Forensic psychology in the dock

This book is clearly intended to be provocative and accessible to a wide readership. The title and style suggest an attempt to be seen in the tradition of publications such as Ben Goldacre’s Bad Science (2008, Fourth Estate). Its central argument is that forensic psychology (prisons and the Parole Board, at any rate) is dominated by procedures for assessing and reducing risk of reoffending that have little or no empirical foundation. It is further argued that the whole enterprise is driven by political and organisational imperatives and maintained by the fallibility of human judgement, inadequate training and defensiveness. Alleged consequences include wasting taxpayers’ money on a grand scale and the injustice of unnecessarily prolonged incarceration. It is recommended that psychologists should not muddy the waters of reliability and validity by the exercise of personal judgement and there should be no straying from procedures supported by rigorous evaluation. One implication is that cognitive-behavioural programmes for addressing complex offence-related behaviour should be abandoned.
Numerous personal anecdotes lean rather heavily on the trope of the voice of reason standing against bureaucracy and vested interests. Resentful reviewers may be tempted to reciprocate by drawing parallels with Robert Martinson (1974), who damaged the field of rehabilitation before publishing a retraction, or even with the author’s near namesake who shot the outlaw Jesse James in the back; I mention these so they don’t have to. Examining where the author may have succumbed to the very heuristics and biases that he criticises in others could be a more productive venture. I hope none of this distracts from the better justified points concerning shortcomings in vision and implementation within the field over the last couple of decades and the Kafkaesque logic that has sometimes attended them. Ultimately, though, I found this book to be disappointing in several respects.
Initially I was intrigued by the author’s conversational style and uncompromising approach towards a questionable orthodoxy that in many ways has been both limited and limiting. To clarify my own direction of travel, I am amongst those who have questioned (e.g. Needs, 2016; Needs & Adair-Stantiall, 2018). As I read on, I became increasingly uneasy at the lack of coverage of existing critiques (there have been many) and this mounted as it became apparent that limited acknowledgement of prior work extends to other key areas (such as the relevance of heuristics and biases). However, it was when I reached the sweeping assertions regarding interventions that I was particularly dismayed by the less than comprehensive use of evidence. I have never been a conventional advocate or apologist for what the author terms the ‘offending behaviour industry’ and to say that the area has a chequered history is an understatement. Nonetheless, we owe it to the reader and the future development of the field to be as accurate and fair as possible. There really is no space to debate this here, but the interested reader could do worse than start with the recent ‘review of reviews’ by Weisburd et al. (2017) and work backwards.
Such considerations caused me to wonder again about the nature of the intended readership. The style is not that of an academic publication but the overuse in places of footnotes sits rather uneasily with a popular work. Also, being a non-specialist is unlikely to confer immunity from the cumulative effects of repetition and occasional sentences that reminded me of the editorials of certain non-broadsheet newspapers. I would not expect everyone to share my frustration at processes involved in life events being reduced to regression to the mean, or developments in improving custodial environments by social means being ignored in favour of token economies and proposals for something that sounds rather like the existing Incentives and Earned Privileges system. Even a prisoner not averse to endorsing a publication that purports to discredit an influential part of the system that holds sway over his life might be confused at this point. In fact I found the pages on future directions the most disappointing of all.
In terms of the evolution of the field the author’s failure to represent important aspects of past, current, emerging or potential practice and associated research could do more harm than the criticisms around which the book is based. If forensic psychology needs to ‘return’ to science, I would urge that there needs to be a debate within forensic psychology about how science is understood and practised. For example, it has been suggested that neglect of context and process can make even randomised controlled trials ‘effectively useless’ (Byrne, 2013). Similarly, failure to think in terms of the dynamics of systems at every level can hamstring the ability of psychologists to engage with them in a productive manner.
If we attempt to locate science precisely where Dr Forde says we left it, we might find that it has moved on.
- Reviewed by Dr Adrian Needs, Principal Lecturer at the University of Portsmouth and Registered Forensic Psychologist
References
Byrne, D. (2013). Evaluating complex interventions in a complex world. Evaluation, 19, 217– 228.
