Moving Forward Making Changes: evaluation of a group-based treatment for sex offenders

Annex A – Topic guides

Treatment Managers topic guide

Pre-interview

Review any emails / previous correspondence with treatment managers and make notes on specific areas to follow-up on/seek more detail about in this interview.

Introduction

• Thanks for taking part
• Introduce self, Ipsos MORI and the evaluation (on behalf of Scottish Government, feeding into application to reaccreditation by SAPOR, interviewing men, staff and key professionals, reporting in January 2018)
• Duration of interview (approx. 1 hour)
• Topics we want to discuss
• Confidentiality – won't use any names in reports or refer to location if quote professionals directly
• Recording – for Ipsos MORI use only, will be securely stored and deleted after project. Check consent to record?
• Any questions?

Roles

I'd like to start by finding out a bit more about your role within the Moving Forward: Making Changes programme and how it fits into any other roles you may have.

• What does their role on MFMC involve?
  • Are they involved in delivery as well as management? ( NB managers are supposed to be involved in delivery 1 out of every 6 sessions)
  • Are they involved in overseeing the monitoring data? In what way?
  • How long working on MFMC? Involved in any previous sex offender programmes?
• NEXT QUESTIONS, REFER TO NOTES FROM EMAIL/INCEPTION REPORT AND CLARIFY IF NECESSARY
  • Is MFMC their only role or other roles too? If yes, what? IF OTHER ROLES – what % of time is on MFMC?
  • Who else is involved in delivering MFMC in their area/prison? How many people in what roles?
  • Are rest of team working solely on MFMC or do they also have other roles?

Management and delivery of MFMC in their area

Before I ask you about your views on specific aspects of the programme, I'd like to find out a bit more about how MFMC is managed and delivered in your area/prison in general . (REFER TO EARLIER EMAILS ON ANY DIFFERENCES, AND FOLLOW-UP / PROBE ON OTHER AREAS AS APPROPRIATE).

• As far as you are aware, are there any elements of MFMC that you manage or deliver differently from the manuals?
  • Why is that?
  • How is this done?
  • What are the pros and cons of doing things differently?
• What are the main challenges to delivering MFMC as it is set out in the manuals?
• How, if at all, could the MFMC manuals be improved?
• What are the benefits and limits to how MFMC is delivered in your area?
  • Are their aspects where deviate from manual/other areas that work particularly well?
  • Are there aspects of delivery they would ideally do differently? If so, why not?
• As far as you are aware, are there any differences between how the programme is managed or delivered in this area/prison compared with how it is delivered elsewhere? PROBE for differences in:
  • How delivery team is structured/roles?
  • Resources available?
  • Assessment processes?
  • How programme itself is delivered? (e.g. group vs. 2-1)
• Views on the reasons for these differences? Resources? Local structures? Tailoring to improve for local needs?
• And views on the pros and cons of these differences – esp. for programme effectiveness

Resourcing of MFMC

Do you feel you have sufficient resources to be able to run the MFMC programme as it is designed in your area/site? If not, what else is needed?

• Staff resources?
• Other resources – e.g. do they have access to all the resources listed in manual (p33): accommodation; recording equipment; learning aids; participant materials; storage facilities?
• Able to operate within budget?
• Have they encountered any unexpected resource issues or unforeseen costs since starting the programme?

Thinking about staffing specifically, do you feel you have sufficient trained practitioners to be able to deliver the programme effectively?

• Do all staff have enough time to do their jobs effectively? If not, why not?
• Have all staff received adequate support and training, at the right time, from the programme? ( NB MANUAL STATES THAT STAFF SHOULD START DELIVERING WITHIN 3 MONTHS OF MFMC TRAINING)
• Staff recruitment – any challenges recruiting appropriate new staff?
• What about resources available for supporting and developing staff in their roles? Are there any challenges around providing appropriate support and development to your teams? (REFER TO EMAIL RE. WHAT SUPPORT IS PROVIDED, INCLUDING BOTH COUNSELLING/DEBRIEFS AND COMPETENCY CHECKS)

Partnership working

Who are the main partner agencies that you work with on MFMC in your area/prison?

