Addressing Violence Risk in the Scottish Prison Service Stephan McAlpine Principal Psychologist

The Extent of the Problem

Why focus on violence? 1. Scotland is a violent place Second highest murder rate in W Europe 2.33 murders per 100,000 people (0.7 in England & Wales) Glasgow ‘murder capital of Europe’ (average of 70 per year) Rising rates of murder, attempted murder

Why focus on violence? 2. Scottish prisoners are violent people In June % (2231) of prisoners serving sentences for violent crimes 707 for murder 980 for attempted murder or serious assault Breaches of discipline June 2004 – June 2005 Assault731 Fighting1298 Destroys property768 Threatening, abusive1172

Why focus on violence? 3. Gap in service provision Anger management = violence intervention But, Anger not a pre-requisite for violence Instrumental versus reactive aggression Correctional excellence

Stage 1 Accessing a Suitable Programme

Accessing a suitable programme Needs Analysis Review existing programmes Memorandum of Understanding: Materials; training; follow-up; training to train Pilot

The Violence Prevention Programme 94 sessions Delivered each morning Monday – Friday (5- months long) Includes group and individual sessions Group of 10 participants Delivered by a programmes officer and psychologist

Stage 2 Identifying those at risk of violent re-offending

VPP and the risk principle The Risk principle Target those with highest risk of recidivism Provide most intensive treatment to highest risk offenders Who to treat VPP and Risk Geared for those at highest risk of violent re-offending High intensity intervention

Integrated Case Management Referral File Review Interview Gather information: assess against selection criteria

Selection criteria

Selection issues Appropriate screener Numbers; waiting lists How to prioritise Local pressures: high profile cases; progression

Integrated Case Management File Review Interview* Gather information: assess against selection criteria Yes / No Referral Group Selection

Exercise

Stage 3 Assessment

Psychometrics Aggression Questionnaire Novaco Anger Scale & Provocation Inventory Paulhaus Deception Scale Eysenck Impulsivity Questionnaire Violence Risk Scale Assessment

The Violence Risk Scale (VRS) Integrates risk assessment and treatment 26 items –6 static risk factors –20 dynamic risk factors

VRS static factors S1Current Age S2Age at First Violent Conviction S3Number of Juvenile Convictions S4Violence Throughout Lifespan S5Prior Release Failures or Escapes S6Stability of Family Upbringing

VRS dynamic factors D1Violent Lifestyle D2Criminal Personality D3Criminal Attitudes D4Work Ethic D5Criminal Peers D6Interpersonal Aggression D7Emotional Control D8Violence during Institutionalisation D9Weapon Use D10Insight into Violence D11Mental Disorder D12Substance Abuse D13Stability of Relationships with Significant Others D14Community Support D15Released back to High- Risk Situations D16Violence Cycle D17Impulsivity D18Cognitive Distortion D19Compliance with Community Supervision D20Security Level of Anticipated Release Institution

Key functions of the VRS 1. Measure of risk for violent recidivism Scoring based on file review and interview Each item rated 0 – 3 Static items: higher rating → more problematic history Dynamic variables: higher rating → greater link with use of violence Pre-treatment risk = total static + total dynamic variable scores Total score can range from 0-78

An example D5 Criminal Peers 0…indicates the individual has none or very few peers who are involved in criminal activities To determine if violence is related to the individual’s association with anti-social peers 3…the individual’s violent behaviour and negative peer influence are closely related

2. Identification of treatment targets and treatment readiness Applies to dynamic factors only: If score 2/3, a treatment target (clear link with violence) If score 1, past problem area or minimal link to violence Of score 0, area of strength

Pre-contemplation Contemplation Action Preparation Maintenance Relapse ENTRY EXIT

Stages of change Pre-contemplation: denial of problem, no insight Contemplation: acknowledges problem but no relevant action taken Preparation: acknowledges problems, observable and relevant changes; unstable and/or relatively recent Action: taking consistent action to make relevant changes; stable over extended period of time relevant to lifetime functioning Maintenance: as with action but clear relapse prevention strategies and implemented across a variety of situations (I.e. those linked to past violence)

