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Legal, criminological and forensic

‘There was no standardised treatment for people who set deliberate fires'

Professor Theresa Gannon (University of Kent) on her journey to impact. As told to our journalist Ella Rhodes.

09 November 2017

I got into psychology through chance really. I applied to university for English, teacher training, law, and psychology because that's what all my A-levels were in and I couldn't choose which to do. When I went to Birmingham University it looked amazing and, I just thought, 'Yeah, okay, I'll do psychology.' That was when things really kicked off for me.

In my third year I had a lecture on paedophilia and cognitive distortions. I'd never ever thought about amalgamating psychology with forensic issues. I'd never thought about how you could use psychology to understand or rehabilitate people who had offended sexually, and that was it for me.

I've always liked things that were a bit off the beaten track and not the norm – it's quite surprising for some people but I just find it fascinating. I applied to do a PhD at the University of Sussex on the cognitive distortions of people who have molested children. My first experience of research wasn't very positive because unfortunately my supervisor left due to health reasons and I didn't get allocated a forensic supervisor. I was really left to do my own thing and ended up going round prisons without any supervision or anyone to guide me, so I had to navigate the process myself.

It was a very difficult experience – I remember my first interview with someone who had sexually offended against children and really not knowing how to deal with some of the things that he was saying. I just didn't have someone to say, 'Watch out for this, make sure you do this, or when you're working with forensic populations you should think about this', so I was really in the dark. In prisons nothing's controlled, everything's loud, and prisoners ask all sorts of questions that back then I didn't feel equipped to deal with.

I ended up applying for a postdoc in New Zealand before I finished my PhD in the area of sexual offending. I moved out there and finished my PhD and was fortunate enough to work with Tony Ward, who is a leading academic in sexual offending. He was a fantastic mentor, and he taught me a lot about creating something new when you see an opportunity. He's a creative person and has developed a lot of theories in sexual offending. I learned a lot under his mentorship. I worked with him for a few years, then came back to the UK with quite a lot of newfound confidence about how to look for gaps in the literature and how to create something new. I also had a lot of knowledge about sexual offending more broadly.

After beginning work at the University of Kent, I gained my practitioner status so began working with forensic populations conducting risk assessments and treatment within sexual offending. I went to see a man in the hospital where I was working and was asked to do an assessment on his sexual offending. It was a really straightforward case; I gave him a treatment plan, and then I went and looked at his case in more detail. I walked away quite troubled because he had a lot of arson in his history. When I looked more closely I realised no one had treated him for any of the arson. So I decided to have a look at the reoffending rates of people who commit arson and looked at whether there were any treatment programmes for it. I'm using the legal term arson here, but typically people in my field use the term deliberate firesetting.

When I looked at it, the reoffending rates for someone who commits arson were the same as those for sexual offenders—around 16 per cent—but there was no standardised treatment for people who set deliberate fires. So I came away from that situation thinking something should really be done on this. I conducted a review on the literature looking at the characteristics of people who have set deliberate fires. I went away and published the review and thought I should write a grant to really look at the characteristics of these people. I wrote a funding bid for the ESRC to look into whether we could distinguish these people from other types of offender, and whether or not they needed specialist treatment. I got the funding and went to the National Offender Management Service to ask if I could go into prisons and do this. They were really supportive.

I conducted my first study with colleagues looking at men in prison who have set a fire vs. men in prison who have never set a fire, matching them on certain characteristics to make sure they were comparable. It was all based on self-report questionnaire measures. We found people who had set a fire had specific psychological characteristics, which were – having an interest in serious fires like house fires and big hotels, identifying more with fire and seeing it as part of their personality, normalising firesetting, and having much lower levels of fire safety awareness skills and self-esteem. We also found that men who had set fires had higher levels of anger rumination and provocation to perceived wrongs.

On the basis of those findings we set about developing a theory of deliberate firesetting for adults. At that time there were only two theories on firesetting, one was looking at adolescents another looked at adults but was based only on the literature for males and didn't really look at mental health problems. It also assumed everyone who sets a fire has to have a fire interest, but we knew clinically that wasn't the case. Sometimes you'll get someone who comes into hospital or prison, they've misused fire but they're not particularly interested in it, they're just interested in it as a tool.

With colleagues we looked at all the literature on firesetting with some of the early results of the research and developed a new comprehensive theory of firesetting based on the male and female firesetting literatures. We used all the strengths of the previous theories, and all the contemporary research evidence and clinical evidence and produced the M-TTAF (Multi-Trajectory Theory of Adult Firesetting). Based on that, and a few other studies, I then developed a standardised treatment programme for firesetters. I wanted to test whether it could be effective in reducing those factors that we found to be related to firesetting.

