Day 1 :
Director, 1,2,3 Working Together, UK
Keynote: Working with schema therapy to make significant therapeutic breakthroughs for forensic patients in a service for men with a diagnosis of severe personality disorder: Recognising the frozen child and strategies to ‘thaw’ him/her
Time : 09:30-10:15
Jacqui Saradjian is a Consultant Clinical and Forensic Psychologist, formerly the Clinical Director of The Fens Offenders with Personality Disorder Pathway Service within a high secure prison which she ran for more than 10 years. She has worked effectively for over 25 years with offenders, both within prisons and within health services, in both hospitals and the community. She has created therapeutic programmes with a strong evidence base from which has had excellent outcomes. She has presented her work nationally in the UK and internationally in Europe, Canada and in the USA.
Purpose: Schema therapy has gone through various adaptations, including the identification of various schema modes. This workshop suggests there may be a further dissociative mode, the ‘frozen child’ mode, which is active for some patients, particularly those that have experienced extreme childhood trauma.
Design/methodology/approach: The workshop is based on a participant observer case study including the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy. This is backed up by various clinical case studies in which this concept has been used therapeutically.
Findings: The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is proposed that patients develop this mode as a protective strategy and that unless recognised and worked with, can prevent successful completion of therapy. Using this concept therapeutically has led to significant therapeutic progress with those patients.
Research limitations/implications: Based on a single case study, this concept is presented as a hypothesis that requires validation as the use of the case study makes generalisation difficult. Nevertheless, supported by the clinical case studies it raises many interesting issues for consideration and discussion.
Practical implications: It is suggested that if validated, this may be one of the blocks therapists have previously encountered that has led to the view that people with severe personality disorder are “untreatable’. Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations as to the most appropriate processes to potentiate such therapy. This will be discussed with regard to several clinical cases, including any cases brought by those attending the workshop.
Originality/value: The suggestion of this potential “new schema mode” is based on service user initiative, arising from a collaborative enterprise between service user and clinician, as recommended in recent government policies. The workshop will give a unique opportunity to have dialogue with an ex-offender who has completed the UK Offender with Personality Disorder Pathway from High Security to the community and, having genuinely changed, is now able to articulate the process of that engagement and change and what had previously stopped him and his peers from genuinely engaging with psychological services, along with a highly-experienced therapist who has written and delivered these programmes with outstanding results.
Philippe-Pinel Institute, Canada
Keynote: Using immersive virtual reality in Forensic Psychology: The Philippe-Pinel Institute experience
Time : 10:15-11:00
Patrice Renaud is the director of the Virtual Reality Applications in Forensic Psychology (VRAFP) laboratory at the Philippe-Pinel Institute of Montreal, a maximum security psychiatric hospital based in Canada. He is the first researcher to have developed and tested a method to assess sexual preferences using virtual reality. VRAFP is the first virtual reality lab built for forensic clinical and research purposes.
Virtual reality and related simulation technologies might change the way we do research and clinical forensic practice in the near future. Assessment of sexual preferences and of self-regulation processes, for instance, can be addressed through virtual reality (VR). VR can be used to track cognitive distortions and planning process of sexual aggression; daily life situations, elements of relapse cycle and stressing events can be simulated in VR to probe into these aspects of sexual aggression as if they were lived in real-time. In the same way, emotional regulation problems, empathy, cognitive distortions and social difficulties in antisocial individuals can be addressed in context, in complex simulated social interactions. Furthermore, the coupling of this kind of VR-based methodology to neurofeedback and real-time brain-computer interface is about to give rise to new therapeutics for deviant behavior in the emerging field of neurorehabilitation. Realistic computer-generated stimuli (CGS) are central to all these uses of VR in the field of forensic psychology research and clinical practice.
University of Bari, Italy
Time : 11:15-12:00
Felice Francesco Carabellese, is an Italian Psychology Professor working in University of Bari at Italy. Achievements include research in Forensic Psychiatric. Carabellese, Felice Francesco was born on August 24, 1959 in Molfetta, Bari, Italy. He completed his degree in Medicine, University Bari, 1986. He started his carrier as a Professor Forensic Psychiatry, University Bari, since 2002 with Italian Army.
In the past, in Italy the treatment of mentally ill offenders at risk for recidivism (“dangerous to the society”) was entrusted by the Judicial Psychiatric Hospital (OPG). The OPG facilities were High Security Hospitals, directly managed by the Ministry of Justice. The six Italian OPG hospitals accommodated about 1,000 patients collectively. These patients were offenders who, with regard to our penal code, were adjudicated not guilty (or partially guilty) by reason of insanity for their criminal offense because they suffered from a severe mental disorder at the time of the crime and were found to be “dangerous to the society”. A recent law (Law n.9, February the 17th 2012) ratified the closure of the OPG hospitals (March the 31st 2015), which have been replaced by rehabilitation communities placed across all Italian regions, controlled by the National Health System on the model of what occurs in Italy for all the other mentally ill individuals, This presentation explains all the steps that have been made in the transition to this new program.
Flinders University, Australia
Time : 12:00-12:45
Sydney Clinical and Forensic Psychology Services, Australia
Keynote: Hip-Hop Therapy: An approach to working with young offenders with severe mental health conditions
Time : 12:45-13:30
Kim Dilati is a Clinical and Forensic Psychologist with the Justice Health and Forensic Mental Health Network (JH&FMHN), Australia as well as in private practice. She has worked with young offenders and at-risk youth in various Australian Government organisations for 12 years. Kim is currently undertaking her PhD at Western Sydney University where she is examining the effects of Hip Hop Therapy in young/adult offenders with mental health disorders. In 2016, she was the recipient of the NSW Health Award for the Rhythm & Rhymes Program (Hip Hop Therapy) and continues to present nationally on the therapeutic effects of hip-hop therapy in young people.
Rap music emerged over four decades ago as a struggle for self-determination following North American slavery and oppression. The Hip-Hop culture was founded on this adversity and illustrates a form of social protest, promoting messages of social awareness, personal consciousness, activism, pleasure and power (Miller et al., 2013). Research to date has supported the therapeutic efficacy of rap music for at-risk young adults (Levy, 2012; Alvarez, 2011; Elligan, 2000). Although, Hip-Hop Therapy is a relatively novel and unconventional mode of therapy for young people, engagement with rap music programs have found to be increasingly high compared to Treatment as Usual (TAU; Elligan, 2000). As such, Hip-Hop therapy remains an effective but underutilized treatment approach targeting at-risk youth and currently, there are few similar programs in the community or correctional settings in Australia or worldwide. The Rhythm & Rhymes Adolescent/Adult Program (RRAP) or Hip-Hop therapy, is a therapeutic group program for young and adult offenders with severe mental health disorders. The objectives of the group is to utlise rap music and song writing to increase prosocial activities, facilitate positive behaviour change, increase engagement in therapeutic programs, improve coping skills, depression, anxiety and hopelessness in young people with severe mental health disorders. Thirty-five adolescent and adult patients from a high secure Forensic Hospital in Sydney, Australia completed a voluntary 12 week Hip-Hop Therapy group. A mixed methods study design was utilised. Pre and post group measures were collected, individual lyrics were qualitatively analysed and post group interviews were conducted.Results found that there were improvements in prosocial behaviours, engagement in therapy, depression, coping skills, anxiety and hopelessness. Overall, this study illustrates how rap music has the potential to promote prosocial behaviour, increase engagement in treatment, improve empowerment, self-efficacy and distress tolerance skills in correctional and forensic settings.