• How effective do you feel partnership working is on MFMC? Are there specific partners where partnership working is more/less effective?
• What areas of interagency working could be improved? How?
• IF NOT MENTIONED BY COMMUNITY TREATMENT MANAGERS – probe around partnership working with psychiatry/psychology – do they feel they have enough support/input from psychology/psychiatry? If not, where would they like more support? (REFER TO EMAILS)

Process of assessing men for MFMC

REFER TO RESPONSES TO EMAILS RE. WHO CARRIES OUT ASSESSMENTS ETC.

How well do you think the process for assessing men for suitability for MFMC works in your area? Why? How could it be improved?

• FOLLOW UP IF NECESSARY ON ANY ISSUES RE:
  • Who carries out assessment
  • Timing of assessment
  • Content of assessment.
• Is the programme reaching its intended target group? If not, who is over or under-represented, and why?

Psychometric assessments

REFER TO EMAIL RESPONSES AND FOLLOW-UP/PROBE

Do all men on the course complete the assessment battery before and after they start the group sessions? If not, why not?

• Any issues / challenges getting these completed (in general / for specific men – e.g. those with learning difficulties)? How do they deal with these issues?
• How useful are the assessments? Are they effective at helping understand men's motivations and needs? Do they inform how they work with individual men?

Transitions between prison and community programme

Have they had many men transferring between prison and community programme in their area/prison?

• How well does this process work?
• What, if anything, could change to improve this?

Engagement with the programme in their area/prison

How common is it for men in your area/prison who are offered MFMC to refuse it altogether? Why do you think this is?

• Are there particular groups of men more or less likely to refuse treatment?

Once men have been assessed as suitable and agreed to take part, in general, how high are the attendance rates on the programme?

• Are there particular groups of men more or less likely to engage with the programme once referred? Why? Probe on individual reasons vs system reasons – i.e. anything about how the programme is delivered that contributes to disengagement?
• Are there particular points / particular modules where men tend to disengage/drop out? Why?
• How do you deal with unwilling participants, who start to withdraw or who skip sessions?

Managing group sessions

How do you allocate men to the different groups/2-1 pairs?

• Are there enough places on the programme to meet current demand?
• How easy or difficult is it to assign a suitable mix of individuals to a group/pairing (in terms of culture, race, age, developmental/cognitive factors, offence type etc)? Have they experienced any challenges re. group mix? How did they address these?
• How easy/difficult is it to fit participants into the different modules (both compulsory and optional)?
• Do they have any men who are also on other programmes – e.g. Caledonian? How does MFMC fit with other interventions? Any challenges / things that could be improved on this front?

How are sessions delivered? (*key question)

REFER TO EMAILS AND FOLLOW UP WHERE NECESSARY

• How often do groups/2-1s run? How long do they last? Any challenges re. timing/frequency of sessions?
• Are sessions very structured, or fairly flexible? Do you tailor your approach depending on the particular group? In what way?
• Are any of the modules more/less effective?
• Any approaches you find more/less effective than others? With particular types of men?
• How is delivery adapted to fit the needs of different offenders? (e.g. rapists vs internet offenders; different learning styles and cognitive abilities)

Ending the programme

• How long do you find men are typically on the programme in your area/prison? Reasons/types of men it takes longer for?
• Do you think the programme is too long/too short?
• After the post-treatment process has been completed how common is it for men to re-enter the programme?
  • Main triggers to relapse?
• How are participants followed up after completing the programme?

Overarching views of MFMC

How effective, overall, do they feel the MFMC programme is?

• How do they assess how effective it is? What evidence do they have of it changing men's attitudes? And their behaviours?
• Is it more or less effective for different types of men? Different types of offence? Different cognitive abilities? Why?
• How does MFMC compare to other reoffending programmes they've been involved in?
  • What are the relative pros and cons / challenges?
• How helpful are the manuals? What aspect are most useful? And least? How could they be improved?

Other changes?

Are there any other areas where they feel the MFMC, or the way it operates locally, could be improved? How? Probe fully.

THANK AND CLOSE. ASK FOR PERMISSION TO EMAIL/RING IF ANY

FOLLOW-UP QUERIES.

