Leam A Craig

• Consultant at FPP Ltd

There is no universally agreed definition or method of case formulation (CF), and although CF routinely forms the central aspect of most psychological inquiry, ironically, the psychological formulation is not adequately systematised. However, there is a broad consensus about what defines CF: The process of a CF ‘involves the inferences about predis...

This chapter considers the risk assessment of a 60-year-old male who is preparing for release from prison after having been convicted of multiple offences of rape and indecent assault against his granddaughter with additional convictions for indecent assault against one of her friends. Although not an atypical case, we hope we have sufficiently dem...

Purpose Forensic mental health care is a unique field that poses complex demands on professionals. Forensic vigilance is a hypothesized specialty of forensic mental health professionals, allowing them to meet the complex demands of working in forensic settings. Forensic vigilance consists of theoretical and experiential knowledge of mental disorder...

Purpose Forensic vigilance is a central competency that forensic professionals need to meet the complex demands of working in forensic settings. Until recently, no instrument for forensic vigilance was available. This study aims to develop a self-assessment tool of forensic vigilance for individuals and teams working in forensic settings, and inves...

Within forensic settings, case formulations (CF) are used to explain and understand offending behaviour. Craig and Rettenberger (An etiological approach to sexual offender assessment: CAse Formulation Incorporating Risk Assessment (CAFIRA), Current Psychiatry Reports, 20 (6), 20–43, 2018) proposed an aetiological model of assessment of offending be...

Case formulation creates a framework for testing hypotheses and making important changes to intervention and risk management. While various offence behaviour specific theories have been developed, these theories do not adequately provide guidance on how to organise and incorporate such theories into a structured assessment, in order to provide an a...

Purpose In January 2013, new court procedure rules were introduced in England and Wales, which resulted in significant changes to the instruction of expert witness psychologists (EWPsychs). This study aims to build on the results of previous survey studies of psychologists working as expert witnesses in identifying the current challenges faced by E...

Sexual Deviance is an authoritative text that provides an understanding to the assessment, management, and treatment of sexual deviance and paraphilic disorders. The international panel of contributors—noted experts on the topic—illuminate the emerging theories that help to explain the developmental influences and pathways of sexual deviance and it...

This chapter provides an overview of the current state of the literature on what works to prevent sexual violence and sexual aggression in global contexts. It includes a discussion of the unique considerations for prevention in global contexts, the current quality of research, and the availability of data. The chapter presents a review of what is c...

This chapter focuses on the community dynamic risk management of individuals convicted of sexual offenses. It surveys public perceptions of sexual violence, because how citizens feel about their safety often drives political and legislative agendas. The chapter critically reviews the most common outcomes of those legislative agendas—measures instit...

Much controversy has surrounded the question about whether or not mental disorder, and more specifically major mental illness (MMI), is associated with sexual violence. This chapter reviews the literature describing the relationship between MMI and problematic sexual behavior. It examines the implications of MMI for risk assessment and formulation,...

Prevention of sexual violence is a worldwide priority. This chapter provides a framework for understanding some of the risk factors and correlates for sexual violence, with an emphasis on gender inequality. It reviews programs targeting young adult men, particularly those with a bystander focus. The chapter provides recommendations for moving the f...

This chapter reviews clinical, empirical, and theoretical models of sexual homicide. It takes a chronological approach to the way the key features of sexual murderers have been reported. The chapter presents the key findings in each of the phases of development of knowledge about sexual murderers. According to the FBI motivational model, both the s...

Pharmacological agents have an important role in treating and reducing risk in some sexual offenders, but also attract controversy, misunderstanding, misrepresentation, and opposition. Sexual offenders can have paraphilic disorders or paraphilia‐related disorders. This chapter covers medications used in current clinical practice to reduce sexual ur...

There are many aspects of the sexual‐offender therapy that can indicate its value to society. Reductions in the number of, and harm to, victims, and the productivity of successfully reintegrated sexual offenders are a few examples of ways sexual‐offender treatment programs can provide benefits to society other than just reduced reoffending. This ch...

Psychometric assessments are used in forensic settings to measure latent variables or dynamic risk factors, which are changeable factors and therefore potentially amenable to treatment. This chapter focuses on the use of psychometric measures to measure dynamic risk factors. The most commonly used psychometric measure targeting the risk factors wit...

