Psychopathy and therapeutic pessimism: Clinical lore or clinical reality?

Abstract

It is a widely held belief that psychopathic individuals are extremely difficult to treat, if not immune to treatment. This therapeutic pessimism is pervasive and undermines motivation to search for effective modes of intervention for psychopathic individuals. A review of 42 treatment studies on psychopathy revealed that there is little scientific basis for the belief that psychopathy is an untreatable disorder. Three significant problems with regard to the research on the psychopathy–treatment relation cast doubt on strident conclusions that deem the disorder untreatable. First, there is considerable disagreement as to the defining characteristics of psychopathy. Second, the etiology of psychopathy is not well understood. Third, there are relatively few empirical investigations of the psychopathy–treatment relationship and even fewer efforts that follow up psychopathic individuals after treatment. Psychologists are encouraged to investigate the psychopathy–treatment relation from multiple perspectives as well as to conduct long-term follow-up studies to establish a modern view of the psychopathy–treatment relation.