Abstract
ABSTRACTThe first results of psychomotor therapy (PMT) as an additional component to Aggression Replacement Training (ART) were explored in a group of forensic psychiatric inpatients (N = 37). Patients were divided into two groups: ART+PMT (experimental group) and ART+Sports (control group). Primary outcome measures of aggression, anger, and social behavior, and secondary outcome measures of coping behavior and bodily awareness during anger were administered on three occasions: pretreatment, posttreatment (after 35 sessions), and follow-up (15 weeks after the final session). The combined group (experimental and control group) showed clinically significant improvements on observed social behavior, observed aggressive behavior, and self-reported anger, but there were no differences in treatment effects between the experimental group and the control group on these primary outcome measures. However, on secondary outcome measures of bodily awareness during anger and coping behavior, the experimental group displayed somewhat more improvement than the control group. Altogether, the results of this pilot study indicate that the addition of PMT to a treatment program for violent forensic inpatients may indeed result in improvements on specific treatment goals of PMT, whereas its effects on aggressive behavior needs further examination.
Highlights
Several treatment programs for forensic psychiatric inpatients with a personality disorder as their main diagnosis have yielded promising results (Bernstein, Nijman, Karos, Keulen-De Vos, & Lucker, 2012; Hornsveld, 2004a)
The ARTCSports group improved on two primary outcome measures (AQ-SF Aggression and Observation Scale for Aggressive Behavior (OSAB) Aggressive behavior) and deteriorated on one outcome variable (OSAB Social behavior)
At the follow-up measurement, the ARTCPMT group improved on two primary outcome measures (NAS Anger and OSAB Social behavior) and deteriorated on none of the measures, whereas the ARTCSports group improved on one (OSAB Aggressive behavior) and showed deterioration on another primary outcome measure (OSAB Social behavior)
Summary
Several treatment programs for forensic psychiatric inpatients with a personality disorder as their main diagnosis have yielded promising results (Bernstein, Nijman, Karos, Keulen-De Vos, & Lucker, 2012; Hornsveld, 2004a). Applied additive interventions to CBT programs for violent offenders are arts therapies (Smeijsters & Cleven, 2006), such as music therapy (Hakvoort & Bogaerts, 2013), drama therapy (Thompson, 1999), and creative therapy (Bennink, Gussak, & Skowran, 2003) Another commonly indicated intervention for violent offenders is psychomotor therapy (PMT), which is an experience-based intervention during which patients learn to gain more control over their anger to prevent them from engaging in aggressive behavior While ART focused on aggression-related cognition and behavior using a variety of generic CBT techniques, the main objective of PMT was to improve emotion regulation skills (bodily awareness during anger and coping behavior). It should be kept in mind that treatment programs for violent offenders often produce positive results, effect sizes are often fairly small (Dowden & Andrews, 2000; McGuire, 2013) and that this is true for offenders with a personality disorder as their main diagnosis (e.g., Derks, 1996; Timmermans & Emmelkamp, 2005)
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