What works in reducing re-offending in individuals with high levels of psychopathy? Jenny Tew.
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Transcript of What works in reducing re-offending in individuals with high levels of psychopathy? Jenny Tew.
What works in reducing re-offending in individuals with high levels of psychopathy?
Jenny Tew
Psychopathy
“far more has been written about the subject than is actually known about it”
(Hemphill and Hart, 2002)
Why does psychopathy
matter? Links to institutional behaviour
(Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells,
2011)
Why does psychopathy
matter?
Links to re-offending
(Rice & Harris, 2013; Yang, Wong & Coid, 2010
Links to institutional behaviour
(Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells,
2011)
Why does psychopathy
matter?
Links to re-offending
(Rice & Harris, 2013; Yang, Wong & Coid, 2010
Links to institutional behaviour
(Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells,
2011)
Links to response to treatment
(D'Silva, Duggan, & McCarthy, 2004; Thornton & Blud, 2007)
“……..psychopathic individuals are not uniquely ‘hopeless’ cases who should be disqualified
from treatment, but instead are general ‘high-risk’ cases who need to be targeted for intensive treatment to maximize public
safety.”
(Skeem, Polaschcek, Patrick & Lilienfeld, 2011)
Psychopathy and RNR
• Risk:Higher levels of psychopathy relate to higher levels of risk.
PCL-R Factor 2 found to be stronger predictor of recidivism than Factor 1.
• Need:Suggested link with higher psychopathy having higher levels of need
Traits can give some information about need
• Responsivity: Higher levels of psychopathy more likely to drop out and gain less benefit
PCL-R Factor 1 found to be more associated with treatment behaviour than Factor 2
Some treatment approaches …..
• Guidelines for a psychopathy treatment programme (Wong & Hare 2009).
• Violence Reduction Programme (Wong & Gordon, 2013)
• High Risk Personality Programme (Wilson & Tamatea, 2013)
• A two component treatment model (Wong, Gordon, Gu, Lewis & Olver, 2012).
• High risk special treatment units (Polascheck & Kilgour, 2013)
• NICE guidelines for treatment of anti-social PD (2010).
Motivation & Engagement
Schema TherapyPhase One:Formulation
Creative ThinkingComponent
Progression andResettlement
Schema TherapyPhases 2 & 3:
Behavioural Experiments/Maintenance
Problem SolvingComponent
Handling ConflictComponent
The Structure of Chromis
Does it work?
Engaging
• Component completion rate of 82% - 98%
• 93% judged to be making some progress by the clinical team.
• Staff reported less resistance, more engagement, more focused on working together in groups sessions and trust staff more over time.
• Over 800 activity hours delivered during 1 week in January.
• A thematic review of art classes found evidence of engagement and gaining benefits that related to desistance.
Gaining benefits from treatment
• HCR-20 reviews show some evidence of reductions in risk.
• Changes in verbal and physical aggression.
• Those who have completed have been considered to progress in some way – further treatment, PIPE, reduced security category.
Principles underpinning the Chromis approach
Personal relevance
Principles underpinning the Chromis approach
Personal relevance
Future focused
Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Transparent & Collaborative
Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Novelty & Stimulation
Transparent & Collaborative
Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Novelty & Stimulation
Transparent & Collaborative
Status & Credibility
Consistent Ideas for treatment
• Treatment targets being criminogenic needs
• Core personality traits considered responsivity issues
• Cognitive behavioural approaches
• Individualised yet structured
• Phases of treatment: developing motivation, learning skills, generalising skills.
• Motivation is important
• Positive and rewarding rather than punitive approaches
• Staff are important
• Problematic behaviour being a target rather than obstacle
• Treatment that considers strengths
• High dose treatment
• Generalisation