.1177/0308022618756593.

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Introduction Assessment of the effectiveness of individual placement and support in forensic mental health settings is a relatively new field of research despite evidence demonstrating its effectiveness in generic mental health settings. Method IPS was implemented into a community forensic mental health setting within a large National Health Service trust in the United Kingdom over 6 months. Using the Consolidated Framework for Implementation Research this paper describes the lessons learned from implementing individual placement and support into such settings. Results Our findings suggest that implementation of individual placement and support in forensic mental health settings is complex and requires robust planning and collaboration with internal and external agencies. Barriers to implementation included staff attitudes, difficulty engaging employers and lack of employment related performance indicators, and facilitators included the support of service managers and outside groups. Adaptations to the IPS model were made to address challenges encountered, including difficulty starting rapid job searches, concerns about stigma, lack of confidence, uncertainty around employment opportunities, offence restrictions and lack of interest from potential employers. Conclusion This paper adds to the limited literature in the field. Findings are relevant to practitioners and service providers who wish to implement individual placement and support services for people with mental disorder and offending histories.

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Khalifa, Najat, Sarah Hadfield, Louise Thomson, Emily Talbot, Yvonne Bird, Justine Schneider, Julie Attfield, Birgit Völlm, Peter Bates, and Dawn-Marie Walker. "Barriers and facilitators to the implementation of individual placement and support (IPS) for patients with offending histories in the community: The United Kingdom experience." British Journal of Occupational Therapy 83, no. 3 (November 5, 2019): 179–90. http://dx.doi.org/10.1177/0308022619879334.

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Introduction We aimed to identify the barriers and facilitators to the implementation of a high fidelity individual placement and support service in a community forensic mental health setting. Method In-depth interviews were conducted with clinical staff ( n = 11), patients ( n = 3), and employers ( n = 5) to examine barriers and facilitators to implementation of a high fidelity individual placement and support service. Data was analysed using thematic analysis, and themes were mapped onto individual placement and support fidelity criteria. Results Barriers cited included competing interests between employment support and psychological therapies, perceptions of patients’ readiness for work, and concerns about the impact of returning to work on welfare benefits. Facilitators of implementation included clear communication of the benefits of individual placement and support, inter-disciplinary collaboration, and positive attitudes towards the support offered by the individual placement and support programme among stakeholders. Offences, rather than mental health history, were seen as a key issue from employers’ perspectives. Employers regarded disclosure of offending or mental health history as important to developing trust and to gauging their own capacity to offer support. Conclusions Implementation of individual placement and support in a community mental health forensic setting is complex and requires robust planning. Future studies should address the barriers identified, and adaptations to the individual placement and support model are needed to address difficulties encountered in forensic settings.

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31

Harris, Suzi, Louise Farnworth, and Lorrae Mynard. "Experiences of disclosure for vocational occupations by forensic mental health consumers." Journal of Vocational Rehabilitation 52, no. 3 (April 17, 2020): 291–301. http://dx.doi.org/10.3233/jvr-201078.

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32

Heard, Clark, Jared Scott, Allan Tetzlaff, and Heather Lumley. "Transitional Justice Housing in Forensic Mental Health: Considering Consumer Lived Experience." American Journal of Occupational Therapy 73, no. 4_Supplement_1 (August 1, 2019): 7311520426p1. http://dx.doi.org/10.5014/ajot.2019.73s1-po3043.

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33

Heard, Clark, Jared Scott, and Stephen Yeo. "Eco Therapy and Spirituality in Forensic Mental Health: A Preliminary Outcome Study." American Journal of Occupational Therapy 74, no. 4_Supplement_1 (August 1, 2020): 7411520472p1. http://dx.doi.org/10.5014/ajot.2020.74s1-po3510.

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34

Smith, Andy, Maggie Petty, Iona Oughton, and Regi T. Alexander. "Establishing a Work-Based Learning Programme: Vocational Rehabilitation in a Forensic Learning Disability Setting." British Journal of Occupational Therapy 73, no. 9 (September 2010): 431–36. http://dx.doi.org/10.4276/030802210x12839367526174.

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35

Connell, Catriona. "Forensic occupational therapy to reduce risk of reoffending: a survey of practice in the United Kingdom." Journal of Forensic Psychiatry & Psychology 27, no. 6 (November 2016): 907–28. http://dx.doi.org/10.1080/14789949.2016.1237535.

