Therapeutic relationship & treatment progression in forensic services
Research type
Research Study
Full title
What aspects, if any, of the therapeutic relationship are helpful or unhelpful in treatment progression amongst high secure forensic inpatients.
IRAS ID
295930
Contact name
Simon Draycott
Contact email
Sponsor organisation
University of Roehampton Research Integrity and Ethics Committee Chair
Duration of Study in the UK
1 years, 2 months, 30 days
Research summary
The therapeutic relationship (TR) encompasses feelings and attitudes that clients and therapists have towards one another, often involved in the process of recovery. Elements of the TR are, but not limited to: collaboration, goal consensus, cohesion, positive regard, affirmation, empathy and the therapeutic alliance (agreed goals, achieved tasks and bond).
A high-secure forensic service provides psychiatric service to individuals that require treatment for mental illness, and are a risk for dangerous, violent, criminal propensities.
Despite the importance of therapy-client relationships to effective treatment outcomes in general psychotherapy (Norcross & Lambert, 2018; Wampold, 2015), little empirical evidence has been found to support these findings within a high-secure forensic population. Research has mostly focused on inpatients' perspectives of quality of life, service provision and experiences of long stay (Holley et al., 2020) but not the client-therapist relationship and treatment outcome from the inpatients' perspective. The aim is to contribute to the challenges forensic services experience, namely reducing long stays in high secure services, reoffending behaviour, and symptom severity. In England, 27% of inpatients in high secure services are detained longer than their initial imprisonment time and receive restrictive care which can impact their quality-of-life (Holley et al., 2020). Therefore, obtaining the views of inpatients is vital in the evaluation of mental health services, particularly as therapy is a court-mandated requirement in treatment.
The proposed research aims to understand what elements, if any, of the therapeutic relationship are helpful or unhelpful in treatment progression in a high secure forensic population. This study is a qualitative study aiming to recruit 8-12 adult male inpatients from Broadmoor Hospital that have been individual therapy. The exclusion criteria is: any patients that are identified as high-risk, have had a reported incident within 24 hours, present with COVID-19 symptoms or tested positive and cannot provide informed consent.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
22/NW/0203
Date of REC Opinion
26 Oct 2022
REC opinion
Further Information Favourable Opinion