This chapter examines research findings concerning several of the most noteworthy examples of: sex offender registration and community notification (a.k.a. “Megan's Laws”); residence restrictions; involuntary and indeterminate civil commitment (a.k.a. “sexually violent predator” laws); and use of electronic monitoring (EM). In a nutshell, sex offen...

This chapter encourages thoughtful and critical evaluation of policies that affect the lives of children under age 18 who have engaged in illegal sexual behavior, as well as the practice of professionals who work with these children. It focuses on the policies enacted in Australia, the United Kingdom, and the United States of America that affect ch...

This chapter reviews the literature on the treatment of sexually abusive behavior with respect to both the general and cognitively disabled populations, and provides recommendations for a model of treatment and support for those with a disability. Developments in the psychological treatment of sexual offending in the general population has followed...

This chapter summarizes single‐factor and multifactorial theories that seek to explain the sexual abuse of children, and outlines empirical evidence that tests these theories. It examines the theories that may explain contact sexual offending against children. The theory that holding a sexual interest in children is causally linked to sexual abuse...

The Crime Classification Manual (1992) utilized exhibitionism and voyeurism as examples of nuisance offenses, and as time progressed with the development of social media and internet pornography sites, child and teen pornography were adopted into this category of noncontact sexual offenses as well. This chapter focuses on voyeuristic and exhibition...

In modern forensic psychology, there are basically three different methodological approaches to risk assessment: unstructured clinical judgment, actuarial risk assessment instruments (ARAIs), and structured professional judgment (SPJ). The Static‐99 is the ARAI most commonly used and best validated for individuals convicted of sexual offenses. The...

Despite the large number of children who are regularly involved, there has been relatively little attention to addressing child sexual abuse in youth‐serving organizations. This chapter is organized around the four‐step public‐health framework. Given the nascent nature of research on child sexual abuse in youth‐serving organizations, the chapter fo...

This chapter reviews the evidence regarding the construct validity of penile plethysmography (PPG) and of indirect measures designed to assess sexual interest in children. For PPG, it focuses on comparisons of men who have committed sexual offenses against children with those who have not, and comparisons of sexual offenders against children (SOCs)...

This chapter describes an effective contemporary program with the aim of tertiary prevention of sexual offending. It draws heavily upon the authors' experience in the design and oversight of programs running in Her Majesty's Prison and Probation Service (HMPPS). The chapter briefly reviews the development of current approaches within the wider cont...

This chapter focuses on responsive treatment options for male adults who have sexually offended. It begins with commentary regarding the processes of getting men into treatment and having them stay there, which includes consideration of what types of therapists are most likely to succeed, under what circumstances. The chapter reviews the processes...

Sexual sadism has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) since the mid‐20th century. The DSM‐5 committee distinguished between sadistic behaviors on consenting partners and nonconsenting persons. The lack of consensus on the diagnostic criteria for sexual sadism is in part responsible for the poor inter‐rat...

Child sexual abuse (CSA) is a common, severe, and preventable problem that contributes to the national and global burden of disease. Effective CSA prevention efforts are needed to avert harm to victim and their families, and reduce monetary and nonmonetary costs borne by victims, their families, and society. This chapter reviews criminal‐justice in...

To shed light on men who sexually offend online, this chapter synthesizes the research on this subgroup of sexual offenders against children, with a focus on typologies, assessment, treatment issues, and prevention strategies for online offenders. It reviews the typologies proposed for three large groups of offenders against children—consumers of c...

The societal impact of sexually abusive behaviors (SABs) makes their reduction an important public health priority. SABs in youth are best understood within their developmental context. Available research has focused on boys, who engage in SAB much more frequently than girls. This chapter provides an up‐to‐date, comprehensive summary of the empiric...

This chapter focuses on the assessment of forensically relevant sexual sadism. Assessing sadism is a complex and challenging task in the course of legal proceedings and in forensic‐clinical settings, given the specific contextual demands at the different stages of the criminal justice process. The same principles that apply generally to effective s...

Craig and Rettenberger proposed an etiological approach to sexual offender assessment integrating the key developmental, offending behavior, and risk‐assessment theory into one model, referred as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model. This chapter seeks to update the model by incorporating neurobiological and neuropsycho...

