Is Treatment Important In Psychopaths?
Psychopath is a collection of personality traits, which includes callousness, low anxiety, remorselessness, failure to form emotional bonds, and externalization of blame. Although the condition affects one’s personality, experts have stated that it has not been coded using the taxonomic system DSM-IV-TR. Furthermore, they have considered that psychopaths are influenced by biological, environmental, psychological and social factors. These factors influence social forces and biological predispositions, which in turn affects one’s personality (Ogloff, 2006). Experts have conducted studies and written scholarly works on the effectiveness of treating psychopaths. Since, the early 19th century there has been no agreed method used to cure the condition; hence, making some people concludes that psychopaths are resistant to treatment. That notwithstanding, case studies and surveys conducted have found out that indeed, the condition is treatable and can reduce cases of juvenile and other associated crimes.
Psychopaths have been considered resistant to treatment, but this allegation has not been evident by empirical research. Psychopathologist believes that this mental disorder contributes immensely on the increased rates of crimes and as such, various ways have been introduced to cure psychopaths. A culture of victimizing psychopathic patients and thereby alleging that he/she is resistant to treatment, emanate from the label people use to define those they do not like. This should not be used as a basis of categorizing and evaluating the extent to which the condition is irreversible.
Salekin, Worley & Grimes (2010) state categorically that in treating psychopaths, medical practitioners focus on symptomatic treatment. Nevertheless, their views were challenged by experts, who noted that the situation may lead to symptom substitution; hence, recurring of the condition. However, they continue adding that the treatment process takes some times. Apart from that, Psychotherapists have testified that the level of aggression and violence have reduced in many regions because of effective treatment of psychopaths. Moreover, there has been some criticism regarding this initiative, stating that in the long run, the psychopathic offenders usually return to the behavioral psychopathic states. With regard to this controversy, the paper seeks to proof that and state that treatment of psychopaths is effective and cures the condition.
The purpose of correctional facilities is to maintain a just, peaceful, and ensure that safety has been enhanced in the society. The federal correctional system, in Canada usually carries out sentences to offenders in a safe and humane way with an aim of assisting offenders in rehabilitation and allows them to be reintegrated in the society as a law-abiding citizen. (Salekin, 2008). This is another way of treating psychopathic conditions in juvenile. Salekin, Worley & Grimes (2010) considered that medical treatment is not the only way the condition alleviating the condition. Currently, treatment of offenders has reduced recidivism rates in twenty percent of the population. In Canada, serious crimes associated with psychopathy usually cost averagely $100 000 per Annum with approximately 400 000 violent crimes reported. A twenty percent reduction in recidivism means that, approximately 580 000 victims of these violent crimes are saved allowing the authorities to save 58 billion dollars are saved annually. With this in mind, in accordance to the goal of the correctional system, in Canada, and the evidence that treatment can be effective; then, psychopathic and antisocial offenders deserve the chance at treatment and rehabilitation facilities considering that the process is now effective (Walters, 2012).
Caldwel (2010) sites Medota Juvenile Treatment Centre program report where youths with psychopaths improved their level of interpersonal scores. During the correctional program, there was also a decrease in engagement of violent and aggressive behavior among the patients. In addition, in more than half psychopathic patients, institutional and community violence reduced showing that the methods used in treating the condition were effective. Accordingly, early identification of psychopathic condition in children contributed to the effectiveness of treating the psychopathic condition in children. Psychopathologists at the training observed that, the condition was less serious when identified at early stages.
Salekin, Worley & Grimes (2010) examined results of 400 psychopathic patients, who had undergone treatment, and concluded that the treatment was beneficial. They add that the analysis of recent studies has also developed psychopathic interventions, whereby the majority of patients are recovering from their condition. They also agree with the views of Caldwel (2010) in stating that beneficial treatment is effective when the psychopathologist identify the condition early.
Salekin, Worley & Grimes (2010) also observed that setting up psychotherapy laboratories at the universities improved research on the condition, considering that medical treatment alone was not sufficient to treat psychopathic conditions. Moreover, the authors state that relating the treatment of the condition with history was another way of ensuring that the treatment process is accurate and can produce positive results. Although most of the psychological disorders like psychopaths may be hereditary or are linked to biological conditions, Salekin, Worley & Grimes (2010) ruled out that there has been no etiological theory, which has proved that psychopaths are incurable.
In a survey conducted in England, results reveal that a small percentage of 500 forensic psychologist believed that psychopaths were untreatable. This is an indication that the majority were optimistic that there are effective ways through which they can employ their expertise to cure the condition. In the same study, it was found out that psychopathic conditions are dimensional and not taxonomic in nature (Salekim, Woley, & Grimes, 2010). This would mean that there is only a difference in the extent to which treatment should be done and not that they are untreatable. Children would require less treatment compared to juvenile youths with psychopathic conditions. The rationale behind it is explained in the way symptomatic conditions may have affected the patient.
In Using the Hare’s models, experts introduced this method where cognitive neuroscience is used “as a start point” to determine neurochemical functioning of the brain. In this model, psychologist agreed that it is one, which contributed to the decline of juvenile crimes in Canada and its environs since the 19th century. Harris and Rice approved that case studies conducted with aims of establishing treating psychopaths were registered positive results (Salekim, Woley, & Grimes, 2010).
Many authors like Salekim, Woley, Grimes, and Walters were challenged for confirming that the treatment of psychopaths was based on a broad etiological theory. Critics raised concerns over the fact that they could not substantiate their views. However, they state that adopting effective managerial procedures in treatment and rehabilitation centers should be considered as an important step in mitigating the curative challenges associated with psychopaths.
