Leanne Gregory, Principal Clinical Psychologist, IVY Heather Irving, Social Worker CYCJ/IVY
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Transcript of Leanne Gregory, Principal Clinical Psychologist, IVY Heather Irving, Social Worker CYCJ/IVY
The Scottish High Risk Mental HealthYouth Project (IVY)– Key Findings
andMessages for Practice
Leanne Gregory, Principal Clinical Psychologist, IVYHeather Irving, Social Worker CYCJ/IVY
Nota Scotland Conference29th April 2014
Framework for Risk Assessment Management and Evaluation (FRAME)
http://www.rmascotland.gov.uk/standardsandguidelines/
Risk Formulation
Formulation is the summation and integration of the knowledge that is acquired by the assessment process (which may involve a number of different procedures). This will draw on psychological theory and data to provide a framework for describing a problem, how it developed and is being maintained”
Division of Clinical Psychology 2001; cited Johnstone & Dallos (2006)
Risk Formulation
Formulation is not a new or novel concept in general terms; it is used in each of the main models of psychotherapy – behavioural, cognitive-behavioural, psychodynamic, systemic and integrative approaches - these are theoretically guided or model specific forms of formulation.
Risk Formulation
No single theory or model of violence exists
therefore
A pragmatically guided formulation has more utility in risk assessment
4 P’s Approach
• predisposing (i.e., factors in the individual’s past that may increase his proclivity or vulnerability to violence)
• precipitating (i.e., events or circumstances that may trigger the behaviour or disinhibit usual behavioural controls); (motivators, disinhibitors)
• perpetuating (i.e., factors that cause the risk to remain) (impeders, unresolved vulnerabilities)
• protective factors (i.e., aspects of the offender’s functioning or circumstances that moderate the risk)
4
11
22
2
1
15
2
13
LOCALITY/BOARD Number
East Dumbartonshire 1
East Lothian 1
Dumfries and Galloway 4
Falkirk 2
Fife 2
Glasgow 2
Highlands 1
Inverclyde 1
Lanarkshire 5
Moray 2
North Ayrshire 1
Renfrewshire 3
Map of Scotland provided courtesy of FreeVectorMaps.com
Diagnosed or Suspected Difficulty Number
Anger 7
Anxiety 1
Autism Spectrum Disorder 6
Attachment Disorder 5
Attention Deficit Hyperactivity Disorder 6
Communication Disorder 1
Complex Post Traumatic Stress 6
Deliberate Self-Harm 7
Dissociation 2
Eating Difficulties 2
Emotional Dysregulation 6
Learning Disability 2
Low Mood 2
Oppositional Defiant/Conduct Disorder 2
Psychosis 2
Sleep Difficulties 2
Substance Misuse Difficulties (Alcohol/Drugs) 7
Suicidal Ideation/Action 6
Unusual perceptual experiences 3
MEAN = 4.4
PRIMARY RISK
N = 17Nature of Risk n =
Primary Risk
Fire-setting 1
Interpersonal Violence
10
Self-harm/Suicidality 3
Sexual offences (contact)
5
Sexual offences (non-contact)
1
Victimisation 1
Violent Extremism 1
Interpersonal Violence
Suicide /DSH
Firesetting
Sexual offences
non-contact
Violent Extremism
Victimisation
Sexual offence - contact
Nature of Risk n = Secondary
Risk
Fire-setting 1Interpersonal Violence
3
Self-harm/Suicidality
3
Sexual offences (contact)
0
Sexual offences (non-contact)
1
Victimisation 5Violent Extremism
0
SECONDARY RISK
Victimisation
Suicide /DSH
Firesetting
Sexual offences
non-contact
Interpersonal violence
Level 2
10 offered 9 accepted
Risk Assessment Learning Disability
Personality
Mental Health Diagnostic Review