Safety in numbers: group therapy-based index offence work in secure psychiatric care

In this paper, I discuss the provision of dynamically based index offence group work for forensic patients who are detained in long-stay residential secure care. I discuss the benefits of reflective, attachment theory-based therapies as complementary to the other models of therapy that are offered to forensic patients. In particular, I discuss the relevance of this type of psychotherapy to index offence work, using the example of a reflective recovery-based therapy group for forensic patients who have killed. I discuss the relevance of identity and agency change in the narratives of group members, illustrating with quotes from the group. I conclude with comment about resistance to such work, and the impact on therapists of working with the trauma of homicide perpetration.