Chakhssi, Ruiter & Bernstein (2010) reported that in New Zealand, in 2008, 381 male offenders who suffered from psychopaths and subjected to treatment, were over three times less likely to be prosecuted for a criminal offense compared to untreated patients with psychopaths. Aggressiveness, remorseful, and violent behaviors declined in psychopathic patients after they had been subjected to a treatment therapy. Sexual violent offenders who were assessed 10 years after the therapy were found out that they depicted positive results of non-sexual violent behavior. The authors confirm that Reliable Change Index, RCI used to measure the level of psychopathic conditions in patients, indicated a positive result after a series of treatment methods had been administered to the 381 male psychopathic patients. Apart from that, Behavioral Status Index, BSI used to ascertain the level of risk one is exposed to criminal offenses, also showed reliable results after treating in forensic psychopathic patients. From the authors study, one would conclude that psychopathic conditions are treatable if effective curative services have been considered. Apart from that, there is a high correlation of psychopathic patients and the levels of crime; therefore, such a state, calls for an effective procedure of rehabilitating, correcting and treating the condition.
TempleMan and Wollersiem (1979) stated that the behavioral approach to treatment of psychopathy was effective in alleviating the problem. They disputed claims of experts who alleged that the condition was incurable. In their approach, they elucidate that there are two ways: one, which involve the instilling of conscience in the psychopathic patient, and the other method, which works to modify the antisocial behavior. A therapist starts with creating a strong relationship with the client as he prepares to instill cognitive, behavioral values through guiding and counseling therapies. During the process, a psychopath is taught how to think, define problem, find alternative solutions and assess the effectiveness of the alternative opted. This process will ensure that the remorseful behavior in the psychopath is alleviated and later introduce mitigation process of reducing antisocialism. The whole process resulted to a change in the behavior of psychopaths; hence, it was approved as effective in treating the condition.
Skeem, Monahan, & Mulvey (2002) disputed the fact that psychopaths are treatable. They state that the psychological detachment of patients may hinder the therapeutic process from administering treatment to a psychopathic patient. Since the process starts with the establishment of client-therapist relationship, it will be impossible to cure the condition. Although this might happen, cognitive therapists have observed that psychopathic patients subjected to therapy were taken through a technical approach of instilling conscience before the actual treatment process starts. Creating relationship does not take place immediately; it takes time because it is the long run treatment process. Skeem, Monahan, & Mulvey (2002) cite evidence where 176 psychopaths were taken to a therapeutic community in Ontario for 2years of rehabilitation and treatment. After the completion of the program, the patients psychopathic conditions were worse that the untreated patients. Apart from that, the authors observe that since psychopaths are not recognized taxonomically by the DSM-IV-TR system, then, there is no proofed medical or psychotherapeutic method, which can treat the condition.
On the other hand, Skeem, Monahan & Mulvey, (2002) challenges optimists regarding the treatment of psychopaths that the condition is hereditary, biological, and not psychological as optimistic experts assert. However, as Rogers, Jackson, Sewell & Johansen, (2004) observe, the process of curing psychopathic conditions may take long and involves the usability of many medical and therapeutic methods of treatment. The latter gives evidence of case studies, which have revealed positive treatment results to psychopathic patients across the globe.
From the above analysis, it is true that the treatment of psychopaths is effective and cures the condition. However, this process takes time and requires the use of various medical and psychotherapeutic methods in curing the condition. Furthermore, the treatment of psychopathic condition has seen many juvenile crimes reduce in some regions like Canada, and New Zealand. This is an indication that the treatment procedures are effective and can result to beneficial actions in other sectors. Although, there are claims that psychopathic conditions are resistant to treatment, the claims are based on etiological theories, which have no empirical proof.
Criticisms on treatment of psychopathy
Caldwell, M. (2011). Treatment-Related Changes in Behavioral Outcomes of Psychopathy Face in Adolescent Offenders. Law Human Behavior, 35(2), 275-287. Chakhssi, F., Ruiter, C., & Bernstein, D. (2010). Change during forensic treatment in psychopathic versus non-psychopathic oﬀenders. Journal of Forensic Psychiatry and Psychology, 21(5), 660-682. Ogloff, J. (2006). Psychopathy/antisocial personality disorder conundrum. Australian and New Zealand Journal of Psychiatry, 40(1), 515-528. Rogers, R., Jackson, R., Sewell, K., & Johansen, J. (2004). Predictors of Treatment Outcome in Dually-Diagnosed Antisocial Youth: An Initial Study of Forensic Inpatients. Behavioral Science and Law, 22(1), 215-222. Salekin, R. (2008). Psychopathy and Recidivism From Mid-Adolescence to Young Adulthood: Cumulating Legal Problems and Limiting Life Opportunities. Journal of Abnormal Psychology, 117(2), 386-395. Salekin, R., Worley, C., & Grimes, R. (2010). Treatment of Psychopathy: A Review and Brief Introduction to the Mental Model Approach for Psychopathy. Behavioral Science and Law, 28(1), 235-266. Skeem, J., Monahan, J., & Mulvey, E. (2002). Psychopathy, Treatment Involvement, and Subsequent Violence Among Civil Psychiatric Patients. Law and Human Behavior, 26(6), 577-604. Templeman, T., & Wollersheim, J. (1979). A Cognitive-Behavioral Approach To The Treatment Of Psychopathy. Psychotherapy: Theory, Research and Practice, 16(2), 132-140. Walters, G. (2012). Psychopathy and Crime: Testing the Incremental Validity of PCL-R-Measured Psychopathy as a Predictor of General and Violent Recidivism. Law and Human Behavior. 36(5), 404-412