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One size does not fit all in forensic practice

Case studies in forensic psychology: Clinical assessment and treatment (2019, Routledge; £26.39) by Ruth Tully and Jennifer Bamford, reviewed by Nisha Pushpararajah.

28 May 2020

Case studies in forensic psychology is a long-awaited compilation of real-life case studies offering exciting insights into forensic practice. The book captures clinical practice within different contexts (prison, psychiatric, and community settings), involving a diversified client group. Moreover, it encapsulates the challenges psychologists working with forensic clients face – from choosing the most appropriate psychological assessment strategy, to risk assessment and case formulation practice, to treatment planning.

The book covers best practice when working with young people, those with personality or neurodevelopment disorders, people with learning disabilities, and those who have committed sexual offences. It considers different client needs, encouraging more responsive ways of working. Real-life case studies detail the impact that mental health issues, trauma, personality disorder and client service involvement can have on a client’s behaviour. Risk factors and other issues that might be relevant to a client’s progress are highlighted, priming practitioners to understand and plan their work, whilst bearing in mind the distresses clients might experience, as well as their instabilities. No case study is alike – assessment and treatment decisions are specific to the different forensic contexts explored, from community to psychiatric services.

This book highlights the relevance of the Adverse Childhood Experiences (ACEs) research in understanding clients’ psychosocial adjustment problems. A client’s reduced ability to think and relate to others is often the by-product of early trauma and victimisation – with long lasting effects. Childhood adversity can ultimately impact on a client’s resilience. Remaining aware of this will enable me to support clients in the best way possible.

The book presents a host of practical and intervention advances – from schema therapy and mindfulness, to utilising the Power Threat Meaning Framework, which is a model that conceptualises how individuals react to different threats and societal powers present in their lifetime and the role these play. The message is conveyed that ‘one size does not fit all’. It highlights the importance of carefully considering the approaches adopted in practice when assessing and therapeutically intervening with different clients.

Specific real-life challenges to working with individual cases were scarcely captured within this book. The inclusion of relational difficulties, readiness issues like the ‘starts and stops of therapy, and patterns of negative thinking, for example, would have helped present a realistic picture of working with complex clients.

Still, this book helps practitioners to thrive, on the hope that even the most complex of cases can be helped. It demonstrates how various psychological models and approaches can enable clients to reach important intervention goals or promote desistance.

- Reviewed by Nisha Pushpararajah, Registered Forensic Psychologist, Her Majesty’s Prison and Probation Service