Practice‐based outcomes of dialectical behaviour therapy (DBT) targeting anger and violence, with male forensic patients: a pragmatic and non‐contemporaneous comparison

Abstract

The results suggest a potential for DBT to impact positively and lastingly on violent behaviour and components of anger in male forensic patients when compared with standard treatment. The power of the current study to detect group differences was reduced by small ns, large confidence intervals, and a non-contemporaneous comparison group. Cost-effective strategies are proposed to take forward research on DBT with this population.

A Critical Analysis of Clinical Evidence from High Secure Forensic Inpatient Services

“…Preliminary evidence for psychoeducation for those with mental illness (including schizophrenia) indicates improvements in insight and therapy engagement, emphasizing the interaction effects of interventions in the high secure setting (Aho-Mustonen et al, 2008). 'Third wave' cognitive-behavioural therapies offer promising evidence of risk reduction for detainees with a history of serious interpersonal violence (Evershed et al, 2003;Tarrier et al, 2010). However, complications with determining quantifiable benefits over TAU, which represents nested interventions within which there are problems of disentangling multiple interacting therapeutic ingredients, limit confidence in comparison (Tarrier et al, 2010).…”

“…A study of Dialectical Behaviour Therapy (n = 8) was compared with TAU (n = 9) in a high security setting (Evershed et al, 2003) and significant changes in self-reported aggression and observed institutional behaviours were observed both mid and post intervention. Most marked changes occurred in violent behaviours (SMD = 1.39) and violence seriousness (SMD = 3.29) post group (18 months).…”

Non-pharmacological interventions for reducing aggression and violence in serious mental illness: A systematic review and narrative synthesis

“…A small sample of eight male HSU patients partook in an unblinded, non-randomised, controlled study [39]. Half had committed sexually violent index offences.…”

Treatment of personality disorder: skills-based therapies

“…Various adaptations have been made to DBT to treat different patient populations: adolescents, in patients, British and Dutch patients, women with substance dependency, women veterans, male and female forensic patients and women with eating disorders (Barley 1993;Springer 1996;Miller 1997;Linehan 1999;Swales 2000;Koons 2001;Low 2001;Telch 2001;Evershed 2003;Verheul 2003). Generally, results have been encouraging and support the value of DBT in treating patients with borderline personality disorder.…”