The issue of sexual abuse is a global socio‐political one, which means that, despite international differences in sexual harm policy and practice surrounding sexual abuse, the creation and implementation of these policies and practices are politically sensitive. This chapter critically considers the risk‐management strategies that are “common” inte...

This chapter presents the noteworthy explanatory theories and models, and empirical results, related to sexual aggression against women. Sexual offending against women is polymorphic, and comprises sexual violence, sexual misconduct, and sexual exploitation. The chapter focuses on rape and contact sexual aggression. The scientific community's inter...

This chapter introduces the scientific literature on the life‐course development of antisocial and criminal behavior. It provides a review of key concepts and findings related to criminal‐career research, developmental criminology, and life‐course criminology. chapter examines some of the implications of such research for the description, explanati...

Understanding and working with women who have sexually offended require an understanding of the nature of sexual offending by women, and gender‐specific assessment, treatment, and management strategies. This chapter provides an overview of these issues. Female sexual offenders, like their male counterparts, engage in a variety of sexually offending...

The 'what works' approach to evidence‐based practice has emphasized the need for systematic reviews and meta‐analyses to explore the effectiveness of correctional interventions. This chapter explores current approaches to Intimate Partner Violence (IPV) perpetrator programmes and contrasts these with the empirical evidence in terms of treatment nee...

This chapter considers empirically supported techniques and methodologies, as part of a 'What Works' approach, in assessing the risk of sexual violence in sexual offenders. In modern forensic psychology, there are basically three different methodological approaches to risk assessment: unstructured clinical judgment, actuarial risk assessment instru...

The effective assessment of the risk of offending in people with intellectual disabilities (IDs) and/or autism spectrum disorder (ASD) is of major interest to practitioners in the field of forensic mental health, and to the wider criminal justice and disabilities sectors. This chapter provides an overview of general offender risk assessment tools w...

This chapter focuses on those men, women, and young people who have personality disorder and who have been harmful to others in the past, and who are regarded as being at risk of harmful behaviour again in the future. It explores what is currently understood about the link between personality disorder and violence. The chapter provides a review of...

This chapter concentrates on Middle Eastern Terrorism (MET), with particular emphasis on ideologically related terrorism. MET was selected because it has been a major international concern since the four coordinated terrorist attacks on September 11, 2001 in New York, Virginia, and Pennsylvania. The chapter reviews history of ideologically‐related...

Mental state is an important consideration in stalking risk assessment and management, and these findings suggest that psychiatric assessment should be routine, at least in acquaintance stalkers. The fear of violence is central to the experience of being stalked: but estimates of the prevalence of violence vary from 3 to 46 percent, depending on de...

Justice and mental health clinicians are often asked to assess the likelihood that an adolescent will engage in violence or other forms of offending. Indeed, youth justice agencies in many American states and Canadian provinces mandate that risk assessments be conducted with adolescents who have been convicted of a criminal offence. This chapter re...

Violent behaviour can fall into five interrelated areas; rates of occurrence, explanations/theory, violent behaviour according to type or groups, person‐based characteristics, and contextual/environmental factors. Rates of occurrence provide a basic understanding of how often violent behaviour occurs within certain groups or contexts. Rates of occu...

The tertiary prevention of human violence through psychologically‐informed interventions is an important component of any overall societal commitment to reducing the harm to mental and physical health that violence causes. This chapter examines 'what works' to reduce violence through psychological treatment programmes in custodial settings with hig...

Assessments of risk for violence, or 'prediction of dangerousness' as it was formerly known, have significant consequences in the criminal justice system and society more widely. This chapter begins with a brief overview of the foundation issues related to violence risk assessment, including terminology, evaluation of accuracy of risk assessment me...

This chapter focuses on the segment from that large volume of work that is concerned with interventions that address aggression and violent crime. It adopts a wide‐ranging ‘lifespan’ approach in considering research from successive phases of development. The chapter also focuses on those that are concerned with outcomes that include direct measurem...

This chapter presents a novel context to understanding behaviour before turning to the chapter's major focus on two domains neglected within the classical violent risk prediction literature; specifically, aggression and biological theory. The primary focus of this chapter is on the biologically‐related systemic approach to understanding the context...

This chapter begins with a review of definitions of violence, then describes its behavioural variability, and relates violence to other forms of antisocial behaviour, such as aggression. It offers sobering data about the magnitude of violence in society and its impact on victims, with a focus on its most severe expression, homicide. Attention is gi...

