Case Report
Cognitive-Behavioural Intervention in Controlling Violence in Custodial Setting: A Case Study
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There is a great concern about the incidences of violent behaviour among youth. Early identification and intervention is a critical issue in the management of violence among youth. This research focuses on the youth with high-risk behaviours, presents brief cognitive-behavioural intervention strategies. Aggression Replacement method was used to provide him with prosocial skills and behaviours. Social Skills Training was provided in which he was trained in interpersonal skills to deal with anger-provoking events and Anger Control Training was used to identify different factors that produced his anger. Moral Reasoning technique was used which covers behavioural orientation, skill-oriented trainings. The following case study covers the impact of Cognitive behavioural intervention is useful for youth having violent behaviour. The main objective of this research is to see the impact of Cognitive-behavioural intervention that is effective in reducing violent behavior of a youth living in prison by comparing pre and post assessments. This participant is identified by using clinical interviews, psychometric as well as behavioural measures. In the present study single case design is used for data collection and analysis. Under this approach this single individual was studied over a period of time in order to examine the effects of certain variables on his behaviour. This treatment plan includes individual intervention. Treatment was terminated after significant improvement in the target behaviours.
Keywords: Violence behaviour, Custodial setting, Cognitive-behavioural interventions, Assessment
INTRODUCTION
The present crime system serves as a ground to convert small time offenders into permanent offenders. This is also help them to be a part of this crime world where limited opportunity is there for self-correction. The biggest failure of this system is limited opportunities for change in attitude and behavior in our society. There is a need to understand the present system of prison setting and rehabilitation systems. Correctional facilities have a responsibility to take "reasonable measures" to preserve and protect inmate safety [1]. In India, thousands of people enter prison and juvenile homes each year, and a very limited numbers are periodically released. There is a very limited opportunity to offer a corrective experience is completely lost in our system which looks at time is a process of punishment and has the attitude that nothing works [2]. The problem of aggression in correctional institutions should be recognized and effective preventive measures need to be put in place against violent behaviours [3].
Imprisonment has a negative psychological effect which leads to different mental health issues such as depression, anxiety, mood disorder, suicidal tendency, increasing hostility [4]. Various researches show that most damaging factor to an inmate is the loss of thing life in the outside world and relations with the family rather than imprisonment.
It is very difficult to adjust and coping with the length of their incarceration, dealing with family, friend separation. He was trying to accept that this place is going to be his new place for some time or forever. Psychological rehabilitation is very neglected area in India. On a humanitarian ground they should receive psychological rehabilitation where most people reluctant to work with them where scope is very limited. In this study with jail authority’s confirmation and interest to give him intervention where no harm contract implemented in which an inmate and the therapist agree verbally that the inmate willn’t harm himself for designated period. Hence the present study is focused on extending services to youths who are into the world of crime and prevented the symptoms at the early stage. The study particularly attempts to evaluate the impact of the Cognitive-behavioural Intervention (CBI) on youth’s violent behaviour.
CASE STUDY
Mr. X is 20 years old boy and has been staying in High alert cell in the past six months. He was a class dropout and spent one year in Juvenile home. His mother is the only earning member of the family who is working as a maid. They are two brothers and one sister. He had been increasingly violent towards his mother and sister without any reason. He was a well-known member of a local gang of youths. This gang is known for murder, sexual assault, vandalism, attacking other people etc. now he has been under trial for a murder case. He killed one of his gang members attacked twenty times with a help of a knife for some dispute. It was a very high-profile case of the year 2015 in Delhi where the victim was killed. He ran away from that place but after three days police arrested him from a nearby rural area. In the last two years he has been staying at the Prison. Now he feels this is his second home. Now he is engaged in making groups in jail and as per the record he became the boss of that Barack.
ASSESSMENT
Initial interview indicated that he lived with his mother and sister although his father visited the home occasionally. His mother had stated that these visits were often triggers for Mr. X’s aggression and anger as his father would come around asking for money or alcohol. After his father had left, he would be extremely angry, and became very violent towards his mother and sister.
He was a below average student throughout his school years till class VIII then he left school and involved himself in different labor works since to ‘hang out with the wrong crowd’. In the first session he revealed that he mistrusted and disliked authority figures but in the main he frequently fidgeted, looked at the floor and avoided any communication. He slouched and exhaled heavily throughout the first two sessions and often tried to avoid giving any appropriate answers to any question put to him. He was clean well groomed, having lots of tattoos and always attended on time, but he refused to disclose anything personal except that heinous crime. While he was narrating that incident seems very overwhelmed and he explained it with proud. He said this news was in media, but “I was targeted by my friends”. He cooperated to complete other assessment scales for violence, personality etc. Assessment tools were used in the present research- 16 Personality Factors (16PF, Cattel, 1967), Violence Risk Sceening-10 [5], Attitude towards Violence [6], Seriousness of Violence Behaviours [6]. After the assessment phase he was little reluctant to engage with the therapeutic process, and concerns that he might not continue to attend the sessions, socialization to CBT model was introduced. At this stage the intension was to assist him to understand his current difficulties and their impact on his life as well as to introduce the principles of CBT. The approach adopted was to explain some incidences of his life using the example of when he became aggressive with his current friends. After that he showed the interest in how situations influenced his thoughts. He could see the negative nature of his thinking and how this then activated physical and emotional responses, which in turn influenced his reactions and behavior. This encouraged him to participate a little more in the assessment process. It was found that he responded well to all informative questioning, which is a method commonly used in CBT to gather information from specific and recent expels of the problem in question.
