An evaluation of group work as an intervention to reduce the impact of substance misuse for offender patients in a high security hospital

Abstract

Despite established epidemiological links between substance misuse, mental illness, and violent behaviour, the impact of interventions for offender patients is not well understood. The high security hospital is a unique environment which restricts access to substances while attempting to address substance misuse behaviours. In this study, 22 high secure patients with a history of substance misuse participated in a CBT group-work programme. They were assessed pre and post with the Stages of Change Readiness and Treatment Eagerness Scale, and the Psychological Inventory of Drug-Based Thinking Styles. A small number also engaged in a qualitative review of the impact of participation. Treatment had a positive significant effect on patients' perceptions and awareness of substance misuse behaviours and associated problems. Some patients reported particular benefits from engaging in psycho-drama relapse prevention skills training. One of the patients who refused the group subsequently tested positive for a urine drug screen test. Overall, results indicate some positive aspects of a substance misuse intervention with male high secure patients. However, acknowledged limitations highlight the need for further research to support these findings, to monitor the behaviours in high security of former substance misusers, and for maintenance/ongoing work for those transferred to conditions of lower security.