The effectiveness of violence reduction therapy in detained adult male populations: Insights from a systematic review and treatment evaluation capturing individual level changes

Abstract

A systematic review first examined the effectiveness of violence reduction therapy in detained forensic populations, considering 23 papers. Six themes of effectiveness were identified: 1.) Evidenced improvements in coping and problem-solving skills; 2.) Evidenced decrease in aggressive beliefs and hostility; 3.) Improvements found in emotion regulation; 4.) Decreased risk of violence and institutional misconduct; 5.) Mixed reconviction outcomes, and 6.) Absence of positive treatment outcome. An observed absence in the literature was failure to consider individual levels of treatment outcome alongside group effects, coupled with paucity of research capturing complex forensic mental health populations. Consequently, the review was followed by an evaluation of a long term aggression therapy programme (Life Minus Violence – Enhanced: LMV-E) among adult male forensic patients (n = 26) detained in high security, which considered both group and individual treatment change, to further determine if the themes of effectiveness noted in the systematic review could be replicated. This was demonstrated to a degree although differences were evidenced when accounting for individual effects, particularly when using the strictest method in this regard – Jacobson-Truax. Accounting for group, individual and the systematic review collectively, it would appear a positive effect on emotional regulation in relation to anger and the ability to control and experience this was particularly evidenced following therapy. The paper highlights the importance of accounting for individual change and outlines implications for improving aggression therapy evaluation in detained samples, by developing more theory informed evaluations.