Participant topic guide

Introductions (5 mins)

• Thanks for taking part
• Introduce self, Ipsos MORI and the evaluation:

e.g. "Ipsos MORI is doing research about 'Moving Forward: Making Changes' for the Scottish Government. We want to find out what people think about taking part in the programme.

The aim of the interview is to understand what you think of the programme and how it could be improved.

Your views and experiences will help the Scottish Government and its partners think about how to improve programmes like Moving Forward Making changes in the future."

• Duration of interview (approx. an hour)
• Topics we want to discuss
  • What you thought when you first heard about the Moving Forward: Making changes ( MF:MC) programme
  • What kinds of things you talk about in MF:MC groups/sessions
  • How, if at all, you think taking part in the MF:MC programme has affected you
  • How the programme can be improved.
• If any questions you don't want to answer, or if you want to take a break, that's fine – just let me know
• Confidentiality – won't use any names in reports or share our conversation with anyone outside the research team at Ipsos MORI. Only time we might need to pass on something you say in an interview with anyone else would be if you tell us something that makes us concerned someone is in danger of serious harm.
• Recording – for Ipsos MORI use only, will be securely stored and deleted after project.
• Any questions?
• Consent sheet - if happy to take part and be recorded, ask them to sign.

Background information (2 mins)

Purpose: to get a bit of context about the participant to help frame/inform later discussion and find out what stage of MFMC they are at.

• Just to start off with, can you tell me how old you are?

COMMUNITY INTERVIEWS ONLY:

• Are you working or not just now? If yes - what kind of work do you do?

ALL:

• How long have you been attending sessions for MF:MC?
• Is this your first time on the programme or have you re-entered? IF YES: When were you on it before, and when did you re-enter the programme?
• And have you only been on Moving Forward Making Changes in (SITE), or did you move onto the programme here from somewhere else? (TO TRY AND IDENTIFY ANY WHO HAVE TRANSITIONED, ESPECIALLY PRISON-COMMUNITY OR VICE VERSA)
• What stage of the programme are you currently at? E.g. are you attending group/2-1 sessions, or have you finished this stage? Do you still have any contact with MFMC staff or have you completely finished the programme?

Expectations of MF:MC (5 mins)

Purpose: to establish what they thought MF:MC was and what their expectations were at the start (before they actually started participating)

I'd like you to think back to when you started with the Moving Forward Making Changes programme. I'm interested in what you knew about it and how you felt about it at the start.

• When did you first hear about the Moving Forward Making Changes programme? PROBE – how found out about it / who heard about it from?
• What did they tell you about it? When you were first told about it, how did you feel about taking part in the programme? PROBE: Were you mainly positive / negative about it?
  • What, if anything, did you hope or expect the programme might do for you?
  • What, if any, concerns did you have about taking part?

General experience / views of group or 2-1 sessions (15 mins)

*** PRIORITY SECTION ***

Purpose: to establish what kinds of things they do/talk about in group/2-1 sessions, and what think more/less useful.

• Do you take part in MFMC in a group with other men, or in a session with one other man?
• Can you take me through a typical group / meeting (if 2-1)? (types of things they do, talk about, who leads it, who else is there, etc).
• PROBE AS NECESSARY
  • How many people are in the group?
  • How long do the groups/meetings last?
  • Where do they take place?
  • Who leads it? Are there other people involved in running sessions?
  • How often do groups/meetings take place?
  • What sorts of things do you usually talk about in group sessions?
  • What kind of exercises or activities do group workers use? What is your opinion on these?
• What kinds of things have you talked about as part of your MFMC groups/sessions? PROBE FULLY – what else?
• What issues did you find it particularly useful to discuss? PROBE: why? Content vs. how it was delivered/covered?
• What issues or topics did you find less useful? PROBE why?
• Why was this issue / topic useful / not useful for you?
• What are the group sessions like? PROMPT IF NECESSARY: For example, would you describe them as engaging or boring? Difficult or easy? Why?
• What are the people who run the groups like? How would you describe them? What is good/bad about how they run the group?
• What is the relationship between the people in the group like?
  • PROBE: how do you get along? Does everyone get chance to contribute? Are there ever any difficulties around working together? How are these resolved?
  • ( If issues around having group members who deny their offence come up, probe fully around this – how does that affect the group?)

