Violent Extremism

A Primer for Mental Health Practitioners

Caroline Logan, Caroline Logan

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000523683
• Edition: 1
• Topic: Psicología
• Subtopic: Psicología forense

This edited book presents international perspectives on the role of mental health problems in understanding and managing the risk of violent extremism.

The chapters included in this book address two themes. First, they describe the research findings on the nature and prevalence of the range of mental health problems (psychosis, personality disorder, post-traumatic stress disorder, anxiety and depression, autism spectrum disorders) in young people and adults who have in the past, committed acts of violence motivated at least in part by extremist ideologies, or who have attempted or threatened such acts, or who for other reasons are thought to be at risk of doing so. Second, the chapters examine what is known about the relationship – or the functional link – between mental health problems and violent extremism. The focus of this book is on clinical practice and understanding the nature of the challenge faced by practitioners and their response to it. It will therefore be of interest to mental health practitioners, service managers and commissioners, and policy makers with a remit to understand and mitigate risk of radicalisation and violent extremism.

The chapters in this book were originally published in The Journal of Forensic Psychiatry & Psychology.

Risk assessment and management in violent extremism: a primer for mental health practitioners

Caroline Logan and Rachel Sellers

ABSTRACT

This paper introduces a special issue of the Journal of Forensic Psychiatry and Psychology dedicated to violent extremism and mental health. We address three challenges faced by mental health practitioners who work with people whose harm potential may be ideologically motived. First, how can practitioners engage in good practice in risk assessment and management when the evidence base for such practice in the violent extremism field is limited? Second, how can a mental health practitioner establish and understand the role of an extremist ideology in a client in their care and differentiate it from motivational drivers that may result in broadly similar kinds of actual, attempted or threatened violence? Third, how can practitioners and their services respond to the risks posed in ways that recognise and balance the needs of both the client and those multiple other agencies dedicated to public protection? Following the examination of these challenges, and a brief comment about the relevance of coronavirus to risk of violent extremism, each paper in the special issue will be introduced and their contribution to the work of practitioners who carry such responsibility summarised. The paper concludes with key points and recommendations linked to the three challenges addressed.

Introduction

Violent extremism is a perplexing phenomenon. The evidence on its presentation in individuals is small (and growing) but fragmented by myriad different perspectives on the evolution of harmful behaviour of this particular kind (Borum, 2015). Also, an act of violent extremism is ultimately a harmful act, and there exists good guidance for understanding and managing a wide range of violence potential (e.g., Eaves et al., 2019; Meloy & Hoffmann, 2014; Otto & Douglas, 2011). However, adjustments are required in order to account for the specific characteristics of violence motivated by an extremist ideology or mindset (Hart et al., 2017). It is still to be established what those characteristics are. Additionally, there remains uncertainty about the extent to which novel guidance may apply not only to the risk of violent extremism but to acts in support of violent extremism, such as facilitating others to plan and carry out a terrorist attack, fundraising for violent extremist organisations, promoting extremist ideologies on- and offline, the passive consumption of proscribed violent extremist material, and so on (Monahan, 2016).

Specialist guidance on risk assessment and management in relation to violent extremism does exist (for recent overviews of the field, see Hart et al., 2017; Herzog-Evans, 2018; Logan & Lloyd, 2019; Scarcella et al., 2016). For example, in England and Wales, the Extremism Risk Guidance-22+ (ERG-22+, Lloyd & Dean, 2015; Webster et al., 2017) supports the work of forensic psychologists in Her Majesty’s Prison and Probation Service (HMPPS) to understand and manage the risk potential of already convicted terrorist offenders. However, the ERG-22+ is not available currently for use outside of HMPPS in this jurisdiction. An alternative is the Terrorist Risk Assessment Protocol-18 (TRAP-18, Meloy, 2018; Meloy & Gill, 2016), which has been developed to assist investigators understand the nature of the terrorist threat posed by an individual. However, its utility for mental health professionals working directly with clients and who require guidance on risk management is unknown. The Multi-Level Guidelines (MLG, Cook et al., 2013) is a robust set of structured professional guidance for understanding violence potential within groups, such as criminal gangs, and has obvious relevance to violent extremists who operate in response to group forces. However, its application to violent extremism has yet to be substantially tested as has its application to individuals who are not part of terrorist groups. There is also the Violent Extremism Risk Assessment-2 Revised (VERA-2 R, Pressman, 2018; Pressman et al., 2016), which is a set of risk assessment guidance used internationally across practitioner and investigative communities. However, the VERA-2 R focuses on the extent to which risk and some protective factors are present and offers no guidance as yet on risk formulation or risk management.

