A Therapeutic Community (TC) treatment program for adult male offenders is summarized and treatment outcome data are discussed. Psychopaths showed less clinical improvement, displayed lower levels of motivation and were discharged from the program earlier than nonpsychopaths. There were significant positive treatment effects for the non-psychopaths and a mixed group. Psychopathy Checklist scores (Hare, 1985) consistently postdict and predict treatment outcome and attrition from the program.
9Criminal psychopaths commit 3.5 times more violent crimes than do non-psychopaths (Hare & McPherson, 1984). Once incarcerated psychopaths also display more violent and aggressive behaviors (Hare & McPherson, 1984; Wong, 1984) and are frequently segregated or referred for treatment (McCord, 1982). They are also more likely to violate conditional releases (Hart, Kropp, & Hare, 1988; Wong, 1984). In many clinical and legal circles, psychopaths are generally seen as untreatable, although the issue is far from settled (Suedfelt & Landon, 1978;Wong, Elek, & Ogloff, 1988). Despite their notorious criminal histories and high recidivism rates, they are just as likely as the non-psychopaths to secure conditional releases (Wong, 1984). Criminal psychopaths, therefore, present significant clinical, legal and administrative concerns that must be addressed by those working within the criminal justice system.
This article describes a treatment outcome study of a Therapeutic Community (TC) treatment program designed to treat personality disordered individuals, many of whom are psychopaths. Cleckley (1976) offered one of the most detailed and generally accepted clinical accounts of the psychopath. He outlined 16 dominant characteristics of the psychopath (see Appendix A) in his book The Mask of Sanity. Despite the general agreement of the conception of psychopathy, there has not been a general consensus regarding
THE ASSESSMENT OF PSYCHOPATHY