Training School 2017 – Patient and Carer Involvement and Participation in Long Term Forensic Care

What is the training school about?

The next upcoming training school for the IS1302 COST Action will primarily focus on patient and carer participation and involvement in long term forensic psychiatric care and how this can be realized without compromising risk factors.

In almost every country, long term forensic care is a necessary pathway. It is well understood that rehabilitating forensic patients is a process that takes time. The danger on the other hand is that forensic patients can get stuck in the system. Several causes of this ‘side effect’ can be determined: patient characteristics, quality of treatment or even the quality and availability of facilities with a lower level of security and/or aftercare, lack of patient involvement, etc. This is wat COST Action IS1302 focuses on.

Establishing the Risk Needs Responsivity principles is a must in forensic psychiatry. In Long Term Forensic Care, where the Risk and Needs can be countered in part by context, responsivity becomes fundamentally important. With a focus on Quality of Life, patient and carer participation and involvement should take into account responsivity factors. The focus of this training school will be patient participation, involvement of patients in long term care and how this can be realized without compromising risk factors.

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TRAINING SCHOOL 2017 – Vilnius, Lithuania – 11-13 January 2017

Written by Inga Markiewicz (law assistant and psychologist at the Department of Forensic Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Poland)

The main topic of the COST Training School (TS) in Vilnius was: Treatment pathways and aftercare for forensic psychiatric patients. At the Vilnius University, in a very welcoming atmosphere, we were exchanging scientific opinions and practical experiences gathered when working with the forensic patients. The representatives of four member states (Lithuania, Poland, The Netherlands and UK) participated in the above-mentioned event.

Overall logistics was provided by our Lithuanian hosts / the Lithuanian’s COST Action representatives – Ass. Prof. Ilona Cesniene and Prof. Arunas Germanavicius, while the scientific programme was lead by two members of the Core Group of the COST Action 1302 – Mr. Peter Braun and Dr. Erik Bulten.

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The TS consisted of lectures, workshops and self-study. The participants had an opportunity to listen to presentations about the theory of ‘recovery’ and the Good Lives Model in the context of Risk Needs Responsibility – principles of forensic psychiatric care.

Taking into account that different countries have different good points and weaknesses in their forensic systems, TS participants characterized the models of forensic psychiatric care in their countries. All good and bad solutions of the systems were analysed in relation to the regulations and common practice, both at the stage of ‘pre-trial’, and the process of diagnosis, as well as detailed studies, risk assessment, comprehensive treatment (bio-psycho-social model), aftercare and discharge aspects.

All contributors of the TS agreed that treatment process and aftercare must involve jurisdictions and legal frameworks to make satisfactory progress within the system and/or in aftercare.

These multi-dimensional analyses and comparisons of various solutions in the system of forensic psychiatry in Lithuania, Poland, England and the Netherlands were used to develop a joint model that can offer guidelines for forensic psychiatry for all European countries. The initial ideas have been put into tables (Table 1) and all participants have been working on them.

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Vilnius Table 1a

 

The ideas and results of our work during the TS in Vilnius should materialize in a paper with recommendations on best practice in treatment and aftercare in forensic psychiatry (the universal model),

based on the SWOT analysis of the systematic best solutions practiced in individual countries. We started editing the common text during TS and now its final version is being prepared.

The TS in Vilnius was very well organized, broadening our knowledge about forensic systems, treatment and aftercare in different EU countries.

During our TS we had an opportunity to visit the Vilnius City Mental Health Centre, where we saw the facilities and talked with the staff and patients. We all found that field trip very interesting.

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Our local organizers also remembered about intellectual, historical, cultural and social activities during TS. We took part in a planned guided tour, visiting many historical places (e.g. Vilnius University Library and Palace of the Grand Dukes of Lithuania) and greatly enjoying excellent national food.

At the end, I would like to thank COST Action IS 1302 and all participants of the TS in Vilnius for providing me with better knowledge, a broader view at the quality of forensic psychiatric care, a number of ideas and solutions that I could draw from the systems of other countries, also for the opportunity to exchange experiences, listen to valuable comments and to take part in constructive discussions in a pleasant working atmosphere.

All in all, the TS in Vilnius has been a very enriching experience.

 

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Training School 2016 Helsinki 21–23th September

Written by Mika Rautanen (M.D. specialising in forensic psychiatry, Helsinki University, Finland)

The COST Training School was comprised of two workshop days for selected participants and a general lecture day in the middle targeted for everyone interested in how modern forensic facilities should be designed today. Altogether, there were well over 70 professionals representing medical, psychological, nursing, juridical and architectural fields of expertise from various European countries.

