The implementation of case formulation by probation officers: service user and carer views

Abstract

Background: The recent UK Government strategy on high-risk offenders with personality disorders (PD) proposes improved identification of this group, assessment of their treatment needs through case formulation (CF) and the subsequent provision of treatment pathways. Little is known about service user and carer views on this strategy. Aims/Hypotheses: This study sought to identify the views of personality-disordered (PD) offenders and carers on the proposed role of Probation staff in CF. Methods: Three focus groups were carried out, two with service users and one with carers, with a total of 10 participants overall. Results: Five themes emerged: ‘power’, ‘conflicting roles’, ‘trust’, ‘building a relationship through consistency of care’ and ‘hope and possibility’. Conclusions/Practical implications: Offenders and carers were sceptical regarding the proposed role of Offender Manager (OMs) in CF and this could pose a potential barrier to the successful implementation of the strategy.

Keywords:

• Assessment
• personality disorder, probation, case formulation

Funding

This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Development Grants Programme [Grant Reference Number RP-DG-0611-10012]. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The role of Offender Manager was introduced with the inception of the National Offender Management Service (NOMS) in the UK in 2004 which combined the responsibilities for Her Majesty’s Prison Service and the National Probation Service. The role is similar to that of ‘ProbationOfficer’ but is now being preferred to emphasise the broad responsibilities of the role, including provision of reports for courts to guide decisions about sentencing, support of offenders throughout their prison sentence and following release as well as the supervision of offenders serving community sentences.

2. Security levels in English prisons are divided into four levels with Category A being the most secure and Category D providing open conditions. High secure hospitals accommodate individuals that present a ‘grave and immediate danger’. While high secure hospitals can also admit patients without an offending history, this is the case in under 10% of individuals and almost exclusively applies to female and learning disabled populations. The content of the focus groups also revealed that participants recruited from this setting did indeed all have offending histories.

3. The IONNA study created a PPI reference group comprised of individuals with either lived experience of PD and offending or being carers of such individuals. The reference group informed the conduct of the study including its remit and practical implementation (such as development of focus group schedules). A member of this group was present at all focus groups.

4. Whilst there remained some uncertainty about how CF was to be implemented by OMs under this strategy, it was likely that it was intended to be an assessment only (that then directs the offender towards appropriate treatment) and not a process that takes place over time – though the assessment would take place as part of a longer, ongoing relationship with the OM.

5. Participants in the two-person group were acquainted with each other. In the three-person group, two of the participants were acquainted.