Seattle University Collaborative Projects - International Academy of ...

A Treatment Program for Psychopathic PatientsInge Breukel, Van der Hoevenklinek, Utrecht, Netherlands (ibreukel@hoevenkliniek.nl)In the Van der Hoeven Kliniek, a forensic psychiatric hospital in the Netherlands, approximately25% of the patients score high on the Psychopathy Checklist – Revised (PCL-R). Althoughresearch on the treatment of psychopathy is scarce, we have attempted to implement a programfor these patients, inspired as much as possible by what is known to be effective for seriouslyviolent offenders in general. The What Works principles as described by Andrews and Bontaconstitute the central framework for the program. Treatment is directed at dynamic risk factors,taking into account the responsivity of patients. Other important elements are the Good LivesModel (Ward), the Stages of Change Model (Prochaska and DiClemente) along withmotivational interviewing (Miller and Rollnick), cognitive behavioural psychotherapy and teamsupervision. We will describe how we incorporate these elements into clinical practice andillustrate this with clinical case examples. Furthermore, we will discuss our failures andsuccesses in the treatment of these particularly difficult patients, and attempt to providedirections for further research.Gender Issues in the Assessment of PsychopathyVivienne de Vogel, Van der Hoevenklinek, Utrecht, Netherlands (vdevogel@hoevenkliniek.nl)Jeantine Stam, Van der Hoevenklinek, Utrecht, Netherlands (jstam@hoevenkliniek.nl)Michiel de Vries Robbé, Van der Hoevenklinek, Utrecht, Netherlands(mdevriesrobbe@hoevenkliniek.nl)The assessment of psychopathy in female forensic psychiatric patients is still a relativelyunexplored area. The findings on the widely used Psychopathy Checklist-Revised (PCL-R; Hare,2003) in female samples thus far are not sufficiently convincing to draw conclusions about thesimilarity of the PCL-R structure across gender (Logan, 2009). In this paper, we will presentresults from a Dutch multicentre study on psychopathy and violence risk assessment in femaleforensic psychiatric patients. PCL-R codings of about 300 women will be analysed and related tocriminal and demographic characteristics, as well as to different violence risk assessment tools,including the HCR-20, the SAPROF for protective factors and the recently developed genderspecifictool for female (forensic) psychiatric patients, the Female Additional Manual (FAM; DeVogel et al., 2011). Furthermore, for a subgroup of female patients, PCL-R codings will becompared to those of a matched male sample. Finally, some clinical case examples of themanifestation of psychopathy in women will be discussed and suggestions will be provided withrespect to the gender-sensitive assessment and treatment of psychopathy in women.38