Case management/other contact with MFMC (5 mins)

Purpose: to establish how relationship with case manager works/feeds into MFMC experience

• Do you have someone you meet with one-to-one as part of MFMC too?
  • Who is that?
  • How often do you meet with them at the moment?
  • What kinds of things do you talk to them about?
• How do you find the meetings you have with your case manager/worker? PROMPT IF NECESSARY: Useful/not useful? Challenging? Supportive? Difficult? Why?
  • Is there anything about how they work with you that you would change?

Level of engagement with MFMC (5 mins)

Purpose: to establish how engaged they've been across the programme and what if anything explains any lower engagement.

(If any points where felt / were less engaged, try and establish when this occurred)

Thinking about everything you have done on the programme since you started …

• Was there any point when you felt less happy about taking part? When? For how long? Why felt that way?
• Was there any stage that you stopped coming to groups or meetings for a while? When? For how long? Roughly how many did they miss?
• Why? What, if anything, encouraged them to come back? At that time was there anything that could have helped to encourage you to come to meetings, or feel more positive about coming to them?

Experience of transition/re-entering the programme (5 minutes) (THOSE WHO HAVE TRANSITIONED/RE-ENTERED ONLY)

• THOSE WHO HAVE TRANSITIONED BETWEEN SITES: Earlier, you mentioned that you'd moved onto the programme here from somewhere else. Can you tell me a little bit more about how moving between different places delivering Moving Forward Making Changes worked for you?
  • Did you experience any issues around moving between sites? What? How did this affect you / your experience of the programme?
• THOSE WHO HAVE RE-ENTERED THE PROGRAMME: You mentioned earlier that you had taken part in MFMC before this time. How was it coming back onto the programme?
  • How did it compare with experience first time round?
  • How did you feel about repeating elements?

Impact of the MF:MC programme (10 mins)

Purpose: to establish what, if any, impact they feel the programme had on them across range of areas it tries to influence.

KEY SECTION – should take most time.

ASK OPEN QUESTIONS FIRST AND PROBE AS FULLY AS POSSIBLE.

• How, if at all, do you feel your life has changed since being on the Moving Forward: Making Changes programme?
• If changed – in what ways? Probe fully for both positives and negatives. What, if any, changes have you noticed to:
  • how you see the world
  • how you behave
  • your you manage your emotions
  • your relationships with other people
  • how you plan for the future?
• What do you think contributed most to this change? PROBE FULLY – MF:MC vs other things?
  • If MF:MC, which elements? Staff delivery (which staff – case manager or group workers?)? Programme content? Etc. If necessary, prompt – being in a group, 1-1 sessions, any particular topic you discussed?
  • If other things, what were they e.g. family/friends, their own self-motivation, other services?
• Are there any other areas where you would have liked to achieve things or change, where you don't feel there has been as much change? IF YES, PROBE AS BELOW, FOR 'NO CHANGES'.
• If no changes – how do you feel about that? Are there areas where you would have liked thing to change? What has got in the way of changing these? What, if anything, could the MF:MC have done that might have made a difference/ helped change these things?

Overview of impact and suggestions for improvement (5-10 minutes)

• Overall, do you think the programme has helped you? In what way in particular? And what part of the programme has helped you most? And what has helped you the least?
• Have there been any negatives from taking part? Probe fully. What might have helped prevent this from happening?
  • Are there parts of the programme that haven't worked as well for you as others? Probe around content, delivery, 1-1 vs group sessions, etc.
• How could the Moving Forward Making changes programme be improved?
  • Are there things you think there should be more of? Why is that?
  • Are there things you think there should be less of? Why is that?
• If you could describe the programme to someone else who was just starting out, what would you say? What would you tell them about it?

Future aspirations and summing up (5 mins)

Purpose: to understand how confident they feel that the programme will help them achieve their goals and what suggestions they have for improving it

Now thinking about the remainder of your time on the MF:MC programme….

