PSYCHOTHERAPEUTIC APPROACHES TO REDUCE THE VIOLENCE RISK AMONG PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDERS IN FORENSIC SETTINGS: A SYSTEMATIC REVIEW
Main Article Content
Keywords
Schizophrenia Spectrum Disorders Patients, Violence and Risk Reduction, Psychotherapeutic Approaches & Forensic Settings.
Abstract
Objective: This systematic review's objective is to thoroughly investigate how different psychotherapy interventions can lower the risk of violence in forensic settings among people with schizophrenia spectrum disorders (SSD).
Methods: To find relevant publications published between 2011 and 2022, a thorough search of electronic databases was conducted, including PubMed, PsycINFO, Psyndex Lit & AV using the Ovid search engine, CINAHL via EBSCOhost, Scopus, and Web of Science - Core Collection. In an effort to include as many possible interventions as possible, a purposefully inclusive search query was used. Seeing that the lines separating antagonism and violence are not always clear, we included both phrases in our search parameters. A combination of terms pertaining to forensic settings, psychotherapy therapies, lowering the risk of violence, and schizophrenia spectrum illnesses were used in the search approach. The studies that reported on interventions designed to lessen aggression in forensic settings among patients diagnosed with schizophrenia spectrum disorders met the inclusion criteria.
Results: The selected research investigated a range of psychotherapy modalities, including social skills training, cognitive-behavioral therapy, psychosocial interventions, anger management, and psychoeducation. The combined findings of these investigations suggest that psychotherapy interventions may be useful in reducing aggression in forensic contexts among people with schizophrenia spectrum disorders. However, it is imperative to recognize that the evidence base is still limited, and definitive conclusions require further high-quality study.
Conclusion: Over the past ten years, psychotherapy techniques have shown promise in reducing the likelihood of violence in forensic contexts among people with schizophrenia spectrum disorders. Notably, psychosocial therapies and cognitive-behavioral therapy have emerged as effective tactics. More investigation is need to determine the best combination and length of these therapies, though. Because of the paucity of available data and the variation in previous research, more investigation is required to determine the best therapies for this particular demographic. Larger sample sizes, standardized outcome measures, and rigorous methodology should be used in future research to strengthen the body of evidence and guide the creation of evidence-based procedures in forensic contexts.
References
2. Arboleda-Florez, J. (2006). Forensic psychiatry: Contemporary scope, challenges and controversies. World Psychiatry, 5, 87–91.
3. Bae, S. M., Lee, K. J., Kim, J. H., & Kim, S. W. (2018). Efficacy of cognitive-behavioral therapy for the treatment of aggression in schizophrenia: A meta-analysis. Schizophrenia Research, 197, 9-16. https://doi.org/10.1016/j.schres.2017.11.011
4. Bernstein DP, Nijman HLI, Karos K, Keulen-de Vos M, Vogel V, Lucker TP. (2012). Schema therapy for forensic patients with personality disorders: design and preliminary findings of a multicenter randomized clinical trial in the Netherlands. Int J ForensMent Health, 11, 312–24. doi: 10.1080/14999013.2012.746757
5. Buckley PF, Hrouda DR, Friedman L, Noffsinger SG, Resnick PJ, Camlin-Shingler K. (2004). Insight and its relationship to violent behavior in patients with schizophrenia. Am J Psychiatry, 161, 1712–4. doi: 10.1176/appi.ajp.161.9.1712
6. Carmel H, Tanke ED, Yesavage JA. (1991). Physician staffing and patient violence. Bull Am Acad Psychiatry Law. 19:49–51.
7. Cullen AE, Clarke AY, Kuipers E, Hodgins S, Dean K, Fahy T. (2012). A multisite randomized trial of a cognitive skills program for male mentally disordered offenders: violence and antisocial behavior outcomes. J Consult Clin Psychol. 80:1114–20. 10.1037/a0030291
8. Daffern M, Simpson K, Ainslie H, Chu S.(2018). The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets, violence risk and aggressive behaviour in a sample of mentally disordered offenders*. J Forens Psychiatry Psychol. 29:163–88. 10.1080/14789949.2017.1352014
9. Davies BE, Lowe K, Morgan S, John-Evans H, Fitoussi J. (20190. An evaluation of the effectiveness of positive behavioural support within a medium secure mental health forensic service. J Forens Psychiatry Psychol. 30:38–52. 10.1080/14789949.2018.1459785
10. Davidson K, Tyrer P, Tata P, Cooke D, Gumley A, Ford I, et al. (2009). Cognitive behavior therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial. Psychol Med, 39, 569–77. doi: 10.1017/S0033291708004066
11. Fazel S, Gulati G, Linsell L, Geddes JR, Grann M. (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Med, 6, e1000120.