Risk assessment is closely tied to the process of managing offender risk; that is, identifying and intervening with key risk factors in an effort to reduce the likelihood of future intimate partner violence (IPV). IPV risk assessment and management can be viewed within the framework of the Risk, Needs, and Responsivity (RNR) principles of effective...

There is no clear framework yet for establishing the validity or reliability of case formulations. This chapter explores issues, skills and competencies that practitioners need to take into account when they undertake a formulation of violence risk. Actuarial measures of risk are based on‐usually predictive‐correlational analysis. The top‐down meth...

The life experiences of people with intellectual and developmental disabilities (IDD) are conducive to the activation of anger and aggression, particularly when child abuse punctuates their family backgrounds. This chapter discusses the impact of aggression on services users and the links between anger and aggression. It describes psychopharmacolog...

There is an understanding that anger is often a key risk factor for violence because it is a common antecedent to aggression. This chapter proposes that there are good reasons to think very carefully about how to best assess anger and how to interpret the meaning and relevance of test results. It reviews some of the assumptions that are occasionall...

People with schizophrenia and a history of violence towards others require treatment both for schizophrenia and for aggressive, and often, antisocial behaviour. This chapter reviews evidence showing that effective treatments could be provided much earlier in the lives of offenders with schizophrenia and hypothesizes that a re‐organization of mental...

This chapter examines different models and strategies for managing sexual offenders. Risk management of sexual offenders differs from that of non‐sexual offenders in important ways, including the level of public alarm, the seriousness of potential failures, the level and duration of risk, and the kinds of factors that contribute to re‐offence risk....

Aggression and violence within intimate relationships has been deemed a significant international problem that affects people across all demographic boundaries. This chapter aims to provide an evidence‐based guide to the risk assessment of an individual who has perpetrated intimate partner violence (IPV), where the focus is on determining the perso...

The public health approach has been used to address a variety of types of violence, including youth violence, child maltreatment and intimate partner violence. This chapter reviews the public health approach to gang violence prevention, particularly as it has been applied in the US. This approach involves four steps that are grounded in the best av...

Community supervision is seen as a less expensive and possibly more efficient method of offender sanctioning. One approach to assessing the likelihood that current supervision practices are related to reductions in recidivism is to examine adherence to the principles of risk, need, and responsivity (RNR). To understand why change‐agent supervision...

Anger treatment, conducted as a cognitive‐behavioural therapy (CBT), has well‐demonstrated effectiveness in reducing anger, but there has been some controversy about whether that efficacy extends to violence and to offender populations. This chapter provides an overview of studies regarding anger as a risk factor for violence in offender population...

This chapter provides a brief overview of the development of violence risk assessment, and reviews structured professional judgement (SPJ) tools in current usage for populations at risk of future use of violence. A summary of specific cohorts that use violence risk assessment tools is surveyed. The chapter reviews the current research in this arena...

The community has substantial concerns regarding the risk posed by violent offenders, especially those recently released from prison. This chapter highlights recent work intended to refine risk assessment to include more acute dynamic risk factors to inform risk re‐assessment and reviews case and risk management strategies specific to non‐sexually...

This chapter focuses on two key areas of work with this group of offenders: the multi‐agency management of high‐risk violent offenders in the United Kingdom (UK); and the increasing requirement to monitor and manage those violent offenders who travel across European Union (EU) borders to commit harmful offences. Multi‐agency public protection arran...

This chapter focuses on the role and relevance of personality‐based measures within the context of violence risk assessment. It provides an overview of the relevance of personality in violence risk assessment per the risk‐need‐responsivity (RNR) model. The chapter reviews relevant research and clinical applications of three sets of personality‐base...

The development and promulgation of the standardized risk assessment methodology is certainly one of the most important advances in forensic and criminological psychology in the past few decades. Based on the seminal work of Paul E. Meehl (e.g., Grove & Meehl, 1996), we are now able to provide reliable and valid prognoses about the recidivism risk...

Case formulation (CF) creates a framework for testing hypotheses and making important changes to treatment along the way. Over the years, various theories of sexual offending behavior have been advanced alongside the development of actuarial mechanism and risk assessment frameworks upon which estimations of risk can be made. It is only in the past...

