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What works in reducing re-offending in individuals with high levels of psychopathy?

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

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What works in reducing re-offending in individuals with high levels of psychopathy?

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  1. What works in reducing re-offending in individuals with high levels of psychopathy? Jenny Tew

  2. Psychopathy “far more has been written about the subject than is actually known about it” (Hemphill and Hart, 2002)

  3. Why does psychopathy matter? Links to institutional behaviour (Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells, 2011)

  4. Links to re-offending (Rice & Harris, 2013; Yang, Wong & Coid, 2010 Why does psychopathy matter? Links to institutional behaviour (Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells, 2011)

  5. Links to response to treatment (D'Silva, Duggan, & McCarthy, 2004; Thornton & Blud, 2007) Links to re-offending (Rice & Harris, 2013; Yang, Wong & Coid, 2010 Why does psychopathy matter? Links to institutional behaviour (Dolan & Davies, 2005; Langton, Hogue, Daffern, Mannion, & Howells, 2011)

  6. “……..psychopathic individuals are not uniquely ‘hopeless’ cases who should be disqualified from treatment, but instead are general ‘high-risk’ cases who need to be targeted for intensive treatment to maximize public safety.” (Skeem, Polaschcek, Patrick & Lilienfeld, 2011)

  7. 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

  8. 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).

  9. Creative Thinking Component Progression and Resettlement The Structure of Chromis Motivation & Engagement Schema Therapy Phase One: Formulation Schema Therapy Phases 2 & 3: Behavioural Experiments/ Maintenance Problem Solving Component Handling Conflict Component

  10. Does it work?

  11. 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.

  12. 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.

  13. Principles underpinning the Chromis approach Personal relevance

  14. Principles underpinning the Chromis approach Personal relevance Future focused

  15. Principles underpinning the Chromis approach Personal relevance Future focused Control & Choice

  16. Principles underpinning the Chromis approach Personal relevance Future focused Control & Choice Transparent & Collaborative

  17. Principles underpinning the Chromis approach Personal relevance Future focused Control & Choice Novelty & Stimulation Transparent & Collaborative

  18. Principles underpinning the Chromis approach Personal relevance Future focused Control & Choice Novelty & Stimulation Transparent & Collaborative Status & Credibility

  19. Treatment targets being criminogenic needs Core personality traits considered responsivity issues Cognitive behavioural approaches Individualised yet structured Phases of treatment: developing motivation, learning skills, generalising skills. Motivation is important Positive and rewarding rather than punitive approaches Staff are important Problematic behaviour being a target rather than obstacle Treatment that considers strengths High dose treatment Generalisation Consistent Ideas for treatment

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