title: Fatal torment--from psychosis-driven index offence to trauma: a case study in forensic psychotherapy, trauma therapy and matricide.
abstract: OBJECTIVE
  This paper presents the case of a forensic inpatient who was found 'Not Guilty by Reason of Mental Illness' for the murder of his mother and illustrates how psychotic symptoms can mask trauma symptoms, leading to neglect in the treatment of trauma in psychotherapy with forensic inpatients.
  
  
  METHODS
  A case study of a forensic inpatient diagnosed with schizophrenia that as part of his rehabilitation program received 19 sessions of therapy (i.e. grief counselling, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and imagery rescripting). The following measures were administered pre- and post-treatment: (a) The Depression Anxiety Stress Scale (DASS), to measure symptoms of depression, anxiety and stress; (b) The Impact of Events Scale-Revised (IES-R), to measure post-traumatic stress symptoms; and (c) The Trauma Attachment and Beliefs Scale (TABS), to measure disruption in beliefs about self and others.
  
  
  RESULTS
  At completion of therapy, he showed a reduction in Post-Traumatic Stress Disorder (PTSD), depression, anxiety and stress symptoms.
  
  
  CONCLUSIONS
  Trauma and PTSD-related symptoms in the forensic inpatient population must be assessed and treated alongside psychotic symptoms, where relevant. TF-CBT was effective in reducing PTSD symptoms in this current case study and should be considered as an intervention in forensic inpatient populations.
authors.affiliation: Provisionally Registered Psychologist, Sydney Local Health District, Concord Centre for Mental Health, Concord, NSWCentre For Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, NSW, Australia info@rkcounselling.com.au.
authors.forename: Rony
authors.initials: R
authors.lastname: Kayrouz
authors.affiliation: Principal Psychologist, Director of Psychology for Sydney Local Health District (SLHD), Professional Senior Psychology SLHD Mental Health Service, Head of Department Psychology, Concord Centre for Mental Health, Sydney, NSWDoctoral Candidate, School of Business and Management, University of Tasmania, Hobart, TAS, Australia.
authors.forename: Lila Petar
authors.initials: LP
authors.lastname: Vrklevski
mesh_terms: D001007:Anxiety / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D057237:Criminals / Q000523:psychology; D003863:Depression / Q000150:complications / Q000628:therapy*; D006708:Homicide / Q000523:psychology*; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*
keywords: cognitive behavioural therapy; forensic inpatients; matricide; post-traumatic stress disorder; psychosis; schizophrenia; trauma; trauma therapy