AI Article Synopsis
- The study investigated the effectiveness of long-term schema therapy (ST) compared to traditional treatment (TAU) for violent offenders with personality disorders (PDs) in the Netherlands.
- A total of 103 male offenders with various PDs were followed for three years, with evaluations every six months focused on rehabilitation and PD symptoms.
- Results indicated that ST led to faster improvements in rehabilitation and reductions in PD symptoms compared to TAU, suggesting that long-term psychotherapy can effectively help rehabilitate violent offenders.
Article Abstract
Background: Violent criminal offenders with personality disorders (PD's) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs.
Methods: We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise-specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms.
Results: Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes - rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms - and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: (5308) = 9.40, < 0.001; unsupervised leave, treatment*time: (5472) = 3.45, = 0.004), and showed faster improvements on PD scales (treatment*time: (1387) = -2.85, = 0.005).
Conclusions: These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874993 | PMC |
| http://dx.doi.org/10.1017/S0033291721001161 | DOI Listing |
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