What works in reducing re-offending in
individuals with high levels of psychopathy?
Jenny Tew
Psychopathy
“far more has been written about the subject
than is actually known about it”
(Hemphill and Hart, 2002)
Why does
psychopathy
matter?
Links to institutional
behaviour
(Dolan & Davies, 2005; Langton,
Hogue, Daffern, Mannion, & Howells,
2011)
Links to reoffending
(Rice & Harris, 2013; Yang,
Wong & Coid, 2010
Why does
psychopathy
matter?
Links to institutional
behaviour
(Dolan & Davies, 2005; Langton,
Hogue, Daffern, Mannion, & Howells,
2011)
Links to response
to treatment
Links to reoffending
(D'Silva, Duggan, & McCarthy,
2004; Thornton & Blud, 2007)
(Rice & Harris, 2013; Yang,
Wong & Coid, 2010
Why does
psychopathy
matter?
Links to institutional
behaviour
(Dolan & Davies, 2005; Langton,
Hogue, Daffern, Mannion, & Howells,
2011)
“……..psychopathic individuals are not uniquely
‘hopeless’ cases who should be disqualified
from treatment, but instead are general ‘highrisk’ cases who need to be targeted for
intensive treatment to maximize public
safety.”
(Skeem, Polaschcek, Patrick & Lilienfeld, 2011)
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
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).
The Structure of Chromis
Motivation &
Engagement
Schema Therapy
Phase One:
Formulation
Schema Therapy
Phases 2 & 3:
Behavioural Experiments/
Maintenance
Creative Thinking
Component
Problem Solving
Component
Progression and
Resettlement
Handling Conflict
Component
Does it work?
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.
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.
Principles underpinning the Chromis approach
Personal
relevance
Principles underpinning the Chromis approach
Personal
relevance
Future focused
Principles underpinning the Chromis approach
Personal
relevance
Future focused
Control & Choice
Principles underpinning the Chromis approach
Personal
relevance
Future focused
Control & Choice
Transparent &
Collaborative
Principles underpinning the Chromis approach
Personal
relevance
Future focused
Control & Choice
Transparent &
Collaborative
Novelty &
Stimulation
Principles underpinning the Chromis approach
Personal
relevance
Future focused
Control & Choice
Novelty &
Stimulation
Transparent &
Collaborative
Status &
Credibility
Consistent Ideas for treatment
•
•
Treatment targets being
criminogenic needs
Core personality traits
considered responsivity issues
•
Motivation is important
•
Positive and rewarding rather
than punitive approaches
•
Staff are important
•
Cognitive behavioural
approaches
•
Problematic behaviour being a
target rather than obstacle
•
Individualised yet structured
•
Treatment that considers
strengths
•
Phases of treatment: developing
motivation, learning skills,
generalising skills.
•
High dose treatment
•
Generalisation