scholarly journals Psychodynamic approaches to violence

2018 ◽  
Vol 24 (2) ◽  
pp. 83-92
Author(s):  
Jessica Yakeley
Keyword(s):  
Risk Assessment ◽  
Mental Health Professionals ◽  
Therapeutic Interventions ◽  
Violence Risk ◽  
List Type ◽  
Violent Behaviour ◽  
Mentally Disordered ◽  
Assessment And Treatment ◽  
Actuarial Risk ◽  
Psychoanalytic Theories

SUMMARYThe assessment and management of violent behaviour in mentally disordered patients are no longer the sole domain of forensic psychiatrists, but are increasingly part of the day-to-day work of all psychiatrists and mental health professionals. Violence risk assessment has become a huge industry, and although the importance of dynamic, as well as actuarial, risk factors is now recognised, a more systematic approach exploring the psychodynamics in the aetiology, assessment and treatment of violent behaviour is often lacking. In this article I revisit some of the key psychodynamic principles and concepts relevant to an understanding of violence, summarising the historical contributions of key psychoanalytic writers on violence and aggression, and exploring the ideas of more contemporary writers working in the field of forensic psychotherapy. A psychodynamic framework for working with violent patients is introduced, focusing on the setting and containment, specific therapeutic interventions and monitoring countertransference reactions.LEARNING OBJECTIVES•Understand historical and contemporary psychoanalytic theories of the aetiology of aggression and violence•Utilise a psychodynamic framework for working with violent patients and offenders•Understand the use of countertransference in the risk assessment and treatment of violenceDECLARATION OF INTERESTNone.

scholarly journals Psychodynamic approaches to suicide and self-harm

2018 ◽  
Vol 24 (1) ◽  
pp. 37-45
Author(s):  
Jessica Yakeley ◽  
William Burbridge-James
Keyword(s):  
Risk Assessment ◽  
Suicide Attempts ◽  
List Type ◽  
Relational Context ◽  
Transference And Countertransference ◽  
Assessment And Treatment ◽  
Self Harm ◽  
Psychoanalytic Theories ◽  
Risk Assessment And Management

SUMMARYRates of suicide and self-harm are rising in many countries, and it is therapeutically important to explore the personal stories and relationships that underlie this behaviour. In this article psychoanalytic and psychodynamic principles and concepts in relation to violence towards the self are introduced and the various unconscious meanings of suicide and self-harm are explored within a relational context and attachment framework. We describe how a psychodynamic approach may enhance the risk assessment and treatment of patients presenting with self-harm and suicidality, particularly examining the role of transference and countertransference within the therapeutic relationship.LEARNING OBJECTIVES•Understand historical and contemporary psychoanalytic theories and concepts regarding the aetiology of suicide and self-harm•Understand the different meanings and expressions of acts of suicide and self-harm•Understand the use of countertransference in the risk assessment and management of self-harm and suicide attemptsDECLARATION OF INTERESTNone.

Assessing Dynamic Violence Risk in a High-Risk Treated Sample of Violent Offenders

Assessment ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1886-1900 ◽  
Author(s):  
Richard B. A. Coupland ◽  
Mark E. Olver
Keyword(s):  
Risk Assessment ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Violent Offenders ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Change Scores ◽  
Assessment And Treatment ◽  
General Community

The present study featured an investigation of the predictive properties of risk and change scores of two violence risk assessment and treatment planning tools—the Violence Risk Scale (VRS) and the Historical, Clinical, Risk–20, Version 2 (HCR-20)—in sample of 178 treated adult male violent offenders who attended a high-intensity violence reduction program. The cases were rated on the VRS and HCR-20 using archival information sources and followed up nearly 10 years postrelease. Associations of HCR-20 and VRS risk and change scores with postprogram institutional and community recidivism were examined. VRS and HCR-20 scores converged in conceptually meaningful ways, supporting the construct validity of the tools for violence risk. Receiver operating characteristic curve analyses demonstrated moderate- to high-predictive accuracy of VRS and HCR-20 scores for violent and general community recidivism, but weaker accuracy for postprogram institutional recidivism. Cox regression survival analyses demonstrated that positive pretreatment and posttreatment changes, as assessed via the HCR-20 and VRS, were each significantly associated with reductions in violent and general community recidivism, as well as serious institutional misconducts, after controlling for baseline pretreatment score. Implications for use of the HCR-20 and VRS for dynamic violence risk assessment and management are discussed.

