Topic 4 DQ 2

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Argosy University *

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621

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Psychology

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Feb 20, 2024

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Topic 4 DQ 2 What type of criminal offenders should be provided psychological treatment? Consider death row inmates, violent offenders, and people with life sentences. 1. Death row inmates  Death row psychiatry may represent the epitome of ethical and legal challenges within psychiatry. Some people may believe that providing diligent medical treatment to inmates waiting to be executed is unnecessary, or even a waste. While everyone has a right to their opinion, the law provides that death row inmates have the right to physical and mental health treatment up until the very moment that they are executed.  The premise behind this is that if things were to go wrong, it would be better to be challenged on the details of a thoughtful clinical or forensic policy than to be challenged on a series of inconsistent and arbitrary actions. For example, it is not uncommon for a death row clinical psychiatrist to be contacted by a forensic psychiatrist or an attorney with requests for information, opinions, and records. While some psychiatrists may have different views on how to best handle this, some will not have any idea at all.  In general, a death row psychiatry program should have these two main goals: 1) Acknowledgment of the unique issues and challenges when treating death row inmates and 2) Alteration of actions when appropriate. 2. Violent Offenders According to a study by the Catalyst Consortium:  It is found psychological treatments with violent offenders to be effective in reducing further violent and criminal behavior. High dose, high intensity treatments that included specific components such as relapse prevention, role playing, and homework have the greatest impact on violent and general reoffending.  Psychological treatments with violent offenders were associated with a small reduction in the rate of violent and general institutional misconduct.  Psychological treatment programs with violent offenders may be most effective in reducing further offending when they: 1) Are intensive, involving 250+ hours of treatment delivered over 3-4 sessions per week. 2) Adopt a multi-target approach, that includes relapse prevention, role playing, interpersonal skills, anger control, and homework activities.

3) Are delivered within a designated treatment/ therapeutic community unit. Are delivered to higher-risk offenders and incorporate group-based interventions. 3. People with life sentences  The process of adapting to prison life, or "prisonization," exerts a dehumanizing effect that may result in feelings of hopelessness and alienation. The psychological effects of prison are believed to vary according to the individual. However, during imposed institutionalization, the inmate is vulnerable to the development of harmful attitudes-such as a negative self-concept, devaluation of life, and other generally destructive cognitions. It might be hypothesized that inmates serving life sentences ("lifers") and who spend the longest time in prison would undergo the greatest degree of prisonization. Whether the life sentence results in an attitude characterized by nihilism or adaptation is unknown; however, one could speculate that an individual's pre-incarceration coping skills and overall constitution play a role. This could result in a serious mental illness that needs psychological attention.  Psychological treatment may help the lifers to achieve in the following way:  Persons serving true life sentences (life without possibility of parole) exist in a unique set of circumstances. Lifers must somehow adapt to the reality that there will be no future release date to sustain hope or a sense of purpose. One might speculate that because they have been subject to an extreme form of permanent social exclusion , lifers would have an increased degree of hostility, mistrust, and nihilistic attitudes. However, as correctional staff can attest, this is not always the case. Lifers often have the regard of their fellow inmates and may be respected for having met the challenge of surviving in prison. Through psychological treatment, some lifers seem to mature into acceptance of their situation. Many take on a leadership role, setting a positive example for other inmates. Reference Knoll IV, J. (2009, August 29). Discussing the Meaning of Life with a “Lifer.” Psychiatric Times. https://www.psychiatrictimes.com/view/discussing-meaning-life-lifer . Papalia, N., Spivak, B., Daffern, M., & Ogloff, J. R. P. (2019). A meta‐analytic review of the efficacy of psychological treatments for violent offenders in correctional and forensic mental health settings. Clinical Psychology: Science and Practice, 26 (2), Article e12282. https://doi.org/10.1111/cpsp.12282 Yanofski J. (2010). Prisoners v. Prisons: A History of Correctional Mental Health Rights. Psychiatry (Edgmont (Pa. : Township)) , 7 (10), 41–44.

Yanofski, J. (2011, February). Setting Up a Death Row Psychiatry Program . Innovations in clinical neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071089/ .

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