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36

Tregoweth, Jenni, Jo Ann Walton, and Kirk Reed. "The experiences of people who re-enter the workforce following discharge from a forensic hospital." Journal of Vocational Rehabilitation 37, no. 1 (2012): 49–62. http://dx.doi.org/10.3233/jvr-2012-0599.

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37

Connell, Caty. "An integrated case formulation approach in forensic practice: the contribution of Occupational Therapy to risk assessment and formulation." Journal of Forensic Psychiatry & Psychology 26, no. 1 (November 17, 2014): 94–106. http://dx.doi.org/10.1080/14789949.2014.981566.

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38

O'Connell, Marita, and Louise Farnworth. "Occupational Therapy in Forensic Psychiatry: A Review of the Literature and a Call for a United and International Response." British Journal of Occupational Therapy 70, no. 5 (May 2007): 184–91. http://dx.doi.org/10.1177/030802260707000502.

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39

Wiglesworth, Sophie, and Louise Farnworth. "An Exploration of the Use of a Sensory Room in a Forensic Mental Health Setting: Staff and Patient Perspectives." Occupational Therapy International 23, no. 3 (May 29, 2016): 255–64. http://dx.doi.org/10.1002/oti.1428.

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40

Tully, John, Leo McSweeney, Katie-Lynn Harfield, Cindie Castle, and Mrigendra Das. "Innovation and pragmatism required to reduce seclusion practices." CNS Spectrums 21, no. 6 (October 28, 2016): 424–29. http://dx.doi.org/10.1017/s1092852916000481.

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Seclusion may be harmful and traumatic to patients, detrimental to therapeutic relationships, and can result in physical injury to staff. Further, strategies to reduce seclusion have been identified as a potential method of improving cost-effectiveness of psychiatric services. However, developing alternative strategies to seclusion can be difficult. Interventions to reduce seclusion do not lend themselves to evaluation using randomized controlled trials (RCTs), though comprehensive literature reviews have demonstrated considerable non-RCT evidence for interventions to reduce seclusion in psychiatric facilities. In the UK, a recent 5-year evaluation of seclusion practice in a high secure UK hospital revealed reduced rates of seclusion without an increase in adverse incidents. To assess the effect of a novel intervention strategy for reduction of long-term segregation on a high secure, high dependency forensic psychiatry ward in the UK, we introduced a pilot program involving stratified levels of seclusion (“long-term segregation”), multidisciplinary feedback and information sharing, and a bespoke occupational therapy program. Reduced seclusion was demonstrated and staff feedback was mainly positive, indicating increased dynamism and empowerment on the ward. A more structured, stratified approach to seclusion, incorporating multidisciplinary team-working, senior administrative involvement, dynamic risk assessment, and bespoke occupational therapy may lead to a more effective model of reducing seclusion in high secure hospitals and other psychiatric settings. While lacking an evidence base at the level of RCTs, innovative, pragmatic strategies are likely to have an impact at a clinical level and should guide future practice and research.

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41

Graham, Anne, Celia Harbottle, and David King. "Resolve: a community-based forensic learning disability service specialising in supporting male sex offenders – our model, approach and evidence base for effective intervention." Journal of Intellectual Disabilities and Offending Behaviour 7, no. 4 (December 12, 2016): 186–94. http://dx.doi.org/10.1108/jidob-10-2014-0014.

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Purpose The purpose of this paper is to examine a model of effective forensic practice with positive interventions for men with learning disabilities who have committed serious sexual offences. It outlines the theoretical and philosophical frameworks which have informed the model of care and support in a community-based setting and the evidence base for the efficacy of the approach. Design/methodology/approach This approach to a community-based forensic learning disability service is informed by systemic practice and underpinned by models of human occupation (Keilhofner, 2008) which informs occupational therapy and total attachment (Harbottle et al., 2014). This is a whole systems model for developing compassionate and participatory practice based on attachment theory and approaches to professional parenting drawn from foster care settings and prevention frameworks for adult safeguarding. It uses Klinean Thinking Environments (1999) to give practical communication to the model. Findings The attachment model which underpins both the support for staff and the framework for scaffolding the care and support provided for service users is building calm, consistent and respectful relationships. This enables workers and service users to feel accepted through the availability of support; to feel a sense of belonging and inclusion in which skills and confidence can flourish helping all to feel more effective. This is evidenced by the stability of the service user group and the staff team. Research limitations/implications The model of whole system care and support care outlined in this paper can help to provide a therapeutic environment in which men who have committed sexual offences can develop effective skills within a safe, supportive and effectively managed setting. This is on-going research but there is evidence of service users and staff in this model of practice, feeling scaffolded, able to enjoy and achieve progress and personal development. Practical implications This model appears to promote stable, sustained, supportive relationships. Placement breakdown has been minimal indicating that the disruption rate is low and therefore therapeutic interventions are likely to take place and be effective. This is a hopeful and positive approach which enables individuals to flourish in a safe environment. Social implications The social implications of this model are positive for creating a stable workforce in an industry plagued with rapid turn over of staff to the detriment of the quality of life for service users. It creates stability and confidence for the residents allowing them to begin to relax and thereafter achieve more positive relationships. Originality/value This paper examines the application of theoretical frameworks drawn from other disciplines and fuses them into a therapeutic approach to support this service user group. It is a model that can have great portability to other settings but it is its application in forensic services that is new and which is growing its evidence base for its effectiveness.