I set about developing the treatment programme, I developed one with my colleague Lona Lockerbie in the hospital setting and one by myself in the prison setting; they're essentially sister programmes. We piloted them in the mental health and prison setting pretty much alongside each other. The ESRC funded the prison evaluation, and we transferred prisoners who had set deliberate fires into HMP Swaleside and HMP Elmley, gave them this programme, which was added as part of their sentence plan, and compared these men to firesetters in other parts of the country where the treatment wasn't available. We gave them questionnaires at the start and end of the programme then three to four months after. What we were looking at was fire interest variables, fire factors, anger, self-esteem, relationship issues or communication problems – those things the literature told us were going to be important for people who set fires. We found the deliberate firesetters, who went through our programme, showed significant decreases on their interest in serious fires and identification with fire as well as an increase in perceived fire-safety awareness. They also showed significant improvements on their anger regulation and their offence-supportive attitudes compared with people who never went through the programme. Those improvements were stable three to four months after the programme.

Before this treatment there were in-house programmes for people who set fires but no standardised treatment. The programme is CBT-based and semi-structured with some psychotherapeutic elements. The participants meet as a group along with a lead psychology practitioner with one or two assistants who might be multidisciplinary. We look at trying to alter the cognitions that have led to a firesetting offence and try to develop new patterns of behaviour. We look through things like relationships, social skills, healthy thinking, fire interest and safety, how to cope with an urge to fire set, and how to decrease the association between setting a fire and pleasure.

We also bring in fire safety officers, who talk about fire safety awareness. Most importantly, perhaps, we seek to change some of those key patterns of thinking that have developed over the years by getting individuals to test out their beliefs in a supportive setting. So, for example, I might be dealing with a person who has set a fire who now strongly believes they can control any fires they set. I might have a fire safety officer say they can't, but the person might not believe that. So we get the person who has offended with fire to make predictions. We might show a video of a front room fire and get them to predict how long it will take for the fire safety officers on the film to extinguish the fire. They might say two minutes. Then we get them to watch the film after making those predictions and see that it actually took eight minutes. We also look at coping skills, because often poor coping occurs in the lead-up to firesetting – it's a way of coping for many. And, we look at all these things and how they were playing out in the lead-up to the firesetting and get treatment recipients to develop a firesetting management plan that outlines how their firesetting came about.

At the start of the pilot many of the participants were reluctant to do it, but we found when they finished the programme they were sending us letters about how positive it had been for them, and even people within the prison were asking if we were bringing it back. We have now trained around 400 people in the UK to provide the new treatment and it's been run in many, many forensic hospitals around the country now. We've also started training professionals in Australia, America, Canada, Belgium and Portugal, so they can provide this new treatment for people in their countries. That's what led us to get the ESRC Impact in Society Award in 2016 and we made a film about the development of the programme and our work on firesetting. Often when you make this type of film with offending populations no one wants their face shown on film. But actually, one of our clients who'd gone through the treatment programme was so positive about it he said he'd be shown on film and wanted to talk about it. So his testimony is there on film about how he found the programme.

I've always liked psychology and I've always liked research. I like to see research having an impact in some way on people's lives, and I think in clinical-forensic psychology you can often get that from being a practitioner, but it's a little bit more rare to see research in action having an impact. It's great, I felt there was a need there and the feedback I've had affirms there was.  

I hope other people will go off and look at this population, there's many more things to be done for them, and you need lots of people with different skills. I was really fortunate to have a fantastic team around me or none of this would've happened. So often those teams get talked about just as 'the team'. From the NHS and prison side there were so many people involved in this. Without them the firesetting project wouldn't have got off the ground.

On the NHS side, people who had a really important impact on making it work were Dr Lona Lockerbie and Dr Nichola Tyler. On the prison side of things important team members were Dr Caoilte Ó Ciardha, Dr Emma Alleyne, Dr Magali Barnoux, Helen Butler, Tamsin Lovell, Aparna Kapoor, Tracey Tosevin, Harriet Danby, Katarina Mozova and Elizabeth Spruin.

We're still training people on the treatment programme, and my colleague Nichola Tyler and I have been training everyone, but the demand has become more than we can offer. So we're trying to look at ways of developing our training so more people can get trained efficiently. We've also begun using a different strand of research looking at undetected firesetters and training the fire service on what we've learned about these people. Things keep bringing me back to the topic of firesetting; one of the things I'm thinking about now is developing a risk assessment alongside the treatment package.

- Professor Gannon's work features on the British Psychological Society's Impact Portal.