Digital desistance Dr James Tangen VC 2020 Lecturer

Digital desistance Dr James Tangen VC 2020 Lecturer in Criminology Rm 00. 04, Hawthorn Building James. tangen@dmu. ac. uk

Overview Question: How can digital technologies support the process of desistance? Structure: • Concepts • Context • Personal Digital Assistants • Self‐guided therapies • Future developments • Conclusions

Concepts Desistance: ‘The long‐term abstinence from criminal behaviour among those for whom offending had become a pattern of behaviour’ (Mc. Neill et al. , 2012: p. 2) Digital competence: ‘the set of knowledge, skills, attitudes […] that are required when using ICT and digital media to perform tasks’ (Ferrari, 2012: p. 43)

Context Digital engagement in the UK Statistical bulletin: Internet access – households and individuals, 2013 (ONS, 2013) • 83% of homes in Great Britain now have internet access • 50% of users are accessing internet banking • 53% of adults in the UK access social media sites, such as Facebook • 43% of internet users have used it to access health information, up from 18% in 2007

Context Digital mental health in the UK • “E‐mental health is not just about technology, but represents a cultural change in mental healthcare by empowering patients to exercise greater choice and control. ” (Hollis et al. , 2015: p. 263) • However: “Few providers appear to be fully exploiting digital technology by delivering services in a markedly different way” (Cotton et al. , 2014: p. 3)

Context Digital mental health in the UK • 83% provided an online directory of their services, • 75% provided general information about mental health conditions on their website. • 66% said they signposted information online, such as contact information for local carer groups. • 50% said they provided options to access services remotely, for example by telephone. (Cotton et al. 2014)

Personal digital assistant • Offers individualised support for change • Should be utilised where digital competence (Ferrari, 2012) is a strength – Not a mechanism for learning new digital skills • Can help to build a positive relationship between supervisor & offender – Based on ‘real‐time’ interactions

Personal digital assistant Charbonneau et al. (2015): • Examined use of digital technology to support people with mental health issues – Cognitive deficits & social/emotive disorders • 12 participants discussed their use of a variety of apps to support their rehabilitation. • A thematic analysis identified effects and issues of the integration of apps in participants' daily life.

Personal digital assistant • The apps helped participants to: – Overcome their cognitive difficulties – Manage daily tasks and socialization – Prevent boredom • Issues: Context; the technology; the individual • What is therapist's role in the integration of personal digital assistants in rehabilitation?

Self‐guided therapies “Self‐help [is] a therapeutic intervention that is based on a sound theoretical background, that uses therapeutic principles from an evidence‐based intervention, and is administered through a “media” that does not involve direct contact with another person” (Naeem et al. , 2016: p. 69)

Self‐guided therapies “There is some support for the role of c. CBT in improving symptoms of depression and anxiety in CYP. There is also evidence from ‘head to head’ trials that therapist‐guided (remote) c. CBT is as effective as Ft. F [face‐to‐face] CBT” (Hollis et al. , 2017; 2016: p. 493)

Self‐guided therapies • A systematic review of digital mental health (Donker et al. , 2013) identified 4 studies describing 3 mobile apps targeted depression: – 2 found a significant reduction in depression caseness and depression and anxiety symptoms – 2 found no statistical difference, but in these cases the control group received largely the same intervention as the experimental group

Self‐guided therapies Donker et al. (2013) also identified a pilot study aiming to reduce substance use (alcohol, drugs, and tobacco) • Adults suffering from borderline personality disorder • Mobile app & face‐to‐face therapy Significant reductions within each session: • Emotional intensity • Urge to use substances

Self‐guided therapies Significant reductions over longer‐term in • Symptoms of depression • Global symptom severity Increase in confidence in participants’ ability to use opposite action (ie, emotion regulation) skills

Future developments Does your organisation plan to utilise any of the following as a means of engaging service users and the public? Online directory of services Social media presence General information about mental health available online Signposting information online Secure website for service users Options for service users to access services remotely Online appointment booking Online and mobile applications to support service delivery 0% 10% 20% 30% (Cotton et al. 2014) 40% 50% 60% 70% 80% 90%