Martinson, R. (1974). What works? Questions and answers about prison reform. The Public Interest, 35, 22–54.
Needs, A. (2016). Rehabilitation – writing a new story. The Psychologist, 29(3), 192–195.
Needs, A. & Adair-Stantiall, A. (2018). The social context of transition and rehabilitation. In G. Akerman, A. Needs & C. Bainbridge (Eds.) Transforming environments and rehabilitation: A guide for practitioners in forensic settings and criminal justice. London: Routledge.
Weisburd, D., Farrington, D.P. & Gill, C. (2017). What works in crime prevention and rehabilitation. Criminology & Public Policy, 16(2), 415–449.
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Comments
Jesse James? Adrian Needs
Jesse James? Adrian Needs rightly says that my book challenges established practices in forensic psychology, and that I am not alone in doing this, but it is hardly assassination. Challenges attract criticism, but (for a reason which will become apparent) I didn't expect quite such vituperation from Adrian.
To take a few of the points: he refers to personal anecdotes, but in a book intended to be accessible to non-psychologists these help to illustrate. They are not the basis of my challenges, which are based on evidence. He also employs an anecdote of his own about a hypothetical confused prisoner. But a criminologist who said he would recommend the book to all his students is an ex-lifer (ie, he had been a real prisoner) and he wasn't a bit confused. Adrian doesn't like the footnotes. Nor I: they were introduced by the publisher. I prefer endnotes. But something was necessary to point interested readers towards published evidence.
Adrian particularly didn't like my comments on interventions. In fact, based on published peer-reviewed evidence available then, I had been predicting the recent results on sex offender programmes since 2005, so this was not off-the-wall stuff. Isn't prediction the test of hypotheses? The really astonishing thing is that these results have not led to a wider questioning of current interventions based on the same principles. I did suggest that other interventions might be more useful, but the fixation with alleged CBT programmes has prevented them getting much attention, so the evidence is limited.
The implication that the evidence was cherry-picked is false. Most of the evidence in this field is of poor quality, which is why one meta-analysis rejected over 80% of papers as being too poor to include (Hanson, Bourgon, Helmus & Hodgson, 2009). Rightly, I think, I concentrated on meta-analyses of good quality. As for scientific method moving on, we need to be careful. Claims that science isn't inclusive enough tend to be raised by those who don't want to accept science. The history of psychoanalysis in a case in point. The fact that even strong research designs can be undermined by circumstances is no argument for using weaker ones. Another straw man is criticising the book for not considering several articles published after it was in production, or even after its publication. As for coverage of heuristics and biases being "limited", Kahneman alone gets 19 mentions and interested readers can go to his popular book (Kahneman, 2012).
A US colleague who liked the book had just one criticism: that I wasn't critical enough. However, I will not be following Martinson in crying that "nothing works", nor in his (actually only partial) retraction. One reason is that, in a BPS conference session where I presented many of the arguments in the book, a UK colleague said that he agreed with "99%" of it. That colleague was Adrian Needs, whose review seems to concentrate on the other 1%, albeit without actually refuting any of the points it makes.
References
Hanson, R. K, Bourgon, G., Helmus, L., & Hodgson, S. (2009). A Meta-Analysis of the Effectiveness of Treatment for Sexual Offenders: Risk, Need, and Responsivity. Public Safety Canada. Retrieved from https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2009-01-trt/2009-01-trt..., 24/1/18.
Kahneman, D. (2012). Thinking, fast and slow. London: Penguin Books.
Response from Adrian Needs
"Bad Psychology" wasn't meant to be an academic treatise
I don’t want this correspondence to become unduly extended, but there are a couple of points I should make.
First, “Bad Psychology” was never intended to be an academic treatise, and I think that’s pretty clear from the presentation. It was meant to be accessible to non-psychologists, and that is a very different sort of book. Anyone wanting something more academic on the subject of risk assessment specifically could do worse than consult my doctoral thesis on the use of risk assessment in parole decisions for life sentence prisoners (http://etheses.bham.ac.uk/5476).
