Conflicting aims in running CBT programmes may also occur; although CBT has been a widely used by GP’s and Nurses in the community there are large differences between offending behavioural programmes offered by the NPS and those offered by clinical psychologists. The obvious difference between organisations is that the probation service’s CBT programmes are aimed at reducing offending rather than at reducing symptoms of a mental disorder. Programmes that run for treatment of mental health problems are usually run for much longer than three months and emphasise ‘freedom of choice’ to participate rather than an enforced approach.
The motivation for compliance to a CBT programme could therefore differ in both settings; if offered in Prison or whilst on Probation motivation for completion could be, for example, to move through the prison system into an open prison or to prevent incarceration altogether. Many health care professionals argue that when these programmes are offered outside of probation there is a much greater emphasis on free choice, and thus a greater probability of success (Brooks et al, 2007, p32). Gibbs (2001) supports this with her research into partnership arrangements. She concluded that where service users had chosen to undertake voluntary partnership attendance they seemed more satisfied with their work and responsibilities, but where users had to attend under compulsion they were less satisfied (Gibbs, 2001, p21).
One important development in partnership working between health and probation with regard to offenders suffering from mental health issues is in the newly commissioned Dangerous and Severe Personality Disorder Programme (DSPD). The programme has been developed to provide a new approach towards managing offenders who are dangerous as a result of a severe personality disorder. The programme has been developed conjointly by the National Offender Management Service (NOMS), the Department of Health, the NHS and the Prison service. The programme will be offered to those serving indeterminate sentences who are likely, if/when released to be managed at Level 2/3 MAPPA.
The programme offers the offender a form of psychological therapy called ‘Dialectical Behavioural Therapy’ which aims to train offenders to tackle everyday situations in a problem solving manner rather than emotionally and aggressively (Brooks et al, 2007, p34). It is thought that after an offender has successfully completed the DSPD programme they would go on to take part in the reoffending reduction courses. This again is evidence of the move towards partnership practice and the recognition that practical or health issues need to be addressed before work can begin on addressing offending related behaviour.
As mentioned above women are also a distinct minority within the criminal justice system; in 1999 only 17% of known offenders were female (Home Office 2002-2003). As such, particular consideration must be paid to their treatment and management. Although it is still felt that much of the assessment of offenders takes a ‘hegemonic’ approach which still largely ignores the issues of gender (Shaw & Hannah-Moffat, 2004, p91).
It has been argued that there still appears a lack of evidence about ‘what works’ in tackling female offending (Clarke, 2003). Some debate that women tend to be sentenced too much fuller sentences because Magistrates see women from a welfare perspective (Brooks et al, 2007, p207). Although viewing women in this way may lead to a holistic approach to sentencing it may work negatively in that female offenders may be sentenced to community orders with lots of requirements, this could be evidenced through my example discussed below. Other issues that women face in undertaking group programmes could be practical restraints such as domestic responsibilities. If a female offender has sole responsibility for a child it may be difficult for her to attend appointments (Worral, 2003). It is quite obvious how a partnership approach could resolve such difficulties in this case. Perhaps offering adequate childcare facilities to female offenders would enable a greater compliance for those previously failing to attend because of such responsibilities.
Although many criminogenic factors that are found in relation to male offending are also evident in female offenders- for example poverty, mental illness and drug abuse they may affect female offenders in a different way to that of the men on probation. For example recent research has pointed out the severe effect that past abuse has on female offenders. The ‘Commission on Women and the Criminal Justice system’ set up by the Fawcett society, found that 50% of women in prison stated that they had been subject to violence by a partner and 1/3 had been subject to sexual abuse (Hinscliff, 2003).
Such abuse may prevent female offenders from engaging with male dominated CBT programmes. Some state that because of such differing needs between men and women so too should there be differences in the way male and female interventions are set (Clarke, 2003). It could thus be argued that separate provision should be made in respect of group programmes. If women are to succeed on CBT programmes they will need to feel comfortable to share experiences and discuss thoughts and feelings relating to aspects of their offending. If they are unable to do so because of their reluctance to trust the men on the group it may be that the programme is unresponsive to their needs- thus contradicting effective practice principles.
How then could partnership working improve the situation? This is a question examined by Durrance and Ablitt (2001) in their research into Empowerment Work. They state that empowerment exercises have been a key aspect of assisting change in female offenders. Indeed Durrance and Ablitt (2001) point out that woman respond to an environment that is positive and supportive. If women feel unable to make the changes then it is unlikely that CBT programmes will work. It is therefore argued that empowerment in women is essential in assisting change (Durrance& Ablitt, 2001).
There has been a movement in this area with the government producing the ‘Women’s Offending Reduction Programme’ (WORP) which looked at the range of factors affecting women’s offending. One focus is to encourage a multiagency approach in working with women who are suffering with mental health, drug and/or alcohol issues (Brooks et al, 2007, p211) in order to empower and support them.
The issue of Risk is an important consideration when looking at the work undertaken by partnership agencies. Although there now stands statutory tools for multiagency risk management (NOMS, 2007) in terms of public protection through MAPPA, partnership agent’s safety still rely on local policy makers. Thus one may argue that whilst the probation service is relying on partnership agents to co-work the ‘day to day issues offenders may face’ they may be forgetting about the potential dangers that the offender may pose to staff at other agencies.
As a TPO I undergo two years of training to understand, identify and manage potential risk of harm, other partnership agents, for example a housing advice worker, may receive none whatsoever. The NPS must therefore be mindful that whilst using partnership working to solve practical difficulties they do not ‘shirk’ the responsibility of risk management. The positive aspects of multiagency risk management in terms of the offender are seen clearly when examining work on domestic violence.