%0 Journal Article
%T Schema therapy for violent PD offenders: a randomized clinical trial
%J Psychological medicine
%D 2021
%A Bernstein, David P.
%A Keulen-de Vos, Marije
%A Clercx, Maartje
%A de Vogel, Vivienne
%A Kersten, Gertruda C. M.
%A Lancel, Marike
%A Jonkers, Philip P.
%A Bogaerts, Stefan
%A Slaats, Mariëtte
%A Broers, Nick J.
%A Deenen, Thomas A. M.
%A Arntz, Arnoud
%V ePub
%N ePub
%P ePub-ePub
%X BACKGROUND: Violent criminal offenders with personality disorders (PD's) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. <br><br>METHODS: We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise-specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. <br><br>RESULTS: Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes - rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms - and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*time: t(1387) = -2.85, p = 0.005). <br><br>CONCLUSIONS: These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community.<p /> <p>Language: en</p>
%G en
%I Cambridge University Press
%@ 0033-2917
%U http://dx.doi.org/10.1017/S0033291721001161