Treating psychopathic offenders: treatment, non completion and effectiveness

Johnson, D., 2019. Treating psychopathic offenders: treatment, non completion and effectiveness. DPsych, Nottingham Trent University.

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Abstract

This thesis aimed to enhance clinical understanding of treatment for psychopathic offenders by examining existing empirical evidence on treatment non-completion for this high-risk group of offenders and evaluating the effectiveness of the Chromis programme. Chapter 1 of this thesis established context by providing a review of relevant literature on the conceptualisation and assessment of psychopathy in clinical practice, with a particular focus on the PCL-R and a critical review of empirical literature on treatment for psychopathic offenders. Chapter 2 presents a systematic review with an overarching aim of synthesising empirical research on treatment non-completion among psychopathic offenders. Seven of the thirteen included studies explicitly reported attrition rates, providing a median non-completion rate for psychopathic offenders of 46%. Whilst synthesised empirical evidence suggested an association between psychopathy as measured by the PCL-R and treatment non-completion, variable findings between the PCL-R construct (facets) and treatment non-completion raises doubt over the reliability of the observed psychopathy (PCL-R total score) and treatment non-completion association. Furthermore, scant evidence established that the predictive relevance of psychopathy and treatment non-completion to recidivism was inconclusive. The systematic review makes a unique contribution to the clinical understanding of treatment attrition among psychopathic offenders and provides needed insight into empirical ambiguities and pertinent clinical issues. In order to further existing research, Chapter 3 examined the treatment responsivity of psychopathic offenders, by examining the effectiveness of a violence treatment programme (Chromis), implemented within a high-security personality disorder treatment service. A high attrition rate (44%) was evident within the availability sample of 120 offenders who had engaged in treatment, with PCL-R total (and factor) scores for this sample not being significantly associated with treatment non-completion. Group- and individual-level analysis of self-reported measures showed treatment gains across the evaluated outcomes; however, this was not moderated by psychopathy level (moderate or high). The findings add to the research around the treatability of psychopathic offenders. Contrary to clinical lore, certain aspects of treatment can deliver a positive outcome with respect to risk-related treatment need areas for psychopathic offenders. Finally, an overall discussion of the work is presented (Chapter 4), drawing together the main findings and implications for future research and practice.

Item Type: Thesis
Creators: Johnson, D.
Date: January 2019
Divisions: Schools > School of Social Sciences
Depositing User: Linda Sullivan
Date Added: 18 Jul 2019 11:25
Last Modified: 18 Jul 2019 11:25
URI: http://irep.ntu.ac.uk/id/eprint/37112

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