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Jill Swindells

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Any thoughts? CBT risks actively modifying cognitions! ... Why chose this workshop? Anything in particular you re keen to find out about? – PowerPoint PPT presentation

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Title: Jill Swindells


1

Pre-trial therapy (not to be confused with
pre-therapy)
  • Jill Swindells
  • qualconsultancy.com

2
Before we begin
  • Housekeeping
  • Toilets, fire alarms, mobile phones
  • Timing
  • Workshop 2.15 to 4ish with a break midway
  • Later
  • Plenary _at_ 4.15
  • Group discussion 5.30-6.30 to scope the legal
    and ethical issues of counselling within the CJS
  • Dinner _at_ 7.00
  • Confidentiality/contracting?
  • Discretion and anonymous/composite case material
  • Permission to record?

3
A bit about me
  • Background in market and social (PC) qualitative
    research, specialising in the vulnerable and hard
    to reach e.g.
  • Court experiences of vulnerable people
    (MOJ/TNS-BMRB)
  • Young Victims (OCJR/TNS-BMRB)
  • Offenders evaluation of 'Alcohol Treatment
    Requirement' service provider (ADSIS/Step Beyond)

4
A bit about me
  • Background in market and social (PC) qualitative
    research, specialising in the vulnerable and hard
    to reach e.g.
  • Court experiences of vulnerable people
    (MOJ/TNS-BMRB)
  • Young Victims (OCJR/TNS-BMRB)
  • Offenders evaluation of 'Alcohol Treatment
    Requirement' service provider (ADSIS/Step Beyond)
  • 13 years Victim Support volunteering with victims
    of all serious crime and children without
    parental permission when necessary

5
A bit about me
  • Background in market and social (PC) qualitative
    research, specialising in the vulnerable and hard
    to reach e.g.
  • Court experiences of vulnerable people
    (MOJ/TNS-BMRB)
  • Young Victims (OCJR/TNS-BMRB)
  • Offenders evaluation of 'Alcohol Treatment
    Requirement' service provider (ADSIS/Step Beyond)
  • 13 years Victim Support volunteering with victims
    of all serious crime and children without
    parental permission when necessary
  • Person-centred counsellor volunteering at
  • HMP Onley
  • Safeline (R/SA agency)
  • CAF counselling in schools
  • Myton Hospices bereaved parents group
    childrens workshops

6
And my interest in pre-trial therapy (ptt)
  • Over 13 years, increasingly concerned about an
    apparent lack of awareness and understanding
    around counselling victims/witnesses,
    particularly pre-trial also if clients decide
    to report during or following counselling.
  • VS Research Counselling
    training/experience
  • Dissertation on Counselling Victims and
    Witnesses of Crime (included Pre-Trial
    Therapy
    awareness and understanding of CPS guidance)
  • Might identifying victims and witnesses of
    crime as a discrete client group
    help highlight clients CJ
    needs and balance opposing ethical/legal issues?

7
A bit about you
  • Name, working / volunteer roles
  • Counselling settings and approaches?
  • Any special counselling interests/expertise?
  • Something about you it might
    surprise us to know?!

8
Pre-trial therapy workshop
  • Why chose this workshop?
  • Anything in particular youre keen to find out
    about?
  • What are your hopes/expectations?
  • Any concerns?

9
Responding to a disclosure
  • Current counselling practice in your prison
    / awareness of what happens in other prisons?
  • Offender regarding another offence?
  • A crime not convicted for, perhaps unreported?
  • An incident in prison?
  • Other issues?
  • Offender as a victim
  • Incident in prison?
  • Past abuse?
  • Other aspects
  • reporting,
  • pre-/ during/post- court support, etc.?

10
pre-trial therapy
  • Current awareness and understanding?
  • Sources of information / training?
  • Any direct experience?
  • Perceptions of PTT
    including relevance to
    prison settings

11
dissertation findings
  • Therapists had little/no concept of
    victims/witnesses of crime (VWC) as a group
    with potentially specialist/overarching needs,
    nor the implications for counselling,
    particularly pre-trial
  • Clients needs relating to criminal justice along
    with potentially conflicting legal and ethical
    issues were not fully appreciated, pre-, during
    or post-reporting or trial

12
dissertation findings
  • Therapists had little/no concept of
    victims/witnesses of crime (VWC) as a group
    with potentially specialist/overarching needs,
    nor the implications for counselling,
    particularly pre-trial
  • Clients needs relating to criminal justice along
    with potentially conflicting legal and ethical
    issues were not fully appreciated, pre-, during
    or post-reporting or trial
  • A lack of appropriate, relevant and up-to-date
    information, advice, guidance and training aimed
    at or originating from the counselling/psychothera
    py world was evident
  • Limited awareness and use of CPS guidance
    (HO/CPS/DH, 2001), along with inadequate
    supervision, policies and procedures,
    risks clients being denied fully informed
    consent as well as compromising
    trials due to counselling being
    inappropriate or ill-conceived