The investigation of acting on delusions as a tool for risk assessment in the mentally disordered

1997 ◽  
Vol 170 (S32) ◽  
pp. 12-16 ◽  
Author(s):  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
Clinical Intervention ◽  
Clinical Information ◽  
Violent Behaviour ◽  
Mentally Disordered ◽  
The Subject ◽  
Medical Involvement

Not everyone thinks that psychiatrists have much to offer in a discussion of dangerousness. The first point made by the advocates of this position is that psychiatrists get it wrong much of the time when they predict violence. The second point is that they do not use clinical information to predict. Exactly how much of the time they get it wrong is the subject of some debate. Those hostile to the idea of medical involvement in risk assessment argue that psychiatrists and psychologists are wrong 95% of the time when they predict violent behaviour (Ennis, 1972). Even sometime supporters of clinical intervention contend that psychiatrists and psychologists are wrong at least twice as often as they are right when they predict violence (Monahan, 1984).

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

2014 ◽  
Vol 22 (2) ◽  
pp. 235-246
Author(s):  
Gennady N. Baksheev ◽  
Danny Sullivan ◽  
Richard Fraser ◽  
Catherine Greenwood-Smith ◽  
Jennifer McCarthy ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Case Control Study ◽  
Case Control ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Mentally Disordered ◽  
Control Study

How do mental health professionals deal with uncertainty in suicide risk assessment?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1628-1628
Author(s):  
K. Manley ◽  
J. Beezhold
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
List Type ◽  
Suicide Risk Assessment ◽  
Individual Level ◽  
Clinical Scenarios ◽  
Image Position

IntroductionSuicide risk-assessment forms a significant part of the workload of mental health professionals (MHPs). There is much research regarding efficacy of different methods/scales of suicide risk-assessment, and effects of formal training on risk-assessment. To date, there is little investigation into how approach to risk-assessment varies amongst professionals on an individual level, or how MHPs react when confronted by lack of information.ObjectiveThis study evaluated how MHPs respond to uncertainty when assessing suicide risk.Methods720 MHPs were given 10 clinical scenarios and asked to assess suicide risk in each case. The scenarios were a mixture of high, medium and low risk cases. In addition, there were scenarios where information provided was incomplete or ambiguous. Subjects graded suicide risk-severity from 1–10 (1 = low, 10 = high).ResultsThe simple scenarios produced a predictable consensus of opinion amongst MHPs. The ambiguous scenario produced three distinct response peaks (Fig. 1) at low, medium, and high risk.Fig. 1[Fig 1]ConclusionsAmbiguous suicide risk separates MHPs into three responder groups:1.‘don’t know’2.more cautious, assumes higher risk3.less cautious, assumes lower risk.This has implications for suicide risk training. Further research is required to fully understand why individuals respond in different ways to suicide risk scenarios.

Validity and Reliability of the Violence Risk Scale–Youth Sexual Offense Version

Sexual Abuse ◽  
2019 ◽  
Vol 32 (7) ◽  
pp. 826-849 ◽  
Author(s):  
Erika Y. Rojas ◽  
Mark E. Olver
Keyword(s):  
Risk Assessment ◽  
Treatment Planning ◽  
Sex Offender ◽  
Sexual Offense ◽  
Violence Risk ◽  
Validity And Reliability ◽  
Assessment Protocol ◽  
Assessment And Treatment ◽  
General Recidivism ◽  
Risk Scale

The present study examined the validity and reliability of a youth sexual offense risk assessment and treatment planning tool, the Violence Risk Scale–Youth Sexual Offense Version (VRS-YSO), on a sample of 102 court-adjudicated youth referred to assessment and/or treatment outpatient services followed up an average of 11.7 years in the community. VRS-YSO scores demonstrated “good” to “excellent” interrater reliability (intraclass correlation coefficients [ICCs] = .64-.83). Exploratory factor analysis (EFA) of the static and dynamic items identified three latent dimensions consistent with the extant risk literature labeled Sexual Deviance, Antisocial Tendencies, and Family Concerns. VRS-YSO scores showed strong patterns of convergence with scores from the Estimate of Risk for Adolescent Sexual Offense Recidivism (ERASOR), Juvenile Sex Offender Assessment Protocol–II (J-SOAP-II), and the Juvenile Sexual Offense Recidivism Risk Assessment Tool–II (J-SORRAT-II). VRS-YSO scores, in turn, demonstrated moderate to high predictive accuracy for sexual, violent (sexual and nonsexual), and general recidivism (significant areas under curve [AUCs] = .67-.88). Examination of pre–posttreatment change data on the subset of youth who attended treatment services found VRS-YSO change scores to be significantly associated with reductions in general recidivism, but not other recidivism outcomes. Future research and clinical applications of the VRS-YSO in youth sexual offense assessment and treatment planning are discussed.

scholarly journals Violence risk assessment and treatment

CNS Spectrums ◽  
2014 ◽  
Vol 19 (5) ◽  
pp. 366-367
Author(s):  
Katherine D. Warburton ◽  
Charles L. Scott
Keyword(s):  
Risk Assessment ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Assessment And Treatment
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