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Carr, Alan
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Carr, Alan
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Carr, Alan
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- PublicationSupporting parents of adolescent perpetrators of CSAThe importance of parental involvement in the treatment of their adolescent CSA perpetrators cannot be underestimated. One of the defining differences between the fields of adult and adolescent sexual offending is the fact that adolescents are still in a formative stage of development. Parents can still exercise a major influence in re-engaging children back on a normative developmental pathway and reducing future risk to a minimum. It is also important to include parents of adolescent CSA perpetrators in treatment programmes because it is well documented in Irish and international studies that some have significant problems.
419 - PublicationPerceptions of the criminal justice system and its association with well-being following a report of child sexual abuse(National Organisation for the Treatment of Abusers (NOTA Ireland), 2007)
; ; ; 101 - PublicationFactor structures of measures of cognitive distortions, emotional congruence, and victim empathy based on data from Irish child sex offenders(Routledge (Taylor & Francis), 2006)
; ; ; ; ; This study evaluated the factor structures of three instruments from the Sexual Offender Assessment Pack. The Children and Sex Cognitive Distortions Scale, the Children and Sex Emotional Congruence Scale, and the Child Victim Empathy Distortions Scale were administered to 203 sex offenders in Ireland. Confirmatory factor analyses did not support the proposed single factor structure for each of the three scales. Exploratory factor analyses suggested more complex factor structures. The Children and Sex Cognitive Distortions Scale was found to have two factors: (a) Perceptions of Children as Sexually Mature and (b) General Justifications for Sex With Children. The Children and Sex Emotional Congruence Scale was found to have three factors: (a) Positive Affect From Children, (b) Special Relationships With Children and (c) Preference for Relationships With Children. The Victim Empathy Scale was found to have two factors: (a) Positive Misattributions of Pleasure and (b) Denial of Negative Feelings in the Child. In clinical settings, the more complex factor structures identified in this study may used in scoring and interpreting responses to the three instruments investigated here. Our results require replication and further research should focus on the correlates of the factorial scales identified in this study.983Scopus© Citations 9 - PublicationFamily–oriented treatment for people with alcohol problems in Ireland: a comparison of the effectiveness of residential and community–based programmesUsing a naturalistic design involving consecutive referrals self-selected for family-oriented treatment, 42 participants from a residential programme and 25 participants from a community-based programme were assessed on a range of alcohol-use and psychosocial measures before treatment. A proportion of these cases were assessed after treatment and at 6 months follow-up. At six months follow-up 79% of both the residential and community groups were either abstinent or drinking moderately. However, more members of the residential group (75%) were abstinent at follow-up compared with the community group (36%). In contrast, more members of the community group were moderate drinkers (43%) at follow-up compared with the residential group (4%). At six months follow-up, compared with the community group, more members of the residential group showed a clinically significant reduction in recent negative consequences of drinking and psychological adjustment problems. Both groups made significant mean gains on indices of alcohol abuse and psychosocial adjustment but there were important intergroup differences. The residential group showed a greater mean reduction in recent negative consequences from drinking but the community group showed a greater mean reduction in the percentage of days heavy drinking.
669Scopus© Citations 8 - PublicationChild sex abuse and the Irish criminal justice systemThe aims of this study were to develop scales to assess experiences of sexually abused children in the Irish criminal justice system (CJS); identify aspects of the CJS which children experience as negative; compare the perceptions of children, parents and professionals of sexually abused children's experiences of the CJS; and determine correlations between perceptions of children's CJS experiences and current psychological adjustment. Forty-three children, 101 parents, 32 mental health professionals, 27 police officers and 21 lawyers completed parallel versions of the Criminal Justice System Questionnaire (CJSQ) which assessed satisfaction with aspects of the CJS relevant to sexually abused children, specifically: Gardaà (police), medical examination, Director of Public Prosecutions, waiting for court, court professionals, court context and the CJS. Fifteen scales were developed by conducting principal component analyses. Children gave negative ratings on nine of these, and on seven children, parents and professionals differed in their perceptions of how children experienced the CJS with mental health professionals viewing the impact of the CJS as more problematic than parents and children. Scores of children and parents on CJSQ scales correlated with indices of current psychological adjustment. These results point to the importance of making the Irish CJS more child-friendly and for evaluating these reforms with the CJSQ. Copyright © 2011 John Wiley & Sons, Ltd.
