Effectiveness of modified therapeutic community treatment within a medium-secure service for personality-disordered offenders

Abstract

There is debate as to whether secure hospital treatment for offenders with personality disorder can be effective relative to criminal justice interventions. This study examines the evidence for long-term treatment of such offenders in hospital within in a modified therapeutic community model including accredited offending behaviour programmes. A panel sample of 47 patients were followed up on measures of violence risk (HCR-20, VRS) and symptom severity (SCL90-R). Intention-to-treat analysis with reliability thresholds showed significant positive change between assessment and discharge in both violence risk (VRS) and symptoms (SCL90-R) indicating a positive treatment effect. Threshold effects for treatment effectiveness seemed to occur at 1 year of treatment for risk and 3 years for symptom reduction.

Keywords:

• personality disorder
• offender
• treatment
• forensic
• outcome
• therapeutic community

Acknowledgements

The authors are grateful to the three anonymous peer reviewers for comments that helped to improve the manuscript.