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Reasoning and Rehabilitation 2

Reasoning and Rehabilitation 2

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R&R2 FOR YOUTHS AND ADULTS
WITH MENTAL HEALTH PROBLEMS
A PROSOCIAL COMPETENCE TRAINING PROGRAM
Dr. Susan Young & Dr. Robert R. Ross

Program Outline

The "R&R2 Program For Youths and Adults with Mental Health Problems" (R&R2 MHP program) is a multifaceted, cognitive behavioural group program designed to teach individuals with mental health problems cognitive, emotional and behavioural coping strategies that can enable them to develop prosocial competence.

Program Rationale: Many individuals with mental health problems benefit from treatment to manage their symptoms. However, those individuals, who in addition to their mental health problems, evidence disruptive, antisocial or criminal behavior require treatment that not only targets their mental health problems but also specifically targets their antisocial behavior.

Historically, most treatment programs for such individuals, including mentally disordered offenders, have been ‘broad brush’ treatments that have not taken into consideration the impaired cognitive, emotional, social skills and values of this population that underly their antisocial life-style. These characteristics impede their progress in rehabilitation, vocational advancement, educational achievement and prosocial development. Moreover, although they may have been involved in many programs throughout their lives, many youths and adults with mental health problems are resistant to treatment.

Many individuals with mental health problems lack a level of prosocial competence that would enable them to cope in non-institutional settings. Many exhibit specific problems in their intellectual functioning such as poor attentional control and processing speed. Deficits in memory and executive functioning are common, resulting in difficulty in recalling verbal and visual information, poor organizational ability, poor planning ability, impulsivity and poor response inhibition.

Many evidence the same cognitive characteristics that have been identified in antisocial individuals, including adolescent and adult criminal offenders, such as egocentricity, poor interpersonal problem solving skills, dysfunctional or self-defeating coping techniques, inadequate social skills, rigid and concrete thinking, thinking errors and antisocial values.

Research Development: The R&R2 MHP program is based on the "Reasoning and Rehabilitation" (R&R) program (Ross & Ross, 1986) that has been delivered over the past 21 years to more than seventy thousand "at risk" and antisocial individuals in seventeen countries. The efficacy of R&R has been demonstrated in numerous independent, international evaluations and through comprehensive reviews, cost-benefit analyses and meta-analyses.

Several secure hospitals for mentally disordered offenders in Scotland, England,
New York, Germany and Colorado are delivering the original R&R to mentally disordered offenders. Several studies have reported program-related improvements on a variety of psychometric measures (Clarke, Walwyn, and Fahy, 2003; Donnelly and Scott, 1999; Gretenkord, 2004). A large-scale, international evaluation of R&R is currently being undertaken that involves several secure settings of the Maudsley Hospital in London and the Haina Hospital for mentally disordered offenders in Germany. These studies and the observations of the many R&R Trainers delivering the program have yielded important insights about the value of an R&R approach to treatment of individuals with mental health problems.

Program Targets: The R&R2 MHP program is a revised R&R program designed not only for institutionalized mentally disordered offenders but also for youths and adults with mental health problems in schools, in community residences or in hospitals.

The program was developed through a collaboration between Dr. Susan Young, Senior Lecturer in Forensic Clinical Psychology and Clinical Psychologist at the Institute of Psychiatry in London and Professor Robert
R&R2 FOR YOUTHS AND ADULTS
WITH MENTAL HEALTH PROBLEMS
A PROSOCIAL COMPETENCE TRAINING PROGRAM
Dr. Susan Young & Dr. Robert R. Ross

Program Outline

The "R&R2 Program For Youths and Adults with Mental Health Problems" (R&R2 MHP program) is a multifaceted, cognitive behavioural group program designed to teach individuals with mental health problems cognitive, emotional and behavioural coping strategies that can enable them to develop prosocial competence.

Program Rationale: Many individuals with mental health problems benefit from treatment to manage their symptoms. However, those individuals, who in addition to their mental health problems, evidence disruptive, antisocial or criminal behavior require treatment that not only targets their mental health problems but also specifically targets their antisocial behavior.

Historically, most treatment programs for such individuals, including mentally disordered offenders, have been ‘broad brush’ treatments that have not taken into consideration the impaired cognitive, emotional, social skills and values of this population that underly their antisocial life-style. These characteristics impede their progress in rehabilitation, vocational advancement, educational achievement and prosocial development. Moreover, although they may have been involved in many programs throughout their lives, many youths and adults with mental health problems are resistant to treatment.

Many individuals with mental health problems lack a level of prosocial competence that would enable them to cope in non-institutional settings. Many exhibit specific problems in their intellectual functioning such as poor attentional control and processing speed. Deficits in memory and executive functioning are common, resulting in difficulty in recalling verbal and visual information, poor organizational ability, poor planning ability, impulsivity and poor response inhibition.

