Treating criminal psychopaths in a therapeutic community program

Abstract

A Therapeutic Community (TC) treatment program for adult male offenders is summarized and treatment outcome data are discussed. Psychopaths showed less clinical improvement, displayed lower levels of motivation and were discharged from the program earlier than nonpsychopaths. There were significant positive treatment effects for the non-psychopaths and a mixed group. Psychopathy Checklist scores (Hare, 1985) consistently postdict and predict treatment outcome and attrition from the program.9Criminal psychopaths commit 3.5 times more violent crimes than do non-psychopaths (Hare & McPherson, 1984). Once incarcerated psychopaths also display more violent and aggressive behaviors (Hare & McPherson, 1984; Wong, 1984) and are frequently segregated or referred for treatment (McCord, 1982). They are also more likely to violate conditional releases (Hart, Kropp, & Hare, 1988; Wong, 1984). In many clinical and legal circles, psychopaths are generally seen as untreatable, although the issue is far from settled (Suedfelt & Landon, 1978;Wong, Elek, & Ogloff, 1988). Despite their notorious criminal histories and high recidivism rates, they are just as likely as the non-psychopaths to secure conditional releases (Wong, 1984). Criminal psychopaths, therefore, present significant clinical, legal and administrative concerns that must be addressed by those working within the criminal justice system. This article describes a treatment outcome study of a Therapeutic Community (TC) treatment program designed to treat personality disordered individuals, many of whom are psychopaths. Cleckley (1976) (Hare, 1980b andSchroeder, Schroeder, &Hare, 1983;Raine, 1985; Wong, 1984 and. Hare (1 983) showed a strong agreement between DSM-I11 diagnosis of subjects with Antisocial Personality Disorder (301.7) and psychopaths identified using the PCL ratings (Hare, 1980b). However, as the DSM-111 and the recent revision, the DSM-111-R, both focus almost exclusively on antisocial behaviors, they may not readily identify individuals who may fit the personality characteristics of psychopathy, but who, for one reason or another, manage to avoid early or frequent contact with the judicial system (Hare, 1983). For the present study, the PCL ratings were used for subject selection. THE ASSESSMENT OF PSYCHOPATHY The Therapeutic Community (TC)The T C concept was developed by Jones (1963 and1982) who stressed that one approach to rehabilitate inmates is to provide them with an environment in which they can learn to take responsibility for their behaviors. To this end, positive peer group influences are mobilized, in addition to therapeutic inputs from staff to bring about behavioral changes (see also Vorrath and Brendtro, 1974). The central method of intervention in the T C program is the daily group meeting which includes all patients and staff. This 'large group' functions both as a forum for therapy, as well as a setting for developing unit rules. Personal and other living problems that the inmates have been experiencing are encouraged to be brought up ...

Social Competence as a Mediating Factor in Reduction of Behavioral Problems

“…This seems to be prominent in pupils with instrumental aggression and is also associated with bullies (Brown, Atkins, Osborne, & Milnamow, 1996). It has been suggested that this group will not benefit from training in social competence, or that training will make them even more devious in manipulating others (Ogloff, Wong, & Greenwood, 1990;Rice, Harris, & Cormier, 1992). Our results, indicating a reduction of behavior problems also for those with a high score on social competence and a high score on behavior problems at the outset, might indicate that the inclusion of moral reasoning training in the ART program is especially important for this group (see also (DeRosier, 2004).…”

The dynamic prediction of criminal recidivism: A three-wave prospective study.

“…However, whether or not enduring personality traits such as psychopathy can be modified through appropriate intewention remains to be conclusively determined. Moreover, some theorÏstç (e.g., Harris, Skilling, & Rice, in press;Mealey, 1995) remain skeptical because emerging empirical evidence continues to generate discouraging results (e.g., Ogloff, Wong, & Greenwood, 1990;Rice, Harris, & Cormier, 1992; Barbaree, 1 999).…”

Risk Assessment Instruments in Repeat Offending

“…Also, most such states demand an expert assessment of treatment progress before releasing sex and violent offenders into society. Ideally, instruments used for monitoring offender treatment would provide information on the indicated goals of a treatment, the required level of security, recommendations for early release (Kroner & Mills, 2001), and information about the therapeutic progress in offenseoriented treatment plans (Ogloff, Wong, & Greenwood, 1990;Seto & Barbaree, 1999). Furthermore, it would seem practical if risk assessment instruments would also include items that assess therapeutically relevant factors, such as openness, awareness of one's own risk factors, and (emotional) authenticity.…”