[The Integrated Psychological Treatment in correctional and forensic psychiatric settings: More than a decade of implementation and adaptation].

Introduction Implementing evidence-based psychosocial interventions is a challenge for most organizations providing mental health care. For correctional and forensic psychiatric settings, specific issues complicate implementation efforts. To ensure the viability of evidence-based practices, it is important that they are in line with the reality of the organization. An adaptation phase is often required following the initial implementation. However, this process remains poorly documented. This project focuses on the implementation in secure settings of a cognitive-behavioural group approach for people with schizophrenia, the Integrated Psychological Treatment (IPT). The aim is to document the process of adaptation and modification of IPT that has occurred in correctional and forensic psychiatric settings since the 2010s. Method A multiple-case study was conducted with correctional and forensic psychiatric settings delivering IPT. Three cases from 2 Canadian provinces were identified: 1 maximum-security forensic psychiatric hospital, 1 regional care centre providing forensic psychiatric services, and 1 federal correctional facility. In each case, the healthcare professionals who facilitate the IPT were interviewed. Interviews were recorded and analyzed using analytical questioning. Results Adaptations to IPT were found in all the cases studied. These adaptations concerned 3 main aspects: the content of the approach, the way in which the approach was delivered, and the training of clinicians. The main adaptations to the content of the approach included the addition of exercises focusing on cognition, the integration of virtual reality as an intervention modality, the removal of certain modules and the abandonment of integration outings. In terms of how the approach was delivered, there was a reduction in the length of sessions, an increase in the number of weekly sessions and the introduction of semi-open groups. As for the training of clinicians, 1 case chose to develop its own intervention manual following the adaptations made to the IPT. Discussion This project shows that the implementation of IPT in correctional and forensic psychiatric settings can be sustainable. Nevertheless, a number of adaptations are made to bring the requirements of the approach into line with the reality of secure settings. Some of these adaptations remain consistent with the approach and should be considered by correctional and forensic psychiatric settings who are planning to implement the approach, or who are already using it with their clients.