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Assessment and treatment of violence–prone forensic clients: an integrated approach

Regional Psychiatric Centre and University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Correspondence: Dr Stephen C. P. Wong, Research Unit, Regional Psychiatric Centre, Box 9243, Saskatoon, Saskatchewan, S7K 3X5, Canada. Email: s.wong{at}sasktel.net

Declaration of interest S.C.P.W. and A.G. are proprietors of VRS and VRP.

¹ Because of increasing needs for such services, changes are underway to admit to this programme more patients with major mental illnesses linked to violence.

Background 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.

Aims 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.

Method The VRS was used to assess risk/need and treatment readiness, and DSM-III/IV psychiatric diagnoses of 203 federal offenders.

Results 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.

Conclusions Integrating risk-need-responsivity principles in assessment and treatment can provide useful guidelines for intervention with violence-prone forensic clients with personality disorder.