13
Some general issues
  • CJS often criticised for sidelining
    victims/witnesses despite
  • their crucial role in the process
  • successful prosecutions being dependent on their
    cooperation
  • evidence-giving often being demeaning or
    intimidating
  • Media coverage, particularly regarding CSA,
    suggests victims and witnesses of crime
    continue to be marginalised or re-victimised

14
Some general issues
  • CJS often criticised for sidelining
    victims/witnesses despite
  • their crucial role in the process
  • successful prosecutions being dependent on their
    cooperation
  • evidence-giving often being demeaning or
    intimidating
  • Media coverage, particularly regarding CSA,
    suggests victims and witnesses of crime
    continue to be marginalised or re-victimised
  • Speaking up for Justice (HO,1998, cited in
    foreword of HO/CPS/DH,2001) stated
    victims/witnesses should not be denied
    the emotional support and
    counselling they may
    need both before and after the trial.

15
Some general issues
  • However, therapy pre-trial/during is often
    avoided or discouraged or fear of tainting
    evidence, witness coaching or undermining their
    credibility (MOJ/CPS/DE/DH/WAG, 2011).
  • Long investigations and court delays threaten
    victims/witnesses welfare and the quality of
    eventual testimony, limiting ability to give
    best evidence as memories fade, are
    suppressed or tainted (Ellison,2001)

16
Some general issues
  • However, therapy pre-trial/during is often
    avoided or discouraged or fear of tainting
    evidence, witness coaching or undermining their
    credibility (MOJ/CPS/DE/DH/WAG, 2011).
  • Long investigations and court delays threaten
    victims/witnesses welfare and the quality of
    eventual testimony, limiting ability to give
    best evidence as memories fade, are
    suppressed or tainted (Ellison,2001)
  • Achieving Best Evidence Guidance (DOJ, 2010)
    recognised delays can worsen the prognosis and
    recommended support, including pre-trial, should
    begin as soon as possible for those deemed
    vulnerable and intimidated.

17
Cps ptt practice guidance
  • Crown Prosecution Service practice guidance
    (HO/CPS/DH, 2001) was issued following similar
    guidance for children and the introduction of
    special measures (CPS, 1999)
  • Provision of therapy for vulnerable and
    intimidated witnesses prior to a criminal
    trial
  • for victims/witnesses perceived as in need of
    additional support, more specifically
    therapeutic, before / during court

18
Cps ptt practice guidance
  • Crown Prosecution Service practice guidance
    (HO/CPS/DH, 2001) was issued following similar
    guidance for children and the introduction of
    special measures (CPS, 1999)
  • Provision of therapy for vulnerable and
    intimidated witnesses prior to a criminal
    trial
  • for victims/witnesses perceived as in need of
    additional support, more specifically
    therapeutic, before / during court
  • It is critical to therapists meeting the possible
    needs of victims/witnesses, working ethically and
    in the clients
    best interests
    balancing recovery with getting justice
  • (Swindells,2012)

19
Cps ptt practice guidance
  • Sought to
  • Provide a framework for good practice
  • Improve understanding, explain roles, timing,
    responsibilities, eligibility and appropriate
    practice
  • Highlight the key issues critical to therapists
    working ethically and legally
  • Inform counselling policies, procedures
    and practice when
    working pre-trial

20
Cps ptt practice guidance
  • Sought to
  • Provide a framework for good practice
  • Improve understanding, explain roles, timing,
    responsibilities, eligibility and appropriate
    practice
  • Highlight the key issues critical to therapists
    working ethically and legally
  • Inform counselling policies, procedures and
    practice when working pre-trial
  • But it has never been widely publicised, so
    awareness and use of the guidance is
    limited (Swindells,2012)

21
Other research suggests
  • Despite the introduction of pre-trial procedures
    (CPS, 2001), very few received therapy pre-trial
    and noted no procedures in place to provide
    during/post-trial counselling
  • Many eligible adult victims/witnesses are not
    identified as vulnerable/intimidated, so not
    referred to counselling and problems persist due
    to
  • Reluctance to disclose vulnerability/intimidation
  • Fear of the consequences
  • Poor information/advice/training of those
    responsible for identification primarily the
    police
  • (Lee and Charles,2008 McLeod et al,2010)

22
From a counselling perspective
  • Therapeutic practice appears to be lagging
    behind the recent developments in the law,
    designed to increase the availability of therapy
    prior to the court appearance of witnesses,
    especially victims and those who are vulnerable
    or intimidated.
  • This is not just a problem for individual
    therapists but for their professional bodies as
    representatives of therapy collectively...(and)
    subsequently leads to complications in litigation
    (which) diminishes the public reputation of
    therapists as a whole.
  • (Bond and Sandhu, 2005/11).

