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What works in reducing re-offending in individuals with high levels of psychopathy?
Jenny Tew
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Psychopathy
“far more has been written about the subject than is actually known about it”
(Hemphill and Hart, 2002)
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Why does psychopathy
matter? Links to institutional behaviour
(Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells,
2011)
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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)
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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)
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“……..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)
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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
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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).
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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
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Does it work?
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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.
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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.
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Principles underpinning the Chromis approach
Personal relevance
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Principles underpinning the Chromis approach
Personal relevance
Future focused
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Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
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Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Transparent & Collaborative
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Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Novelty & Stimulation
Transparent & Collaborative
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Principles underpinning the Chromis approach
Personal relevance
Control & Choice
Future focused
Novelty & Stimulation
Transparent & Collaborative
Status & Credibility
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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
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