Assessing and Treating Violent Offenders

Abstract

This chapter provides an overview of the assessment and treatment of adult violent offenders, theory, research, and clinical practice. The topic of coverage features general violence, specifically, crimes against the person that may involve any physical, threatened, or psychological harm, excluding sexually motivated crimes or intimate partner violence. The chapter begins with an overview of the frequency and prevalence of violent offending. We follow with a discussion of the theoretical context guiding service delivery focusing on the General Personality and Cognitive Social Learning (GPCSL) theory of criminal behavior and Risk-Need-Responsivity (RNR) model of offender service delivery (Bonta and Andrews, The psychology of criminal conduct, 6th edition, Routledge, New York, NY, 2017). The chapter proceeds to review mental health and diagnostic considerations with violent offender populations, noting the elevated rates of violent offending among mental health diagnostic groups, but particularly substance related mental health diagnoses and personality disorder. The chapter continues with an overview of tools and approaches for violence risk assessment vis-a-vis Bonta’s (Risk-needs assessment and treatment, In Choosing correctional options that work: defining the demand and evaluating the supply (pp. 18–32), Sage, Thousand Oaks, CA, 1996) generational classification framework; guidelines are provided for the explicit linkages of violence risk assessment with violence reduction interventions. The most substantive part of this chapter is a review of the violent offender treatment literature arranged in terms of what works, what might work, and what doesn’t work based on a thorough review of the literature and providing a sampling of approaches from each. Under what works, are programs that broadly adhere to RNR principles. These are arranged into two broad categories. First, there are comprehensive, multi-intervention, integrated violence reduction programs. These tend to target a broad array of criminogenic needs linked to violence and aggression, they utilize a combination of group and individual treatment modalities, use manualized interventions, have a coordinated referral and intake process that includes pretreatment, interim assessment, and posttreatment assessments of violence risk, employ a multidisciplinary treatment team of corrections and mental health professionals. The second grouping of interventions are singular focused interventions (focused programs or FPs) that tend to target selected criminogenic needs (e.g., anger, criminal attitudes, aggression) or a particular domain of functioning (e.g., cognitive, affective, behavioral) linked to violence risk. Under what might work, we discuss a class of interventions, with examples, that are potentially helpful for reducing violence, yet: (1) are not sufficient as standalone interventions; (2) tend to be new and not yet evaluated; (3) have yet to develop the same evidence base as traditional therapies; and/or (4) have generated mixed results. Finally, under what does not work, we discuss interventions and programs that have been demonstrated to not work, whether this be reducing crime in general or violent offending in particular. Many such examples are illustrative of correctional quackery, that is, interventions derived from the common-sense movement that are not based on existing knowledge of what causes crime or what programs have been demonstrated to change offender behavior. The chapter concludes with suggested future directions and innovations for violent offender research and practice.