Purpose While there is a significant proportion of people with a mild intellectual disability (MID) or borderline intellectual functioning (BIF) who commit sexual offenses, little research has focused on the risk factors for sexual recidivism in people with MID-BIF. The purpose of this paper is to compare the scores on the STATIC-99R and STABLE-200...

Purpose The purpose of this paper is to adapt a social climate measure for use within a forensic intellectual and developmental disabilities (IDD) service and examine perceptions of social climate and the links with patient aggression across three levels of security. Design/methodology/approach Four staff participated in a focus group to discuss h...

This chapter outlines several important variables that should be considered when assessing inappropriate sexual behaviour (ISB) in men with intellectual and developmental disabilities (IDD). An overview of the prevalence of men with IDD engaging in ISB is provided, and the literature and protocols for assessing the problem are detailed. Specificall...

Purpose of review: Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffer...

Purpose The purpose of this paper is to consider the impact of mental capacity legislation when applied to parents with learning difficulties who lack capacity within childcare and family law proceedings in England and Wales. Design/methodology/approach The paper relies on a range of material including reports published by independent mental hea...

This introductory chapter presents an overview of the concepts discussed in the subsequent chapters of this book. Family violence and child maltreatment is a serious and international public health concern. The book aims to put the need to evidence child protection practice at the forefront. It sets out to provide a comprehensive overview of the cu...

This chapter explores and specifies the assessment of parental risk in child custody evaluation cases where one or both parents, usually the father, is reported to have possessed and/or engaged in the distribution, trading and/or production of child sexual exploitation material (CSEM). It presents a clinical analysis of CSEM offending and risk in f...

This chapter considers a number of approaches to assessing risk in sexual offenders and measures used to assess levels of deviancy in sexual offenders and how this relates to treatment. It discusses assessment considerations for Internet, juvenile, and female sexual offenders, and sexual offenders with intellectual disabilities, special subgroups t...

The aim of this chapter is to offer guidance to forensic practitioners on assessing mental capacity and fitness to plead in offenders with intellectual disabilities. It considers the newly revised diagnostic criteria for intellectual developmental disorder (IDD) and the assessment process when determining whether a defendant with an IDD can demonst...

The social climate of forensic settings is thought to impact on a number of important clinical and organisational outcomes and is, therefore, an important construct in relation to the successful functioning of forensic units. A variety of self-report questionnaires have been developed to objectively measure the social climate of forensic settings (...

Working with Sex Offenders is a unique book which brings together leading practitioners in the field to provide a comprehensive and up-to-date distillation of relevant guidance to assist anyone who works with sex offenders. The authors examine topics including assessment, treatment, supervision and safeguarding. Skills and strategies for successf...

Purpose – The purpose of this paper is to explore the different clinical features of pathological demand avoidance (PDA) and antisocial personality disorder (ASPD) presented in the form of a single case study. The study highlights the potential of misdiagnosis and conceptual confusions to practitioners in forensic settings between the two condition...

The Wiley Handbook on the Theories, Assessment and Treatment of Sexual Offending is a three–volume collection of up–to–date readings contributed by international experts relating to the assessment, intervention, and theoretical foundations of sexual offending. Offers cutting–edge theories of sexual offending, including the latest multifactorial an...

The development and promulgation of the actuarial risk assessment methodology are certainly one of the most important advances in forensic and criminological psychology in the last few decades. Actuarial risk assessment instruments (ARAIs) represent highly structured risk assessment scales using combinations of empirically determined and thoroughly...

The contents of each of the 29 chapters in this volume, divided into seven sections, are summarized. The accurate assessment of treatment need and recidivism risk is the cornerstone of effective practice in treating and managing sexual offenders. Over the last 30 years, sexual offender assessment and treatment protocols have developed beyond recogn...

This chapter begins with a review of the literature on the current methods used to assess sexual recidivism risk in sexual offenders based on the presence of static and dynamic risk factors. We consider the development of actuarial risk assessment instruments and structured dynamic frameworks and describe approaches used to assess treatment targets...

Social climate is a term used to describe the environment of a particular setting which may influence the moods and behaviors of the people inhabiting that setting. This review explores perceptions of social climate in secure forensic services and the associations with aggression. Article searches were conducted using electronic databases, hand-sea...