Psychotherapeutic approaches to aggressive and violent patients

Jonathan E. Alpert, M. K. Spillmann

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Behavioral and cognitive-behavioral strategies and a broad range of group, family, couples, and milieu treatment approaches have been developed for the psychotherapy of aggressive and violent patients. These methods have been carried out in diverse settings ranging from hospitals and prisons to individual outpatient practices and have been applied across diverse populations including adults with mental retardation, dementia, and brain injury; children with attention deficit and conduct disorders and autism; recurrent violent offenders with antisocial personality disorder; and individuals with chronic psychotic disorders, mood disorders, or medical illnesses such as hypertension. Bridging these different strategies are the underlying principles of psychotherapy with aggressive and violent patients. These include ensuring the safety of clinician, patient, and potential victims as the foremost concern; developing a finely detailed assessment of aggressive and violent acts and of the antecedents, assumptions, and consequences that are attached to them; formulating well-defined goals and striving for clear communication to achieve consistency in the pursuit of these goals between therapist and patient, and among therapist and other clinicians, staff, and relevant family members or agencies; specifying ahead of time well-considered outcome measures to be used to gauge the effectiveness of treatment; and maintaining a healthy vigilance for countertransferential and similar reactions and a willingness to use consultation as an integral part of treatment.

Original languageEnglish (US)
Pages (from-to)453-472
Number of pages20
JournalPsychiatric Clinics of North America
Volume20
Issue number2
DOIs
StatePublished - 1997
Externally publishedYes

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Psychotherapy
Antisocial Personality Disorder
Conduct Disorder
Prisons
Attention Deficit Disorder with Hyperactivity
Patient Safety
Autistic Disorder
Mood Disorders
Intellectual Disability
Psychotic Disorders
Brain Injuries
Dementia
Outpatients
Referral and Consultation
Communication
Outcome Assessment (Health Care)
Hypertension
Therapeutics
Population

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Psychotherapeutic approaches to aggressive and violent patients. / Alpert, Jonathan E.; Spillmann, M. K.

In: Psychiatric Clinics of North America, Vol. 20, No. 2, 1997, p. 453-472.

Research output: Contribution to journalReview article

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