The Efficacy of a Compassion-Focused Therapy–Based Intervention in Reducing Psychopathic Traits and Disruptive Behavior: A Clinical Case Study With a Juvenile Detainee

Abstract

Conduct disorder (CD) is the most diagnosed psychopathological disorder in juvenile detainees. The presence of a CD diagnosis, especially when associated with psychopathic traits, contributes to a poor prognosis, high recidivism rates, and low responsivity to treatment in these youth. Although group intervention programs have proven to be effective in decreasing antisocial behavior, studies testing their efficacy in reducing psychopathic traits are scarce and limited. Moreover, there is a lack of research focused on the efficacy of individual treatment approaches specifically designed to reduce psychopathic traits and disruptive behavior in juvenile detainees. Compassion-focused therapy (CFT) shows promising results in the treatment of several psychopathological disorders. Besides, there is some theoretical support to consider CFT a suitable approach to treating juvenile detainees. However, there are no treatment programs based on CFT that are designed to target psychopathic traits and disruptive behavior in these youth. Consequently, treatment outcome research in this area is absent. This clinical case study presents the treatment of a juvenile detainee with CD, a high psychopathic profile, and a very high risk for criminal recidivism using the PSYCHOPATHY.COMP program (a 20-session individual CFT program), which was specially designed to reduce psychopathic traits and disruptive behavior. The treatment outcome data revealed a significant reduction in psychopathic traits and disruptive behavior. The treatment gains were maintained and/or increased over time (3 months after program completion). This clinical case study demonstrates the feasibility and efficacy of the PSYCHOPATHY.COMP program in reducing psychopathic traits and disruptive behavior in a juvenile detainee.

Clinical change in psychopathic traits after the PSYCHOPATHY.COMP program: preliminary findings of a controlled trial with male detained youth

“…These findings support the idea that the absence of tailored interventions targeting psychopathic traits may account for an important deterioration in the levels of psychopathic traits in detained youth, which may increase the odds of these youth to display disruptive and antisocial behavior after release (Edens et al 2007;Gretton et al 2004;Hecht et al 208;Leistico et al 2008;Ribeiro da Silva et al 2019b). Taking into account previous research, showing that it is the combination of all psychopathic traits that is particularly relevant for the display of disruptive and antisocial behaviors and, consequently, for criminal recidivism in detained youth (Edens et al 2007;Leistico et al 2008;Ribeiro da Silva et al 2019b), it seems crucial to deliver tailored intervention programs to these youth that are able to reduce psychopathic traits (Ribeiro da Silva et al 2019a).…”

“…These findings suggest that the PSYCHOPATHY.COMP program may be able to provide substantial improvements on GM traits, compared to TAU. As GM traits are regarded in the literature as an important roadblock in the efficacy of intervention efforts (because they are linked to manipulation, deceitfulness, dishonesty, and lying; Harris and Rice 2006;Salekin 2016Salekin , 2017, it seems essential that therapeutic efforts take into account and accurately address this set of traits (Ribeiro da Silva et al 2019a;Salekin 2017).…”

Are shame and self‐criticism the path to the pervasive effect of social stress reactivity on social functioning in psychosis?

“…In spite of the cross-sectional and noninterventional design of the present study, our results seem to indicate the potential benefit of clinical interventions aiming at reducing the negative influence of shame. In fact, compassion-based approaches, specially developed for people with chronic, complex, and severe conditions associated with high levels of shame and self-criticism (Gilbert & Irons, 2005), have been emerging with promising results on social outcomes in several populations (e.g., Gilbert & Procter, 2006;Ribeiro da Silva, Rijo, Castilho, & Gilbert, 2019), including people with psychosis (Braehler et al, 2013;Laithwaite et al, 2009).…”

Creating a Compassionate World: Addressing the Conflicts Between Sharing and Caring Versus Controlling and Holding Evolved Strategies

“…Can these individuals be turned to change these fundamental evolved strategies that are running their show? It is unclear, but there are glimmers that compassion training, which involves specific techniques to stimulate care-focused social mentalities, by helping people process some of the neglect and harshness they themselves experienced, is proving an exciting potential intervention for forensic youth (e.g., Ribeiro da Silva et al, 2019 , 2020 ). Shirtcliff et al (2009) show that individuals who are callous are not emotionally in tune or physiologically responsive with their own emotional pain.…”