23
From a counselling perspective
  • Sims (2010) suggested therapists
  • are often unaware of being involved in forensic
    practice
  • have limited awareness of legal implications
  • inadvertently risk breaking the law through
    ignorance
  • Spence (1983) explained that CJ requires
  • historical truth supported by corroborative
    evidence,
  • whilst counselling entails narrative truth
    making sense of what
    happened,
    even if it is unclear,
    ambiguous or
    not the absolute
    truth.

24
From a counselling perspective
  • Whilst some therapists seem unaware of PTT
    guidelines
  • Others avoid such work for fear of
  • their notes being subject to a court-order
  • being called to give evidence themselves
  • potentially undoing progress achieved prior to a
    trial
  • compromising the therapist, client and
    therapeutic relationship
  • (Bond and Sandhu, 2005/11)

25
From a counselling perspective
  • How do you feel about counselling pre-trial?
  • And PTT?
  • Any examples
    from practice?

26
From a counselling perspective
  • Therapists may be intimidated by and cautious of
    PTT as it exposes them to a legal minefield and
    opposing ethical priorities
  • (Bond and Sandhu, 2011)
  • Justice?
  • Beneficence and non-maleficence?
  • Autonomy?
  • Fidelity?
  • Self respect?

27
From a counselling perspective
  • Therapists may be intimidated by and cautious of
    PTT as it exposes them to a legal minefield and
    opposing ethical priorities (Bond and
    Sandhu, 2011)
  • Justice?
  • Beneficence and non-maleficence?
  • Autonomy?
  • Fidelity?
  • Self respect?
  • What ethical issues come to mind?

28
From a counselling perspective
  • Some examples
  • Justice?
  • Clients may feel re-victimised by CJS do more
    harm than good
  • Therapists may inadvertently compromise
    client/trial by invalidating evidence
  • Beneficence and non-maleficence in tension
  • When supporting a client to report/have PTT
  • Therapists/their notes may be requested by the
    courts
  • Autonomy?
  • Following the guidance client/therapist unable
    to make free/fully informed choices
  • Important for contracting to highlight all the
    issues to maximise autonomy
  • Fidelity?
  • PTT compliant counselling policies and procedures
  • Access to counselling/PTT for offenders in
    custody/the community?
  • Self respect?

29
From a counselling perspective
  • So PTT requires
  • Detailed consideration of ethical, professional
    issues and legal requirements
  • Compatibility with the law and public interest to
    avoid conflict
  • A different mindset and way of thinking
  • Systematic and rigorous approach
    until the trial is
    over
  • (Bond and Sandhu, 2011 Mitchels and Bond ,2010)

30
CPS PTT practice guidance ....
  • What do you know about the dos and
    donts?
  • Whos eligible?
  • Who decides?
  • When should you start?
  • What it recommends to do/avoid?
  • Changes to normal practice?
  • Contracting/confidentiality
  • Notes and records
  • Court preparation
  • Etc.

31
Who is eligible?
  • Vulnerable and intimidated witnesses
  • Adults aged over 18 years
  • Physical/mental health difficulties
  • Learning disabled/capacity impaired
  • Affected by sexual/domestic abuse or
    weapon-related crime
  • The elderly/frail
  • And all children/young people under 18 years
  • N.B. Only these victims/witnesses are
    entitled to pre-/during
    trial therapy,
    not all victims/witnesses

32
Vulnerable and intimidated offenders?
  • 36 of all prisoners have physical/mental health
    issues
  • 20-30 of all offenders have learning
    disabilities/ difficulties which affect coping
    with CJS
  • 23 young offenders have learning difficulties
    and 36 borderline learning difficulties

33
Vulnerable and intimidated offenders?
  • 36 of all prisoners have physical/mental health
    issues
  • 20-30 of all offenders have learning
    disabilities/ difficulties which affect coping
    with CJS
  • 23 young offenders have learning difficulties
    and 36 borderline learning difficulties
  • 49 women and 23 male prisons suffering from
    anxiety/depression
  • 25 women and 16 men in prison reported
    psychotic symptoms
  • 23,183 incidents of self harm in custody in 2013

