Annual Report 2004-2005 - Forensicare

Consolidating and Strengthening Clinical Programs (CSCP)
Addressing Dual Diagnosis and Offending Issues
Treatment Pathways in Forensicare
Level 2 Assessment Level 2 Intervention Discharge and Follow-Up
Level 2 Assessments are conducted on an as-need basis
following a decision of the treatment team, based on the patients’
issues and situation.
Level 2 –
Dual Diagnosis Assessment
• Drawing on the Level 1 assessment
results, Level 2 assessments comprise
a formulation and proposed treatment
plan
• Comprehensive examination includes
a consideration of the patient’s
psychosocial needs and problems,
including the severity of mental health
and substance use disorders,
conditions associated with the
occurrence and maintenance of these
disorders.
Level 2 –
Dual Diagnosis Intervention
• Patients moved beyond psychoeducation
and information to in-depth
therapeutic interventions, aimed at
treating the substance use disorder
• Areas covered include refusal skills,
relapse prevention strategies, coping
with unpleasant feelings, managing
cravings, social skills and relaxation
skills.
Information from patients’ assessments
and intervention pertaining to both dual
diagnosis and offending issues form part
of patients’ discharge plans. Remaining
issues are identified and targeted for
ongoing intervention.
Level 2 –
Offending Issues Assessment
• HCR-20 (assesses patients’ historical,
clinical and risk management factors)
• LSI-R (comprehensively identifies areas
of vulnerability associated with the risk
of offending that require intervention)
• Offence chain analysis (identifies the
important causal and functional
relationships associated with offending
behaviour)
• Case formulation and treatment plan
development
Level 2 –
Offending Issues Intervention
• Targeted at the areas identified in the
Level 2 assessment.
• Depending on the patient, interventions
are aimed at –
• cognitive skills (problem solving,
social skills, anger management,
stress management)
• offence specific matters (history
of violence, perceptions, thought,
feelings, and attitudes)
• Long-tem benefits could include reduced re-offence rates and less frequent
return to prison and to hospital
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