NCJ Number
50888
Journal
American Journal of Psychotherapy Volume: 31 Issue: 2 Dated: (1977)
Date Published
1977
Length
10 pages
Annotation
GROUP PSYCHOTHERAPY OF AGGRESSIVE PATIENTS IN AN INPATIENT AND OUTPATIENT SETTING IS DESCRIBED AND COMPARED.
Abstract
IN 1972, A SPECIAL OFFENDER CLINIC (SOC) WAS ESTABLISHED BY THE MARYLAND DEPARTMENT OF PROBATION AND PAROLE AT THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE, WHICH WAS DESIGNED TO TREAT OFFENDERS PREVIOUSLY INSTITUTIONALIZED BECAUSE OF LACK OF ADEQUATE COMMUNITY RESOURCES. TWO TYPES OF OFFENDERS WERE INVOLVED: SEXUAL OFFENDERS, SUCH AS VOYEURS, EXHIBITIONISTS, PEDOPHILES, AND RAPISTS; AND AGGRESSIVE OFFENDERS CONVICTED OF TWO OR MORE ASSAULTS. OFFENDERS WERE REFERRED TO THE SOC AFTER CONVICTION BUT BEFORE SENTENCING. AFTER EXAMINATION BY A PSYCHIATRIST AND A PSYCHOLOGIST, EACH REFERRAL WAS PRESENTED TO THE STAFF--CONSISTING OF A PSYCHIATRIST-DIRECTOR, PSYCHIATRISTS, PSYCHOLOGISTS, AND PROBATION OFFICERS FOR CONSIDERATION. THOSE SELECTED FOR THE PROGRAM WERE PLACED ON PROBATION BY THE JUDGE, WITH THE CONDITION THAT THEY ATTEND THE SOC. STANDARDS FOR SELECTION OF CLIENTS ARE NOT DISCUSSED. UPON COMPLETION OF TREATMENT, THE PATIENT REMAINED UNDER THE SUPERVISION OF THE SOC PROBATION OFFICER UNTIL EXPIRATION OF PROBATION. THERAPIST TECHNIQUES AND CLIENT RESPONSES ARE DESCRIBED FOR AGGRESSIVE PATIENTS IN THE SOC PROGRAM AND THOSE IN A STATE HOSPITAL AND PATUXENT CORRECTIONAL INSTITUTION, (MD.) BASED ON THE OBSERVATIONS AND EXPERIENCES OF THE AUTHOR, WHO WORKED AS A PSYCHOLOGIST WITH CLIENTS IN BOTH SETTINGS. CLIENTS IN THE OUTPATIENT SETTING ARE CONSIDERED TO HAVE HAD MORE CONTROLS TO AID FUNCTIONING IN FAMILY, JOB, AND SOCIAL SITUATIONS THAN THE INSTITUTIONALIZED CLIENTS. THE AGGRESSIVE ACTING-OUT BEHAVIOR OF THE OUTPATIENTS WAS OF THE EXPLOSIVE TYPE, OCCURRING AFTER PERIODS OF CONTROLLED FRUSTRATION. THERAPY WAS CONSIDERED MORE SUPERFICIAL IN TERMS OF DEALING WITH FEELINGS IN THE SOC CLIENTS THAN WITH INSTITUTIONALIZED CLIENTS. ADVICE WAS PRACTICAL IN ITS FOCUS ON CONTROLLING BEHAVIOR, RATHER THAN CHANGING FEELINGS. TRUST IN THE THERAPIST IS DEEMED IMPORTANT IN BOTH CONTEXTS, AND THE HANDLING OF COUNTERTRANSFERENCE REACTIONS IS DISCUSSED AS CRUCIAL IN DEALING WITH CLIENTS. THE RECIDIVIST RATE FOR THE SOC PROGRAM WAS 28 PERCENT AND THE PROBATION OFFICERS RATED SOCIAL ADJUSTMENT OF CLIENTS IN THE COMMUNITY AS SIGNIFICANTLY IMPROVED. THERAPIST RATINGS ALSO SHOWED A PATTERN OF IMPROVEMENT IN CLIENTS OF SOC. (RCB)