Support for the predictive validity of the Multifactor Offender Readiness Model (MORM): forensic patients’ readiness and engagement with therapeutic groups

摘要

Background Treatment non-engagement in forensic settings has ethical and economic implications. The Multifactor Offender Readiness Model (MORM) proposes a framework for assessing treatment readiness across person, programme and contexts.\udResearch question: Are the internal factors of the MORM associated with whether forensic patients engage, complete, refuse or drop out of groupwork interventions?\udMethod: In a retrospective design, associations between internal factors of the MORM, measured as part of assessment for group participation, and the outcomes of treatment refusal, treatment dropout and treatment completion were investigated.\udResults: 118 male high security hospital patients consecutively referred for group treatment agreed to participate. Internal factors of the MORM associated with treatment refusals included: psychopathic cognition, negative self-evaluation/affect and effective goal seeking strategies. Those associated with dropouts included emotional dysregulation, low competencies to engage and low levels of general distress. MORM factors associated with completion included: low motivation, ineffective goal seeking strategies, absence of psychopathic cognition, high levels of general distress and competency to engage.\udConclusions: Internal factors of the MORM could be useful contributors to decisions about treatment readiness for hospitalised male offender-patients. Up to one in three programmes offered were refused, so clinical use of the MORM to aid referral decisions could optimise the most constructive use of resources for every individual.