Forensic psychotherapy
Encyclopedia
Forensic Psychotherapy is the application of psychological
knowledge to the treatment of mentally disordered or mentally ill patient
s who commit violent
or destructive acts against others or themselves. Commonly applied diagnoses
would include personality disorder
and psychosis
. The link between personality disorder and offending is not firmly established although many of those who commit offences have one or more personality disorders. The term forensic psychotherapy is usually associated with Psychodynamic psychotherapy
including group psychotherapy
and the therapeutic community
approach. Cognitive behavioral therapy is more commonly associated with the field of psychology, particularly Forensic Psychology.
It has remained difficult to establish with great certainty which methods, if any, are effective over a significant period of time. However psychodynamic forensic psychotherapy has been shown to have some effect as have Therapeutic Communities
The intimacy and profound experience of therapy may enable an offender to reframe and restructure these harsh imagos which tend to blunt sensitivities and , when projected out onto others, act as a rationale or driving force for criminal acting out. The patient may develop self awareness, and an awareness of the nature of their deeds, and ultimately be able to live a more adjusted life. The effectiveness of psychodynamic psychotherapy, as is the case with other psychological therapies, is limited far as behavioral change for antisocial personality or psychopathic offenders. These two types of offenders comprise the primary diagnostic group found in forensic psychotherapy work. The evidence which is emerging, suggests that a range and variety of treatments may be most helpful for such offenders.
Treatment of high risk offenders poses particular problems of perverse transference and counter transference which can undermine and confound effective treatment so it would be usual to expect such treatment to be conducted by experienced practitioners who are well supported and supervised.
References
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
knowledge to the treatment of mentally disordered or mentally ill patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
s who commit violent
Violence
Violence is the use of physical force to apply a state to others contrary to their wishes. violence, while often a stand-alone issue, is often the culmination of other kinds of conflict, e.g...
or destructive acts against others or themselves. Commonly applied diagnoses
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
would include personality disorder
Personality disorder
Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors. Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders or DSM-IV-TR of the American Psychiatric Association.Personality disorders are...
and psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
. The link between personality disorder and offending is not firmly established although many of those who commit offences have one or more personality disorders. The term forensic psychotherapy is usually associated with Psychodynamic psychotherapy
Psychodynamic psychotherapy
Psychodynamic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis. It also relies on the interpersonal relationship between client...
including group psychotherapy
Group psychotherapy
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group...
and the therapeutic community
Therapeutic community
Therapeutic community is a term applied to a participative, group-based approach to long-term mental illness, personality disorders and drug addiction...
approach. Cognitive behavioral therapy is more commonly associated with the field of psychology, particularly Forensic Psychology.
Contentious Area
It has been difficult to illustrate a clear link between psychological interventions that successfully reduce the incidence of offending and those that do not and clearly nothing has led to the elimination of crime. At times this has contributed to a profound pessimism about the effectiveness of any treatment . This was particularly so in the United states of America but the influence spread to the United Kingdom and arguably adversely affected the provision of rehabilitative treatments. The development of cognitive behavioural therapy which made it possible to demonstrate an effect upon some attitudes and offending behaviours and for this to be measured in controlled research studies led to the introduction of structured treatment programmes in prisons across Canada, the United States, the United Kingdom and more recently, mainland Europe. For a period there have been positive benefits in the provision of resources particularly in prison settings. However there has been serious conflict as professionals compete for limited resources and one model claimed superiority over another.It has remained difficult to establish with great certainty which methods, if any, are effective over a significant period of time. However psychodynamic forensic psychotherapy has been shown to have some effect as have Therapeutic Communities
Dangerous and Severe Personality Disorder
In an attempt to establish whether it could be effective to treat serious and high risk offenders the United Kingdom Government launched a programme in 1999. This established treatment centres in two high security prisons and two high security hospitals and a further four medium secure hospitals.Forensic Psychotherapy
Working from the premise that the offender has a complex internal world which may be characterised by punitive and unreliable internal representations of paternal and other figures, psychotherapy can shed light on the unconscious impulses, conflicts, and primitive defense mechanisms, involved in his or her destructive actions and "acting out".The intimacy and profound experience of therapy may enable an offender to reframe and restructure these harsh imagos which tend to blunt sensitivities and , when projected out onto others, act as a rationale or driving force for criminal acting out. The patient may develop self awareness, and an awareness of the nature of their deeds, and ultimately be able to live a more adjusted life. The effectiveness of psychodynamic psychotherapy, as is the case with other psychological therapies, is limited far as behavioral change for antisocial personality or psychopathic offenders. These two types of offenders comprise the primary diagnostic group found in forensic psychotherapy work. The evidence which is emerging, suggests that a range and variety of treatments may be most helpful for such offenders.
Treatment of high risk offenders poses particular problems of perverse transference and counter transference which can undermine and confound effective treatment so it would be usual to expect such treatment to be conducted by experienced practitioners who are well supported and supervised.
References
External links
- International Association for Forensic Psychotherapy http://www.forensicpsychotherapy.com/