Charlotte Aelick

The development of treatment models specific to psychopathic offenders marks an exciting and important time for research of psychopathy. Research involving psychopathic offenders has been slow moving and rife with controversy. However, this research has begun to show some hope for positive treatment outcomes. The development of psychopathy-specific treatment programs provides optimism to those tasked with the treatment of psychopathic individuals despite the chronic and stable nature of their dominant personality traits. Given the high rates of re-offending among psychopathic offenders in the community, the importance of any positive treatment outcomes cannot be understated. The positive results we have begun to see within the literature demands increased attention be paid to this area in hopes of reducing the risk of violent, sexual, and general re-offending among psychopathic offenders.

Why is Clinical Pessimism Pervasive in this Field?

As our understanding of the psychopathic personality evolved some traits remained consistent: they lack empathy, they are charming, impulsive, and manipulative, and they engage in various types of criminal offences. Taken alone, lacking empathy works against any treatment that tries to deter an offender from committing crime by appealing to their emotions or sense of remorse. Without empathy they will not feel the same guilt or remorse for their actions that a non-psychopathic offender would in these programs meaning they will not be compelled to change their behavior. However, when considered with the other manipulative and antisocial traits, a lack of empathy also means that in treatment a psychopathic offender can take advantage of the therapist, give the impression of making prosocial life changes, and instead apply what they have learned in therapy to criminal offences when they are released to the community. This combination of traits certainly poses a threat to positive treatment outcomes and contributed to past research concluding that psychopathic offenders not only fail to benefit from treatment but can also be made worse by treatment.

Without empathy they will not feel the same guilt or remorse for their actions that a non-psychopathic offender would in these programs meaning they will not be compelled to change their behavior.

What has Changed?

Research involving psychopathic offenders and modern treatment approaches has begun to show promising results for treatment outcomes. In 2002, Salekin conducted a meta-analysis which compiled 42 studies on treatment of psychopathy and analyzed their outcomes. The results of this analysis pointed to a number of successful approaches that reduced the rates of re-offending among psychopathic offenders. This study noted patterns in the literature such as insight training and cognitive-behavioural therapies that had the most impact for psychopathic offenders. These approaches are employed by the Correctional Services of Canada in their Sex Offender Treatment Programs and have also had success with psychopathic offenders. Studies like this one and this one have shown that the programs can be effective with psychopathic sexual offenders. Taken as a whole, the current literature has identified patterns in therapeutic interventions that are successful with psychopathic offenders and has begun to demonstrate that therapy with this population may be effective.

A number of successful approaches reduced the rates of re-offending among psychopathic offenders.

What Strategies are Successful?

As previously noted, many personality factors in psychopathy can interfere with treatment which means they will not respond to the same treatment approaches as non-psychopathic offenders. The literature points to longer treatment duration, insight training, and cognitive-behavioural methods as being the most successful with psychopathic offenders. In the correctional community this intervention strategy is summarized by the Risk-Need-Responsivity Model (RNR). This states that treatment duration should be longer for higher-risk offenders, should specifically address individual criminogenic needs that make the offender more likely to commit another offence, and must use an education and cognitive-behavioural approach that the offender is most likely to respond to. For psychopathic offenders this means treatments should last 6 months to a year because they are very high risk to the community. The therapist also needs to be aware of the risks associated with psychopathic personalities and specifically address manipulative or prosocial attitudes. Finally, in order for a psychopathic offender to be most likely to respond to treatment, educational approaches that appeal to insight and problem solving will be more effective than appealing to emotions such as remorse or empathy.

Longer treatment duration, insight training, and cognitive-behavioural methods are the most successful with psychopathic offenders.

What’s the Big Deal?

Psychopathic offenders have notoriously been associated with reckless and dangerous behavior that poses a significant threat to the community. The ability to treat these offenders can reduce this threat and promote prosocial attitudes before they are released into the community. Furthermore, the success of current literature in this field has led to a number of important changes to interventions. For example, the success of Canadian intervention strategies in this area has inspired similar programs to be developed in New Zealand which have also shown success in treating psychopathic offenders. This research has also paved the way for treatment programs specific to psychopathic offenders to be developed.

Research shows there is hope in reducing the risk psychopathic offenders pose to the community.

In 2015, Wong and Olver adapted the Risk-Need-Responsivity Model to address specific obstacles in treating psychopathic offenders. The Risk-Need Responsivity 2C (RNR-2C) model was designed to apply the principles of the RNR model to the 2 factors of the psychopathic personality. Component 1 addresses the interpersonal and affective traits of Factor 1, such as manipulation and disruptive behaviours, as responsivity issues. In sum, these are factors to be managed in treatment to mitigate disruptions and drop out. Component 2 conceptualizes the antisocial lifestyle features of psychopathy (ie. Factor 2) as criminogenic needs to be targeted in treatment in keeping with the risk and need principles of the RNR model. A recent review of this model can be found here. This treatment model marks a huge step in treating psychopathic offenders and has the potential to revolutionize the way we approach treatment of this high-risk population.

From pessimistic outlooks to the development of treatments for psychopathic offenders, we have come a long way in our understanding of treatment outcomes for this population. Research has begun to show us that there is hope in reducing the risk of a psychopathic offender committing further offences upon their release to the community. This certainly calls for more research in this area for the benefit of the community and those responsible for treating this complex and high-risk population.

Suggested reading:

Abracen, J., & Looman, J. (2015). Treatment of high-risk sexual offenders: An integrated approach. John Wiley & Sons.

Suggested citation:

Aelick, C. (2019, July 13). Optimism in the treatment of psychopathic offenders [Weblog post]. Retrieved from https://wp.me/p2RS15-ip