Future developments Barriers to further engagement • Financial constraints • Investment • Problems with IT supplier • Connectivity in rural areas • IT literacy of staff and service users. (Cotton et al. , 2014)

Conclusions Digital technologies may: • Provide a bridge between referral & face‐to‐face intervention • Promote informal approaches – Reworks the boundaries of formal appointments • Enable offenders to determine how/when engage – Skills practice; communication with OM • Enables offenders to engage in a mode they prefer – Only if offender already has a good level of digital competence

Conclusions • Positive supervisory relationship as continuous engagement – Digital communication is frequently asynchronous (Facebook; Twitter; Instagram) • Enables OMs to recognise progress in a timely manner – No longer need to wait for next appointment, or review – Potential for using digital rewards, such as ‘badges’ and milestone tracking (cf fitness trackers; Headspace)

Questions? Thank you Dr James Tangen VC 2020 Lecturer in Criminology James. tangen@dmu. ac. uk

References Charbonneau, K. , Lalande, M. , & Briand, C. (2015). The personal digital assistant: A tool for supporting mental health rehabilitation. Canadian Journal of Occupational Therapy. Revue Canadienne d'ergothe rapie, 82(4), 254. Cotton, R. , Irwin, J. , Wilkins, A. , Young, C. (2014) The future’s digital Mental health and technology. London: Mental health Network, NHS Confederation Dahlen, K. , & Johnson, R. (2010). The humanism is in the details: An insider's account of humanistic modifications to a cognitive‐behavioral treatment program in a maximum‐security prison. The Prison Journal, 90(1), 115‐ 135. doi: 10. 1177/0032885509357722

References Donker, T. , Petrie, K. , Proudfoot, J. , Clarke, J. , Birch, M. & Christensen, H. (2013) Smartphones for Smarter Delivery of Mental Health Programs: A Systematic Review, Journal of Medical Internet Research, 15(11), pp. e 247. Ferrari, A. (2012). Digital competence in practice: An analysis of frameworks (p. 92). Luxembourg: Publications Office of the European Union. doi: 10. 2791/82116 Gallardo‐Echenique, E. E. , Janaina Minelli de Oliveira, Marqu&, L. & Esteve‐ Mon, F. (2015) Digital Competence in the Knowledge Society, Journal of Online Learning and Teaching, 11(1): pp. 1‐ 16

References Hollis, C. , Morriss, R. , Martin, J. , Amani, S. , Cotton, R. , Denis, M. , Lewis, S. (2015) Technological innovations in mental healthcare: harnessing the digital revolution. The British Journal of Psychiatry 206 (4) 263‐ 65; DOI: 10. 1192/bjp. bp. 113. 142612 Hollis, C. , Falconer, C. J. , Martin, J. L. , Whittington, C. , Stockton, S. , Glazebrook, C. & Davies, E. B. (2017; 2016) Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review, Journal of Child Psychology and Psychiatry 58(4): pp. 474‐ 503.

References Mc. Neill, F. , Farrall, S. , Lightowler, S. , Maruna, S. (2012) How and why people stop offending: Discovering desistance. Glasgow: Institute for Research and Innovation in Social Services Mc. Neill, F. , and Weaver, B. (2010) Changing lives? Desistance research and offender management. Glasgow: Scottish Centre for Crime and Justice Research. Naeem, F. , Johal, R. , Mc. Kenna, C. , Rathod, S. , Ayub, M. , Lecomte, T. , Husain, N. , Kingdon, D. & Farooq, S. (2016), "Cognitive Behavior Therapy for psychosis based Guided Self‐help (CBTp‐GSH) delivered by frontline mental health professionals: Results of a feasibility study", Schizophrenia Research, 173(1‐ 2): pp. 69‐ 74.

References ONS (2013), Statistical bulletin: Internet access – households and individuals, 2013. London: Office for National Statistics. Available at www. ons. gov. uk/ons/dcp 171778_322713. pdf