• What are your aims for the rest of the programme / now you've left the programme? What would you like to achieve in the remainder of your time / in the future?
• How confident do you feel that this will happen? Why / why not?
• IF LEFT THE PROGRAMME – what happened after you finished MFMC? Did you have any ongoing contact with programme staff / other services? How did you feel about that? Helpful or not? Why / in what ways?
• Is there anything else you would like to say about the programme that we haven't covered? This could be good points or things you would like to change.

Close

• Any final questions from participant
• Thank participant and close interview
• Reiterate reassurances of confidentiality
• Pass on support leaflet of local and national services – explain to participant that it is standard practice for us to give out at the end of interviews.

Case Manager topic guide

Introduction

• Thanks for taking part
• Introduce self, Ipsos MORI and the evaluation (on behalf of Scottish Government, feeding into application to reaccreditation by SAPOR, interviewing men, staff and key professionals, reporting in January 2018)
• Duration of interview (approx. 45 minutes, depending on how much they have to say)
• Topics we want to discuss
• Confidentiality – won't use any names in reports or refer to location if quote professionals directly
• Recording – for Ipsos MORI use only, will be securely stored and deleted after project. Check consent to record?
• Any questions?

Participant's role and contact with the MFMC programme

• I'd like to start by finding out a bit more about your role in general and on MF:MC specifically – can you tell me a bit about that?
• Probe on:
  • How MF:MC fits into wider role?
  • Caseload of MF:MC men (what % of total caseload is this?)
  • Time allocated to/spent on MF:MC vs. other elements of job?
  • Whether support clients on other, similar programmes too?
  • And can you tell me a little bit about what your involvement in MF:MC involves?
• Probe on whether involved / in what way at each stage:
  • Risk assessment – do they have any involvement in carrying these out pre or post MFMC?
  • Pre-group preparation?
  • During group stage?
  • After programme finishes / maintenance?

Joint working with MF:MC

• How do you work with the MF:MC team that delivers the group programme in your area?
• Level of contact with MF:MC (frequency, intensity)
• Nature of contact
• From your perspective, how effective are current arrangements for liaison between yourself and the MF:MC team?
• What are the things that work well? Work less well?
• Are you happy with the frequency of updates you receive from the team throughout the programme?
• Are there any stages during the programme where communication between yourself and the team could be improved?
• (e.g. risk assessment, pre-group stages, on-going liaison throughout the programme, post group process)

Assessment process

• Now thinking in a bit more detail about your different roles throughout the programme. How effective do you find the risk assessment process in determining men's suitability for the programme?
• Is it reaching the right groups of men?
• If not, why not / who is missing? How could it reach them more effectively?
• Do you feel that there are sufficient places available on the programme for offenders?
• How common is it for men to refuse to take part in the programme?
• If yes – why do you think this is? What are their reasons for doing so?
• Are there any particular groups of men more or less likely to do so?
• Are there particular groups of men more or less likely to engage with the programme once referred?
  • Why? Probe on individual reasons vs system reasons – i.e. anything about how the programme is delivered that contributes to disengagement?
  • Are there particular points / particular modules where men tend to disengage/drop out? Why?

Case management

• Thinking now about case managing individuals while they are on the programme. How well does the programme integrate with your other case management duties?
  • e.g. Good Lives and Keep Safe planning?
• Are there any areas or stages of the programme which can be more challenging in terms of case managing an individual?
• e.g. any stages where additional support is required for some groups of men; any particular modules that can be problematic; ongoing risk assessment; post group process?

Post programme

• And now thinking about the post programme process. How useful is the post programme report from the MF:MC team in terms of informing ongoing treatment and goals for the individual?
• Community based: And how useful are the report feedback sessions delivered by the programme practitioners to participants?
• IF CM COMPLETES THE POST-PROG RISK ASSESSMENTS - Do you have any issues with the timescales involved in completing the (Stable 2007) risk assessments following completion of the programme? Why? What timescales are feasible in practice?