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Tahir, Fizza, Hina Zafar Raja, Muhammad Nasir Saleem, Ayesha Iqbal, Muhammad Saad Ullah, and Faiqua Yasser. "Awareness of Forensic Odontology among Dentists in Pakistan and its Impact on Dental Record Keeping." Pakistan Journal of Medical and Health Sciences 16, no. 8 (August 31, 2022): 92–95. http://dx.doi.org/10.53350/pjmhs2216892.

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Background: Forensic odontology (FO) has an important role to play in the field of forensic science to gather evidence for human identification. Dental records form an integral component of forensic evidence in this regard. Dental practitioners need to be aware of the legal significance of dental record keeping. They should be able to provide accurate information on which forensic evidence can be based. Aim: To assess the awareness regarding FO and dental record-keeping practices amongst dental partitioners in Pakistan. Methods: A cross-sectional study was conducted among dental practitioners to assess the awareness regarding FO and dental record-keeping in clinical practice. Results: A total of 380 responses were received. Results showed that only 2% of the respondents studied the subject of forensic dentistry at the undergraduate or postgraduate level. 88 % of the individuals were interested in receiving formal training in forensic dentistry and 96% recommended the subject of forensic dentistry to be introduced as a separate postgraduate training program in Pakistan. More than half of the respondents reported a lack of record-keeping in their clinical practice. Conclusions: Limited awareness was observed regarding FO among dental practitioners in Pakistan primarily due to lack of exposure to the subject. In terms of dental record keeping, a limited number of practitioners in our study reported adhering to it. Hence, there is a need to develop measures to promote awareness and knowledge about FO and dental record management in Pakistan. Keywords: Forensic odontology, awareness, education, dental records, dental identification.

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Baird, Stephanie, and Sharon Rae Jenkins. "Vicarious Traumatization, Secondary Traumatic Stress, and Burnout in Sexual Assault and Domestic Violence Agency Staff." Violence and Victims 18, no. 1 (February 2003): 71–86. http://dx.doi.org/10.1891/vivi.2003.18.1.71.

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This study investigated three occupational hazards of therapy with trauma victims: vicarious trauma and secondary traumatic stress (or “compassion fatigue”), which describe therapists’ adverse reactions to clients’ traumatic material, and burnout, a stress response experienced in many emotionally demanding “people work” jobs. Among 101 trauma counselors, client exposure workload and being paid as a staff member (vs. volunteer) were related to burnout sub-scales, but not as expected to overall burnout or vicarious trauma, secondary traumatic stress, or general distress. More educated counselors and those seeing more clients reported less vicarious trauma. Younger counselors and those with more trauma counseling experience reported more emotional exhaustion. Findings have implications for training, treatment, and agency support systems.

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Mortlock, Anna-Marie, Fintan Larkin, Callum C. Ross, Nitin Gupta, Samrat Sengupta, and Mrigendra Das. "Effectiveness of paliperidone depot injection in seriously violent men with comorbid schizophrenia and dissocial personality disorder in a UK high-security hospital." Therapeutic Advances in Psychopharmacology 7, no. 5 (March 27, 2017): 169–79. http://dx.doi.org/10.1177/2045125317693513.

