APPROACHES TO TREATMENT (FROM PSYCHOPATHIC BEHAVIOUR APPROACHES TO RESEARCH, 1978, BY R D HARE AND D SCHALLING - SEE NCJ-57500)

• NCJ Number: 57509
• Author(s): P SUEDFELD; P B LANDON
• Date Published: 1978
• Length: 30 pages
• Corporate Author: John Wright and Sons, Ltd
• Publication Format: Document
• Language: English
• Country: United Kingdom

Annotation

A CRITICAL REVIEW OF THE LITERATURE ON MODES OF TREATMENT FOR PSYCHOPATHS IS PRESENTED.

Abstract

THE REVIEW ENCOMPASSES INDIVIDUAL PSYCHOTHERAPY, GROUP THERAPY (MILIEU AND STRUCTURED), INCARCERATION WITHOUT TREATMENT, SOMATIC THERAPY (DRUGS, PSYCHOSURGERY, SHOCK THERAPY), BEHAVIOR MODIFICATION, AND AROUSAL MODIFICATION. EMPIRICAL EVIDENCE ON THE EFFECTIVENESS OF EACH AS A MEANS OF TREATING PSYCHOPATHS IS SUMMARIZED. THE REVIEW SUGGESTS THAT, IN VERBAL THERAPY, THE PSYCHOPATH DOES BEST WITH FIRM (BUT NOT OPPRESSIVE), CONSISTENTLY ENFORCED RULES AND A THERAPIST WHO IS WARM AND UNDERSTANDING (BUT NOT UNCRITICAL). EFFECTIVE THERAPISTS ARE THOSE WHO MAKE CLEAR THAT THEY SEE THROUGH THEIR PATIENTS' ATTEMPTS TO MANIPULATE AND WHO ARE REALISTICALLY RATHER THAN GULLIBLY SUPPORTIVE. THE LITERATURE CONTAINS CONSIDERABLE SUPPORT FOR THE LIMITED USE OF DRUGS TO INDUCE TEMPORARY CHANGES IN MOOD AND TO OPEN PATIENTS TO INCREASED RAPPORT WITH THERAPISTS, AND FOR THE USE OF STIMULANTS (ESPECIALLY WITH JUVENILE PSYCHOPATHS). THE DATA ON MILIEU THERAPY ARE MIXED, BUT THERE IS EVIDENCE THAT THE APPROPRIATE KIND OF THERAPEUTIC COMMUNITY--IN WHICH THE PATIENT IS GIVEN RESPONSIBILITY AND EXPECTED TO LIVE UP TO IT--CAN BE HELPFUL. THERE IS THE ALTERNATIVE OF INSTITUTIONALIZING THE PSYCHOPATH UNTIL HIS ANTISOCIAL BEHAVIOR DIMINISHES OR DISAPPEARS WITH AGE. ANOTHER, SOCIALLY PREFERABLE ALTERNATIVE IS TO MOVE THE PSYCHOPATH INTO AN ENVIRONMENT WHERE HIS TRAITS ARE PRODUCTIVE AND VALUED (E.G., CERTAIN OCCUPATIONS IN THE ECONOMIC, POLITICAL, MILITARY, AND ATHLETIC SPHERES). IT IS CLEAR THAT THERAPY WORKS BEST FOR THOSE WHO NEED IT LEAST. WHETHER THIS IMPLIES A NEED TO CONCENTRATE ON THE TREATABLE OR TO EXPLORE MEANS OF REACHING THE UNTREATABLE IS A SOCIOECONOMIC RATHER THAN A SCIENTIFIC QUESTION. A MORE PRAGMATIC, ECLECTIC APPROACH BY RESEARCHERS, PRACTITIONERS, AND PROGRAM ADMINISTRATORS WOULD BE HELPFUL IN VALIDATING EXISTING TREATMENT MODES AND TESTING NEW ONES. A SIX-PAGE LIST OF REFERENCES IS INCLUDED. (AUTHOR ABSTRACT MODIFIED--LKM)