Perceived impact of the Programme

• How effective, overall, do you feel the MFMC programme is?
  • Why? (Probe fully – find out what they are basing views on – direct observation, feedback from participants, feedback from colleagues, or what?)
  • Positives/negatives?
  • What works well / less well?
  • Is it more or less effective for different types of men? Different types of offence? Different cognitive abilities? Why?
• How does MFMC compare to other programmes that work with male sexual offenders? Or other kinds of offenders? (e.g. Caledonian)
  • How, if at all, is it different from these services/interventions?
  • Aspects of MF:MC they think compare well / less well with other services? Reasons for saying that?
• What could be improved?

Other changes?

• Are there any stages in the programme where you feel you require more support from the MF:MC team?
• Are there any other areas where they feel the MF:MC, or the way it operates locally, could be improved? How? Probe fully.

THANK AND CLOSE. ASK FOR PERMISSION TO EMAIL/RING IF ANY FOLLOW-UP QUERIES.

Other stakeholders topic guide

Introduction

• Thanks for taking part
• Introduce self, Ipsos MORI and the evaluation (on behalf of Scottish Government, feeding into application to reaccreditation by SAPOR, interviewing men, staff and key professionals, reporting in January 2018)
• Duration of interview (approx. 30 mins depending on how much you have to say)
• Topics we want to discuss
• Confidentiality – won't use any names in reports or refer to location if quote professionals directly
• Recording – for Ipsos MORI use only, will be securely stored and deleted after project. Check consent to record?
• Any questions?

Participant's role and contact with the MFMC programme

• I'd like to start by finding out a bit more about your role in general – can you tell me a bit about that?
• Different people we are speaking to have different levels of contact with and knowledge about the Moving Forward: Making changes programme. How much contact do you have with MF:MC?
• Probe for details around:
  • When first heard about MF:MC
  • Level of contact with MF:MC (frequency, intensity)
  • Who they / their organisation usually have contact with (Particular staff? Participants?)
  • When have contact? In what context?
  • How contact with MF:MC fits into their wider job / role?

Overview of knowledge of MF:MC

• Probe around understanding of:
  • What it's trying to achieve?
  • How it is delivered?
  • How does it fit into what else delivered locally relating to sexual offenders?

NHS stakeholders ONLY

• During which stages of the programme do you typically provide support and input to the programme?
  • Probe: initial risk assessment stage; psychometric assessments (pre and/or post); Healthy Sexual Functioning module; supporting staff on how to deal with participant issues (e.g. mental health, psychopathology).
  • For each stage they are involved in, probe:
• What works well in terms of joint working with MF:MC?
• Any issues or challenges faced in terms of your involvement with this stage?
• In terms of working with MF:MC team at this stage, anything that could be improved?

OTHER STAKEHOLDERS - Joint working with MF:MC

• From your perspective, how effective are current arrangements for liaison between you / your organisation and the MF:MC team?
  • e.g. referral routes to/from MF:MC, joint working protocols, etc.
  • What are the things that work well?
  • What are the areas that could be improved?

Perceived impact of the Programme

The Moving Forward: Making changes programme attempts to reduce the re-offending of men convicted of sexual offences and increase their opportunities and capabilities for meeting needs by non-offending means. From what you've seen, what, if any, impact do you think it is having on offenders?

• How effective, overall, do you feel the MFMC programme is?
  • Why? (Probe fully – find out what they are basing views on – direct observation, feedback from participants, feedback from colleagues, or what?)
  • Positives/negatives?
  • What works well / less well?
  • Is it more or less effective for different types of men? Different types of offence? Different cognitive abilities? Why?
• From what they know, is it reaching the right men?
  • If not, why not / who is it missing? How could it reach them more effectively?
• How does MFMC compare to other programmes that work with male sexual offenders? Or other kinds of offenders? (e.g. Caledonian)
  • How, if at all, is it different from these services/interventions?
  • Aspects of MF:MC they think compare well / less well with other services? Reasons for saying that?

How does it compare to other services or interventions that work with:

Other changes?

Are there any other areas where they feel the MF:MC, or the way it operates locally, could be improved? How? Probe fully.

THANK AND CLOSE. ASK FOR PERMISSION TO EMAIL/RING IF ANY FOLLOW-UP QUERIES.