Activating lone parents: an evidence-based policy appraisal of welfare-to-work reform in Britain

The 2008 welfare reform introduced by the previous Labour government requires (most) lone parents with older children to be available for work. This article examines the potential effect of this reform on the employment rate of lone parents and whether the age of the youngest child is a good indicator of ‘ability to work’. The reform will not lead to the desired increase as the target group is too small and the levels of multiple disadvantages within the group too high. ‘Ability to work’ needs to be conceptualised more broadly if it is to mean ‘ability to get a job’

Prospective observational cohort study of ‘treatment as usual’ over four years for patients with schizophrenia in a national forensic hospital

Abstract Background We evaluated change in response to multi-modal psychosocial ‘treatment as usual’ programs offered within a forensic hospital. Methods Sixty nine patients with a diagnosis of schizophrenia or schizoaffective disorder were followed for up to four years. Patient progress was evaluated using the DUNDRUM-3, a measure of patient ability to participate and benefit from multi-modal psychosocial programs and the HCR-20 dynamic items, a measure of violence proneness. We report reliable change index (RCI) and reliable and clinically meaningful change (RMC). We assessed patients’ cognition using the MCCB, psychopathology using the PANSS. The effect of cognition and psychopathology on change in DUNDRUM-3 was examined using hierarchical multiple regression with age, gender, and baseline DUNDRUM-3 scores. Results The DUNDRUM-3 changed significantly (p < 0.004, d = 0.367, RCI 32% of 69 cases, RMC 23%) and HCR-20-C (p < 0.003, d = 0.377, RCI 10%). Both cognition and psychopathology accounted for significant variance in DUNDRUM-3 at follow up. Those hospitalized for less than five years at baseline changed more than longer stay patients. Mediation analysis demonstrated that the relationship between cognition and change in violence proneness (HCR-20-C) was both directly affected and indirectly mediated by change in DUNDRUM-3. Conclusions Change in response to multi-modal psychosocial programs (DUNDRUM-3) reduced a measure of violence proneness over four years. Forensic in-patients’ ability to benefit from psychosocial treatment appears to be a function of the outcome measure used, unit of measurement employed, degree of cognitive impairment, psychopathology, and length of stay. Lower risk of re-offending may be partially attributable to participation and engagement in psychosocial interventions