34
Vulnerable and intimidated offenders?
  • 36 of all prisoners have physical/mental health
    issues
  • 20-30 of all offenders have learning
    disabilities/ difficulties which affect coping
    with CJS
  • 23 young offenders have learning difficulties
    and 36 borderline learning difficulties
  • 49 women and 23 male prisons suffering from
    anxiety/depression
  • 25 women and 16 men in prison reported
    psychotic symptoms
  • 23,183 incidents of self harm in custody in 2013
  • 46 women prisoners attempted suicide at some
    point in their lives
  • 12 of the prison population is over 60, some
    older prisoners have a physical health status
    over 10 years older
  • (Bromley Briefings Summer 2014)

35
Who decides and when to start
  • The vulnerable/intimidated, their
    carers/therapists are ultimately responsible for
    decision making
  • And may also flag up eligibility if appropriate
    and not already identified
  • The police / CPS need to be informed
    disclosure made to the defence depending on the
    stage reached
  • Therapy should not start until after the police
    interview
  • If new disclosures during therapy, put on hold
    till follow-up interview(s) completed
  • Communication with police/CPS may need to be
    on-going

36
CPS PTT guidance recommends ...
  • Avoiding
  • Recounting, re-enacting or rehearsing the
    incident(s)
  • Attempting to distinguish fantasy from fact
  • Implanting/false memories
  • Interpretive/psychodynamic psychotherapy
  • Hypnotherapy/psychodrama
  • Regression techniques
  • Unstructured group work

37
Other sources recommend...
  • Avoiding
  • Guided imagery, dream interpretation
  • Imaginal/exposure therapy
  • Crisis intervention/desensitisation
  • EMDR/Rewind technique/NLP
  • Bibliotherapy
  • (Fieldman-Summmers, 1996
  • Miller, 1998 Counselling Directory)

38
CPS PTT guidance recommends ....
  • Therapy focussing on
  • The impact of the crime
  • Mental health issues
  • Emotional/behavioural disturbance
  • Dealing with/avoiding abusive situations
  • Building self-esteem and confidence
  • Stress reduction
  • Reassurance and support

39
CPS PTT guidance recommends ....
  • Therapy focussing on
  • The impact of the crime
  • Mental health issues
  • Emotional/behavioural disturbance
  • Dealing with/avoiding abusive situations
  • Building self-esteem and confidence
  • Stress reduction
  • Reassurance and support
  • And states a preference for CBT
  • Generalised evidence based rationale?
  • Appropriate evidence lacking?
  • (Joseph et al 1997, Itzin et al, 2010))

40
A person centred approach?
  • The Delphi Expert Consultation reported CBT alone
    is
  • insufficient to meet victim/survivors needs
    no single therapeutic approachworks best for
    every victim/survivor
  • and recommended
  • approaches should be needs-led and
    victim/survivor centred associated with
    characteristics such as empowerment, giving
    control and choice to victims/survivors
    (Itzin et al,2010)

41
A person centred approach?
  • The Delphi Expert Consultation reported CBT alone
    is
  • insufficient to meet victim/survivors needs
    no single therapeutic approachworks best for
    every victim/survivor
  • and recommended
  • approaches should be needs-led and
    victim/survivor centred associated with
    characteristics such as empowerment, giving
    control and choice to victims/survivors
    (Itzin et al,2010)
  • Therapists working with trauma victims should be
  • as involved and engaged as is possible
    without violating
    therapist-client boundaries

    real, warm, concerned, empathic, responsive
  • (McCann and Pearlman, cited by Janoff-Bullman,
    1992)

42
A person centred approach?
  • Providing PTT information, contracting
    appropriately, sharing responsibilities for
    boundaries and stopping clients talking about the
    incident(s)/evidence is NOT directive if done
    sensitively with
  • Empathic understanding
  • Respect for their experience, autonomy
    and frame of
    reference

43
A person centred approach?
  • Providing PTT information, contracting
    appropriately, sharing responsibilities for
    boundaries and stopping clients talking about the
    incident(s) is NOT directive if done sensitively
    with
  • Empathic understanding
  • Respect for their experience, autonomy
    and frame of reference
  • The therapists job is to follow where the
    client leads, putting aside theoretical
    understanding and any other expert knowledge
    (Wilkins,2010)
  • Clearly PTT requires some adaptations to meet CPS
    requirements and balance ethical considerations

44
The danger of discussion...
  • Discussions of any kind prior to trial
    perceived to increase the potential for
  • Gaps/inconsistent accounts of events in question
  • Deliberate/inadvertent fabrication (sense-making)
  • Risks becoming more convinced/convincing of
    evidence, but no less mistaken and, hence,
    perceived as less reliable as a witness
  • Therapy just ONE kind of discussion, others
    include family, friends prison officers,
    other prisoners
  • May lead to allegations of coaching/
    contamination/unreliability

