Forensic groups

The use of groups in forensic psychotherapy has established credibility for principles of positive intervention with populations previously thought untreatable, creating movement in both directions across the most impervious boundaries in society. (14) There is pioneering literature from Special Hospitals such as Broadmoor and Rampton, and from prisons such as Grendon and Barlinnie. (115,116,117,,118,119,!20) Pioneering work is also taking place in outpatient services, and Welldon ^.ll22) has given a comprehensive account based on experience at the Portman Clinic, London. Lees et al.(!23) have recently produced a systematic international review of therapeutic community treatment, including groups, for mentally disordered offenders which provides a good overview of practice in other countries, in particular North America and Western Europe.

Caddick's surveys show that 'the Probation Service is the agency most actively involved in the groupwork in Britain today', (!24) and that 'the use of groups in the Probation Service—particularly in direct work with offenders—is now probably more extensive than and varied than it has ever been'. (125) A recent report for the Department of Health and the Home Office confirms the many studies of therapeutic communities and their small groups which have shown 'the most promising results of any form of treatment for psychopathy'. (l24)

Foulkes(!26) suggested that: 'The neurotic acts in his dreams whilst the criminal dreams in his actions'. The aim of forensic group therapy is to help patients find words that speak, rather than actions, so that the dream-like quality of the primary process, and the impulses or compulsions through which it has been expressed, can be uncoupled from action and explored in the relative safety of reflective language. Cox and Theilgaard (!27) describe this as negative elaboration—the elaboration of emotions including hostility, anger, despair, loss, and envy which becomes a major part of the group's work as it provides psychic space for perspective, negotiation, recognition, acceptance, and verbalization of hurt. Sharing the past and present can make it accessible as internalized, persecutory, and vengeful monologues are brought into dialogue.

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