Needs Assessment, Risk, and Evidence-Based Interventions: Where’s It All taking Us?

Clive R. Hollin

University of Leicester, United Kingdom

In public services, including the health system and the criminal justice system, great store is laid on evidence-based practice. The requirement for evidence in support of interventions is based on two premises: (1) those receiving services should expect the intervention to deliver its intended outcome; (2) if public money is to be spent on an intervention then the public should be assured that their taxes are being spent wisely. These points are highlighted by initiatives in the UK Probation Service and the Prison Service, particularly offending behaviour programmes (OBPs), that are intended to reduce rates of reoffending. The evidence base that informed the design of OBPs was a string of meta-analyses, mainly published in the mid-1990s, after which there is now a substantial body of outcome research evidence concerned with the effectives of OBPs.  The aim of this paper is to review briefly some of the basic concepts associated with evidence-based practice – need, risk, responsivity, and integrity – and then to look at what has been learned over the past decade. The recent empirical evidence has highlighted a number of issues critical to future practice. These issues cover the full spectrum of practice, management, and evaluative research: they include precision in the assessment of need; the importance of the risk-need principle (i.e., the intensity of an intervention should be proportionate to the risk involved); advances in thinking about responsivity, readiness to change, and engaging people in interventions; and challenges in researching effectiveness. The way in which these various considerations impact on practice are highlighted by the use of examples from work in both high security and the community that seeks to build on and strengthen what we currently hold to be effective.

The emperor has no clothes: The glaring gap between what we know and what we deliver in the domestic violence field

Tonia L. Nicholls

British Colombia Mental Health & Addiction Services, Canada

Violence in the family is a pervasive public health problem. Domestic violence is at once common and often leads to acute and chronic problems at the individual, family, and community level. Domestic violence can have a cumulative effect for a whole host of internalizing and externalizing problems for the direct victim, as well as child witnesses. Moreover, children in abusive and violent families are at greater risk of being the direct victim of assaults than children raised by non-abusive couples. Deleterious outcomes for the victims and their children include somatic complaints, psychopathology, disrupted attachment, and death; family violence is also implicated in the intergenerational transmission of abuse and criminal behaviour. In forensic mental health we see the ubiquitous nature of family violence and the devastating effects across the diverse populations we serve.

Although a relatively youthful field of inquiry we now have nearly thirty years of research to inform our interventions with families struggling with partner abuse. This growing body of research is challenging some of the most basic, long-established assumptions about intimate partner abuse. This includes the role of patriarchy, the extent to which domestic violence is overwhelmingly committed by men, and the utility of an ideologically drive, "one-size-fits all" approach to treatment (Hamel & Nicholls, 2007).

In this presentation, a consideration of the most important findings from the past three decades of intimate partner abuse research will be used to review the conventional and uniform approaches currently guiding much of the work of researchers, police, victim services workers, shelters, lawyers, mental health professionals, the courts and treatment providers. I will explore the implications of setting aside the gender paradigm and reconceptualizing domestic violence as a multidimensional public health problem (Dutton & Nicholls, 2005).

The emperor eventually put his clothes on to avoid embarrassment, acknowledging that he could no longer ignore the evidence disputing what he initially believed to be true. The gap between what we know and what we deliver in the domestic violence arena is no less stark. The prevailing treatment model (Duluth model) rejects theory and treatment modalities which have gained considerable traction with other groups (e.g., Cognitive behavioural therapy and Dialectical behavioural therapy). What is required is transformational change to confront the feminist hegemony and the prevailing focus on punitive approaches which maintains the status quo in the domestic violence field and has had limited success in advancing the safety and well-being of individuals and families (Babcock et al. 2004; Levesque, 1998; Gelles, 2001). Treatment providers and other professionals must be supported in employing interventions that reflect best-practices, are individualized and flexible, and multidimensional; this will require a radical reconsideration of domestic violence practice. In addition, the sheer incidence of violence in the family indicates that clinical interventions alone are unlikely to be sufficient. As a result, primary prevention efforts need to be an increasing focus of forensic mental health experts. Fortunately, there are several examples of emerging approaches to support these efforts (Dutton, 2006; Hamel, 2005; Mills, 2003).

What Can Alice in Wonderland Teach Us about Criminal Careers, Life-Course Criminology, and the Prevention of Serious & Persistent Criminal Activity

Alex Piquero

Florida State University, United States

One of the most consistent findings in criminological and psychological research is that antisocial and criminal behavior early in the life course is strongly linked to similar types of behavior later in the life course. At the same time, not all problem/delinquent children emerge as problem/criminal adults. Why some continue and some persist in antisocial behavior is thus highly relevant for theoretical and policy issues and decisions. This presentation will review the foundations of developmental/life-course criminology, the main research findings, and the critical public policy issues emerging from this research area. Additionally, the presentation will provide an in-depth overview of the public policy efforts aimed at preventing the onset of serious and persistent delinquent and criminal careers as well as those effective programs that have been successful at thwarting criminal careers that would otherwise persist into adulthood. The talk is inter- and multi-disciplinary in nature, and will appeal to researchers, academics, and policy-officials alike.