Many evidence the same cognitive characteristics that have been identified in antisocial individuals, including adolescent and adult criminal offenders, such as egocentricity, poor interpersonal problem solving skills, dysfunctional or self-defeating coping techniques, inadequate social skills, rigid and concrete thinking, thinking errors and antisocial values.

Research Development: The R&R2 MHP program is based on the "Reasoning and Rehabilitation" (R&R) program (Ross & Ross, 1986) that has been delivered over the past 21 years to more than seventy thousand "at risk" and antisocial individuals in seventeen countries. The efficacy of R&R has been demonstrated in numerous independent, international evaluations and through comprehensive reviews, cost-benefit analyses and meta-analyses.

Several secure hospitals for mentally disordered offenders in Scotland, England,
New York, Germany and Colorado are delivering the original R&R to mentally disordered offenders. Several studies have reported program-related improvements on a variety of psychometric measures (Clarke, Walwyn, and Fahy, 2003; Donnelly and Scott, 1999; Gretenkord, 2004). A large-scale, international evaluation of R&R is currently being undertaken that involves several secure settings of the Maudsley Hospital in London and the Haina Hospital for mentally disordered offenders in Germany. These studies and the observations of the many R&R Trainers delivering the program have yielded important insights about the value of an R&R approach to treatment of individuals with mental health problems.

Program Targets: The R&R2 MHP program is a revised R&R program designed not only for institutionalized mentally disordered offenders but also for youths and adults with mental health problems in schools, in community residences or in hospitals.

The program was developed through a collaboration between Dr. Susan Young, Senior Lecturer in Forensic Clinical Psychology and Clinical Psychologist at the Institute of Psychiatry in London and Professor Robert

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Published by: Cognitive Centre of Canada on Aug 12, 2008
Copyright:Attribution Non-commercial

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03/05/2013

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REHABILITATING REHABILITATIONThe cognitive-behavioral model has been the prevailing model of offenderrehabilitation and delinquency prevention over the past thirty years. Manyprograms based on this model have yielded reductions in re-offending among a widevariety of types of juvenile and adult offenders. However, the average reductionmay not be sufficiently robust to sustain political support for offenderrehabilitation programs against the increasing popularity of "getting tough oncrime" programs.Dr. R. R. Ross, University of Ottawa, argues that it "time to think" again aboutthe adequacy of the cognitive behavioral model in the light of recent research hehas reviewed in the following areas:• research on the relationship between antisocial behavior and cognition• research on the relation between cognition and emotion• research on the role of emotion in prosocial competence• research on moral reasoning and values• research on “emotional values”• research on empathy• research on desistance from a criminal lifestyle• research on the development of prosocial competence• research on “automatic thinking and feeling”• research on social cognitive neuroscience.He has presented a revised rehabilitation model - the "neurocriminology" modelthat is based on recent neuroscience studies that have determined that the adverseeffects on the developing brain of being exposed to adverse socio-environmentalcrinimogenic conditions can be long-term. Inadequate nutrition, poverty, lowsocial status, abuse, deprivation, neglect, victimization, oppression, racism,social isola¬tion, alienation, and other cultural, ethnic, racial, classinfluences and mental health difficulties that have been identified by manystudies as criminogenic risk factors can permanently impact the development of thebrain and the functioning of par¬ticular neurotransmitters and their receptorsites (Farah, Noble, and Hurt, 2006).The brains of children who, for example, are raised in a socially toxicenvironment of isolation; poverty; rejection; hostility; abuse and maltreatment;or who experience consistent failure in school have those experiences seared intheir brains in neural networks that can trigger deep feelings of anxiety, fear,anger and hostility that can engender antisocial behavior. Enduring antisocialpatterns can be developed deep in the brain early in brain develop¬ment inchildhood and adolescence. However, social cognitive neuroscience has developed anunderstanding of how such new neural connections are formed; an understanding thatcan enable us to guide the formation in a prosocial direction.Criminological research has identified not only factors that put the individual atrisk of developing an antisocial lifestyle - the risk factors. It has also hasidentified protective factors that lead individuals to refrain from or desist fromantisocial behavior –"prosocial growth factors". Such research yields anunderstanding of how we can help antisocial individuals develop new neuralpathways that will engender not antisocial but prosocial feelings, thoughts,attitudes, values and behaviors. Neuroscience research indicates how that can beachieved by particular forms of program interventions designed to influence braindevelopment such that even individuals with long histories of anti-social andcriminal behavior can be led to acquire prosocial competence and a prosocialidentity.

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