Nichola Tyler, Theresa A. Gannon, & Lona Lockerbie

1. The Evaluation of the Firesetting Intervention Programme for Mentally Disordered Offenders (FIP-MO) Nichola Tyler, Theresa A. Gannon, & Lona Lockerbie

2. Overview • High prevalence rate of firesetting in mentally disordered offenders • Lack of existing treatment programmes • Promising initial results • Future directions

3. Firesetting in Mentally Disordered Offenders • High prevalence rates amongst psychiatric populations (Coid et al., 2001; Geller & Bertsch, 1985) • Firesetting = Acts of setting fire that may or may not have been legally recorded as arson, or legally recorded at all • Mental illness is consistently reported in the literature as a risk factor for repeat firesetting (Tyler & Gannon, 2012)

4. What Treatment Programmes Exist for Firesetters? • No standardised treatment available (either in prison or hospitals; Palmer, Caulfield, & Hollin, 2007) • Some treatment in psychiatric settings (e.g., Rampton, Broadmoor, Ashworth) • Very little treatment or evaluation is published

5. Why Such Little Work With Firesetters Generally? • Lack of knowledge regarding risk factors (Palmer, Hollin, Hatcher, & Ayres, 2010) • We assume needs are met by general programmes (e.g., social skills, problem solving) • Lack of understanding of the role mental health plays in the offence process for firesetting (Hollin, 2012) • Untreated firesetters re-offend at rate of 16% (Rice & Harris, 1996)

6. Why Do We Need to Treat Firesetters? • Firesetters found to request treatment to focus more directly on their firesetting behaviour (Haines et al., 2006) • Recidivism rates for sexual offending similar (16.8%) • Research suggests mental health plays an important role in the offence process for firesetters (Tyler et al., 2013) • Estimated that deliberate firesetting costs the UK economy £53.8 million per week (Arson prevention Forum, 2013)

7. The Firesetting Intervention Programme for Mentally Disordered Offenders (FIP-MO) • Developed at the Trevor Gibbens Unit • Positive patient feedback • Wanted to develop further and roll programme out multi-site to evaluate it’s effectiveness

8. The Firesetting Intervention Programme for Mentally Disordered Offenders (FIP-MO) • Cognitive behavioural with psychotherapeutic elements • Dual focus: • Increase patients’ understanding of the factors associated with their firesetting • Increase patients’ skills to manage risk/lead a rewarding life

9. FIP-MO Structure • 28 week programme (approx 85-95 treatment hours • Weekly group sessions (approx 2 hours in length) • Weekly individual sessions (approx 1 hour in length) • Patients do not need to: • Admit their firesetting or, • Have actually set a fire (threats to set a fire, interest in explosives can be included

10. Treatment Targets The FIP-MO addresses 4 key areas: • Offence Supportive Attitudes • Self Management/Coping • Communication/Relationships • Fire Interest/Identification

11. Treatment Targets • Offence Supportive Attitudes (Mills & Kroner, 1999) • Attitudes that support violence • Attitudes that support antisocial behaviour • Sense of entitlement in relation to offending • Criminal associates

12. Treatment Targets • Self Management/Coping • Anger (Spielberger, 1999) • Locus of control (Nowicki, 1976)

13. Treatment Targets • Communication/Relationships • Self esteem (Battle, 1992) • Emotional loneliness (Russell, 1996) • Assertiveness (Jenerette & Dixon, 2010)

14. Treatment Targets • Fire Interest/Identification (Ó Ciardha et al., 2013) • Every day fire interest – “Having a box of matches in your pocket” • Serious fire interest – “Watching a person with his clothes on fire” • Fire Safety Awareness – “I know a lot about how to prevent fires” • Identification with fire – “Fire is part of my personality” • Normalisation of fire – “Most people have set a few small fires just for fun”