INTERVENTIONS
Total twelve sessions were used. In the present research Aggression Replacement Training [7] is used. Based on previous work with at-risk youth, this method was used for the present research to provide him with prosocial skills and behaviour. They could be used in different situations as well as skills to manage anger impulses that lead to aggressive and violent actions. This technique also can increase his ability to view his world in a more fair and equitable manner by taking others’ perspectives into account.
SOCIAL SKILLS TRAINING
For this research Social skills training was provided in which he was trained in interpersonal skills to deal with anger-provoking events. It was based on the assumption that aggressive and violent youth have skill deficits and that this is related to his offending behaviors. Some cognitive and some affective areas were covered in this research work such are: Understanding of feelings, provide respectful gestures, prepared for difficult conversations, own anger management and deals with others anger, to be respectful toward others, helping others, avoid aggressive conversation, showing affection and love, management of failure and deals with group pressure.
ANGER CONTROL TRAINING
The main intention of this intervention was to identify those factors that produced his anger. Role-plays and different life incidence discussions had been used for self-control and to understand his aggressive behaviour. This includes environmental events that cause emotions and the internal feelings that increase angry responses(triggers), physical reactions that indicate anger arousal (cues). By using different methods such as breathing exercise, backward counting, pleasant imagery they reduced anger. Some self-statements used that instruct him in ways to reduce and reinterpret angry emotions and aggression used as reminders. Some activities were introduced for his self-evaluationin which instruction had been provided how to get self-reward and self-coaching techniques to improve his performance.
MORAL REASONING
He attended some sessions on separate days each of these components for four weeks which covers behavioral orientation, skill-oriented trainings. It attends to both extra personal circumstances (events) and intrapersonal processes (thoughts, emotions, beliefs, attitudes) that lead to criminal conduct and substance abuse. This technique was used as a set of procedures designed to raise the participant’s level of understanding, justice, and concern with the needs and rights of others.
RESULTS AND CONCLUSION
In the present study single case design is used for the data collection and analysis. Under this approach this single individual was studied over a period of time in order to examine the effects of certain variables on his behaviour.
As per the 16 Personality Factors (16PF, Cattel, 1967) assessment, the result shows he is more reserved, detached, critical, less intelligent, affected by feelings, humble, socially clumsy, group dependent and conservative where in other hand he is absent minded and tense.
Violence Risk Sceening-10 [5], his pre intervention score is 16and after intervention score is 10. there is a noticeable change can be seen in the pre and post scores. Attitude towards Violence [6], his pre score is 26 and post score is 18 here can see the difference between pre and post scores. Seriousness of Violence Behaviours [6] his pre intervention score is 4 and post intervention score is 1. So, in all areas such as violence, aggression, anger etc. there is a noticeable difference in results due to the intervention impact. As per the pre and post assessment it seems there is a significant change in the behaviour of the participant.
Aggression Replacement Training, Social Skills Training, anger control training moral reasoning are major intervention strategies used in the present study. These Cognitive skill trainings are designed to introduce offenders to pro-social thinking skills, reasoning skills and problem-solving strategies that will help them to avoid those patterns of thinking which are associated with offending behaviour. When evaluating the effectiveness of these types of interventions, it should not be assumed that programmes ‘work’ simply because they possess some in built quality which elicits conditioned responses from participants. Consequently, when evaluating what constitutes effective practice with regards to cognitive skills training, one needs to be aware that levels of involvement in, and commitment to, such programmes may vary from one individual to another. In the present case study, there is a noticeable change we can see after the use of this intervention. Thus, in order to develop a full understanding of what constitutes effective practice, it is essential to explore what social and institutional factors enable prisoners to use the treatment programmes successfully and how the prison and resettlement contexts can encourage or inhibit that process. There is very limited research on the applications of therapy in prison setting in India. In the present available literature on therapeutic researches in India, it is very important for us to extend the services to above mentioned institutions which will help prisoners for recidivism and community re-entry.
- Cohen D (2001) Cultural variation: Considerations and implications. Psychol Bull 127: 451-471.
- Dahlberg LL, Toal SB, Swahn M, Behrens CB (2005) Measuring violence-related attitudes, behaviours and influences among youths: A compendium of assessment tools, 2nd ed., Atlanta, GA: Centers for disease control and Prevention, National Centre for Injury Prevention and Control.
- Dash P, Jena SPK (2018) The need for behavioural rehabilitation in prisons among youth. Int J Indian Psychol 6: 42-46.
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- Merecz-Kot D, Cebrzynska J (2008) Aggression and mobbing among correctional officers. Med Pr 59: 443-451.
- V-Risk-10 (2007) Centre for Research and Education in Forensic Psychiatry, Oslo, Norway.
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