Case study: David D12 Substance Abuse 0…individual does not have a substance abuse or substance related problem linked to violence To determine the extent to which substance abuse is linked to violence 3…a substance abuse or substance related problem has been linked to violence

Key aspects of treatment targets Must be clear link to violence Prefer collaboration between participant and facilitator Need specific, manageable targets: –e.g. recognise triggers for anger, not stop being violent Don’t expect clarity all the time Recognise as the start of the process: progress takes time Treatment targets are dynamic and can change for the better, or the worse Focus on the individual

VPP and the needs principle The Needs principle Effective interventions should specifically target: Criminogenic needs, i.e. those factors clearly linked to offending Dynamic risk factors What to treat VPP and Needs Targets 6 dynamic, criminogenic risk factors: Anger and emotion control Poor problem solving Poor self-management Poor interpersonal skills Violent thinking Violent goals

Stage 4 Programme Participation

The Programme 1. Making Changes (6) 2. Violence Awareness (12) 3. Anger Control (12) 4. Solving Problems (10) 5. Social Attitudes (10) 6. Positive Relationships (8) 7. Resolving Conflicts (8) 8. Positive Lifestyles (8) 9. Self Control (8) 10. Violence Prevention (12)

The importance of motivation Resistance / poor motivation, barriers to change Motivation significant to the change process Work on ambivalence; creation of intrinsic motivation to change Modules 1 and 2 focus on (i) motivation and (ii) increasing dissonance

Delivering VPP

Wouldn’t it be nice if people attended programmes because they wanted to?

Delivering VPP Realistic expectations: what Stage will most be at? What would you expect from group members? De-selection: when is enough enough?

Resistance The action taken by individuals and groups when they perceive that change is a threat to them A normal and expected tendency to push back when pushed Why resist? Happy where they are Where they are is what they know (safe) Change is likely to be difficult Don’t like the look of where they would end up Fear of the unknown (what will they lose?) Do not trust those asking them to change

VPP and the responsivity principle The responsivity principle Offenders are not all the same Refers to the approaches used to influence change, e.g. modelling, reinforcement, skill enhancement Consider staff and client characteristics; match the style and mode of intervention accordingly How to treat VPP and responsivity Variety of techniques Importance of pro-social modelling Group and individual contact Sessions are ‘adaptable’ / flexible Psychologist and Officer team: offers diversity in terms of style, pace, strengths Responsivity your responsibility

VPP and treatment integrity Treatment integrity Standards of professional conduct are upheld by providing staff with training, supervision, and ethical guidelines The intervention is delivered as intended How well treatment is delivered VPP and treatment integrity Ongoing facilitator evaluation Preparation Knowledge Facilitation Provision of regular supervision (1 in 5 sessions)

The story so far Initial training September 2003 First programme began end full programmes run to date 30 started: 28 completed (2 de-selections) Now running in Perth & Glenochil

Programme Effectiveness

Stage 5 Post-Programme Reports

Post-programme report Facilitators VRS author Progress against VPP treatment targets: Anger & emotion control Problem solving Thinking which supports the use of violence Interpersonal P.S. & communication skills Working towards goals Self-management Progress against treatment targets Specific Recommendations

What happens next? Progression within the SPS Booster programme? How can this link in with the community?

The Underlying Theories

1. Cognitive Behavioural Theory

2. Social Learning Theory Offending is LEARNED –e.g. modelling, positive reinforcement Repeated learning become “scripts”, i.e. behaviour that is almost ‘automatic’ e.g. driving –Offending situations become the same (or similar) Offending scripts guide the individual’s orientation, interpretation, and responses to their environment → Can learn not to offend

3. Social Information Processing (SIP) Even though violence is learned, people are not violent all the time. Social information processing helps the individual understand why he behaves violently in any situation Individuals differ in the way they process information about their social environment

The 6 stages of SIP (Crick & Dodge, 1994) 1. Encoding of cues: what you notice, and what that means to you 2. Interpretation of those cues 3. Goal selection 4. Response Access (menu) 5. Response Decision (outcomes / efficacy) 6. Action