Second, anyone expecting a programme for the future development of forensic psychology was inevitably going to be disappointed. The point of the book was to challenge the baleful effects on our profession of the offending behaviour industry, and to present evidence concerning those effects, much of which has been available for many years but which has been disregarded and denigrated by those with vested interests.
Adrian Needs refers to “glimmers of hope”, and I agree with him that these do exist. But the offending behaviour industry has not claimed to provide glimmers of hope. If it had, I would never have written the book. On the contrary, it has claimed to provide comprehensive detailed risk assessment which actually means something, and treatment programmes which produce highly significant behaviour change. In the USA one organisation has tried to establish itself as the only source of effective treatment for sex offenders (using methods similar to the discredited SOTP). One UK forensic psychologist used regularly to claim that “we know (sic) that these programmes reduce risk by 50%”. Others have regularly claimed to know what a given PCL-R score means in terms of risk, or that a SARN-TNA gave an understanding of treatment need. All of these claims are false.
The problem is not that good scientific work in these areas did not exist. The problem is that it was ignored in favour of unsound work which better suited practitioners’ preferences. This is still going on. There is no sign that the lessons of the SOTP fiasco have been learned, or that anyone wishes to learn them. Indeed, lawyers who still work in parole hearings tell me that the discredited SARN-TNA is still being presented as evidence in those hearings, although it is supposed to have been dropped. New programmes have been brought in without any pilot schemes to test their effectiveness, only their ease of administration. Unless there is a change of direction, there will be further fiascos, further unnecessary victims, and ultimately forensic psychology will be completely discredited.
I think it deserves better.
Second response from Adrian Needs
There are signs that in some respects forensic psychology might be entering a new phase of what Kelly (1955) termed the 'creativity cycle': After being immersed in 'preemption' (narrowness and rigidity) the growth of interest in areas such as social climate, strength- based approaches, trauma- informed care and contextual factors in risk assessment might suggest that we are entering a more creative and integrative phase of 'circumspection'. This will present its own challenges (particularly in terms of how we practice science) and there are lessons to be learned from the past. However I wouldn't want such developments to be dismissed out of hand because of the past (or one person's interpretation or incomplete representation of it). If change in a discipline shows some of the same patterns as change in an individual then we might start to think in terms of the need to build new 'attractor states' at the same time as weakening maladaptive ones (e.g. Hayes, Yasinski, Barnes & Bockting, 2015). There are times when criticism needs to be accompanied by genuine alternatives and sometimes these are the most effective (albeit implied) criticisms of all. Of course translating developments into practice usually requires change at the organisational level as well.
Green shoots (and some more established growth) deserve better than to be trampled on.
Criticism of "Bad Psychology": an anxiety reaction?
I think the outstanding feature of Adrian’s criticism is that he does not dispute any of the claims I make in the book; indeed he states his agreement with many of them. He has also found the criminal justice system to be impervious to evidence it doesn’t like, witness his anecdote of the letter that has not been replied to in 25 years. Instead, his criticism seems to centre on things that I did not say but that he feels I should have done, including criticisms by others and more positive features of forensic psychology. In the end, people must make up their own minds about that, but I have never claimed that the book was an impartial academic study (if there is such a thing). Nor have I claimed that I was the only person opposing the current orthodoxy. Indeed I quote several others in the book, e.g.Neal and Grisso (2014), Dror and Murrie (2017) and Hagen (1997).
Neither did I claim that forensic psychology was useless, as Adrian acknowledges. To quote from chapter 1: “my contention is not that psychology in general, or forensic psychology in particular, has no value. Far from it. I firmly believe that it could help us avoid many policy mistakes and take better decisions.” (Page 15). So, if he doesn’t dispute the facts that I present, and he doesn’t think I am rubbishing forensic psychology as a whole, what is Adrian’s criticism really about?
