Assessment and treatment of violence-prone forensic clients: an integrated approach.
BACKGROUND
A risk-reduction treatment programme complemented by a focused assessment, both guided by the risk-need-responsivity principles, is suggested as the preferred treatment for violence-prone individuals with personality disorder.


OBJECTIVE
Violence Reduction Programme (VRP) and Violence Risk Scale (VRS) were used to illustrate the design and implementation of such an approach. Participants from a similarly designed Aggressive Behaviour Control Programme were used to illustrate the principles discussed and to test programme efficacy.


METHODS
The VRS was used to assess risk/need and treatment readiness, and DSM-III/IV psychiatric diagnoses of 203 federal offenders.


RESULTS
Participants had a high probability of violent recidivism and many violence-linked criminogenic needs, similar to offenders with high PCL-R scores. Most had antisocial personality disorder and substance use disorders; in terms of treatment-readiness, most were in the contemplation stage of change. Outcome evaluation results support the objectives of the VRP.


CONCLUSIONS
Integrating risk-need-responsivity principles in assessment and treatment can provide useful guidelines for intervention with violence-prone forensic clients with personality disorder.
Wong
Stephen C P
SC
Regional Psychiatric Centre, University of Saskatchewan, Box 9243, Saskatoon, Saskatchewan, S7K 3X5, Canada. s.wong@sasktel.net
Gordon
Audrey
A
Gu
Deqiang
D
D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003415:Crime; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011329:Prisoners / Q000523:psychology*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014754:Violence