A systematic review of group work interventions in UK high secure hospitals

Background: Rehabilitating high secure hospital patients poses significant challenges. Group work is thought to play a key role in patient recovery; however, there have been no reviews conducted specifically assessing group work interventions for high secure hospital patients.

Objectives: To review the focus of group work interventions that are being implemented and evaluated with high secure hospital patients in the UK, and to examine the effectiveness of these interventions and the methods used to assess intervention effectiveness.

Method: A systematic literature search combined with reference screening was conducted examining group work interventions with high secure hospital patients in the UK.

Results: In total, 28 manuscripts (outlining 29 group work intervention evaluations) were identified for review inclusion. Across these, ten focuses of group work intervention emerged: anger/aggression, offence-specific, enhancing insight and understanding of mental illness, thinking skills/problem solving, substance misuse, self-harm, relationships, self-esteem and well-being, relapse prevention, and moving on. Positive outcomes were generally reported across all ten areas.

Conclusions: Studies assessing the impact of group work interventions could be improved by increasing sample sizes, reducing sole reliance on self-report measures, employing clear statistical and clinical significance testing, and increasing the use of follow-up assessments and control groups.