IIPR Award Voting

FREE is a unique program within an inpatient forensic psychiatric setting that is designed to formally incorporate cognitive skills building and competency restoration following expert recommendations for clinical practice in cognitive remediation (Bowie et al., 2020; Wykes et al., 2024). The program incorporates (a) interventions delivered by trained and active facilitators, (b) repeated and scaffolded practice with direct feedback in the context of a rewarding learning environment (e.g., errorless learning, social praise, token economy), (c) identification and monitoring of cognitive and problem-solving strategies, and (d) transfer of acquired skills to functional goals-in the present case, trial competency. Six (6) patients per group are enrolled in a 12-week manualized program. DSH-Patton serves approximately 80 patients per year; DSH-Metropolitan serves approximately 40 patients per year. To facilitate transfer of learned cognitive skills, FREE places emphasis on directly applying cognitive strategies to learning and understanding the adjudicative process. By incorporating cognitive training, the program aims to increase the effectiveness of trial competency restoration treatment for individuals with severe mental illness also manifesting cognitive challenges.

FREE values:
(1) partnership with group members that communicates authentic commitment to sharing responsibility for group members to reach their treatment goals.
(2) being strength-based by providing frequent opportunities for success with the belief that development of competence instills confidence.
(3) evidenced-based treatment informed by science to effectively deliver material.
(4) empowerment for patients with severe mental illness deemed IST to be able to participate in their legal proceedings with dignity and respect.

The FREE program in its current iteration has been running at DSH-Patton since 2020 and at DSH-Metropolitan since 2024. The effectiveness of the program has been reported in a recent peer-review article (King & Aguilar, 2025) entitled: “Applying Cognition-Focused Interventions to Trial Competency Restoration: A Quasi-Experimental Study of an Integrative Treatment Program.” The study suggested that defendants with cognitive deficits who have been adjudicated IST can benefit from having cognitive training such as FREE integrated into competency restoration treatment.

The Hearnes Acute Rehabilitation Program (HARP) serves individuals who are dually diagnosed with serious mental illness and developmental disabilities and who are in need of psychiatric medication stabilization. This program is operated within the inpatient setting of Hearnes Psychiatric Center at Fulton State Hospital in Fulton, Missouri. There are 15 available beds, with the goal of no more than a 90-day length of stay. HARP considers psychiatric rehabilitation to be the primary goal for treatment, utilizing evidenced-based practices such as Tools of Choice, Dialectical Behavior Therapy, Behavioral Skills Training, Case Management, and Peer Support in order to meet individuals on their recovery journey and build upon their strengths. HARP understands that while dually diagnosed individuals share features, each person has a unique learning history, ability level, cultural background, and method of self-management. It is important to include the individual in setting goals and developing a plan for treatment that supports the mission of the program as well as meets the individual’s wants and needs. To best support each person as they become psychiatrically stable, HARP offers treatment for the whole person including psychiatric medication management, mental health therapies, recreational activities, medical services, and connection with the community members who are involved in their care. These services are offered within their setting to promote engagement and streamline resources. In terms of community involvement, HARP works closely with guardians, family members, support coordination, and providers in order to strengthen continuity of care as well as ensure positive community reintegration upon discharge from HARP. The ultimate goal is for individuals to reach a point of psychiatric stabilization where they can successfully continue on their road to recovery and improve their quality of life once they return to the community. Individuals are empowered to draw upon their strengths to achieve their personal goals. HARP fosters hope through the belief that all individuals have the capacity to succeed.

The Oasis Room embodies the core principles of psychiatric rehabilitation-recovery, empowerment, and holistic wellness-by creating a healing environment that honors autonomy, choice, and human dignity. Grounded in evidence-based sensory modulation and occupational therapy, this multi-sensory program allows over 100 individuals to take an active role in their own care, nurturing the hope and self-determination essential to recovery. Participants enter the Oasis Room to set a personal intention and select sensory tools that align with their current emotional or physical state. Whether choosing calming LED lights, weighted blankets, rhythmic movement, or guided meditation sounds, individuals learn to identify and regulate their sensory and emotional needs-key self-management skills for recovery and community reintegration. This process transforms treatment from something done to patients into something done with and through them, reflecting a true person-centered, strengths-based model. The program draws from extensive research demonstrating that sensory environments reduce agitation, enhance self-regulation, and promote emotional stabilization (Champagne, 2006; Scanlan & Novak, 2015). Integrating these findings into a forensic psychiatric context represents a unique and innovative approach-bridging clinical rehabilitation and human experience. The Oasis Room’s dual use by both patients and staff reinforces shared humanity and co-regulation, promoting mutual respect and modeling healthy self-care. This aligns with psychiatric rehabilitation’s guiding principle of holistic wellness-attending to emotional, physical, social, and spiritual dimensions of recovery. Transition to community life is supported through education and individualized sensory profiles, empowering participants to carry learned strategies beyond the hospital. They develop self-awareness, coping tools, and confidence to navigate life’s challenges, embodying the ultimate goal of psychiatric rehabilitation: to live, learn, and contribute meaningfully within the community with renewed independence, dignity, and hope.