Horgan Harry, Charteris Chloe, Ambrose Derval
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, London, UK.
Crim Behav Ment Health. 2019 Dec;29(5-6):286-295. doi: 10.1002/cbm.2123. Epub 2019 Sep 2.
There is limited evidence for treatment programmes for offenders with a diagnosis of personality disorder deemed to be of high risk of violence towards others.
This study sought to evaluate change in clinician-rated risk of violence in males among offenders accepted to a specialist medium-secure hospital providing treatment based on the Violence Reduction Programme (VRP).
A retrospective, records-based cohort study design was used to explore change in risk of violence in a sample including five VRP cohorts composed of 33 offenders. Violence risk scale (VRS) score was the primary outcome measure. Correlates of treatment dropout were also explored.
Twenty-seven men completed treatment. Paired pretreatment and posttreatment VRS scores were available for 19 men. Six men disengaged with treatment. There was a significant mean reduction in risk of violence score (d = 1.08). At the individual level, eleven (57%) participants in the VRP showed reliable reduction in risk of violence. No treatment completers with a complete rating pair demonstrated an increased risk of violence. Younger age and referral from prison were significantly associated with treatment dropout.
VRP-based treatment appears to be a promising intervention for specialist services for offenders with a personality disorder diagnosis in the United Kingdom. Longer term follow-up to ascertain whether these apparent treatment gains are accompanied by actual reduction in violent recidivism is now required, and a full scale trial warranted.