45
Other changes to normal practice
  • In addition to not talking about the evidence
  • Incident(s) / people involved
  • What others said/did (heresay), etc.
  • Contracting needs to be PTT specific, thorough
    (ideally written) and on-going in case the
    situation changes
  • Confidentiality cannot be guaranteed
  • Notes may be seized/counsellor called as a
    witness
  • Notes should be brief, factual and, ideally,
    shared, reviewed, signed as
    accurate dated
  • Contain no personal disclosure/opinion
  • Carefully record and disclose any additional
    allegations
  • Court preparation and support should be kept
    separate

46
What if
  • Circumstances/situations/decisions change
  • Counselling client first discloses childhood
    sexual abuse several weeks into counselling?
  • Depressed/anxious counselling client discloses
    alleged physical/emotional abuse/neglect of
    their neighbours child by parents?
  • Non-reporting and not vulnerable/intimidated
    counselling client decides to report
    during/post-therapy?
  • PTT client reveals new information about the
    crime (s)/another unreported crime?
  • PTT client offends/re-offends in the meantime and
    due in court as offender first?
  • After failed reporting by autistic client and
    starting counselling believing not going to
    trial, the police/CPS decide to proceed as other
    victims/witnesses/new evidence/crime(s) emerge?

47
So
  • Circumstances/situations/decisions can change
  • Hence, prudence recommended when counselling all
    potential victims/witnesses at any stage in their
    quest for recovery and/or justice
  • (Godsi,1999 Swindells, 2012)

48
an ex-offenders personal experience of PTT
Starting initially as a CSA victim reporting for
the 3rd time ... Partway through PTT, reoffended,
so facing trial and the possibility of prison
where shed experienced further abuse
After 33 sessions and currently taking a break
between trials. Played with the clients
permission.
49
Good practice guidance ...
  • Adoption of common terminology PTT, CPS
    guidance
  • So everyone is talking the same language
  • Be prepared
  • Proactive gt reactive multi-agency working
    (Donlan Jenkins 2010)
  • Familiarity with CPS guidance updates
  • Relevant training and supervision?
  • Policies on disclosure, notes, records, etc.
  • Fully informed consent contracting on-going
  • Not guaranteeing confidentiality
  • Avoiding certain approaches/coaching/evidence
  • Appropriate focus
  • Pre-court preparation and support separate

50
Good practice guidance ...
  • Dont forget resuming normal therapeutic
    practice post-trial as
  • ...the same concern about external
    evidence...necessary in the courtroom is
    not required in recovery and healing
  • (Whitfield,1995).

51
How do you feel about PTT now?
52
Any questions?
53
The more useful references
  • HO/CPS/DH (2001) Provision of therapy for
    vulnerable and intimidated witnesses prior to a
    criminal trial. HO Communications Directorate,
    London. http//www.cps.gov.uk/publications/prosecu
    tion/pretrialadult.html
  • Bond, T. and Sandhu, A. (2005/2011) Therapists in
    Court Providing Evidence and Supporting
    Witnesses. (BACP) Sage, London.
  • Department Of Justice (July 2010) Achieving best
    evidence in criminal proceedings. Guidance on
    interviewing VW, the use of special measures and
    the provision of pre-trial therapy.
    http//www.dojni.gov.uk/index/public-consultations
    /archive-consultations/draft_achieving_best_eviden
    ce_guidance.pdf.pdf
  • Donlan, L. and Jenkins, P. (2010) Vulnerable
    Witnesses Conference 13th January 2010. Pre-trial
    therapy and the impact of trauma on Victims and
    Witnesses. BACP, Criminal Justice Forum.
  • Lee, V. and Charles, C. (2008) A consultation on
    the CPS Policy on prosecuting criminal cases
    involving people with mental health problems
    and/or learning disabilities as victims and
    witnesses. CPS, London.
  • McLeod, R. Philpin, C., Sweeting, A, Joyce, L.
    and Evans, R. (2010) Court experience of adults
    with mental health conditions, learning
    disabilities and limited mental capacity. MOJ,
    London.
  • MOJ/CPS/DE/DH/WAG (2011) Achieving Best Evidence
    in Criminal proceedings Guidance on interviewing
    victims and witnesses, and guidance on special
    measures. http//www.cps.gov.uk/legal/assets/uploa
    ds/files/Achieving20Best20Evidence20in20Crimin
    al20Proceedings.pdf
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