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Clinical Appraisals of Individual Differences in Treatment Responsivity Among Patients With Psychopathy: A Consensual Qualitative Research Study
Criminal Justice and Behavior ( IF 2.1 ) Pub Date : 2020-11-06 , DOI: 10.1177/0093854820970597
Evelyn Klein Haneveld 1 , Wineke Smid 2 , Kelsey Timmer 3 , Jan H. Kamphuis 4
Affiliation  

This study addressed which factors expert clinicians consider crucial in successful completion versus dropout in the mandatory forensic psychiatric treatment of psychopathic patients in the Netherlands. Eleven clinicians were interviewed about patient characteristics, treatment (provider) characteristics, and other factors they deemed associated with failure (transfer to another facility) or completion. The interviews were coded using the guidelines of Consensual Qualitative Research (CQR). Overall, extremely high scores on Psychopathy Checklist–Revised (PCL-R) Facets 1 (Deceitful Interpersonal Style) and 2 (Defective Affective Experience) were thought to impede treatment retention, particularly by its negative impact on motivation and therapeutic relationship. Older patients, those with a prosocial network, and/or patients with comorbid borderline traits appeared to fare better. Treatment success was deemed more likely when treatment goals and expectations are stipulated in a concrete fashion, when an extended and gradual resocialization trajectory is offered, and the treatment team is expert, cohesive, and stable.



中文翻译:

精神病患者治疗反应个体差异的临床评估:一项共识性定性研究

这项研究探讨了在荷兰,专家临床医生认为哪些因素对于成功完成结局与放弃对精神病患者进行强制性法医精神病治疗至关重要。采访了11位临床医生,以了解患者的特征,治疗(提供者)特征以及他们认为与失败(转移到另一家医院)或完成有关的其他因素。访谈使用共识性定性研究(CQR)的准则进行编码。总体而言,精神病检查清单修订版(PCL-R)方面1(欺骗性人际风格)和方面2(不良情感经历)的最高分被认为会阻碍治疗的保留,尤其是对动机和治疗关系的负面影响。年龄较大的人(具有亲社会关系的人)和/或具有合并性边缘性征的患者的情况似乎更好。当以具体的方式规定治疗目标和期望,提供扩展和渐进的重新社会化轨迹并且治疗团队是专家,凝聚力和稳定时,认为治疗成功的可能性更大。

更新日期:2020-12-23
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