Wong Stephen C P, Gordon Audrey, Gu Deqiang
Regional Psychiatric Centre, University of Saskatchewan, Box 9243, Saskatoon, Saskatchewan, S7K 3X5, Canada.
Br J Psychiatry Suppl. 2007 May;49:s66-74. doi: 10.1192/bjp.190.5.s66.
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.
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.
The VRS was used to assess risk/need and treatment readiness, and DSM-III/IV psychiatric diagnoses of 203 federal offenders.
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.
Integrating risk-need-responsivity principles in assessment and treatment can provide useful guidelines for intervention with violence-prone forensic clients with personality disorder.