Therefore, whilst there exists guidance to which mental health practitioners may refer to enhance their understanding of the harm potential of someone who threatens violence and claims adherence to an extremist ideology as a motive or justification, the support that guidance can offer is variable and potentially limited at this time. Given the implications of assessments of violence risk for an individual’s liberty, it is important to know the nature of those limitations and the ways in which they may be supplemented or overcome in order to address the particular challenges faced by mental health practitioners (e.g., psychologists, psychiatrists, nurses). Thus, if a mental health service is referred an individual who is both psychotic and a fervent admirer of a violent and extreme right-wing ideology, how are its practitioners to make sense of the relationship between the disorder and the beliefs and to manage interventions and risk accordingly? Also, how might this process of assessing and managing risk differ if the individual has a form of high functioning autism instead of a psychotic disorder? Alternatively, if a practitioner is working with a person with an antisocial personality disorder, a significant history of non-extremist criminality and violence, and a recent conversion to an extremist interpretation of a religious faith, how might this combination of variables impact on the practitioner’s formulation of that person’s risk of both extremist and non-extremist violence? It is our assertion in this paper and this special issue that these challenges may benefit from discussion in order to ensure that existing guidance on the risk assessment and management of violent extremism – and on violence potential more generally – can be applied appropriately and usefully by mental health practitioners to address the clinical situations they encounter.

Thus, this opening paper of this special issue of the Journal of Forensic Psychiatry and Psychology dedicated to violent extremism and mental health addresses three challenges in the field likely to be relevant to practitioners dedicated to supportive and preventative interventions with their clients. First, how might mental health practitioners engage in good practice in risk assessment and management with clients at risk of an act of violence that is motivated at least in part by an extremist ideology? Second, how can a mental health practitioner establish and understand the role of an extremist ideology in a client in their care and differentiate it from motivational drivers that may result in broadly similar kinds of actual, attempted or threatened violence? Third, how can mental health practitioners and their services respond to the risks posed in ways that recognise and balance the needs of both the client and other agencies dedicated to public protection? Following the examination of these challenges (which will be explored in much more detail in Logan, Gill & Borum, in preparation), and a brief postscript about the relevance of coronavirus to our subject, each of the papers in the special issue will be introduced in turn and their contribution to the work of practitioners who carry such immense responsibility briefly summarised. The paper will end with a summary of its main conclusions and a set of recommendations linked to the three challenges it addresses.

Three challenges in violent extremism and mental health practice

Challenge 1: good practice in risk assessment and management in violent extremism

Good practice in risk assessment and management is underpinned by several important principles (e.g., Logan, in press, 25). First, risk assessment is for the purpose of risk management; assessing risk without proposing a range of possible strategies for its mitigation is a recipe for high blood pressure only (Farnham, 2016). Second, risk assessment and management are live and reviewable undertakings; that is, they should both anticipate and respond to changing circumstances, especially the receipt of new information or following direct interventions. Risk assessment and management should never be one-off, static and unchanging (Eaves et al., 2019). Third, the harm potential of an individual at any one time is a reflection of the interplay among a range of risk and protective factors that range across the individual and their context, whose influence upon one another and the context in which they operate should be considered in the round – in the aggregate – rather than separately (Douglas et al., 2013a).

Fourth, risk assessment and management guidance, such as the ERG-22+ and the VERA-2 R, may be viewed as maps that one might use to explore the terrain of a person’s hitherto unknown harm potential. The landscape of violent extremism as a whole is relatively uncharted territory compared to the general violence or sexual violence fields. Therefore, at the present time, there are comparatively few maps available to support risk assessment and management activity in this field compared to others (Hart et al., 2017; Logan & Lloyd, 2019). However, what we have in the guidance available is an important start. The opportunity exists now to develop more guidance and the existing frameworks further in order that we might chart more fully the range of violent acts motivated by an extremist ideology (e.g., from acts of violence through to radicalisation of others and fundraising for extremist causes). In addition, opportunities must be taken to develop guidance to range across different degrees of granularity (e.g., from rapid and relatively superficial risk triage through to in-depth and more comprehensive risk evaluations), depending on the requirements of the undertaking.

