Exploring men's qualitative accounts of psychological therapy in forensic hospitals

Background: Compared to women, men are less likely to help-seek or engage with psychological therapies in community settings due to stigma and gender-role conflict. However, engagement with psychological interventions is encouraged in secure services. As such, this review aimed to explore men’s experiences of psychological interventions in secure services.

Method: A systematic search of three databases (Web of Science, PsycInfo and Applied Social Sciences Index and Abstracts) was conducted and 11 papers were included in the review, which represented 104 participants. The quality of papers was appraised using the Critical Appraisal Skills Programme checklist for qualitative studies. The ‘results’ and ‘findings’ sections of papers were analysed and synthesised using Thematic Synthesis.

Results: Participants found it difficult to engage with psychological interventions in secure services due to concerns about confidentiality, coercion and feeling stigmatised due to gender identity or offence histories. Despite these barriers, many men built trusting relationships with their psychologist, valued the peer support from groups and were felt more hopeful about their futures.

Conclusion: Men may require more support when first engaging with psychological interventions. Ideas for facilitating engagement may include exploring men’s relationship to help, offering preparatory work and considering ways to maximise autonomy in restrictive environments.