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Background: High-security hospital patients are often complex in presentation and are characterized by treatment resistance, medication nonadherence and history of violence. Paliperidone is licensed both as an oral and depot antipsychotic medication in the treatment of schizophrenia. Clinical trials have shown that paliperidone depot is well tolerated with similar efficacy to risperidone depot but with additional practical advantages. Whilst data exist for the effectiveness of paliperidone palmitate (PP), there are no studies involving patients in forensic settings or those with comorbid personality disorder. Our aim was to evaluate the effectiveness of PP on violence, aggression and personality disorder symptoms. Methods: This project was a retrospective service evaluation involving 11 patients, carried out in a high-security hospital. A combination of patient records and interviews with the treating consultant psychiatrist were used to ascertain a Clinical Global Impression (CGI) score, the effect of PP on specific personality disorder symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol and affective dysregulation) and incidents of violence and aggression. Engagement with occupational and psychological therapies was also evaluated. Metabolic parameters were reviewed. Results: A total of 6 out of 11 patients continued on PP, most of whom had schizophrenia and dissocial personality disorder with histories of violence. All showed improvement in the CGI score with associated benefits in the three personality symptom domains. Overall, two patients demonstrated a reduction in the risk of violence. There was improvement in engagement with occupational therapy and psychological work. No significant effects on metabolic parameters were noted although hyperprolactinaemia, albeit asymptomatic, was consistently recorded. Conclusions: This pragmatic service evaluation of a small but complex patient group demonstrated, for the first time, that PP was effective in reducing violence as well as improving personality pathology across all dimensions: a finding which could have significant implications for management of such high-security patients.

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Cross, Cosmina. "Improving physical health for psychiatric patients detained in a low secure forensic psychiatric unit in the United Kingdom." BJPsych Open 7, S1 (June 2021): S180—S181. http://dx.doi.org/10.1192/bjo.2021.490.

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AimsThis project aimed to improve physical health and to tackle obesity in patients detained in a low secure forensic psychiatric unit.BackgroundPeople suffering from severe and enduring mental health problems have a life expectancy of 15-20 years less than the general population. The main cause of death is cardiovascular disease due to lifestyle factors, such as smoking, substance misuse and obesity.Physical health problems such as metabolic syndrome, diabetes and heart disease have a knock on effect on motivation, self-esteem and concordance with treatment.Over 60% of the general population and up to 80% of patients detained in forensic psychiatric units in the UK are classed as overweight or obese, with serious consequences to physical health.Southfield Low Secure Unit is a 28 bed unit. Most patients suffer from treatment resistant schizophrenia and are prescribed high doses of antipsychotic medication, some up to 250% of the maximum recommended dose.MethodBaseline data were collected using Body Mass Index (BMI) and Simple Physical Activity Questionnaire (SPAQ). Following the initial data collection, patients were involved in focus groups, community meetings and a monthly physical health action group. There was input from the care team including psychology, occupational therapy, nursing, catering and security. New activities have been made available such as “physical health and mental health education group”, “rambling group”, “gym sessions”, “patient focus groups” and “walking group”.ResultThis project has been running for 9 months and is ongoing.There has been a modest change in the BMI – initial results ranging from BMI 23.6–42.8kg/m2. Of the initial cohort (n = 14), there has been weight loss (n = 3), weight gain (n = 3) and no change (n = 8).The initial SPAQ results showed that on average patients spend 19.8 hours per day either in bed or doing sedentary activities and only 1.68 hours per day walking or doing physical activities. This pattern is being reassessed.The qualitative data from patient focus groups shows increased interest in activities, motivation and desire to contribute to the project.ConclusionThe preliminary results show an increase in patient motivation and engagement with available activities. There have also been patient-led challenges which were well received. Patients feel positive about the programme and valued for their input. Further support is required to maintain progress.

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Idzinga, Riet. "Occupational therapy, forensics and the care and treatment of addicts." World Federation of Occupational Therapists Bulletin 36, no. 1 (January 1997): 16–19. http://dx.doi.org/10.1080/14473828.1997.11785351.

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Kazitskaya, Anastasiya S., Oleg I. Bondarev, Maria S. Bugaeva, Anna G. Zhukova, and Tatyana K. Yadykina. "Morphometric and genetic studies of the mechanisms of damage to the cardiovascular system in Kuzbass miners with dust lung pathology." Russian Journal of Occupational Health and Industrial Ecology 61, no. 9 (October 20, 2021): 611–19. http://dx.doi.org/10.31089/1026-9428-2021-61-9-611-619.

