Is a moral reasoning programme for offenders with intellectual disabilities effective?

Prisoner behind bars

Over recent years, media and research have highlighted the large number of offenders in prison who have an intellectual or developmental disability. The Prison Reform Trust (2007), estimated this to be 20-30% of all current offenders in prison (although todays numbers may be even higher!), and that this group of individuals are more likely to re-offend due to unidentified needs and a consequent lack of appropriate support and services.

Gibbs (2003) argued that illegal behaviour is driven by delays in moral reasoning which interact with social skills deficits. In this paper, Langdon, et al. (2003) were interested in the moral reasoning skills of adult offenders who had intellectual disabilities (IDs), and felt that in these adults moral reasoning skills are slower to develop in comparison to the norm, due to a limited cognitive ability.

Previous studies have shown that the moral reasoning skills of adults with intellectual disabilities were very similar to that of young offenders

Previous studies have shown that the moral reasoning skills of adults with intellectual disabilities were very similar to that of young offenders

Langdon and colleagues had previously concluded that the moral reasoning skills of adults with ID were very similar to that of young offenders and sought to examine whether moral reasoning intervention programmes, designed for young offenders, may also be of use with adult offenders with IDs as well. In particular they were interested in evaluating the effect of the ‘Equipping Youth to Help One Another’ (EQUIP) programme, designed to target distorted cognitions and teach social skills, to encourage moral development of offenders through peer culture groups.

Methods

Seven offenders with intellectual or other developmental disabilities all took part in a 12-week EQUIP programme. All men had an ID and a history of criminal offending, and were recruited from an NHS medium-secure hospital unit.

A single case series design was adopted and measures were used to assess participants within the first 2-3 weeks of the programme and again at the end, in order to evaluate the impact of the EQUIP intervention. The measures used were a production measure of moral reasoning, a measure of cognitive distortions, a problem solving ability assessment, as well as an inventory to index anger.

Intervention: The EQUIP programme was delivered to participants 4 times a week for 12 weeks by a clinical psychologist. This programme consisted of two meetings:

  1. ‘Mutual Help Meetings’ to encourage offenders to share their difficulties within a framework that helps them work together as a group to problem solve an appropriate resolution, and
  2. ‘Equipment Meetings’, which were compromised of anger management skill lessons, social skills teaching, and social decision making training sessions.

Results

The results suggested that EQUIP was successful at:

  • Increasing moral reasoning ability ( all p’s = <0.05) ,
  • Reducing distorted cognitions
  • Improving ability to choose effective solutions to problems (P = 0.023)

However, treatment did not have a significant effect upon anger.

Conclusions

The authors concluded:

The findings indicated that participants’ moral reasoning, and ability to choose solutions that were more likely to overcome the relevant obstacles, achieve the desired goal, and result in a minimum of negative consequences increased. There was also a significant reduction in overall levels of distorted cognitions.

However,

Disappointingly, however, overall problem solving ability did not change significantly, and there was no significant reduction in anger scores following treatment.

Strengths

The EQUIP programme does represent a promising intervention that may show effectiveness in offenders with intellectual disabilities

The EQUIP programme does represent a promising intervention that may show effectiveness in offenders with intellectual disabilities

  • Other previous studies have not found significant effects of the EQUIP programme, whereas this study has. This may be due to the composition of the group containing adults with IDs, not just young offenders
  • The significant findings in relation to distorted cognitions are consistent with other similar studies
  • Positive increase of problem solving skills in this group suggests a larger scale study may also show further improvements

Limitations

  • Single case series design means we cannot generalise these findings to the larger population
  • Unable to determine causality of results due to very small sample
  • Some of the participants had received previous treatments which may have affected their scores
  • None of the men self-rated themselves as having anger management needs, which may not be representative of other groups of offenders with IDs
  • Sample selection from a medium-secure unit suggest participants would have already been exposed to interventions or therapeutic support before
  • No follow-up data was collected so we cannot assess the long-term effects of EQUIP

Summary

Whilst this study has many limitations, the significant findings are positive. It would seem the EQUIP programme does represent a promising intervention that may show effectiveness in offenders with IDs. A positive point about EQUIP is that it is not offender specific and that a group of individuals with different needs and backgrounds are able to meet together to aid one another in a peer support format. Additionally, these interventions can easily be adapted to the specific needs of the attendees which make it a good option for individuals with varying intellectual or developmental disabilities.  However, in conclusion, in order to evaluate the effectiveness of EQUIP further, a larger and more controlled study would be essential to justify its effectiveness as a suitable intervention programme for offenders with IDs.

Links

  1. Gibbs J. C. (2003) Moral Development and Reality: Beyond the Theories of Kohlberg and Hoffman. Sage Publications, London.
  2. Langdon, P. E., Murphy, G. H., Clare, I. C.H., Palmer, E. J. and Rees, J. (2013), An Evaluation of the EQUIP Treatment Programme with Men who have Intellectual or Other Developmental Disabilities. Journal of Applied Research in Intellectual Disabilities, 26: 167–180
    http://www.ncbi.nlm.nih.gov/pubmed/23281218
  3. The Prison Reform Trust (2007). No One Knows: offenders with learning difficulties and learning disabilities. http://www.prisonreformtrust.org.uk/uploads/documents/NOKNL.pdf
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Rachel Allan

Rachel Allan

Rachel Allan was previously a Practice Lead working for The Royal Mencap Society, supporting and developing good practice in services for individuals with a wide range of complex disabilities. She graduated in psychology and went on to study both developmental psychology and mental health at post-graduate levels. Rachel has previously worked in many different care and educational settings for children, young people and adults with a wide range complex learning disabilities. She has also worked within academic research, specifically completing a two-year research associate post looking at the mental health of individuals with profound and multiple needs (PMLD). She is particularly interested in person centred planning, supporting the mental health and well-being of people with complex disabilities, and more recently, the effects of trauma and abuse in this group of individuals. Having recently taken voluntary redundancy from her role at Mencap, Rachel is now enjoying some free time (!?) to explore her personal interests while she assesses what may be the next chapter in life.....

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