A fruitful and open discussion was set as the leading principle through the Training School by Dr. Allan Seppänen, clinical director at Helsinki University Hospital and Finland’s COST- Action representative. He kept the content of the program open in the sense that instead of tight schedules we had time to tackle and discuss real-life problems presented by the trainers and us trainees. Due to great interest in participating, the lectures had to be moved to a larger venue which proved to be a necessary solution for the workgroup days too. Facilities and catering were just right for our purposes.

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Training School 2017 – Treatment pathways and aftercare for forensic psychiatric patients

What is the training school about?

Forensic patients can get stuck in the system due to patient characteristics, quality of treatment but also the quality and availability of facilities with a lower level of security and/or aftercare. The focus will be on the quality and availability of facilities with a lower level of security and/or aftercare, the transitions between systems and the boundaries and problems of these transitions will be connected to the aims of the Action.

Models of aftercare will be discussed. The mechanisms behind pathways and aftercare will be analysed. The theory of ‘recovery’ and the ‘Good Lives Model’ approach will be presented and connected to the aim of this training school; both models will be integrated in the Risk Needs Responsivity-principles of forensic psychiatric care.

Different countries will have different strengths and weaknesses in their treatment pathways and aftercare. Based on specific SWOT analysis of the system characteristics of the participating countries, a guided discussion will result in specific issues, opportunities, best practices, legislation and threats on the patient’s progress through the specific stages of treatment and aftercare.

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Training School 2016 – Modern forensic in-patient facility design standards

The next upcoming training school for the IS1302 COST Action will primarily focus on how to develop modern forensic in-patient facilities. How society defines its basic ethical principles changes in time, and it is a matter of continual ethical, clinical and legal debate where the line between security and therapy is drawn at any given time. By entering into an open, international discussion with clinicians, architects, policy-makers and medico-legal authorities this training school aims to develop our services to a better standard by focusing on how modern forensic facilities should be designed.

Experts from EU countries will share their experiences of developing (long-stay) forensic units and the challenges associated with it. The three day training school will be held between 21-23 September 2016 and participants can choose to soak into the Finnish culture over the following weekend.

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 Photo credit: Miguel Virkkunen Carvalho via Source / CC BY

The programme involves lectures, videos, discussions anddebates in small groups. The speakers are international experts in the field of forensic psychiatry and mental health and bring with them a wealth of experience (speakers list). The training school will cover basic, internationally applicable standards for forensic psychiatric facilities and how to integrate concepts of therapy and security.

Please find here a time-table for the 3 day programme.

For further information and application please click here.

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Training School – Long Stay in Forensic Psychiatric Services

The next training school for the ISCH1302 COST will primarily focus on best practice within long-term forensic psychiatric care in Europe. Experts from the UK and other EU countries will share their experiences of working in long-stay units and the challenges associated with working in such units. The three day training school will be held between 2-4 September 2015 and participants can choose to soak into the varied culture over the following weekend. Day 1 of the school will comprise of best practice in long stay units, day 2 will focus on the challenges in conducting EU wide research, especially with a niche clinical group of individuals and the final day will provide an opportunity to form networks, indulge in case studies and apply knowledge gained over the first two days. The training school will also involve a visit to secure forensic services including both medium and low secure units. This will enable participants from other EU countries to compare it with systems within their own countries.

 

 

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The training school will be held at the University of Warwick in the United Kingdom. The University of Warwick has been ranked as the 3rd fastest-rising young university in the world and has a stunningly beautiful campus. For further information and applications please click here.

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Training School 2015 – Long Stay in Forensic Psychiatric Services

What is the programme like?

The programme involves lectures, videos, discussions, debates and field visits in small groups. The speakers are international experts in the field of forensic psychiatry and mental health and bring with them a wealth of experience ( speakers list). The training school will cover best practice in long stay forensic psychiatric care as well as EU issues in forensic psychiatry.

Participants will have the opportunity to visit all three levels of security in forensic psychiatric care in the United Kingdom – high, medium and low and availability of such visits is very rare. It is an excellent opportunity to gain insight into what is happening on the ground. You will need to bring along two pieces of ID with you during each of these visits.

Please find here a time-table for the 3 day programme.

English will be the official language of the training school although some of the speakers speak other European languages.

