|dc.description.abstract||Background: Strength-based approaches to working with Mentally Disordered
Offenders (MDOs) move from a focus on mental disorder and risk to a wider
consideration of the individual that considers their strengths, personal priorities and
competencies. There is an increasing emphasis on values and recovery in health
and forensic mental health services. This represents a shift in perspective from a
deficit focus to an abilities focus. There is however a paucity of research into values
and strength-based approaches. This thesis portfolio aims to contribute to this area
Methods: A systematic review of the literature was conducted to review strengthbased approaches for mentally disordered offenders in forensic mental health
settings. Four databases (MELINE, PsycINFO, EMBASE and SCOPUS) were searched
and 10 studies were included in the review. The outcomes measures in the
included studies were recovery, quality of life, violence/risk, recidivism, mental
health symptoms, therapeutic milieu, and engagement.
In the empirical study, a Grounded Theory Methods was used to build a theory of
values of men in a medium secure unit who have offended. Interviews were
conducted with nine inpatients in a Scottish medium secure unit.
Results: The findings of the systematic review, although limited, suggest that a
strength-based approach will facilitate outcomes in quality of life, recovery, mental
health symptoms, violence, risk, recidivism, and engagement. Limited evidence
was found and there was also a lack of consistent findings. Further consideration of
the long-term impact of such an approach and further high-quality research is
needed to establish the effectiveness of strength-based approaches.
In the empirical paper, a model of values in mentally disordered offenders was
produced. The expressed values of MDOs were made up four separate categories
relating to: (1.) connecting with others; (2.) living a healthy life; (3.) being
productive and contributing; and (4.) having agency and being in control. As part of
the model, a consideration is given to the development of values throughout life
and the barriers and opportunities that impact on an individual’s life and the impact
that has on values.
Conclusions: The findings of this thesis indicate that there is a benefit to using
strength-based and values informed approaches to working with mentally
disordered offenders. The findings of this research support the view that mentally
disordered offenders share similar values to non-offenders. Further research is
needed, to be able to clearly support the effectiveness of strength-based approaches and also to evaluate the use of values to guide clinical care and treatment.||en