15. Multi-Site Research Project • Research being conducted across 22 sites (NHS and Non-NHS in the UK). • NHS • Newton Lodge • Arnold Lodge • Trevor Gibbens Unit • Allington Centre • Ravenswood House • Brockfield House • George McKenzie House • Edenfield Centre • Broadmoor Hospital • Hellingly Centre • Roseberry Park Hospital • Ardenleigh • Guild Lodge • Reaside Centre • Independent Sector • Alpha Hospital Bury • St Andrews Healthcare • Alpha Hospital Sheffield • Waterloo Manor (Inmind) • The Dene (PiC) • Cygnet Hospital Derby • Cygnet Hospital Stevenage

16. Multi-Site Research Project • Research being conducted across 21 sites (NHS and Non-NHS in the UK). • NHS • Newton Lodge • Arnold Lodge • Trevor Gibbens Unit • Allington Centre • Ravenswood House • Brockfield House • George McKenzie House • Edenfield Centre • Broadmoor Hospital • Hellingly Centre • Roseberry Park Hospital • Ardenleigh • Guild Lodge • Reaside Centre • Independent Sector • Alpha Hospital Bury • St Andrews Healthcare • Alpha Hospital Sheffield • Waterloo Manor (Inmind) • The Dene (PiC) • Cygnet Hospital Derby • Cygnet Hospital Stevenage

17. Current Research Research Questions • Do firesetters who have attended the firesetting treatment make pre-post treatment improvements on the treatment areas of interest? (2) How do these improvements or shifts compare with control firesetters who have not attended the programme?

18. Current Research: Design TreatmentGroup Psychometric Tests Time 1 Psychometric Tests Time 2 FIP-MO Treatment 28 Weeks Control Group Psychometric Tests Time 2 Psychometric Tests Time 1 28 week break

19. Current Research • 12 FIP-MO groups (5 female and 7 male) • Data collected for 35 treatment participants to date. • Preliminary results for those who have completed treatment.

20. Participants: Treatment Group • 19 male and 16 female firesetters • Aged 22 – 57 (M = 38.08, SD = 10.44) • Majority White British/Irish (85.7%) • All have a current psychiatric diagnosis

21. Results: Offence Supportive Attitudes • Violence = 45.4% of sample showed a reduction • Entitlement = 39.3% of sample showed a reduction • Antisocial = 42.4% of sample showed a reduction • Associates = 45.4% of sample showed a reduction

22. Results: Self Management/Coping • Experience of Intense Angry Feelings = 21.8% of sample showed a reduction • Anger Expression = 63.6% of sample showed a reduction • Locus of Control = 50% of sample showed a shift towards a more internal locus of control

23. Results: Communication/Relationships • Self Esteem = 51.5% of sample showed an increase • Assertiveness = 37.5% of sample showed an increase • Emotional Loneliness = 30.3% of sample showed a reduction

24. Results: Fire Interest/Identification

25. Results: Fire Interest/Identification • Identification with fire = 54.5% of sample showed reduction • Serious Fire Interest = 48.4 % of sample showed reduction • Fire Safety Awareness = 72.7 % of sample showed increase • Everyday Fire Interest = 54.5% of sample showed reduction • Normalisation of Fire = 45.4% of sample showed reduction

26. Patient Feedback “The worst thing about the group was waiting for it to start.” “The worst thing about the group was having to get up an hour earlier than usual.” “The group could have been better if it was shorter.”

27. Patient Feedback “I thought that the group was good, interesting, and will help me in the future.” “The group helped me a lot.” “[The individual sessions] help you understand things you might not know about yourself.” “I got a better understanding about myself than I did before and also it made me think twice about fires and made me realise they were more dangerous than what I thought.”

28. Discussion • Preliminary findings suggest that FIP-MO is successful in addressing some of mentally disordered firesetters key deficits • Patients report positive experience of FIP-MO • Starting point for an evidence based intervention for patient benefit

29. A New Structured Treatment Programme for the NHS? • Complete the full evaluation of FIP-MO (i.e., compare pre-post treatment shifts to those of control group) • Examine any differences in treatment outcomes across gender • Revise programme manual based on outcome of evaluation

30. Thank you! Contact email: nt202@kent.ac.uk