Therapeutic Process and Treatment Evaluation in Forensic Psychiatry and Prison

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Background

This Collection is the second volume of the Research Topic: Therapeutic Process and Well-Being in Forensic Psychiatry and Prison

There is a widespread consensus among researchers and clinicians that patient characteristics and treatment program characteristics should be matched to optimize treatment outcomes, but not on the question of what specific factors should be taken into account. The present topic theme focuses on the internal (e.g., patient characteristics) and external (e.g., characteristics of the therapist/therapy and treatment setting) factors that may hinder or enhance the learning process in therapy. On the therapist's side, crucial factors may include the ability to implement effective interventions in a targeted and individualized manner and the ability to establish a trusting therapeutic relationship. On the patient’s side, besides personality variables like personality disorder, social anxiety and self-confidence, cognitive and intellectual abilities (e.g., intelligence, verbal skills, problem-solving skills), demographic factors (e.g., gender, cultural background, previous convictions), and treatment motivation must be considered. Whereas motivation used to be viewed as a stable personality trait, today the complexity of reciprocal influences of internal and external factors on the change process is emphasized and motivation is conceptualized as a dynamic concept or interpersonal process involving the patient and therapist.

Since reduction of recidivism rates is the primary goal of treatment in forensic psychiatry and prison settings, therapy has always served a dual function, namely treatment and control. This often requires close networking and collaboration between the psychotherapist, the judiciary and the probation service. The dual role in therapy (i.e., treatment and control) represents a balancing act. This necessitates a transparent procedure, explicit awareness of the limits of confidentiality in the therapy and transparent flow of information between the key stakeholders.

The current topic theme aims to collect examples of how to effectively promote therapy in forensic psychiatry and prison settings while serving the unenviable dual function of treatment and control. We want to start an informative discussion about different treatment modalities and their evaluation. The effectiveness of a specific treatment program becomes more apparent after discharge, so studies that focus on the long-term outcomes of discharged patients are welcome. We appreciate all different types of papers including systematic reviews, meta-analyses and original research using observational or interventional designs, case-reports and theoretical reflections.

Keywords: Forensic Psychiatry, Prison, Well-being, Quality of Life, Prevention

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