541Scopus© Citations 9 - PublicationProfiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland(Wiley, 2010-12)
; ; ; ; ; ; ; ; Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups that described severe sexual (N = 60), physical (N = 102), or emotional (N = 85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post-traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profile of survivors of severe physical abuse occupied an intermediate position between the other two groups. A thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse, since this may have important implications for the intensity of services required. Survivors of severe sexual abuse may require more intensive services.1079Scopus© Citations 31 - PublicationThe Waterford mental health survey(University College Dublin. School of Psychology; Health Services Executive, 2015-02)
; ; ; The primary objective of the Waterford Mental Health Survey was to document the prevalence of co-morbid personality disorders in a sample of inpatients and outpatients attending the HSE mental health service in Waterford and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical Interviews for DSM-IV axis I and II disorders, the Childhood Trauma Questionnaire, the Global Assessment of Functioning rating scale, the SCORE family assessment instrument, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Participants were consenting, consecutive referrals who were not too unwell to engage with the study. The sample interviewed was probably slightly higher functioning than all cases attending the service. With regard to the primary objective of the study, we found that 98.4% of cases had DSM-IV axis I psychiatric disorders and 39.3% of these had comorbid axis II personality disorders. Between approximately a half and three-quarters of cases with personality disorders had comorbid anxiety, depressive or alcohol and substance use disorders. Compared to those without personality disorders, cases with personality disorders had experienced more child maltreatment; had poorer personal and family functioning and more severe presenting problems; and reported greater unmet service needs and motivation for psychotherapy. In terms of service development, approximately 2 out of 5 patients attending the public mental health services in Waterford require specialist psychological therapy for personality disorders which addresses low levels of personal and family functioning and past history ofchild maltreatment. Specialist psychological therapies include dialectical behaviour therapy (Linehan, 1993. 2014), schema therapy (Young et al., 2007), cognitive behaviour therapy (Beck et al., 2004) and brief psychodynamic psychotherapy such as mentalization-based treatment (Bateman & Fonagy, 2006; Clarkin et al., 2010). A review of psychology staffing levels is required to determine the number of psychologists required to provide this type of service in line with recommendations in the national mental health policy - Vision for Change (Department of Health & Children, 2006) - and the HPSI Psychology briefing paper for the HSE mental health division (Heads of Psychology Services Ireland, 2014). Intensive initial staff training and ongoing supervision are required for psychologists to provide these specialist evidence-based interventions.1081 - PublicationProfiles of parents of adolescent perpetrators of CSAThe present study aimed to expand our knowledge about the profiles of families of adolescent CSA perpetrators by comparing a group of parents of adolescent sexual offenders (PASO); a clinical control group (CC) of parents of non-offending adolescents attending a child and adolescent mental health service; and a normal control group (NC) of parents of non-offending adolescents in the community on a range of demographic, developmental, personal adjustment and family environment variables.
241 - PublicationEvaluation of functional family therapy in an Irish contextIn an Irish context we conducted a retrospective archival study of functional family therapy (FFT) for adolescents with behavioural problems. Strengths and difficulties questionnaire data were collected from 118 families at the beginning and end of therapy (at baseline and follow up for dropouts) in a community-based clinic in a socially disadvantaged Dublin suburb. Analyses of the improvement in mean scores and clinical recovery rates showed that the outcome was associated with treatment completion and the extent to which therapists adhered to the FFT treatment manual. Therapy completers treated by high-adherent therapists had the most favourable outcome. In contrast, the worst outcome occurred for dropouts. The outcome of cases treated by low-adherent therapists fell between these two extremes. These results show that FFT may be effectively implemented in an Irish context, and that the effectiveness of treatment is associated with families remaining in treatment for an average of seventeen sessions, and receiving treatment from therapists who implement FFT with a high degree of fidelity.
780Scopus© Citations 25 - PublicationProfiles of Irish survivors of institutional abuse with different adult attachment styles(Routledge (Taylor & Francis), 2009)
; ; ; ; ; ; ; ; Two hundred and forty seven survivors of institutional abuse in Ireland were classified with the Experiences in Close Relationships Inventory as having fearful (44%), preoccupied (13%), dismissive (27%) or secure (17%) adult attachment styles. The group with the secure adult attachment style had the most positive profile, while the most negative profile occurred for the fearful group in terms of DSM IV diagnoses and scores on the Trauma Symptom Inventory, the Global Assessment of Functioning Scale, the World Health Organization Quality of Life 100 scale, and the Kansas Marital Satisfaction Scale. The profile of the preoccupied group was more similar to that of the fearful group. The profile of the dismissive group was more similar to that of the secure group740Scopus© Citations 13