Fifth, the structured professional judgement approach to risk assessment and management – most fully operationalised in the general violence field by the Historical, Clinical and Risk Management-20 Violence Risk Guidance 3^rd edition (HCR-20^V3, Douglas et al., 2013b) – is the industry recommended approach in the field of violent extremism risk assessment and management (Borum, 2003; Monahan, 2016). Actuarial approaches, focusing on risk prediction rather than prevention, are extremely limited in their potential to assist and may be misleading (Cooke & Logan, in press, 25). Sixth, those undertaking such evaluations and making risk management recommendations that may impact significantly on the liberty of clients in their care ought to have expertise in both risk assessment and management in general and violent extremism specifically. The quality of the risk formulations and intervention plans produced by specialists in one area but not the other should be subject to quality assurance.

Seven, in the violent extremism field, as in all others, there is a requirement and a duty to ensure evidence-based, transparent, accountable, and defensible practice in understanding and managing risk (Douglas et al., 2013a). Therefore, the explicit use of evidence-based guidance to inform information gathering, problem exploration and explanation, and decision-making about risk management is recommended to support that level of practice. Finally, peer support, clinical supervision, and the informal and formal evaluation of practice are strongly recommended in order to ensure and indeed demonstrate the highest level of clinical care. Given the very broad range of ideologies that can influence harmful behaviour and the many ways that those ideologies can manifest in harmful form, it is not possible for a single practitioner to have expertise in all – but teamwork can ensure a high level of overall competency.

These eight principles apply to the violent extremism field at least as much as they apply to risk assessment and management activity elsewhere. Indeed, they may be more applicable given the nascent state of research, practice, and evaluation in this field and the very particular scrutiny that such evaluations are liable to attract. This is especially so when fears about an individual’s harm potential are realised (e.g., Intelligence and Security Committee of Parliament, 2018).

Concluding comments

Good practice in risk assessment and management in the field of violent extremism should reflect good practice elsewhere in respect of harm prevention. The key requirements are systematic decision-making processes, often embodied in a set of published guidance for practitioners, built on evidence about the harmful behaviour to be prevented, as well as a commitment to evaluation and continuously improved practice.

Challenge 2: establishing an extremist motive

Violence and aggression are always the consequence of a decision made by the actor – its perpetrator – to behave in such a way (Douglas et al., 2013a). That is, violence and aggression are purposeful and intentional, regardless of whether the outcome was the one planned by the actor (e.g., as when the victim died when the actor only meant to assault or threaten that person). Further, the perpetrator chooses violence and aggression from amongst all the options available to him or her because these specific behaviours are thought most likely to bring about the desired outcome and at the speed required. Violence and aggression may be selected in encounters between a perpetrator and one or more victims for a variety of reasons (e.g., Daffern & Howells, 2009; Howells, 2011; Logan, 2017). For example, one person may be harmful towards another in order to protect the perpetrator from the harm the victim intended to do to them until stopped (a self-defence motive). Alternatively, a perpetrator may decide to be violent towards a victim in order to gain something from that person (e.g., their money or possessions, or sexual gratification; a gain or profit motive). Violence and aggression may also be chosen in order to make victims do things they do not want to do, such as to comply with orders or do something different ...

Table of contents

• Cover
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Notes on Contributors
• 1 Risk assessment and management in violent extremism: a primer for mental health practitioners
• 2 Systematic Review of Mental Health Problems and Violent Extremism
• 3 Severe Mental Disorder and Terrorism: When Psychosis, PTSD and Addictions Become a Vulnerability
• 4 Reviewing the links between violent extremism and personality, personality disorders, and psychopathy
• 5 Violent extremism, mental health and substance abuse among adolescents: towards a trauma psychological perspective on violent radicalization and deradicalization
• 6 Autism spectrum disorders and terrorism: how different features of autism can contextualise vulnerability and resilience
• 7 Characteristics of autism spectrum disorder and susceptibility to radicalisation among young people: a qualitative study
• Index