In the past 10 years, there has been an impressive proliferation of information regarding the prediction of violence risk. Much of the information is devoted to describing the empirical basis of risk prediction and the various instruments available for the assessment of risk. Yet, there has been little discussion of how risk assessments can inform the therapeutic process. This article describes the application of risk assessment to clinical practice in a maximum-security forensic hospital. A brief discussion of the forensic systems issues is also included.
Two studies were conducted to investigate the possibility of individual differences in the ability of inpatients to process interactions in group psychotherapy. The first was a pilot study conducted on groups of major depressive patients and matched normal subjects. Subjects were asked to give process comments after viewing simulations of typical group therapy interactions. These comments were later rated on the extent to which they reflected process qualities and accuracy. These data led to a more rigorous and extensive study that included more appropriate control groups as well as measures of potential confounding factors, such as simulation realism, verbal ability, and interaction comprehension. Results indicated that major depressives suffer from deficits in the ability to process group interactions, relative to three types of control groups, including normals. These differences in processing were not significantly positively correlated with any of the potential confounding factors. The implications for understanding interactional processing and group psychotherapy are discussed.
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