It is interesting that he mentions Norman Dixon’s book “On the psychology of military incompetence” (Dixon, 1976), which I also heartily recommend. I was a student of Dixon’s many years ago and first read the book in the late 70s. Coincidentally, I re-read it a couple of months ago. I had the opportunity shortly after its publication to hear Dixon talk about it and describe the two typical reactions which he had encountered from military personnel. The first was “So what? We knew all this already”, and the second was “How dare you? This threatens the credibility of the entire military system”. It seems to me that Adrian’s reaction to my book approximates to the second. He appears not really to be against its message, but against the effect he fears it might have. Surely this is why he floats the idea that prisoners or politicians might read this book and think they understand all about forensic psychology? Is this really likely? Is it not more an expression of an unwarranted anxiety, especially when applied to a popular paperback which is not likely to be that influential?
But apparently I am the one with unwarranted anxieties, not to say conspiracy theories. In fact, the organisation (the Association for the Treatment of Sexual Abusers) which I suggested was trying to monopolise sex offender treatment in the United States has come under severe criticism by American forensic psychologists for doing precisely that. It has a history of trying to influence state authorities to give it undue influence over policy. Here are two quotes (emailed yesterday) from American forensic psychologists:
“In Illinois, the state's ‘Sex Offender Management Board’ … has apparently adopted the ATSA treatment guidelines and tried to foist them upon practitioners. I critique them routinely.”
“As you know since I took a stand against ATSA about a dozen years ago I have had nothing to do with them. Unfortunately there are colleagues of ours who apparently just can't help but to act as facilitators of bad people and terrible organizations. I am not one of them.”
Perhaps not flirting with “conspiracy theory” after all.
“Bad Psychology” was intended to challenge the current dominance over penal policy by certain groups with vested interests. It was not intended to provide a description of “forensic psychology and psychologists - past present and future”. I think that is very clear from the style of the book. If Adrian feels that it is closer to journalism than to an academic treatise then I am content with that. That is what it was meant to be.
References
Dixon, N. (1976). On the psychology of military incompetence. London: Jonathan Cape.
Dror, I. E., & Murrie, D. C. (2017). A Hierarchy of Expert Performance Applied to Forensic Psychological Assessments. Psychology, Public Policy, and Law. doi: 10.1037/law0000140
Hagen, M. (1997). Whores of the court: The fraud of psychiatric testimony and the rape of American justice. New York, NY: HarperCollins.
Neal, T. M. S., & Grisso, T. (2014). The cognitive underpinnings of bias in forensic mental health evaluations. Psychology, Public Policy, & Law (preprint publication online). doi: http://dx.doi.org/10.1037/a0035824
Third response from Adrian Needs
Andrews, D. A., & Dowden, C. (2005). Managing correctional treatment for reduced recidivism: A meta‐analytic review of programme integrity. Legal and Criminological Psychology, 10(2), 173-187
Lipsey, M. W., Landenberger, N. A., & Wilson, S. J. (2007). Effects of cognitive-behavioral programs for criminal offenders. Campbell systematic reviews, 6(1), 27.
McGuire, J., Bilby, C. A., Hatcher, R. M., Hollin, C. R., Hounsome, J., & Palmer, E. J. (2008). Evaluation of structured cognitive–behavioural treatment programmes in reducing criminal recidivism. Journal of Experimental Criminology, 4(1), 21-40.
Pearson, D., McDougall, C., Kanaan, M., Bowles, R. A., & Torgerson, D. J. (2011). Reducing criminal recidivism: evaluation of Citizenship, an evidence-based probation supervision process. Journal of Experimental Criminology, 7(1), 73-102.
Sadlier, G. (2010). Evaluation of the impact of the HM Prison Service Enhanced Thinking Skills programme on reoffending. Outcomes of the Surveying Prisoner Crime Reduction (SPCR) sample. England: Ministry of Justice.
Tong, L. S., & Farrington, D. P. (2006). How effective is the “Reasoning and Rehabilitation” programme in reducing reoffending? A meta-analysis of evaluations in four countries. Psychology, Crime & Law, 12(1), 3-24.
Wilson, D. B., Bouffard, L. A., & MacKenzie, D. L. (2005). A quantitative review of structured, group-oriented, cognitive-behavioral programs for offenders. Criminal Justice and Behavior, 32(2), 172-204