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

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.