Evaluation of Aggression Control Therapy for violent forensic psychiatric patients

Abstract

Aggression Control Therapy is meant for Dutch forensic psychiatric patients and consists of 15 weekly sessions and three follow-up sessions at 5-week intervals after completion. It includes the components: Anger Management, Social Skills, Moral Reasoning and Self-regulation Skills. It has been shown in various forensic psychiatric hospitals that Aggression Control Therapy can be given to both inpatients and outpatients. Inpatients had a 12% dropout rate and outpatients a 34% dropout rate. The self-report questionnaires showed a significant decrease in hostile and aggressive behaviour in both inpatients and outpatients. This decrease was maintained at the follow-up assessment. Follow-up research with a control condition and with more objective outcome measures is needed to confirm this improvement. No changes in socially competent behaviour were observed, probably because patients reported at the beginning of the therapy less social anxiety and more social skills than a norm group. The therapy turned out to be beneficial for patients who had a comparatively high level of anger as a personality characteristic. It is recommended that the Social Skills component of the therapy focuses on a decrease in “limit-setting” skills like giving criticism and more on an increase of “approaching” skills like giving a compliment. A design for a future controlled study is described briefly.