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TRAINING SCHOOL 2015 – Koper, Slovenia – 14-17th July 2015

Written by Ana Cristina Neves (Forensic Psychology Assistant Professor at Instituto Superior de Ciências da Saúde Egas Moniz, Portugal) and Valentina Campani (Psychology Master Student, trainee at Reggio Emilia Forensic Unit, Italy)

The Training School (TS) was focused on the concepts of quality of life (QoL) and needs within a long-term forensic psychiatric context, how to assess them and how to improve conditions of long-term patients while meeting their needs. As one of the aims of the TS was the interaction between participants, we were just 18, what allowed the experience of a friendly and functional environment. Treatment realities vary substantially within Europe according to different legal frameworks and resources, so group work and discussion was actively stimulated by the trainers. They also provided valuable advises on how to integrate both concepts into everyday practice.

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Training School 2015 – Quality of Life and Needs in a Forensic Psychiatric Context

Training School 2015 will focus on ‘Quality of Life and Needs in a Forensic Psychiatric Context’ 

Rationale: Treatment in forensic psychiatry is focused on improving mental health and reducing the risk of recidivism of mentally disordered offenders. In long-term forensic psychiatric care this focus shifts. Instead of aiming at re-entry into society, treatment is principally aimed at psychiatric and medical care and optimizing quality of life.

In order to offer adequate psychiatric and medical care, the needs of service users residing in long-term term forensic psychiatric care must be addressed. This might be a variety of mental and general health problems, as well as aging and psychosocial functioning. Mentally disordered offenders with an above average length of stay may well require a different type of treatment. For instance, a study on forensic service users over 55 years of age or residing for longer than 10 years, showed high rates of physical illness, mobility impairment, sensory impairment and polypharmacy (Lightbody et al., 2010). Shaw (2002) suggests that long term forensic service users have needs across a variety of domains including quality of life, personality disorder, psychotic symptoms, and alcohol and drug misuse. Furthermore, Shaw found that certain individuals do not benefit from particular interventions and that their needs in those domains remain unmet but that there is progress in other domains e.g. an improved quality of life.

Some authors stress that in a high secure context, with long-term involuntary liberty deprivation, aspects like autonomy, lack of freedom, sense of control, restriction of movement and constraint of sexual relations will negatively influence the quality of life of service users (Coid, 1993; Mercier & King, 1994). Empirical research in this area is scarce and has so far been single-centered, decreasing the generalizability of the findings (Swinton, Carlisle, & Oliver, 2001; Van Nieuwenhuizen, Schene, & Koeter, 2002; Saloppé & Pham, 2006). Besides, the instruments used in these studies to assess quality of life are either based on the norms for the general public or psychiatric service users, ignoring the restrictive context of long-term forensic psychiatric care and its influence on quality of life (Van Nieuwenhuizen & Nijman, 2009; Swinton, Oliver, & Carlisle, 1999; Walker & Gudjohnson, 2000). The conceptualization of quality of life, based on perceptions of service users in long-term forensic psychiatric care, differs from that required for use in general forensic psychiatric studies (Vorstenbosch et al., 2010).

To assess both needs and quality of life two different approaches can be used: 1. a normative approach that considers the clinician as most capable of assessing the service user’s needs/quality of life or 2. a subjective approach that includes the service user’s own perspective and that of their family members or carers. A combination of both approaches facilitates intervention in a tailored manner and constitutes ´best practice´ in long-term forensic psychiatric care.

Aim: This Training School is being organized to draw attention to the importance of the concepts ´needs´ and ´quality of life´ within long-term forensic psychiatric care and to give an incentive to the inclusion of these concepts in future research projects in forensic psychiatry in Europe.  It will include: a) lectures/presentations on needs and quality of life, b) provide training in the use of assessment instruments, c) advice on how to incorporate both concepts in every day practice and d) result in constructive contributions for the COST Action IS1302 (reports and/or publications/networking).

Expected Outcomes: Improved outcomes for service users, due to better met needs and an improved quality of life.

This years training school will take place in Koper, a coastal city in Slovenia, on the 14th till the 17th of July 2015. The program will include a visit to the forensic psychiatric facility in Maribor.

For more details and registration please click here. Also if you´d like to apply for reimbursement, please subscribe here. The eight researchers with the best motivation letters will get reimbursed.

The registration deadline ends at the 25th of June.

In case you have any questions, please do not hesitate to contact us.

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Training School 2015 – Quality of Life and Needs in a Forensic Psychiatric Context

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The first Training School of 2015 will take place in Koper (Slovenia, 14-17 July) and will focus on quality of life and meeting needs within a forensic psychiatric context as well as on how to assess both concepts within the restrictive context of LFPC.

More specifically, this Training School will focus on the needs brought about by (severe) psychiatric symptoms and long-term residence in a highly restrictive setting, and how meeting these needs might optimize quality of life of patients in LFPC. For more details and a complete overview of the program please click here.

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