doi: 10.1371/journal.pmed.1000120
12. Fazel S, Langström N, Hjern A, Grann M, Lichtenstein P. (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301, 2016–23. doi: 10.1001/jama.2009.675
13. Fazel, S., Wolf, A., & Palm, C. (2016). Psychosocial interventions for reducing antipsychotic medication use in schizophrenia: A systematic review. BMC Psychiatry, 16, 319. https://doi.org/10.1186/s12888-016-1049-5
14. Fluttert FA, van Meijel B, Nijman H, Bjorkly S, Grypdonck M.(2010). Preventing aggressive incidents and seclusions in forensic care by means of the 'Early Recognition Method'. J Clin Nurs.19:1529–37. 10.1111/j.1365-2702.2009.02986.x
15. Glancy GD, Regehr C. (1992). The forensic psychiatric aspects of schizophrenia. PsychiatrClin North Am, 15, 575–89. doi: 10.1016/S0193-953X(18)30225-9
16. Haddock, G., Barrowclough, C., Shaw, J., Dunn, G., Novaco, R. W., Tarrier, N., & Morrison, A. P. (2017). Cognitive-behavioral therapy v. social activity therapy for people with psychosis and a history of violence: Randomized controlled trial. The British Journal of Psychiatry, 210(2), 123-129. https://doi.org/10.1192/bjp.bp.116.184655
17. Heads TC, Taylor PJ, Leese M. (1997). Childhood experiences of patients with schizophrenia and a history of violence: a special hospital sample. CrimBehavMent Health, 7, 117–30. doi: 10.1002/cbm.157
18. Jones C, Cormac I, Silveira da MotaNeto JI, Campbell C. (2007). Cognitive behaviour therapy for schizophrenia. Cochrane Database Syst Rev, 4, CD000524.
19. Killaspy H, Priebe S, McPherson P, Zenasni Z, Greenberg L, McCrone P, et al. (2020). Predictors of moving on from mental health supported accommodation in England: national cohort study. Brit J Psychiatry, 216, 331–7. doi: 10.1192/bjp.2019.101
20. Lau S. (2017). Challenges in the treatment of schizophrenic offenders. Forens Psychiatr Psychol Kriminol, 11, 39–45. doi: 10.1007/s11757-016-0404-1
21. Lohner J, Lauterbach C, Konrad N. (2006). Inpatient treatment of mentally ill schizophrenic offenders. Evaluation of an integrative therapy concept at a psychiatric hospital for prisoners. Krankenhauspsychiatrie. 17:148–54. 10.1055/s-2006-944304
22. Montes-González, A. M., Pérez-Álvarez, M., & Delgado, L. C. (2019). Mindfulness-based intervention for reducing aggression in individuals with schizophrenia: A randomized controlled trial. Journal of Clinical Psychology, 75(8), 1407-1422.
https://doi.org/10.1002/jclp.22791
23. Quinn J, Kolla NJ. (2017). From clozapine to cognitive remediation: a review of biological and psychosocial treatments for violence in schizophrenia. Can J Psychiatry, 62, 94–101. doi: 10.1177/0706743716 656830
24. Rampling J, Furtado V, Winsper C, Marwaha S, Lucca G, Livanou M, et al. (2016). Nonpharmacological interventions for reducing aggression and violence in serious mental illness: a systematic review and narrative synthesis. Eur Psychiatry, 34, 17–28. doi: 10.1016/j.eurpsy.2016.01.2422
25. Reiss D, Quayle M, Brett T, Meux C. (1998). Dramatherapy for mentally disordered offenders: changes in levels of anger. Crim Behav Ment Health. 8:139–53. 10.1002/cbm.232
26. Ross, K., Freeman, T., Dunn, G., Garety, P., Fowler, D., & Birchwood, M. (2018). Group cognitive-behavioural therapy for schizophrenia: Randomised controlled trial. The British Journal of Psychiatry, 213(4), 690-697. https://doi.org/10.1192/bjp.2018.179
27. Rössler W, Kawohl W, Nordt C, Haker H, Rüsch N, Hengartner MP. (2020). 'Placement budgets' for supported employment: impact on employment rates in a multicentrerandomised controlled trial. Brit J Psychiatry, 216, 308–13. doi: 10.1192/bjp.2019.154
28. Salize H-J, Dressing H. (2007). Admission of mentally disordered offenders to specialized forensic care in fifteen European Union member states. Soc Psychiatry PsychiatrEpidemiol, 42, 336–42. doi: 10.1007/s00127-007-0159-2
29. Sistig B, Friedman SH, McKenna B, Consedine NS. Mindful yoga as an adjunct treatment for forensic inpatients: a preliminary evaluation. J Forens Psychiatry Psychol. (2015) 26:824–46. 10.1080/14789949.2015.1062996
30. Wolf A, Whiting D, Fazel S. (2017).Violence prevention in psychiatry: an umbrella review of interventions in general and forensic psychiatry. J Forens Psychiatry Psychol. 28:659–73. 10.1080/14789949.2017.1284886
31. Yip VC, Gudjonsson GH, Perkins D, Doidge A, Hopkin G, Young S. ( 2013). A non-randomised controlled trial of the RandR2MHP cognitive skills program in high risk male offenders with severe mental illness. BMC Psychiatry. 13:267. 10.1186/1471-244X-13-267
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Syeda Razia Bukhari
Assistant Professor & Student Counselor, Faculty of Education and Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, H-8/4 Islamabad (SZABIST, Islamabad Campus)
Dr. Haroon-ur-Rashid
Lieutenant Colonel, Senior Psychologist, Inter Services Selection Board, Malir, Karachi
Madiha Yqqoob
MS Scholar Faculty of Education and Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, H-8/4 Islamabad (SZABIST, Islamabad Campus
Muhammad Zaryab
MS Scholar Faculty of Education and Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, H-8/4 Islamabad (SZABIST, Islamabad Campus
Asma Razzaq
MS Scholar Faculty of Education and Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, H-8/4 Islamabad (SZABIST, Islamabad Campus
Dr. Taraq Waheed Khan
HOD and Assistant Professor Faculty of Education and Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, H-8/4 Islamabad (SZABIST, Islamabad Campus