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Introduction. The combined impact of unfavorable factors of the production environment in miners leads to the development of associated pathology of the bronchopulmonary and cardiovascular systems, the predisposition to which depends on the individual susceptibility of the body. In this regard, it is important to comprehensively study the pathogenetic mechanisms underlying the formation and course of occupational and work-related diseases for a personalized approach to the diagnosis, prevention and therapy of this pathology. The purpose of this study was to study the mechanisms of damage to the cardiovascular system in miners with dust lung pathology on the basis of morphological and genetic studies. Materials and methods. For genetic studies, venous blood drawing was conducted in 190 Kuzbass miners. The main group included 126 miners of the main professions with the previously proven diagnosis "dust lung pathology", the comparison group consisted of 64 workers without a proven diagnosis working in similar sanitary and hygienic conditions. Morphometric studies were carried out using autopsy material obtained during 80 forensic medical examinations of miners in the Kemerovo region. All the miners were divided into 4 groups depending on their underground work experience. The control group was formed from 20 cases of forensic medical examinations of men who died in road accidents and did not have organ pathology according to the results of autopsies. Results. The study of the autopsy material revealed the presence of morphostructural changes in the vascular walls of the miners’ hearts in the form of hypertrophy of the smooth muscle cells of the medial layers, thickening of the endothelial lining, and the development of fibroplastic changes in the perivascular zones. These changes began to form from the first years of work in the underground conditions and progressed with increasing work experience contributing to the "recalibration" of the heart vessels with the formation of the lumen "obstruction". One of the mechanisms of endothelial damage in miners was a change in the expression of the EDN1 gene, which regulates the synthesis of endothelin-1. The risk and resistance genotypes of the development of dust lung pathology for the rs5370 polymorphism of the EDN1 gene were identified. Morphostructural rearrangement of the endothelium in the combination with its pathological activation contributed to the occurrence of endothelial dysfunction in miners. Conclusions. The conducted studies of the parameters of the vascular endothelium indicate its key role in the pathogenesis of bronchopulmonary and cardiovascular pathology in miners of the main professions. Getting into the body of workers, particles of coal-rock dust lead to morphostructural rearrangement of the cells of the endothelial layer and its pathological activation. The contribution of molecular and genetic mechanisms to the development of occupational lung pathology and associated diseases of the circulatory system in miners is revealed. Ethics. The studies were carried out in compliance with the ethical standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, elaborated on the basis of the Helsinki Declaration of the World Medical Association "Ethical Principles for Conducting Human Scientific Medical Research" as amended in 2013 and the "Rules of Clinical Practice in the Russian Federation" approved by the Order of the Ministry of Health of the Russian Federation No. 266 dated 19.06.2003. All workers were informed about their participation in the molecular-genetic study and gave written consent to carry it out. The research of the dead miners was based on the secondary examination of blocks and ready-made histological micro-preparations of the material of the Bureau for Forensic Medical Expert Examination of the cities of Novokuznetsk, Osinniki, and Prokopyevsk. The study of pathomorphological material was carried out in accordance with the Federal Law of 21.11.2011, No. 323-FZ "On the Fundamentals of Health Protection of Citizens in the Russian Federation", in particular, with Article 67 "Carrying out pathological and anatomical autopsies", Federal Law of 12.01.1996, No. 8-FZ "On burial and funeral business" (Article 5, paragraphs 1, 2), as well as on the basis of the Order of the Ministry of Health of April 29, 1994, No. 82 "On the procedure for conducting pathological and anatomical autopsy" (Annex to the Order of the Ministry of Health and Medical Industry of 29.04.1994 No. 82), the Order of the Ministry of Health of Russia of 24.03.2016. No. 179n "On the rules for conducting pathological and anatomical examinations".

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Bhootra, B. L., and J. Kitinya. "Deaths from accidental steam inhalation during traditional therapy." Journal of Clinical Forensic Medicine 12, no. 4 (August 2005): 214–17. http://dx.doi.org/10.1016/j.jcfm.2005.02.001.

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Wilson, P., R. Watson, and G. E. Ralston. "Methadone maintenance therapy in general practice: patients, workload and outcomes." Journal of Clinical Forensic Medicine 2, no. 1 (March 1995): 56. http://dx.doi.org/10.1016/1353-1131(95)90047-0.

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Lee, Wang-Soo, and Jaetaek Kim. "Cardiotoxicity associated with tyrosine kinase-targeted anticancer therapy." Molecular & Cellular Toxicology 14, no. 3 (June 23, 2018): 247–54. http://dx.doi.org/10.1007/s13273-018-0027-z.

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